Head injuries during sports activities has increased more than 200% among female athletes between the ages of 14 and 18, according to a new study released at the 2021 American Academy of Orthopaedics annual meeting in San Diego, California.
To better understand the epidemiology of sports-related concussions and closed head injuries in high school females at the national level, particularly for unorganized sports and recreational activities, researchers investigated sex differences in sports-related concussion epidemiology.
They also found that this increase was not always directly correlated to increase in sport participation.
Studies investigating sex differences in sports-related concussion epidemiology report that female athletes face concussion rates nearly twice as high as their male counterparts when participating in sex-comparable sports.
Female athletes are also more likely to sustain recurrent concussions, experience atypical symptoms, and require longer recovery times before returning to sport.
“In addition to concussions, we made sure to include closed head injuries as part of our analysis because, in both cases, we wouldn’t want athletes to return to play without an evaluation,” said Kevin Pirruccio, M.D., orthopedic surgery resident at Yale New Haven Hospital.
“Closed head injury is the most common type of traumatic brain injury; it is a blunt, non-penetrating head trauma that doesn’t create a break in the skull. While there is a lot of overlap between sports-related concussions and closed head injuries, concussion refers to the symptoms. (dizziness, nausea, blurry vision, etc.) and closed head injury is the mechanism of the injury.”
The study, “Sports-Related Concussions in High School Females: An Epidemiologic Analysis of 20-Year National Trends,” included female athletes across 56 sports or recreational activities from 2000 to 2019. Findings were based on data from the Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS), which documents activity-associated injuries that present to U.S. emergency departments.
“We used the NEISS database because it captured injuries occurring in sports and activities outside of a school setting, such as horseback riding, snowboarding, and rugby, providing a more accurate look at data outside of what is typically studied among high school athletes,” Pirruccio said.
Overall, the estimated number of female patients ages 14 to 18 presenting to U.S. emergency departments with sports-related concussions or closed head injuries increased from 9,835 cases in 2000 to 31,751 cases in 2019.
The researchers calculated that 39.1% of the annual sports-related concussion and closed head injuries presented to U.S. emergency departments occurred among this patient population. And over one-quarter of these injuries occurred in 15-year-old females.
The five sports and recreational activities linked the most to these types of injuries were soccer (20.6%), basketball (18.5%), cheerleading (10.4%), softball (10.1%), and volleyball (6.5%).
Pirruccio and team plan to investigate further potential causes of the variations in these injuries which could include changes in practice rules or training regiments, cultures within a sport, or reporting differences between individual athletes.
“While concussions can be classified as an epidemic, it’s important to consider that 96.7% of patients who were admitted to the emergency department with an SRC [sports-related concussion] or CHI [closed head injury] were treated and went home,” Pirruccio said.
“Sustaining a concussion shouldn’t necessarily preclude our youth from participating in the sports and physical activities they love. Instead, we hope this study encourages mindfulness among athletes, coaches, and parents and stimulates the adoption of comprehensive return to play protocols to prevent further harm. This is especially important with non-school sanctioned sports and activities, which may lack a dictated return-to-play guideline.”
