Published 12/5/2017

When contact sports cause concussion injuries, who comes out ahead?

Study in the Journal of the American Academy of Orthopaedic Surgeons looks at sex-specific predictors

ROSEMONT, Ill. (December 5, 2017) — Concussions are common injuries among contact sport athletes. While most athletes experience full recovery within a few weeks and can return to their sport, according to a study published in the December issue of the Journal of the American Academy of Orthopaedic Surgeons, female athletes tend to experience a higher concussion injury rate than male athletes. Additionally, athletes who suffered a concussion injury prior to college were three times more likely to suffer a contact sport-related concussion than their collegiate peers without a history of the injury.
In a 15-year retrospective study of 1,200 varsity student athletes at Columbia University in New York, study authors found:
  • the most commonly reported concussion symptoms include headache, impaired concentration, and dizziness;
  • the risk of concussion was higher among females (23.3 percent) than males (17 percent) over the course of their collegiate career; and,
  • the findings support prior research that indicate female contact sport athletes have a greater risk of concussion injuries than their male counterparts. The reasons for this difference are not clear, but awareness of this finding is an important step in taking these injuries into consideration.
“Concussion injuries in football, for instance, receive the lion’s share of media attention, but in our study female athletes were more likely to suffer a concussion injury,” says lead study author Cecilia Davis-Hayes, BA. “The greater the number of reported post-concussion symptoms, the greater the likelihood the athlete will have a prolonged recovery period and a longer to return to play than athletes reporting fewer symptoms. This was more prevalent among female compared to male contact sport athletes.”
“For the most part, a concussion is a concussion, regardless of the sport in which it happens. But each concussion is different in mechanism, symptoms and recovery even within a single individual,” says study co-author James M. Noble, MD, neurologist at NewYork-Presbyterian/Columbia University Irving Medical Center and assistant professor of neurology at Columbia University Irving Medical Center. “Young men and women experience similar concussion symptoms and recovery periods. Our study also supports past findings that suggest women may be more likely to either experience or report poor sleep while men may be more likely to report poor memory immediately after the concussion.”
Team physicians, parents and coaches should:
  • maintain a high index of suspicion for concussion injuries among female athletes;
  • establish a positive environment towards athletes so that they do report concussion injuries, and discourage athletes from hiding concussion injury symptoms; and,
  • be aware that concussed athletes expressing a greater number or severity of symptoms are more likely to experience a prolonged recovery.
“While our study was not designed to explain why the latter occurred, one can reason that more symptomatic patients are experiencing a more severe injury requiring a longer recovery period,” says Davis-Hayes.
The co-authors intend to follow-up their multifaceted study on this group of collegiate athletes to identify subsequent risk of orthopaedic injury as well as subtle neuropsychological deficits among athletes who have had a concussion, and long-term outcomes following a contact sports career.
From the College of Physicians and Surgeons (Ms. Cecilia Davis-Hayes), Columbia Athletics (Mr. James Dr. Gossett and Mr. Jumpei Harada), the Department of Orthopaedics (Dr. William N. Levine), the Department of Neurology, the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, and the Gertrude H. Sergievsky Center (Dr. James Noble), Columbia University, New York, NY; the Department of Neurology, East Tennessee State University Quillen College of Medicine, Johnson City, TN (Dr. Tanzid Shams); and the Department of Neuroscience, University of Michigan, Ann Arbor, MI (Mr. Jeremy Mitnick).
Mr. Gossett or an immediate family member has stock or stock options held in Johnson & Johnson and serves as a board member, owner, officer, or committee member of the National Athletic Trainers’ Association. Dr. Levine or an immediate family member serves as an unpaid consultant to Zimmer Biomet. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Ms. Davis-Hayes, Dr. Shams, Mr. Harada, Mr. Mitnick, and Dr. Noble.
J Am Acad Orthop Surg 2017;00:1-11. DOI: 10.5435/JAAOS-D-17-00276

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