Concussion issues becoming evident in women’s sports

It might not get as much attention as it does in football, but women’s sports have a concussion problem.

Most studies show female athletes generally suffer concussions more frequently than males in comparable sports, even in lacrosse and ice hockey, where additional rules exist to prevent contact for women. The Chairman of the Department of Neurosurgery at the NorthShore University Health System in Chicago and the Co-Director of the Northshore Neurological Institute, Julian Bailes, said learning more about gender differences has become a priority for researchers.

“There’s three reasons that people have traditionally said it may be higher in girls,” Bailes said. “One is neck muscles. Two is that some people say that women are more genetically predisposed and three, it’s been contended that women are just more honest in reporting their symptoms.”

Whatever the reasons, Northwestern State softball coach Donald Pickett can certainly relate to concussions as a rising concern. Head trainer Jason Drury estimated Lady Demons have suffered 13 concussions over the last five years, easily the most of any sport except football, which accounted for 45 of the 77.

More than one of those head injuries happened to Samantha Cordairo (Roberts while at NSU), who vaguely remembered her worst incident when she got “tackled” by a baserunner while playing first base in a game at Baylor. She landed on her head and lost consciousness for a few seconds before going to the hospital, where she couldn’t remember the home run she hit earlier in the day.

“It got to that point where I’d never made a ‘C’ before in school and I remember I had to drop my first class because I was struggling in it,” said Cordairo, who suffered at least four concussions, including one in a car wreck. “It took about six months before I could feel like myself again.”

She missed about two months of softball and eventually earned third-team All-Southland Conference honors as a senior in 2012. But others, such as Northwestern State soccer recruit Susan Lucas, can’t shake their symptoms and end their careers early.

Soccer leads in concussion rates

Loyola coach Mark Matlock said concussions forced 2015 Times All-Region defender Madeline Bodden to quit club soccer, and former Northwestern State goalkeeper Brooke Bourbonais recalled multiple concussions cost teammate Alexandria Jackson much of her college career. Bourbonais suffered a serious concussion of her own in a collision that required three stitches near her eye and kept her out of classes for a week.

A study featuring soccer players at 100 high schools from 2005 to 2014 showed 4.5 concussions for every 10,000 students participating in a soccer game or practice compared to just 2.8 among boys. An 11-year study in Fairfax County, Virginia, released in 2010 listed women’s soccer as the sport with the second-highest concussion rate behind football, and a report on NCAA athletes in 2003 as well as one on both high school and college athletes in 2007 agreed the highest incidence in women’s sports occurs in soccer.

“It’s amazing how many concussions we must have missed in the past or what’s happening,” said NSU coach George Van Linder, who remembers only one or two concussions in his first 10-15 years of coaching and now keeps extra spots on his roster in case of head injuries. “That’s what baffling to some of us old-timers.”

Longtime Byrd coach Lisa Levermann believes weaker neck muscles make women less capable than men of bracing themselves to prevent their head and brain from moving during collisions. She also suggested girls don’t know how to fall as well as boys, and Matlock — who also serves as the U12-U14 director of coaching for Caddo Bossier Soccer Association — said girls seem to struggle more with depth perception when judging the ball prior to a mid-air challenge.

Both agree women’s soccer keeps getting more and more physical, particularly at the high school level. Louisiana Tech coach Keven Sherry believes from middle school to professionals, officials clamp down harder on violent play for men.

“In the women’s game the officiating is far less strict,” said Sherry, who has coached both genders across virtually all levels since 1987. “If that was stricter, that would decrease the level of violent play and by percentages, you would decrease the level of concussions.”

US soccer took action last fall when it decided to ban headers for children 10 and under and limit it in practice for kids ages 11-14. Van Linder, Levermann and Matlock all disagree with the new guidelines, noting not knowing how to head the ball could lead to more injuries.

“I agree with limiting the headers in training and making sure that you’re not doing hour-long training sessions focused on heading,” Matlock said. “But I do think that it’s important to teach the proper technique while they’re young, so maybe using a softer ball to introduce the technique versus doing it with a full-size, fully aired up ball.”

Impossible to prevent all contact

Even if soccer completely eliminated heading, that would be unlikely to solve its concussion problems. Just as in other sports, freak accidents will happen and contact can’t always be avoided.

Pickett said he’s seen his softball players hit in the head by any number of random events, including foul tips, bad bounces, or players colliding. Both Pickett and Cordairo said those incidents occur more often in softball than baseball, since everything is faster with shorter basepaths, a smaller field and a shorter distance between hitter and pitcher.

It’s tougher to explain in ice hockey, considering body checking is illegal in the women’s game. But a review of limited data in 2010 revealed 2.72 concussions per 1,000 player hours in women’s ice hockey — even higher than the rate of 2.34 in football and well above the men’s rate of 1.47.

A five-year study of NCAA athletes released in 2015 put the women’s hockey concussion rate just below the rate for men, but still above football and all other women’s sports. Explanations for the high rates vary, from physiological differences to the fact that because of the rules women aren’t anticipating the hit.

One theory players and coaches don’t seem to believe is that women or girls are more likely to self-report their injuries. All coaches and players interviewed for this story said increased awareness and more cautious concussion protocols have made their players more reluctant to reveal headaches or dizziness for fear of having to miss games.

That makes it all the more important for everyone involved to be aware of the signs, since many concussions don’t look obvious to a casual observer. Bailes said officials can often be the first line of defense, which is why Shreveport high school soccer referee assignor Milt Magaw encourages vigilance and concussions are always a major focus at training sessions.

“We’re really limited as to what we can do,” said Magaw, who estimates area officials note concussions in game reports once or twice each season. “We’re not certified health professionals and we can’t diagnose.”

But referees can get the attention of trainers or even not allow players back on the field if they seem dizzy or shaken up after taking a blow to the head. Levermann recalled a recent club match where her goalie ran into the post with her cheek, and the official refused to allow her to continue playing until a trainer cleared her of symptoms.

Education and other improvements

Strides continue to be made with more information presented to players, annual classes for coaches and improved concussion protocols, which include much more recovery time and cessation of any activities until symptoms subside. Cordairo, who plans to graduate with a nursing degree this spring, said it’s vital to keep working to make everyone cognizant of the symptoms and consequences of concussions.

Some new rules have been created in the name of player safety, including a mandate for all softball hitters to wear helmets with facemasks in summer and travel leagues. Northwestern State began requiring them in 2009, and Pickett said a similar rule will be introduced soon by the NCAA.

As in all areas of concussion research, many questions remain unanswered. Bailes said learning more about gender differences could be beneficial for efforts to prevent and treat the so-called “invisible injury” in every sport, including football.