Concussion study indicates higher risk for females -- another reminder for coaches to review recognition protocols
by Dr. Dev Mishra

My colleagues at Stanford and I have had a feeling that women are more likely to sustain concussions than men, and that the women often took longer to recover from the concussion than men.
Most of this thought was based upon our possibly unreliable experiences, with not a lot of hard data to back this up. But now there is some very good evidence out of Columbia University in New York that women are in fact more likely to sustain a concussion than men, however their recovery times are similar (both took about 14 days).

This study by primary author Cecilia Davis-Hayes and co-authors followed varsity athletes at Columbia University (in the Ivy League) over a 15-year period from 2000 through 2014. This study has a number of strengths, such as the careful monitoring of the athletes and their symptoms over time, consistency in definitions of concussion and return to play protocols, and a very high followup rate.

• Females are 1.5 times more likely to have a concussion compared to males.

• History of a concussion prior to attending college, 2.9 times more likely to have a collegiate concussion compared to athletes with no prior concussion.

Additionally, this study highlighted a number of other interesting findings. First, male athletes were much more likely to report memory problems in the post-concussion period than females, and the average return to play time for all athletes was 14 days. This average return to play time had a high amount of variability, with some athletes taking many months to return to play.

The interesting part about this is that we’ve come to take for granted that once an athlete is diagnosed with a concussion they typically take about a week to return to play. This was not true in the Columbia study, and is in line with my own experience with high school and collegiate athletes.

I think there are a few important take-home points from this study.

• Female athletes should be particularly cautious about return to play if you’ve had a concussion.

• If you’re a coach of female athletes be aware that your players are more likely to sustain a concussion than males. Know your concussion recognition protocols very well.

• The real world experience with collegiate athletes shows that concussion recovery often takes longer than what we would be lead to believe in the media.

Key Points
• A recently published study confirms suspicions that female athletes are more likely to sustain a concussion than males.
• Average return to play times for males and females was similar, but far longer than typically reported for athletes, at about 14 days.