Concussion Recovery Takes Twice as Long for Young Female Athletes

Young female athletes tend to experience concussion symptoms twice as long as their male counterparts, according to a new study published in The Journal of the American Osteopathic Association.

The researchers believe that the longer recovery period may be due to underlying conditions typically more prevalent in girls, such as migraines, depression, anxiety, and stress.

According to the Mayo Clinic, common symptoms after a concussive traumatic brain injury are headache, loss of memory (amnesia), and confusion. The amnesia usually involves forgetting the event that caused the concussion.

For the study, the researchers analyzed the medical records of 110 male and 102 female athletes (aged 11 to 18) with first-time concussion diagnoses. The median duration of symptoms was 11 days for boys and 28 days for girls. The findings show that symptoms resolved within three weeks for 75 percent of boys, compared to 42 percent of girls.

“These findings confirm what many in sports medicine have believed for some time,” said lead researcher John Neidecker, D.O., a sports concussion specialist in Raleigh, N.C. “It highlights the need to take a whole person approach to managing concussions, looking beyond the injury to understand the mental and emotional impacts on recovery when symptoms persist.”

Previous studies have found that concussions can worsen some pre-existing conditions, including headaches, depression, anxiety, and stress. All of these are more prevalent in girls and mirror hallmark concussion symptoms, according to a consensus statement from the 5th International Conference on Concussion.

Understanding the overlap of symptoms means physicians must be skilled at eliciting patient history to get a full understanding of factors that might complicate recovery.

“Often in this age range, issues like migraines, depression, and anxiety have not yet been diagnosed,” said Neidecker. “So, if I ask a patient whether they have one of these conditions, they’re likely to say ‘No’. But when I ask about their experiences, I get a much clearer picture.”

Neidecker gave an example of a young female patient with no history of migraines but who reported experiencing weekly headaches before her head injury occurred. She thought the headaches were normal, but in fact she had been suffering from migraines.

Neidecker uses a similar roundabout approach to uncovering anxiety, mental stress, and depression, and said diagnosis can be difficult because adolescence is inherently emotional and stressful. For example, he recommends asking young athletes whether they are hard on themselves or feel bad when they don’t perform their best.

Young people with Type A personality traits typically have a baseline level of stress about the need to perform and become more stressed when they cannot, Neidecker explained. Losing the physical outlet of sport for managing their stress worsens the problem during the recovery period.

“It can really become a vicious cycle for some of these kids,” said Neidecker. “Uncovering and addressing any underlying conditions gets them back on the field faster and ultimately helps them be healthier and happier in the future.”

Source: American Osteopathic Association