Girls Are More at Risk for Concussions
It was the only indoor soccer game that season that Nora’s mom didn’t go to. Abby Patriquin’s other kids were sick, so Nora’s grandpa took her instead.
It was March 2024. The game had just started when a teammate passed the ball to 10-year-old Nora, who was then checked into the wall accidentally by an opposing player, at the same time that Nora tripped. Her head and left wrist slammed into the wall and she fell down. She got back up quicky, but her arms began to flail and she looked dazed. She fell again and started crying.
That’s when everyone at the indoor facility in Acton, Massachusetts, realized that something had happened to the tallest and strongest girl on the team. Her lip began to puff up, and a bruise was forming over her eye. The little girl said her head felt “squishy.”
“She was complaining that she couldn’t move her head very well, that it really hurt,” Abby said. An ambulance was called. First responders put a neck brace on Nora, loaded her onto a stretcher, and took her and her grandpa to a nearby hospital, where Abby met them.
That’s where Nora was diagnosed with a concussion—or a mild traumatic brain injury—based on her symptoms, plus a broken left wrist.
Girls and women are more at risk for concussions and appear to have a longer recovery.
More Research on Girls Needed
Girls and women are more at risk for concussions and appear to have a longer recovery. However, most research on concussions in general has been on boys and men over the decades, leaving a lot of unanswered questions about why females may be more at risk and what that means for concussion prevention, treatment, healing and risk of a second concussion.
A 2017 study found that girls who played high school soccer had more concussions than any other high school athlete. Girls overall had a significantly higher concussion rate than boys. The researchers examined injury data across the U.S. from 2005 to 2015 from the High School Reporting Information Online injury surveillance system. They looked at nine sports: football, soccer, basketball, wrestling and baseball for boys; soccer, basketball, volleyball and softball for girls. Of the 40,843 reported total injuries, there were 6,399 concussions—showing almost 16% of the injuries included concussions.
Other studies have showed that football led to more concussions but that girls’ soccer was close behind. A 2019 study in the Pediatrics journal showed that football had the highest concussion rate, but in the sports that boys and girls both play—like soccer and basketball—concussion rates were higher in girls.
Theories for why girls may suffer more concussions include that they are more likely to report injuries, but also that their body type and physiology make them more susceptible to concussions. In a 2024 University of Utah article, neurosurgeon Sarah Menacho, MD, said, “Women tend to have thinner skulls than men, along with smaller neck muscles, which can predispose female athletes to getting a concussion.”
Girls and boys also differ when it comes to hormones and brain blood flow, but how much that plays a role needs more research.
Females may also show different symptoms. Traditional concussion symptoms include neck pain, headache, confusion and feeling dazed. But women may have more trouble with vision, memory, sleep and mood-related symptoms like anxiety and depression, Dr. Menacho said in the article.
Research has long shown that females are more likely to suffer from motion sickness and migraines than males. And both motion sickness and migraines increase the risk of concussion, said Michael “Mickey” Collins, PhD, clinical and executive director of the University of Pittsburgh Medical Center Sports Medicine Concussion Program. Dr. Collins is a clinical neuropsychologist and concussion expert.
“Girls are more at risk for more protracted recovery from concussion, and they’re probably more at risk to sustain a concussion, because some of the best predictors of who gets a concussion are patients with a history of car sickness, migraine or anxiety,” Dr. Collins told BrainWise. “These are very similar pathways in the brain—motion sensitivity, migraine, anxiety—that kind of coexist for these patients, and it sets them up to have a worse outcome, especially if it’s not treated the right way.”
After Nora Patriquin’s concussion, she had on-and-off headaches for a week. She returned to school after one day at home, but took it easy for a couple of weeks. By the time spring outdoor soccer started, she was ready to get back out there. The bubbly young athlete continues to play soccer and basketball and swim on a local team.
The top 10 high school sports with the highest rates of concussion are, in order:
- Boys tackle football
- Girls soccer
- Boys lacrosse
- Boys ice hockey
- Boys wrestling
- Girls lacrosse
- Girls field hockey
- Girls basketball
- Boys soccer
- Girls softball
