Girls are 1.88 times more likely to suffer a concussion than boys, a study found; more research is going into concussion management and whether that should be sex-specific
Tuesday 27 April 2021 19:34, UK
Teenage girls playing football are at almost twice the risk of suffering a concussion as their male counterparts, a new study has found.
The study, funded in part by the Professional Footballers' Association (PFA) and the FA, indicates the need for concussion management to be sex-specific in this age group, one of its authors has said.
Injury data from 40,000 female and 40,000 male players aged 14 to 18 at the Michigan High School Athletic Association was reviewed by Professor Willie Stewart from the University of Glasgow as well as academics in the United States.
The study found the risk of sports-related concussion was 1.88 times greater in girls compared to boys.
It also found boys were most often injured in collisions with other players and were 1.5 times more likely to be removed from the field on the day of the injury than girls, who most regularly suffered concussion after contact with equipment, such as the ball or a goalpost.
Dr Abigail Bretzin from the University of Pennsylvania and the lead author of the study said: "Our findings add to research showing that female athletes are at increased concussion risk compared to male athletes and highlight the importance of sex-specific research in this field."
Professor Stewart added: "Given we know the importance of immediate removal from play for any athlete with suspected concussion, it is notable that 'if in doubt, sit them out' appears more likely to happen for boys than girls.
"This, together with the finding that mechanism of injury appears different between boys and girls, suggests that there might be value in sex-specific approaches to concussion education and management in this age group."
The FA announced new guidance for heading in U18s football in February 2020.
It advises against any heading in training for children of primary school age, moving on to a "graduated approach", which in U14s to U16s means a maximum of 10 headers once a week.
Between 16 and U18 level there is no maximum, but coaches are advised to reduce heading drills "as far as possible".
Heading guidelines for the professional and adult grassroots game are expected to be published ahead of the 2021/22 season, the Premier League said last month.
Those guidelines will be informed by an ongoing study involving men's youth and women's senior team players at Liverpool and Manchester City wearing specially-designed retainers in their mouths during training to measure the impact of different types of heading.
Repetitive heading and concussion are thought to be a factor in the increased risk of death due to neurodegenerative disease among footballers compared to the general population which was established in the 2019 FIELD study, led by Professor Stewart.
He told MPs conducting a parliamentary inquiry into concussion in sport last month: "We take the position that the only thing that connects football to American football to boxing to rugby to wrestling to other sports where we have seen this pathology is head impact and head injury exposure.
"There must be something else because people can have exposure to head injury, people can play the sport the same way and don't develop problems, there must be other things contributing to it, but the one common factor is this head injury.
"To prove it beyond a reasonable doubt as opposed to on the balance of probabilities is a virtual impossibility, because the exposure is in their 20s and the outcome is 30, 40 years later. It is vanishingly difficult to prove beyond a reasonable doubt, but on the balance of probabilities I think we're there."
The PFA has not been "asleep" on the issue of dementia in the game, according to outgoing chief executive Gordon Taylor.
The union boss addressed a parliamentary inquiry on Tuesday examining concussion in sport, and was asked to address criticism directed at the PFA from campaigners such as Dawn Astle and Chris Sutton.
Both have raised issues with the organisation's record on research into the possible link between concussive and sub-concussive injuries and the onset of neurodegenerative disorders.
Taylor said: "We've never been asleep on it. I am always prepared to put my head above the parapet because what we do needs to be out there. I am more than prepared to do that with anybody."
