Mounting evidence about Traumatic Brain Injury has made many parents wary of high school football, perhaps contributing to continuing decline in high school football participation.
But research presented at the American Academy of Orthopaedic Surgeons' 2017 conference reminds parents that they might be overlooking the dangers in other sports. Michael Schallmo from the Wake Forest School of Medicine found that female high school athletes are more likely to get concussions than their male counterparts, with female soccer players the most likely to sustain concussions.
More overall concussions
Concussion rates across all high school sports appeared to increase during the study period, with concussion rates more than doubling between 2005 and 2015.
That increase does not necessarily mean that sports are less safe than they were a decade ago. In fact, it may prove the opposite. The increased rate of concussions may just represent increased reporting of injuries, a result of successful interventions to combat Traumatic Brain Injury in high school athletics.
Girls have more concussions than boys
The researchers found that in gender-matched sports (like girls volleyball and boys volleyball), girls had a higher rate of concussions than boys. This same phenomenon has been recorded by other studies of female athletes at the middle school and college levels.
Assuming that coaches across sports and genders are reporting concussions at an increased rate, the higher relative rate of concussions in girls' soccer requires an explanation.
Do girls use their heads more than boys?
Are girls' sports inherently more dangerous? There's not yet a clear explanation for why female athletes sustain more concussions than males. But it does appear clear that brain injuries are different for girls than boys.
One theory is that high school girls' soccer involves more heading than high school boys' play. But a 2015 study in JAMA Pediatrics found that injury rates for heading were about the same across genders. The majority cause of concussions for both groups was player-to-player contact – almost 69 percent for boys and 51 percent for girls. Heading – which could involve contact with the ball or another player – was related to about 30 percent of boys' concussions and 25 percent of girls' concussions.
Another explanation for the difference in the concussion rate is that girls' physiology makes them more prone to concussions. Some researchers have hypothesized that girls' neck size and strength predisposes them to injury. Other researchers have suggested that concussions sustained prior to menstruation interfere with progesterone production, which in turn affects healing.
What parents can do
Faced with the evidence about girls' soccer injuries, parents have at least three options:
1 | Demand your daughters not play soccer
That's as much an overreaction to concussions as parents demanding their sons not play football. The evidence researchers have gathered so far suggests that it's not the sport, but the rules of play, that would benefit from change.
2 | Lobby for rule changes within your child's leagues
One response to the concussion rate, not just for girls but for all young players, might be to ban heading. U.S. Soccer has already responded to research into Traumatic Brain Injury by banning heading for all kids aged 10 and under, and to limit kids ages 11-13 to no more than 30 minutes of heading per week. The researchers behind the JAMA Pediatrics study concluded that because headers were the most common source of concussions for high school athletes regardless of gender, a ban on headers could significantly reduce the concussion rate. But they also concluded that such a recommendation was not likely to be "culturally acceptable." Increased regulation of player-player contact, however might be "culturally tolerable."
3 | Support continued research
PINK Concussions, a not-for-profit organization devoted to pre-injury education and post-injury treatment, is one good place to start. And if you or your child has a concussion-related story to share, PINK Concussions is seeking contributors for an upcoming book.