PHILADELPHIA (KYW Newsradio) — A recent study shows that women and girls are more prone to sports-related concussion than men. However, medical treatments for concussion, which can vary widely, are based on studies of men’s injuries.
KYW Medical Editor Dr. Brian McDonough joined KYW’s Michelle Durham to discuss that disparity in research.
Listen to their conversation
Q: It seems like women are more prone to sports-related concussion than men, but all the studies that the treatments are derived from are conducted on men. What do you make of that disparity?
A: If you go back in the past, many of the studies on heart disease and everything else were first done on men. And then there was this realization — ‘Well, wait a minute. Women and men are quite different physiologically’ — that we should be looking at both. And that has started to happen, fortunately.
Concussion has kind of lagged behind because, when the first research was being done, probably 10, 15 years ago, that research was being done primarily on pro athletes in men's sports. But obviously women play sports as well. Not only do they play sports as well, but they're playing competitive sports — especially, some of them, like soccer, lacrosse and others, where there can be head trauma. And the realization is here that, not only do women seem to have more issues with concussions than men, more symptoms, but they need to be studied.
There was an analysis of research done at Penn back in 2017. They looked at it and, clearly, there is a difference in the brain in how messages are transferred back and forth through axons and, you know, the intricate mapping of the brain — that actually women are more sensitive and susceptible to injury. So, that alone is enough reason that women need to be studied more.
The other issue that's really important is the impact of hormones also can be very different on how the brain reacts to trauma — what happens in trauma — and that's an issue.
And the third thing, which I always think is important, is muscular structure and size of people. And can the body sustain the hit? Is it more of a jolt to the brain?
All of those things play into it. So, you're right on target: We need to be looking at men and women, certainly.
Q: And the concussion treatment varies widely. Some people go to their general practitioner. Some people see a concussion specialist. And I think we need to talk about that a little bit, too.
A: There's so much that we are learning about concussion.
The first and primary thing is: Every physician, health care provider, needs to know this is an issue and take it seriously and take the steps to get the person off the field — or wherever the trauma could be occurring. That's No. 1.
But No. 2 is: What are the approaches — what is the systematic way of diagnosing where somebody is in a concussion protocol? And it varies dramatically. Most of the big work was done at University of Pittsburgh, and the rest of the medical world is kind of following that guidance. But there is clearly not enough knowledge out there about how to approach this.
The one thing that's really important for our listeners, and I know this is tough, especially when it comes to sports: If you have a son or a daughter who is playing sports, I know there's that feeling of ‘Oh, my gosh! There's a scholarship out there! We gotta do well! My child has to win all the awards!’ It's not worth it. I mean — if they need to get off, get out of the competitive arena.
As a parent, you're your child's best advocate. Hopefully coaches are thinking the same way. But you don't want that player going back in there after they’ve more or less had their bell rung. Those days of doing that are gone — and they should be gone.
If it's your child, really protect them, because the repeat concussions are when we really start to have an impact. And you are more prone to have another concussion once you've had your first — especially a short period of time after.
Get more medical reports from Dr. Brian McDonough.
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