Sex, age affect athletes' concussion recovery

Female and high school athletes may need more time to recover from a concussion than their male or college counterparts, a new study finds.

Researchers found that of 222 young athletes who suffered a concussion, female athletes tended to have more symptoms than males. They also scored lower on tests of "visual memory" – the ability to recall information about something you've seen.

Meanwhile, high school athletes fared worse on memory tests than college players, and typically took longer to improve.

For parents, coaches and athletes, the key message is to have patience with concussion recovery, according to lead researcher Tracey Covassin, an assistant professor at Michigan State University in East Lansing. "It's going to take time for your child to fully recover, so don't rush them back into the sport," Covassin said.

Extra time for female athletes

And some extra time, she said, may be in order for female athletes and high scholars.

The findings, which appear in the American Journal of Sports Medicine, are based on 222 high school and college athletes who suffered a concussion over two years.

That included football, soccer and volleyball players, for example.

Covassin's team gave them standard tests of memory and other mental skills, as well as balance, over the first two weeks post-concussion.

Overall, female athletes complained of more symptoms than their male counterparts – an average of 14 symptoms, versus 10. Concussion symptoms include problems like headache, dizziness, nausea, ringing in the ears, fatigue and confusion.

Female athletes also had lower average scores on visual memory tests – though male and female players alike gradually improved over the two weeks.

High school athletes lag behind

High school athletes, meanwhile, performed worse on memory tests than their college counterparts, and improved more slowly. After one week, they were still lagging behind the older athletes.

And among male athletes, high scholars also had more problems when researchers tested their balancing skills.

The study is not the first to suggest that younger brains, or female ones, may need a little more time to recover from a concussion.

But it adds to evidence that such differences exist – and that doctors, parents and coaches should be aware of them, Covassin said.

Younger athletes, she said, likely need more recovery time because the teenage brain is still developing. It's also smaller, which means it can more easily be "knocked around" within the skull if a young athlete takes a hit.

It's not clear why female athletes may fare worse than males, according to Covassin. But there's research suggesting that differences in brain structure are at work.

More awareness, more concerns

The study comes at a time of rising concern about concussions in young athletes.

While experts say the benefits of exercise and sports surely outweigh the risks of concussion, young athletes do seem to be sustaining head injuries more often than in years past.

A recent study found that in 2008, there were five concussions for every 10,000 US high school athletes who hit the playing field. That was up from just one per 10 000 a decade earlier.

That's partly because more people are playing contact sports, and young athletes are training more aggressively at an earlier age. Doctors are also becoming more vigilant about diagnosing concussions.

The American Academy of Pediatrics (AAP) recommends that young athletes with concussions get cleared by a doctor before they get back on the playing field.

Ensure head injury fully is healed

That assessment -- with tests like those used in the study – is important to ensure that the head injury is fully healed, Covassin pointed out.

"It's not like you wake up, and if you don't have a headache anymore, you're OK," she said.

The biggest concern is the risk of so-called "second-impact syndrome," which can occur when someone takes another blow to the head before a concussion is healed. Second-impact syndrome can have severe consequences – including bleeding inside the skull, brain swelling and death.

But to ensure that concussions are fully taken care of, athletes, parents and coaches first need to spot the symptoms, Covassin noted.

The symptoms may not be dramatic. (Contrary to popular belief, concussions usually do not involve loss of consciousness.) It could be, for example, that your daughter took an elbow to the head during a basketball game, then has no appetite for dinner that night, according to Covassin.

Rest physically and mentally

She also stressed that parents should not dismiss the possibility of a concussion just because their child is not involved in rougher sports like football or ice hockey.

Once a concussion is recognised, the AAP says that young athletes should rest – not only physically but mentally as well. That's because schoolwork and other mental tasks, even video game playing, can make symptoms worse.

(Amy Norton, Reuters Health, May 2012) 

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