Relative Risk for Concussions in Young Female Soccer Players

Abstract

The objective of this study was to determine the relative risk and reported symptoms of concussions in 11- to 13-year-old, female soccer players. For this, a survey to compare the reported incidence of concussion in age-matched female soccer players to nonsoccer players was performed. The survey included 342 girls between the ages of 11 and 13: 195 were involved in an organized soccer team and 147 were not involved in organized soccer but were allowed to participate in any other sport or activity. A total of 94 of the 195 soccer players, or 48%, reported at least one symptom consistent with a concussion. The most prevalent symptom for these girls was headache (84%). A total of 34 of the 147 nonsoccer players, or 23%, reported at least one symptom consistent with a concussion in the previous six months. These results determined that the relative risk of probable concussions among 11- to 13-year-old, female soccer players is 2.09 (p < .001, α = .05, CI = 95%). This demonstrates that the relative risk of probable concussions in young female soccer players is significantly higher than in a control group of nonsoccer players of the same sex and age.

Incidence and Risk of Concussions in Youth Athletes: Comparisons of Age, Sex, Concussion History, Sport, and Football Position

“…A literature review of sex difference in sport concussion in high school, college, and professional levels likewise showed higher CRs for females compared to males in similar sports (Dick, 2009), a pattern that has been noted in several previous studies of high school athletes (Lincoln et al, 2011;Marar et al, 2012;Rosenthal et al, 2014). Possible explanations for sex differences in concussion patterns are limited, with some suggesting biomechanical (body mass, small head-to-ball ratio, neck strength), neuroanatomical, or hormonal factors underlying female concussions (Covassin, Swanik, & Sachs, 2003;Strand, Lechuga, Zachariah, & Beaulieu, 2015). Psychosocial influences may lead males to minimize injuries, play despite injury and underreport symptoms in order to continue to play (Kerr, Register-Mihalik, Kroshus, Baugh, & Marshall, 2016).…”

Sport-Related Concussion in Female Athletes: A Systematic Review

“…We identified 5 studies that examined concussion-reporting behavior in female athletes. 6 , 22 , 38 , 45 , 53 Studies showed that a significant percentage of adolescent, 45 , 53 high school, 38 and collegiate athletes 6 , 22 failed to report concussion-like symptoms (CLS) and that many of these athletes returned to play with CLS ( Table 5 ). O’Kane et al 45 surveyed adolescent female soccer players over 4 years for the incidence of concussion.…”

“… 14 However, our review found that despite higher rates of reporting in female compared with male athletes, 57 underreporting still exists and leads to potentially untreated concussions. 6 , 22 , 38 , 45 , 53 …”

“…As shown in Table 1, these studies reported a wide range of head impact magnitudes. However, it is important to note that McCuen et al 37 recorded head impacts with a resultant linear acceleration Wilcox (2015) 58 Cross-sectional study 2b Good Reed (2017) 48 Cohort study 2b Good Lynall (2016) 35 Prospective cohort study 2b Good Press (2017) 47 Cross-sectional study 2b Good McCuen (2015) 37 Cross-sectional study 2b Good Lamond (2018) 32 Cross-sectional study 2b Good Hanlon (2012) 26 Cross-sectional study 4 Fair Caswell (2017) 8 Descriptive epidemiology study 2b Good King (2018) 31 Prospective cohort study 2b Good Lovell (2013) 34 Case series 4 Good Ellemberg (2007) 19 Prospective cohort study 3b Good Forbes (2016) 20 Prospective cohort study 3b Good Gutierrez (2014) 25 Descriptive laboratory study 4 Good Kaminski (2007) 30 Cohort study 2b Good Kaminksi ( 2008) 29 Cross-sectional study 2b Good Chamard (2013) 10 Cohort study 3b Good Chamard (2014) 9 Cohort study 3b Good Chamard (2016) 11 Cohort study 3b Good Schranz (2018) 51 Prospective cohort study 2b Good Snook (2017) 52 Prospective cohort study 2b Good Gallagher (2018) 22 Retrospective review 3b Fair O'Kane (2014) 45 Prospective cohort study 3b Good Strand (2015) 53 Prospective cohort study 3b Good McDonald (2016) 38 Descriptive epidemiology study 3b Good Brook (2017) 6 Descriptive epidemiology study 2b Good Caswell et al 8 characterized head impacts sustained in girls' varsity high school lacrosse games over the course of 2 competitive seasons (28 games total). All game-related impacts greater than 20g recorded by impact sensors were verified with video analysis, which demonstrated that only about half of the measured impacts greater than 20g were associated with impacts to the head.…”

Pre-injury variables and risk of sport concussion

“…The type of sport is a predictor of risk of sport concussion. For example, young female soccer players aged 11-13 have 2 times the risk of sustaining a sport concussion compared to their non-sport and other-sport playing counterparts (Strand, Lechuga, Zachariah, & Beaulieu, 2014). However, this study assessed "probable" concussions, which makes this result less reliable.…”