Sports Related Concussion Recovery in 11-18 year olds

This week from Dr. Cerami and Utah Sports and Wellness

From: Journal of the American Osteopathic Association, October 2017

Quick Summary:

Concussions represent almost 9% of all injuries in high school athletics. This study was performed to determine whether female athletes in middle school and high school with a first time, sports related concussion remained symptomatic longer than their male counterparts. A significant difference was found in the median number of days female athletes remained symptomatic (28 days) when compared with male athletes (11 days). At 3 weeks post concussion, 82 of 110 male athletes (75%) and 43 of 102 female athletes (42%) experienced recovery of concussion symptoms. The difference in the recovery rates following concussion is “complex and multifactorial,” probably dependent upon biomechanical and biological differences.  A possible reason for this , “Females may be at higher risk for concussions because their necks are smaller and do not absorb shock as well as the necks of males.” The 5th International Conference on Concussion in Sport in October 2016 went on to state “that a sizeable minority of youth, high school and collegiate athletes take much longer than 10 days to clinically recover and return to sport.”

Abstract:

A retrospective medical record analysis was performed among athletes who sustained a concussion between 2011 and 2013. Inclusion criteria consisted of age between 11 and 18 years and diagnosis of first-time concussion sustained while playing organized sports. Using the documented notes in the medical record, length of time that each athlete was symptomatic from his or her concussion was calculated. A total of 110 male and 102 female athletes (N=212) met the eligibility criteria for the study. A significant difference was found in the median number of days female athletes remained symptomatic (28 days) when compared with male athletes (11 days) (P<.001). No statistically significant difference was found in symptom duration between age groups. When matched for sex, no statistically significant differences were found in symptom duration between the type of sports played. Female athletes aged 11 to 18 years with first-time, sports-related concussions remained symptomatic for a longer period when compared with male athletes of similar age, regardless of sport played. The mechanism behind this difference needs to be further elucidated.

These authors also note:

• “Concussion is one of the most common injuries in athletes.”
• 9% of all injuries in high school athletics are concussions.
• “Studies propose that female athletes are at greater risk for concussion than their male counterparts.”
• Most studies note that 80% to 90% of sports-related concussion symptoms resolve in 7 to 10 days. However, most of these studies involved male collegiate or professional football players, not adolescents and not adolescent girls.
• Mental stress plays a role in concussion recovery.
• “The most recent consensus statement [2016] recognizes that pediatric populations in general take more time to recover from a concussion than adults, and they recommend that the diagnosis of ‘concussion with persistent symptoms’ not be used in children until symptoms have been present for longer than 4 weeks.”
• “Current research states that the majority of adolescents with concussions recover within 4 weeks. The findings of the current study suggest that with first time sports-related concussions in middle school and high school athletes, female athletes remain symptomatic longer when compared with male athletes, regardless of the sport played.”
• “A significant difference was found in the median number of days female athletes remained symptomatic (28 days) when compared with male athletes (11 days).”
• “Female athletes aged 11 to 18 years with first-time, sports-related concussions remained symptomatic for a longer period when compared with male
  athletes of similar age, regardless of sport played.”