News & Podcast

Greetings from the Tucker Center! In this newsletter you will learn about all of the exciting and award-winning endeavors we’ve been up to since last Fall. You will also get a sneak preview of what we are planning for in the coming months. At the heart of our mission is engagement in interdisciplinary research. We rely on thoughtful and critical examination to advance our knowledge regarding how sport and physical activity impact the lives of girls and women in a variety of settings. Faculty and graduate students affiliated with the Tucker Center seek answers to the most significant and compelling issues facing the world of women’s sports. Toward that end, our Spring Distinguished Lecture will focus on a critical and under-examined topic—female athletes and concussion. We’ve invited three nationally recognized experts who are at the cutting edge of research in this area. They will address what is known about the impact of concussions on athletic females, as well as highlight the numerous gaps in the research literature ranging from neuroscience to sport psychology. They will also focus their remarks on strategies related to education and prevention. You can read more about the Distinguished Lecture and the panelists in the DLS story. To get a glimpse of their perspectives in advance of the lecture, read the feature story. In that same story we invited former Gopher hockey player Kelli Blankenship to share what it was like for her to deal with the painful and often scary consequences of sport-related concussions.

Kudos & Announcements highlights our numerous and varied research efforts. Read about our scholarly, educational, and outreach accomplishments from publishing in peer-reviewed journals, to winning prestigious national awards and grants, to invited speaking engagements at national and international conferences.

We are always trying to find new and innovative ways to honor the achievements and increase the visibility of female athletes. Just last month we hosted the inaugural Tucker Center Film Festival in which we featured a sneak preview of The Mighty Macs, a soon-to-be released film about the women’s basketball team at Immaculata College in Pennsylvania and their pioneering and inspirational head coach, Cathy Rush. Finally, next November, the Tucker Center is hosting the 2011 Girls & Women in Sport Conference. This one-day event precedes the annual meeting of the North American Society for the Sociology of Sport (NASSS).

Our newsletter is rapidly becoming too small to capture all the work we are doing, so be sure to check out the rest of our Web site or follow us on Facebook or Twitter for the latest and most up-to-date information on all we do to make a difference in the lives of girls and women.

—Mary Jo Kane, Director

Introduction

What do Olympic gold medal skier Lindsay Vonn, NHL star Sidney Crosby, and MLB Twins’ player Justin Morneau have in common? If you said they have all had to cease competing due to sports-related concussions, you would be correct. The issue of sport concussions is a hot topic in the news from youth sports, to updates on high-profile pro athletes, to the NFL’s controversial and much-debated decision to enforce new safety rules for players. In spite of much media coverage and public debate, one factor has been missing from our discussions—the impact of concussions on female athletes. As we now know, previous patterns of scholarly inquiry and public discourse often failed to examine how one’s gender might influence sports participation or was not deemed all that relevant. And in far too many cases, it was assumed that data collected on male subjects could be directly applied to females.

Contemporary scholars have critiqued this past approach as not only problematic and flawed, but in some cases, even dangerous. It is interesting (not to mention troubling) that eerily similar patterns, attitudes, and belief systems are alive and well within the scientific community when it comes to female athletes, traumatic brain injury, and sports-related concussion. In this feature story we have invited perspectives from three noted scholars on what is known about female athletes and concussions in order to push the public discussion and research agenda forward in productive and meaningful ways. We finish the piece with a perspective from a female student-athlete.

Definition, Description and Surveillance
Professor Diane Wiese-Bjornstal, School of Kinesiology, U of M; Association of Applied Sport Psychology Certified Consultant

Concussions are mild traumatic brain injuries (MTBIs) that lead to changes in how the brain functions. They range from mild to severe, and can result from direct hits or blows to the head, as well as from back and forth “whiplash” movements of the head following body hits. Coaches, parents, and teammates who observe athletes sustain these types of forceful blows or jarring hits should be alert for changes in their functioning or behavior–losing consciousness, moving clumsily, or appearing dazed, confused, or forgetful–and ensure their immediate removal from play and prompt examination by health care professionals. Symptoms of concussions can include a variety of short- and long-term physical, emotional, cognitive, and somatic indicators. Physical symptoms such as headache, pressure in the head, nausea, blurry vision, and excessive fatigue are common, while emotional effects may be irritability, sadness, or anxiety. Cognitive symptoms include difficulties in thinking clearly, concentrating, or remembering new information, and somatic indicators such as drowsiness or sleep disturbances are also symptomatic of concussions. Physical, cognitive, and emotional rest are essential during the healing process, and concussed athletes should not return to play until symptom free and cleared by medical professionals as brain healing continues even after symptoms abate. Concussions are serious injuries, and recovery recommendations need to be followed closely to speed healing and reduce the likelihood of further damage or complications such as second-impact syndrome (SIS) or post-concussion syndrome (PCS). The Centers for Disease Control (CDC) Heads Up: Concussion in Sports program and resources provide parents, coaches, and players with easy online access to excellent educational materials about concussion signs, symptoms, and care.

Surveillance evidence shows that about 9% of all sports injuries to high school athletes and about 5% of all intercollegiate sports injuries are concussions. They are generally most frequent in contact and collision sports, among younger athletes, and during competitions. Females have lower total incidences of sport-related concussion than males due to factors such as limited participation in collision sports, less sport participation in general, and lower physical activity levels. But females have higher rates (injuries expressed per unit of participation time) of concussion injury than males in several comparable sports. Data for high school and college athletes show higher rates of concussion for females than males in ice hockey, soccer, and basketball, and gender-similar rates in base/softball, volleyball, and lacrosse. The highest concussion rates for female athletes in high school and college occur in ice hockey, soccer, and basketball, and rates are higher for females in intercollegiate compared to high school sport. Some of the cultural, social and psychological risk factors for concussion injury and response among female athletes include sport norms (e.g., expectations to be “tough” and play through pain and injury), rules of play (e.g., greater concussion risk in ice hockey checking leagues), sportsmanship/illegal play (e.g., illegal play increases the risk for concussion injuries), and reporting rates (e.g., although female athletes are more likely to report injuries than males, many athletes of both genders fail to report concussion at all).

The Role of Sex Differences and Sex Hormones on Concussions
Dr. Jill Brooks, Clinical Neuropsychologist, Head to Head Consultants, Gladstone, NJ

An overview of research on sex differences and how it applies to traumatic brain injury is confusing and equivocal. Hormonal effects have been studied in the womb. Physical changes at puberty have been associated with differences in behavior, cognition, and mood in early adolescence. Scholars have suggested that sex differences are linked to the brain’s responsiveness to sex hormones throughout the lifespan. There is evidence to suggest that male and female nervous systems respond differently to injury caused by stroke or trauma. Conflicting findings also exist as to whether girls and women suffer less brain damage following a blow to the head when compared to their male counterparts. A loss of circulating female sex hormones eliminates neuroprotection (prevention of degeneration of neurons within the brain and central nervous system [CNS]) at a cellular level. In animal models, sex differences exist in that females consistently exhibit less cellular damage following CNS insult. Finally, female hormones such as estrogen and progesterone also appear to protect rodents from brain damage following head injury. These disparate findings and lines of inquiry have led scholars to ask: What does all this research mean for female athletes?

One answer to that critical question is that gender and sex differences (and similarities) are an important fundamental variable in human research. Another answer is that efficacy of potential treatments for central nervous system injury (i.e., concussion) may differ by sex. Gender and sex differences exist on the biological, social, educational, and cultural levels, but are not always clearly or completely teased apart. Hormone levels during the lifespan influence cognitive, emotional, and physical attributes as well as neuroprotection, response to injury, and potential outcome. Incidence and severity of traumatic brain injury appear different for males and females, yet the examination of neuropsychological outcomes following concussion is in its infancy and most of the research has focused on male athletes. Neuroprotection and hormonal influences hold promise for both prevention and treatment in the areas of concussion and more severe brain injury. Finally, and perhaps most importantly, the study of concussion in men and boys should not be a model against which girls and women are measured.

Education of Parents, Coaches, Athletes and Fans about Prevention of Concussions
Dr. Aynsley M. Smith, Research Director, Mayo Clinic Sports Medicine Center

The decision to focus on the female athlete and concussion is timely and important for several reasons. In contact sports such as ice hockey participation has escalated; the few research studies conducted suggest females have a higher prevalence; and some data suggest concussed females take longer to recover than males. In addition, prevention strategies currently receiving emphasis, such as a movement to postpone body checking in hockey until Bantams (age 13) fails to impact specifically on girl’s hockey.

Research that accommodates gender differences in hockey and in soccer is beginning to accumulate, although admittedly it is in its infancy. Differences between genders related to concussion occurrence seem to be related to factors such as; greater head impact accelerations (movement in response to a blow/impact); head neck anthropometrics and isometric neck muscle strength; neck muscle mass; and possibly core strength on skates. In addition, anticipation, reaction time in terms of activation, likelihood to self report, and the social acceptance of self-reporting may also impact on the prevalence of concussion in female athletes. Finally in soccer there is decreased effectiveness of head gear to reduce acceleration in female soccer players compared to males. The acceleration actually increases when head gear is used by females.

To provide meaningful education to females about concussion, it may be helpful to consider gender specific content, motivators and learning preferences so the material will be well received. To identify why females are concussed more often than males, health care professionals are being surveyed. Surveys will be administered to physical medicine and rehabilitation (PM&R) physicians, orthopedic surgeons, physical therapists and athletic trainers. The survey results on perceptions of healthcare providers will be integrated with the literature reviewed to help inform attendees at the Tucker Center lecture about why females are concussed more often. Educational programs, developmentally appropriate, will be discussed to inform attendees. It is anticipated the educational programs will be capable of modifying concussion prone behavior. 

A Female Athlete’s Perspective on Concussions
Kelli Blankenship, Kinesiology Undergraduate, Tucker Center McNair Scholar, and Gopher Women’s Hockey Team Alumnae

For the 18 years I played competitive hockey, I was unaware of the seriousness of head injuries until I attended college. The first time I had any sort of noticeable head trauma was during a 14 and under boys’ game. I took a check head-on and blacked out. I continued to play because it was not until a few months later that I realized I might have experienced a concussion.

I had three more concussions during my sophomore year of high school. One was so severe that I underwent brain scans and was hospitalized. In spite of this, the constant pressure from my coaches and teammates to skate made it difficult for me to properly recover. I felt as though many people thought I was faking my injury and just did not want to compete. Unlike a broken bone, people cannot as easily witness the physical implications of a concussion, let alone the cognitive and emotional repercussions. Due to external pressures and my lack of awareness, I returned to the ice too early and consequently still continue to experience side effects such as headaches, fatigue, light-headedness, buzzing sounds, light sensitivity, and stars (white and sometimes blue circles).

It was not until I went to college that I finally realized the importance of rest and down time athletes need in order to recuperate and recover from a head injury. I was taught the importance of concussion awareness when each player had to take an impact test at the beginning of my freshman year at the U of M. This test alone taught me the significance of head trauma on the basis of reaction time, memory, and coordination. I suffered two mild concussions during my senior year. The team doctor recommended that I get as much rest as possible and avoid any stress and physical activity until all signs dissipated.

I have spoken with other college athletes who have expressed their frustrations because of the amount of time it takes for concussions take to heal. I believe that those who are aware will take the necessary time they need away from their sport in order to reduce the risk of more permanent brain damage. Concussion education and awareness should be targeted at the high-school level. By focusing on this age group, we can also educate parents and coaches about the risks and proper preventative measures for sport-related concussions.

To hear more about concussions, the latest research, prevention, and educational strategies pertaining to female athletes, be sure to attend our Distinguished Lecture.