Why Head Injuries Affect Girls Differently Than Boys

Research shows that girls may be at higher risk of concussions than boys, but why?

kids playing outside, soccer, soccer ball, sunset, blue sky

Bumps and bruises are a normal part of childhood, especially if your young one is a fan of playground activities, like capture the flag or jump rope, or is involved in organized sports. Team sports help kids and adolescents form friendships, boost self-esteem and get physically active, but they also increase the risk of injury—the most frightening of which tend to be injuries to the head and brain.

Some 45 million children and adolescents in the US are involved in organized sports. In 2013, team and group sports were the leading cause of injury-related hospital visits among older children, young adults and males, and research suggests certain sports, like football, field hockey, soccer and basketball, pose a greater risk for head injury.

"The number of athletic head injuries has been going up significantly over the last 10 years and I think that's more a function of awareness than anything else," says Robert Abramson, MD, a neurosurgeon with Doctors Hospital of Augusta in Augusta, Georgia. "These things are being reported a whole lot more."

Female athletes are at a higher risk for these types of injuries, and often take longer to recover than their male counterparts. Here's what else Dr. Abramson had to say about cranial contusions, from detection to recovery and more.

Girls are at a greater risk

Teenage girls involved in team sports are more likely to sustain head injuries, according to a 2017 study that analyzed 27 sports in 147 US high schools.

This is true even for boys and girls playing the same sports. Results from a review of 15 college sports suggests female softball players were two times more likely to experience concussions than male ball players. Another study of high school athletes suggests female soccer and basketball players endure head injuries more frequently than male classmates.

The exact reason for these disparities is somewhat unclear, but experts have a few theories. For one, girls may be more apt to report a bump on the head.

There's more. "I think one thing that is apparent is that musculature in the shoulders and neck, especially in younger girls, is not as strong," Dr. Abramson says.

The strength of your neck muscles may indicate the likelihood of a head injury, especially during sports like soccer, where athletes often make contact with the ball using their heads. Boys and men typically have stronger necks than girls and women, which may explain the lower rate of concussions.

Gender and recovery—the shocking difference

Research seems to suggest the post-concussion recovery period is longer for girls than boys, too. The typical recovery period for adolescents is a few weeks, but girls are often on the higher end.

A 2017 study of 212 male and female athletes between the ages of 11 and 18 suggests young women may exhibit symptoms of a head injury, like headache, nausea, fatigue and irritability, for a longer period of time. On average, girls reported symptoms up to 17 days longer than boys.

Another 2-year study of 296 high school and college athletes suggests both age and gender impact your rate of concussion recovery. The study measured skills like visual and verbal memory of concussed participants two, seven and 14 days after injury. High school athletes—boys and girls—struggled more with visual and verbal memory than college-aged participants, and took nearly twice as long to recover. College athletes were symptomless by day seven; high school participants took as long as two weeks. Results from the study also linked female athletes, regardless of age, to slower rates of recovery and more reported symptoms.

More research is needed to determine the exact reason concussion recovery is a longer process for females. Experts theorize the same neck muscles that make females more likely to sustain a head injury may have something to do with it.

There's more. "Girls tend to be more responsible in reporting symptoms, but that doesn't explain all of it," Abramson says. "There are probably some hormonal factors that go along with it, too."

Results from one study of 144 women between the ages of 16 and 60 suggest women who endured a head injury in the two weeks before their period—when progesterone levels are low—took longer to heal than those with an injury sustained in the two weeks following a period. Women taking birth control pills were also slower to heal.

Knowing the signs of a serious head injury, getting swift treatment and taking precautions to prevent injuries are healthy ways to protect children and adolescents.

Signs you shouldn't ignore

Head injuries shouldn't be ignored, and there are some serious indicators your young one should be seen by a medical professional. This type of head injury often presents with physical, cognitive and emotional symptoms.

"The things to look for in children are headache, dizziness, nausea, vomiting and irritability," Abramson says.

Other common signs include:

  • Difficulty thinking and concentrating
  • Inability to remember new information
  • Blurred vision
  • Problems with balance
  • Sadness or anxiety
  • Changes in sleep, including snoozing more or less or having trouble dozing off

Onset of these symptoms may occur immediately after the injury, or appear hours, days or even months later. Adults caring for children should keep a close watch for worrisome symptoms and seek care when necessary. If signs worsen or will not go away, it's a good idea to see a doctor, who can monitor recovery and let you know when it's safe to return to school, work and other activities.

Rest, including a break in physical and mental activity, is the key to a healthy recovery. Jumping back into daily activities before full recovery can make symptoms even worse and lengthen the recovery period.

Another reason to report injuries to your doctor? For some, the effects of traumatic brain injuries last long beyond the initial impact. Issues with memory, reasoning, balance, communication and depression can persist for years. Head injuries can also lead to conditions like Alzheimer's disease and epilepsy.

Prevention strategies that really work

"Studies have been done on kids that have had concussions, and they are more prone to progress to undisciplined behavior, like drinking and taking drugs," Abramson says. So, preventing head injuries, whenever possible, is important.

It's not always possible to prevent head injuries, but there are some proven techniques to reduce your child's risk of traumatic brain injuries. These precautions won't eliminate a child's risk for a bump on the head altogether, but they will likely reduce the severity if an injury.

Seeking out parks and playgrounds with shock-absorbing surfaces is one way to protect your children from serious fall-related head injuries. Wearing the proper helmet during activities like contact sports, bike riding, skateboarding, snowboarding, horseback riding, snowmobiling or riding a motorcycle can help prevent traumatic brain injuries. If you're unsure about the proper size and style for your child's desired activity, your local bike shop or sporting goods store should be able to help.

Motor vehicle accidents can also cause serious head trauma. To protect your passengers, ensure older children and adults fasten their seatbelts, and small children are secured in the proper car seat.

Window guards and safety gates also help safeguard children from injury at home. For more tips to prevent injury, speak with your healthcare provider.

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