A disparity in concussion recovery times between male and female adolescent athletes is the subject of an October article in The Journal of American Osteopathic Association. The article’s findings have been covered by CBS News.
The root of the difference, researchers found, may be linked to pre-existing conditions that are more prevalent in girls, including depression, anxiety and migraines. Concussions may exacerbate these pre-existing conditions, according to a consensus statement from the 5th International Conference on Concussion.
In a study of 110 male and 102 female athletes, ages 11 to 18, with first-time concussion diagnosis, the median for the duration of symptoms for boys was 11 days, compared to 28 days for girls. The data also showed that 75 percent of symptoms resolved for boys within three weeks, compared to only 42 percent of girls.
Researchers noted that the overlap of symptoms makes it imperative that physicians be skilled at eliciting patient history to understand the scope of factors that might hinder or delay recovery.
“Often in this age range, issues like migraines, depression and anxiety have not yet been diagnosed,” said John Neidecker, DO, a sports concussion specialist in Raleigh, North Carolina.
“So, if I ask a patient whether they have one of these conditions, they’re likely to say ‘No’. But when I ask about their experiences, I get a much clearer picture.”
Dr. Neidecker gives an example of a patient with no history of migraines who admitted experiencing weekly headaches prior to the head injury. She thought the headaches were normal, but in fact the patient was suffering from migraines.
He uses a similar approach to uncovering anxiety, mental stress and depression, and says diagnosis is tricky because adolescence is inherently emotional and stressful. To better understand the patient, he recommends asking young athletes whether they are hard on themselves or feel bad about not performing their best.
Patients with Type A personality traits typically have a baseline level of stress about the need to perform and become more stressed when they cannot, Dr. Neidecker explained. Losing the physical outlet of sport for managing their stress compounds the issue during the recovery period.
“It can really become a vicious cycle for some of these kids,” said Dr. Neidecker. “Uncovering and addressing any underlying conditions gets them back on the field faster and ultimately helps them be healthier and happier in the future.”