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Originally published Sunday, February 2, 2014 at 6:17 AM

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Concussions are a bigger issue than most people realize in women’s sports

Although concussions are almost a given in men’s football, when it comes to head injuries, women’s sports have got men’s sports beat.

Special to The Times

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Like the rest of Seattle, I’ll be rooting for the Seahawks in today’s Super Bowl. But I’ll also be hoping for fewer head injuries.

Seattle’s last game against San Francisco was a nail-biter, but it also had some dramatic injuries. I groaned in sympathy when 49er linebacker NaVorro Bowman’s knee twisted in a not-so-anatomic fashion. Musculoskeletal injuries like that draw a lot of airtime in replays, but concussions — which have less visibility — can be far more serious.

And though concussions are almost a given in men’s football, when it comes to head injuries, women’s sports have got men’s sports beat.

A concussion is a mild form of traumatic brain injury sustained by a direct blow to the head or by a strong force transmitted to the head, like whiplash. Concussions can occur without loss of consciousness. Symptoms can include headaches, dizziness, concentration difficulties, emotional changes and memory loss.

A single concussion most often resolves without significant consequences, but if a player returns to play too soon, symptoms can be more severe and take more time to resolve. If he or she sustains another head injury in the same game or has repeated injuries over time, there can be more serious neurological damage.

Imaging is usually not helpful, and careful questioning and observation of the player are critical in the moments and days after the injury. Avoiding repeat head trauma is critical to recovery.

A growing awareness of the consequences of repeated head injuries in men’s football has led to the implementation of concussion protocols that help determine whether an athlete should return to play. This type of protocol pulled Seahawks player Percy Harvin out of play and practice after he got hit by another player and later landed on the turf after leaping for a pass a few weeks ago.

Female athletes suffer more concussions than men playing the same sports, and they tend to have more severe symptoms, though it is unclear exactly why there is this gender discrepancy.

Women’s ice hockey, rugby and soccer are higher risk sports. Cheerleading has the highest rate of catastrophic injuries (those involving brain, skull and spine) in women’s sports.

Much of the literature on concussions in women revolves around college athletes, but we now know that head injuries are a concern at even younger ages.

As reported in JAMA Pediatrics just a few weeks ago, researchers at the University of Washington studied middle-school girls who play soccer and observed that most of the players did not leave the field despite having concussion symptoms, and less than half of them sought medical care for their symptoms.

The concussion rates in this group were higher than those in older age groups. These findings are concerning and point to a need for more education and consideration for similar protocols in this age group.

Today’s Super Bowl promises to be a very exciting game, and I’ll be cheering for one free of concussions.

Linda Pourmassina, M.D., is an internal-medicine physician who practices at The Polyclinic in Seattle. She has a blog at and can also be found on Facebook and on Twitter (@LindaP_MD).

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