From flag football to the NFL, football is an incredibly popular sport to play and watch. Live television coverage of games, and even video games like Madden NFL, demonstrate just how passionate players and fans are about the sport. They also reveal how commonplace concussions can be for the athletes.
Lately, young women have been getting more involved in football and recent evidence revealed that women, particularly young women, may suffer more severe concussion symptoms. While it’s exciting to see young women evening the playing field of a male-dominated sport, experts argue that concussions are so common in football that playing simply isn’t worth the risk.
“Why bring girls into it? We should be taking the boys out of it,” said Dr. Robert Stern, director of clinical research for the Boston University CTE Center, which studies chronic traumatic encephalopathy (CTE), the degenerative brain disease often seen after repeated impact. “It doesn’t make sense to expose our children to repetitive head impacts during periods of incredible maturation of the most important organ in our body, the brain.”
As March is Brain Injury Awareness Month, we want to explore how concussions affect physical and mental health. Let’s dive in and dissect the subject.
The Concussion Legacy Foundation found that CTE occurs in people with a long history of brain trauma, and isn't just caused by concussions. Repeated impact, like that seen in tackle football, is also dangerous and can contribute to CTE, even if it doesn’t lead to a concussion. The Concussion Legacy Foundation uncovered that sub-concussive impact, or blows to the head, may be a big risk factor in developing CTE.
The implications of CTE are huge. Symptoms can range from confusion to progressive dementia. Symptoms can manifest years, even decades, after the last brain trauma occurs.
The Foundation noted that the younger someone is when exposed to such blows, the higher their risk for CTE may be. Beyond the long-term effects of concussions, impact sports can cause immediate changes in the brain for young people. Research has found that playing a high-impact sport before age 12 can put young people at a higher risk for emotional and behavioral health issues later in life.
In fact, playing in just one season of tackle football, without getting a concussion, can change the brain’s white matter at this age.
Symptoms of a concussion may include memory issues, confusion, impaired judgement and progressive dementia. Behavioral symptoms, which usually manifest before cognitive symptoms, can include depression, irritability and anxiety.
“The long term effects of multiple concussions are still unknown,” Katherine Snedaker, LCSW, who founded PINK Concussions, told Teen Vogue. “There are two factors. There are the actual concussions. There’s also sub-concussive hits. When you’re talking about a football player, there’s a lot of talk about CTE. That’s based on sub-concussive hits. In my situation, I’ve had 25 concussions but I haven’t had multiple hits over years.”
It may be surprising to hear, but there are cases of CTE in athletes that have never been diagnosed with a concussion. Instead, sub-concussive hits are a driving factor of CTE. These hits are just below the concussion threshold, which means the brain is shaken, but not so violently that the damage to brain cells is severe enough to see concussion symptoms.
Snedaker has worked with young women who are fiercely dedicated to playing sports and are mentally engaged in the game. She’s seen firsthand what occurs when a young woman cannot participate in her sport due to a head injury.
“When they get a concussion and pulled from that group, when they can no longer participate in that sport, it’s incredibly exhausting,” she said. “They become socially isolated very fast.”
Aside from the trauma of a brain injury, the loss of the social aspect of sports, especially for young women, may lead to mental health issues as they are isolated from their friend group and the sport they love.
Another facet of brain trauma in women is their menstrual cycle. Research has found that women who are injured in the first two weeks of their menstrual cycle tend to have a longer recovery. General pediatricians may not be trained to ask young women about their periods in relation to a brain injury, which may affect the prescribed treatment plan. If you’ve recently suffered a brain trauma and think your menstrual cycle may be affecting your recovery, speak with your clinician.
Jessie Garcia, founder and CEO of Tozuda, shared how mental health symptoms are often not part of the concussion conversation. After sustaining 5 concussions, Garcia knows what it’s like to experience the symptoms firsthand.
“I think a huge aspect that people haven't talked about [is] the mental health part of it, but I was just really depressed,” she said. “I had negative thoughts afterward. My mood changed a lot. At the time, I didn’t realize how much it was connected to the injury until I started educating myself on it.”
Young women may be passionate and dedicated to their sport, but we are starting to see a shift in how professional athletes are addressing their mental health in relation to competition.
Most recently, Gracie Gold, a U.S. Olympic figure skater, withdrew from the 2018 U.S. Championships while she was receiving treatment for depression, anxiety and an eating disorder. She made a public statement about how she was prioritizing her mental health, despite her desire to compete.
Michael Phelps has also been vocal about taking time from swimming in order to receive proper treatment for his depression.
By being honest about their mental illness and sharing their story with the public, these athletes are setting the stage for aspiring athletes, especially those who play a contact sport.
Read more about the impact concussions have on young adults here.