Teenage girls playing football face twice concussion risk of boys, study shows

Female players less likely to be removed from play and take longer to recover than male counterparts

Action from the Girl’s Cup between Broadstone Middle School and Thomas Telford School at Wembley Stadium (PA)

Teenage girls who play football are nearly twice as likely to suffer concussion compared to teenage boys playing the same sport, a study has found.

Professor Willie Stewart, of the University of Glasgow, reviewed three years of injury data for a population of around 40,000 female high-school footballers in the Michigan High School Athletic Association.

Along with researchers at the University of Pennsylvania and Michigan State University, Prof Steward compared data for a similar number of male footballers. He found that the risk of sports-related concussion among female footballers was 1.88 times higher than that of their boy counterparts.

The study also suggests teenage girls are less likely to be removed from play and take on average two days longer to recover and return to play than boys.

For male footballers, the most common cause of injury was colliding with another player. They were 1.5 times more likely to be removed from play on the day of the injury, the study found.

In contrast, female players were most often injured from contact with equipment such as the ball or a goalpost, said the study which was published in JAMA Network Open.

Prof Stewart - who conducted the Field (Football’s Influence on Lifelong Health and Dementia Risk) study - said the outcomes raised the question of whether sports should consider sex-specific approaches to both participation and concussion management.

He said: “Given we know the importance of immediate removal from play for any athlete with suspected concussion, it is notable that ‘if in doubt, sit them out’ appears more likely to happen for boys than girls.

”This, together with the finding that mechanism of injury appears different between boys and girls, suggests that there might be value in sex-specific approaches to concussion education and management in this age group.”

The study comes as Gordon Taylor, chief executive of the Professional Footballers’ Association, denied being “asleep at the wheel” over the link between heading footballs, concussion and dementia.

Appearing in front of the digital, culture, media and sport (DCMS) committee, Mr Taylor also dismissed comments from former Blackburn and Celtic striker Chris Sutton that he had “blood on his hands” for turning his back on the issue.

In March this year, Prof Steward told a DCMS session on head injuries in sport that the new head injury substitute rules, which were introduced this year, are a “shambles”.

He told the hearing: “Football has a habit of, when it is forced to develop, it develops something unique to other sports. What football has introduced is a shambles in 2021.”

His work has been funded by the Football Association and the Professional Footballers’ Association, NHS Research Scotland, the Penn Injury Science Center and a Brain Injury Training Grant.

Dr Abigail Bretzin, another lead author of the study as well as postdoctoral fellow and certified athletic trainer at the University of Pennsylvania, said this was the first detailed study on “sex-associated differences in concussion management and outcomes in teenage footballers”.

She added: “Our findings add to research showing that female athletes are at increased concussion risk compared to male athletes, and highlight the importance of sex-specific research in this field.”