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Story Retrieval Date: 11/23/2014 3:04:47 PM CST

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High school headaches: Girls' concussions outnumber boys' in most sports

by Hallie D. Martin
Jan 24, 2008


Hallie D. Martin/Medill

Jill Lundeen, No. 32, suffered a concussion two years ago when she was knocked over during a basketball game. She said she had migraines for almost three months after the injury.

Related Links

CDC site on youth sports

Treatment and prevention of concussion

Concussion prevention starts with education. If athletes and coaches know the signs and symptoms of a concussion, they can prevent a more serious injury.

But physical conditioning and training also help prevent concussions. In women's sports that traditionally don’t use helmets, it’s beneficial to teach athletes body control, balance and how to sustain a fall, said Layeh Litin, assistant athletic director at Gordon Tech. 

“Majority of concussions heal without problems, but there are risks for permanent cognitive deficits,” said Dr. Cynthia LeBella, a sports medicine pediatrician.

The best way to treat a concussion is rest. Litin has a chart she has the athletes fill out every day after they get a concussion. It lists the symptoms, and they have to circle how they are feeling on a scale from zero (no symptoms) to six. She does not let them play until each symptom has a zero next to it.

The Centers for Disease Control and Prevention has resources and fact sheets for parents, coaches and athletes on concussions in youth sports at

Signs and symptoms of concussion

  • Athlete appears dazed, stunned or confused about assignment or position
  • Forgets sports plays and is unsure of game, score or opponents
  • Moves clumsily
  • Answers question slowly
  • May lose consciousness (even briefly)
  • Can’t recall events prior or following hit or fall
  • Athlete reports headache or “pressure” in head
  • Is nauseas or vomits
  • Has trouble balancing and concentrating
  • Feels confused, dizzy, sluggish, hazy or groggy
  • Sensitivity to light or noise
  • Does not “feel right”

Source: Centers for Disease Control and Prevention

Jill Lundeen’s coach said he’s never seen anyone bounce on the court the way she did when she got a concussion during a basketball game two years ago.

The Gordon Tech High School junior was playing against St. Francis in 2006. Late in the last period she moved to intercept a pass, and was then suddenly on the floor holding her head.

Lundeen doesn’t remember the incident because she blacked out, but her coach told her what happened: A girl, who was much bigger than her, tackled her from the side. Lundeen flew a few feet and smacked the back of her head on the court.

She was back at practice three days later, thinking she was fine because all the concussion symptoms went away. But the migraines, a throbbing pain starting at the back of her head and moving to her forehead, persisted for nearly three months.

Female high school athletes are more prone to concussions than boys in all sports in which both participate, the Journal of Athletic Training reports. Boys suffer the largest number of concussions overall because they play football. But when football is excluded, girls suffer more concussions, especially in soccer and basketball.

Last December’s issue says 29,167 female high school soccer players suffered from a concussion in the 2005-2006 school year, while 20,929 male soccer players did. The difference is more dramatic in basketball: 12,923 girls suffered from a concussion while only 3,823 boys did. Girls also reported more concussions in softball than boys did in baseball.

Soccer players got concussions from collisions, falls and head-to-elbow or - knee contact. Heading the ball does not cause a concussion, said Dr. Cynthia LeBella, a sports medicine pediatrician and medical director at the Institute of Sports Medicine at Children’s Memorial Hospital in Chicago.  

Basketball players got concussions from collisions and charging, a defensive maneuver.   

Though more female athletes are getting concussions, Dr. LeBella said she does not recommend wearing helmets in sports like soccer and basketball.

“Some people are advocating head gear, but it there is no evidence to show it would reduce the risk of concussions,” she said.

Under the National Federation of State High School Association, head gear is permitted but not required in soccer, said Bob Colgate, the assistant director of association.  There is no talk of mandating helmets or mouth guards, which act as a shock absorber and reduce the risk of getting a concussion, in basketball. 

Each state decides its own mandates on sports safety gear, and Illinois does not have a position on requiring headgear, said Joe Terrasi, the girl’s varsity basketball coach at Gordon Tech. 

 Lundeen said she would never wear a helmet while playing basketball, and coaches agree that it is not necessary.

Layeh Litin, the athletic trainer and assistant athletic director at Gordon Tech, likes the idea of basketball players wearing mouth guards, but says helmets in soccer would change the trajectory of the ball when players head the ball.

Research on girls and concussions is new, and that’s why they are seeing a rise in numbers, Dr. LeBella said, adding research previously focused on men’s football.

“Concussions were previously undocumented and underreported,” the high school federation’s Colgate said.

Cultural and biological factors can also contribute to the increase in girls’ concussions. The Journal of Athletic Medicine suggests fewer boys may report concussions. They also said girls are treated differently after an injury and tend to sit out, while boys are encouraged to “suck it up” and get back in the game.

 “Girls tend to have more symptoms and are more significantly emotionally affected after an injury,” LeBella said.

Girls also fall and recover from a jump differently than boys, and their balance isn’t as developed, which increases the risk of a concussion, LeBella said.

“Girls fly around the court and fall awkwardly,” Gordon Tech’s Litin said, adding boys also start sports much younger than girls do, so those balance skills are more developed by high school.

More girls involved in sports also contributes to more injuries. In Illinois, there are roughly 17,500 girls playing high school basketball and 15,500 female soccer players. 

Donnie Kirksey, the athletic director at Hyde Park Career Academy High School in Chicago, points to the increasingly competitive and aggressive nature of high school sports.

“Women’s basketball is getting more physical, competitive and equal,” he said, referring to the WNBA. “They want to stand out or get a scholarship [to college] so they can pay less.”

The first female basketball games were “ladylike,” passing games, Litin said, but now the athletes are skilled and more aggressive.

“This is a contact sport,” Lundeen said.

Gordon Tech coach Terrasi knows head injuries are serious, he’s seen three of his players get a concussion in the last three years, and feels the sports community doesn’t worry enough about head injuries.

“Head injuries are frightening when they happen, but [the athletes] don’t understand the dangers,” he said. “They can’t see it, it’s not as graphic and symptoms appear to go away, but they are still very serious.”