By David Robson
Women athletes are twice as likely as men to get concussed – and the effects are more severe. But with research focusing mainly on men, what can we do to make sure women with concussion aren’t left behind?
Few sports are as fast and furious as roller derby. The hour-long game unfolds in frenetic two-minute bursts as two teams race anti-clockwise around an oval track.
Each team has a “jammer” aiming to pass four opposing “blockers”, and they score points for each opponent they lap.
Blockers can obstruct the path with their torso or push opponents off course with a swift nudge of their upper legs or upper arms. Jammers “juke” – a sideways dummy move – and “whip” – where a team member grabs their hand and swing them forwards ahead of the pack.
Fans are addicted to the ferocious drama of the competition, but, as you would expect for any contact sport, injuries are commonplace.
Jessica had just moved to the USA from France when she attended her first roller derby match. “From that first game I really fell in love with it,” she says. She started competing, eventually leading Team France in the 2011 World Cup, and she even met her wife through the game.
In the summer of 2016, Jessica was playing blocker for a team in the Bay Area, California. She was in front of the opposition’s jammer, and just as she turned to check her position, an opposing blocker collided with her at high speed.
As the blocker’s shoulder hit the right side of her chin, Jessica felt an extraordinary pain on the opposite side of her skull and fell to the floor. The sudden jerking movement of her head, she now knows, caused her brain to ricochet within the skull – leading to the sharp pain and severe concussion. She didn’t seek immediate medical care. When she had suffered concussion previously, her doctor’s advice was to take it easy for a few weeks before returning to play. And it had seemed to work fine.
This time, however, she had continued headaches and sense of mental constriction – a feeling of pressure, like a “vice” on the brain, she says – no matter how much she rested. Concentration for any length of time was often extremely difficult, and she was sensitive to the bright light of computer and phone screens, meaning that she had to wear sunglasses at work.
She also experienced inexplicable dips in her mood; at work, she would sometimes have to go and cry in her car. “There was nothing that would have prompted it,” she says. “And I was not somebody who cried very easily, so it was exceedingly alarming for me to suddenly have these bursts of tears happen from nowhere.”
It is now three years since her injury, but Jessica still hasn’t recovered fully from these symptoms. “I haven’t given up hope, but at this point, it’s not like there’s a clear path to being better, or a clear timeline of when that would be.”
Could Jessica have been at a higher risk of concussion simply because of her sex? Compelling new research suggests this is a distinct possibility, with a growing recognition that male and female brains may respond to injuries very differently.
This follows a wider growing concern about concussion, triggered, in part, by high-profile injuries in sports like soccer, American football, rugby and boxing.
Concussion is changed neurological function as the result of a bump, blow or jolt to the head. The violent movement of the head causes a momentary release of various neurotransmitters that throws the brain’s signalling out of balance. It can also cause the neural tissue to swell and reduce the flow of blood to the brain – and along with it, the glucose and oxygen – starving our nerve cells of their fuel.
Immediate symptoms include seeing stars, feeling dizzy and confused, or losing consciousness entirely. Many people also suffer from post-concussion syndrome long after the event, with a constellation of lingering symptoms, including nausea, headaches, dizziness and mental confusion. These can last for weeks, months or even years. Some studies suggest that a concussion may also be accompanied by an increased risk of suicidal thinking, and there are concerns that repeated injuries could lead to long-term damage and brain degeneration…