Understanding Concussion and Mild Traumatic Brain Injury in Female Athletes and Military Cadets

November 27, 2023


By Dayne Hopkins

Concussion/mild traumatic brain injury (mTBI) is a prevalent concern, especially in specific populations such as collegiate female athletes and military service academy cadets. Despite the recognition of concussions in these groups, the female-specific aspects and recovery outcomes have been underrepresented. “Concussion research has historically been male-biased and consequentially resulted in clinical practice guidelines being male-biased as well,” said Dr. Landon Lempke, a postdoctoral research fellow at the University of Michigan Concussion Center and Human Performance & Sports Science Center. “Our collective findings provide insights into the normative injury characteristics, assessment outcome performance, and recovery trajectories for female collegiate student-athletes and cadets. We hope that the findings help provide more equitable healthcare moving forward”.

Two studies published in September 2023 by Dr. Lempke et al. in the Annals of Biomedical Engineering aim to bridge this gap by exploring the initial characteristics, assessment performance, and return-to-activity outcomes in female collegiate athletes and military cadets who experienced concussion or mTBI.

The first study, Female Collegiate Athletes’ Concussion Characteristics and Recovery Patterns: A Report from the NCAA‑DoD CARE Consortium focused on 1,393 female collegiate athletes from 30 institutions and aimed to better understand their injury characteristics and recovery trajectory. Key findings included the following:

  • Median days to return to learn: 6
  • Median days to initiate return to play (iRTP): 8.1
  • Median days to unrestricted return to play (uRTP): 14.8

These findings offer estimates of the recovery trajectories for female collegiate athletes after concussion. The second study, Initial Mild Traumatic Brain Injury Characteristics and Recovery Patterns Among Females Across the United States Military Service Academies: A Report from the NCAA‑DoD CARE Consortium looked at 472 female cadets from four US military service academies who experienced mTBI. Key findings in this study included:

  • Median days to return to learn: 7
  • Median days to initiative return to duty (iRTD): 14.7
  • Median days to unrestricted return to duty (uRTD): 26

Female athletes and cadets experienced potentially different recovery patterns for initiating and reaching unrestricted return to activity status. Though these female athlete and cadet groups were not formally compared to each other, and differences could be attributed to numerous aspects; this work highlights the importance of describing typical outcomes specific to a group.

Dr. Lempke

The findings are consistent with existing literature, showing similar return-to-activity times. Both studies provide insights into the concussion experiences of female athletes and military cadets. These results bring to light the importance of an individualized approach to concussion management, providing guidance for healthcare providers in formulating policies and strategies for concussion prevention and assessment.