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Not Just for Boys: Concussion in Women’s Hockey” by Dr. Moser in USA Junior Hockey Magazine

Not Just for Boys: Neuropsychologist discusses concussions in women’s hockey

By Rosemarie Scolaro Moser, PhD

Paige Decker: “The sports climate is beginning to change as a result of concussions ... soon hockey will be safer and we will have a better understanding of concussions.”

Last year, the topic of concussions went “Hollywood” with the opening of the lm “Concussion,” starring Will Smith as the neuropathologist, Dr. Bennett Omalu, who exposed the long term effects of thousands and thousands of repeated blows to the head over many years in some National Football League (NFL) players.

The message is important and, although it should spur all of us to take a long, hard look at improving safety in all sports, we should also realize that having a concussion does not equal a sentence of neurodegenerative brain disease.

In fact, experts say 90 percent of concussions completely resolve in a matter of days or weeks.

Still, concussions are a very serious matter, and if managed immediately and properly, full recovery is typical. However, for some athletes, when concussions are not identified or treated appropriately, and/or become repetitive events, a post-concussion syndrome of continuing symptoms like headaches, dizziness, balance problems, visual problems, slowed mental processing, and memory problems can persist and interfere with activities of daily living, as well as end an athletic career.

As we know, concussions happen not just to male football players. The NHL has seen its share of athletes whose careers were jeopardized by the aftermath of concussions: Eric Lindros, Pat LaFontaine, Paul Kariya, Steve Moore, Derek Boogard and Keith Primeau, to name a few.

For the most part, the focus has been on concussions in male athletes. Until now.

Since the first International Ice Hockey Federation (IIHF) Women’s World Ice Hockey Championship was held not so long ago in 1990, women’s hockey has become one of the fastest growing sports, with Canada and the United States dominating the field in athletic participation and competition.

Increased sports participation means increased athletic injuries. Even though women’s hockey prohibits body-checking, a 2014 study by Dr. Kristin Abbott in Current Sports Medicine Reports revealed that females sustain alarmingly more concussions than males.

The female concussion rates across six different research studies ranged from .82 to 14.93 per 1000 athletic exposures, compared to .41 to 7.5 for males.

Although there was wide variability depending on the study, for the most part, women displayed higher rates of concussion. It may be that females sustain about twice as many concussions as males do in ice hockey.

There have been many hypotheses or guesses as to why women sustain more concussions than men do in general. Some have suggested it is a matter of neck strength, or of female hormones, or of sex differences in brain anatomy, or that women just report more concussions than men do.

If anyone knows women hockey players, they are just as fierce and as dedicated to the game as their male peers, so drop the last hypothesis.
Paige Decker, who played on the Yale University women’s hockey team, was recently interviewed by Katherine Prince Snedaker, founder and Executive Director of PINKconcussions.

“Absolutely. I played hockey with what ended up being a career-ending concussion for two straight days before reporting it to my trainer,” said Decker. “I know of plenty of teammates who have done the same, which is a big problem and something that needs to change.”

Josephine Pucci, also interviewed for PINKconcussions, was a U.S. Women’s National Hockey team Olympian in Sochi 2014 who battled concussions in high school and while on the Harvard Crimson’s team.

“I cannot remember being successfully educated on concussions. Unfortunately, most of what I learned is from having concussions myself, speaking with doctors and doing research. I wish I knew then what I know now!”

Snedaker remarked that in a 2014 survey she helped conduct, 70 percent of female athletes reported hiding their concussions primarily because of lack of awareness or lack of resources (such as an athletic trainer), whereas 79 percent of the males primarily hid concussions due to “allegiance to their team [and] lack of perceived severity.”

A more detailed look at the responses revealed that 64 percent of women reported “lack of awareness” about concussion whereas 36 percent of men reported “lack of awareness.”

Similarly, 63 percent of women reported “lack of resources” compared to 37 percent of men.

Why such differences? It may be that men’s sports continue to harness the bigger budgets, personnel, and attention that are needed to support effective concussion safety programs.

Unfortunately, there still continues to be a lack of education and knowledge about concussions in general, and many parents, coaches, and athletes, when in doubt, would rather take risks than skate off the ice and sit it out.

Decker emphasizes: “No one, whether directly or indirectly, should ever pressure a player with a possible concussion to play.”

To that end, Decker recently started a blog,, about her own concussion journey.

Decker also shared her praise of ice hockey and described how it “taught me the true meaning of hard work, resilience, determination and teamwork. Hockey is a special sport and will always have a very special place in my heart.”

“I gained life-long lessons and life-long friendships,” Pucci added. “Through hockey, I have experienced some of the best moments of my life.”

Dr. Rosemarie Scolaro Moser is the author of “Ahead of the Game: The Parents’ Guide to Youth Sports Concussion,” director of the Sports Concussion Center of New Jersey, and a board-certified neuropsychologist.

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