Lou Portero

Urban Health Today

A <a href="https://meridian.allenpress.com/jat/article/60/3/238/503814/Attention-Deficit-Hyperactivity-Disorder-as-a">study</a> of nearly 1,000 high school athletes has revealed significant gender disparities in concussion recovery, with female athletes consistently taking longer to return to both academic activities and sports participation compared to their male counterparts.The research, which analyzed 935 concussion cases from 60 high schools over eight years, found clear evidence that female sex was a significant predictor of prolonged recovery duration. Female participants took 1.13 times longer to return to learning than male participants, with female athletes completing the return-to-learning process in 12.28 &plusmn; 9.12 days compared to 11.04 &plusmn; 8.24 days for male athletes.For return to sports, the gender gap was similarly pronounced. Female athletes required 18.91 &plusmn; 12.58 days to complete the return-to-sport process, while male athletes took 17.81 &plusmn; 11.21 days. This result is consistent with the literature on clinical recovery from concussion, in which the mean return-to-sport duration for 13- to 18-year-old males was 15.7 days and for 13- to 18-year-old females was 18.3 days.The study also examined how attention-deficit/hyperactivity disorder (ADHD) affects concussion recovery, revealing an additional layer of complexity for affected individuals. Athletes with ADHD are predicted to take 1.16 times longer to complete the return-to-learning process and 1.17 times longer to complete the return-to-sport process than their non-ADHD counterparts.Of particular concern is the intersection of gender and ADHD. The research found a striking gender imbalance among athletes with ADHD: of the 78 athletes with ADHD in the study, only 13 (16.7%) were female, and 65 (83.3%) were male, creating a female-to-male ratio of 1:4. This disparity may reflect ongoing challenges in ADHD diagnosis among girls and young women, as females with ADHD are often underdiagnosed in childhood due to their difference in symptom presentation and social norms preventing them from exhibiting typical ADHD behavior.Age also plays a crucial role in recovery, with younger athletes facing greater challenges. The analysis indicated that the risk for longer return-to-sport became higher as age decreased. This trend was observed specifically for return-to-sport outcomes and not with return-to-learning, suggesting different mechanisms may affect academic versus athletic recovery.These recovery differences have tangible consequences for young athletes. The researchers provided practical examples: the predicted return-to-sport days for a non-ADHD 18-year-old male athlete is 17.29 days, whereas that for a 15-year-old female athlete with ADHD is 23.10 days. This difference could mean missing additional competitions. If an injury occurred during a weekend competition, an athlete with a typical 20-day return-to-sport timeline could return during the third week of recovery, missing 2 weekend games. However, if the athlete takes 23 days to return to sport, they would miss 3 weekend games, as day 23 falls in the fourth week of recovery.Additionally, research supports that female athletes use more academic accommodations, such as modified attendance, rest breaks, and limited screen time, than their male counterparts during their recovery period.Healthcare providers need to adjust their expectations and counseling based on these findings. The research emphasizes that ADHD status, female sex, and younger age are potential risk factors for prolonged recovery from sport-related concussion. Clinicians should be aware of the possible longer recovery for athletes with ADHD, particularly younger female athletes, to provide anticipatory guidance and to address questions regarding the return-to-sport recovery timeline following concussion.This research analyzed data from a standardized concussion management protocol used across 60 high schools. All participants completed baseline computerized neuropsychological testing, and recovery was monitored through a systematic 7-step return-to-play protocol. One of the strengths of this study is that all included data represents complete recovery data from baseline to return-to-learning to return-to-sport, monitored by school athletic trainers under a standardized protocol.The findings highlight the need for personalized concussion management that considers gender, age, and pre-existing conditions like ADHD. Return-to-learning and return-to-sport duration can have a significant impact on an athlete and their family as well as their coach and team, making accurate recovery predictions crucial for proper planning and support. The research underscores the importance of recognizing that concussion recovery is not a one-size-fits-all process and that young female athletes, particularly those with ADHD, may need additional time and support to fully recover from these brain injuries.&nbsp;
<div class="post-references"><h3>References</h3>Source: Tanaka S, Sato M, Onuki E, et al. Attention-Deficit/Hyperactivity Disorder as a Predictor of Prolonged Functional Recovery From Sports-Related Concussion in High School Athletes. Journal of Athletic Training. 2025;60(3):238-247.
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ADHD status, female sex, and younger age are potential risk factors for prolonged recovery from sport-related concussion