Concussions Are an Even Bigger Problem in Women's Hockey
Female ice hockey players suffer more concussions than their male counterparts
Puck drop is now! Jill got a backstage pass to the Cleveland stop of the 2025 Rivalry Series between the women’s ice hockey teams from the US and Canada. She got to chat with goalkeeper Ava McNaughton and defensive player Rory Guilday. Then at the Team USA Media Summit, we sat down with para ice hockey players Jack Wallace, Declan Farmer, and Malik Jones. What can we expect from the hockey tournaments at the Milano-Cortina 2026 Olympics and Paralympics? We have the scoop on this week’s podcast!
When we spoke to Dr. Cathy O’Connor, team doctor for the U.S. women’s ice hockey team at the Torino 2006 Olympics, in 2019, we asked her about concussions among girls in the sport. Dr. O’Connor mentioned that she did not have a problem with compliance with concussion protocols at the youth or collegiate level because parents recognized that girls did not have a professional future in hockey and they needed to protect their brains. (That discussion starts at around minute 18).
A lot has changed for women in professional hockey since the early 2000s; opportunities have grown exponentially. Another thing that has grown too fast? Concussions among women and girls in ice hockey. Concussion risk has become a hot topic among medical professionals working with athletes in all sports but women and girls face unique challenges in protecting their brains while playing sports.
Research shows that despite experiencing fewer impacts, female athletes across all sports are significantly more likely to sustain concussions than their male counterparts in the same sport. In ice hockey, the concussion risk for girls may be as much as 81% higher than for boys. Girls and women also report much higher incidence of post-concussion syndrome, where symptoms persist months after the injury.
Why and what can be done to better protect women and girls playing ice hockey?
What is a Concussion?
A concussion is a type of traumatic brain injury caused by impact to the head. The head can be in motion and hit a stable object (like the ice or the boards in hockey) or the head can be stable and be hit by a moving object (like the puck or another player). A person does not need to lose consciousness to suffer a concussion. Symptoms may appear immediately or 1-2 days after the incident. Along with headache, blurry vision, and confusion, symptoms can include nausea, vomiting, fatigue, slurred speech, and sensitivity to light and sound.
Post-concussion syndrome occurs when symptoms persist for months after the initial injury. Those with post-concussion syndrome can experience depression, changes in personality, forgetfulness, changes in taste and smell, and short-term memory loss, in addition to persistent headaches and other physical symptoms.
Reporting or Reality
Researchers have not come up with conclusive reasons why women are at greater risk but there are plenty of hypotheses. As Dr. O’Connor noted, girls are more likely to report symptoms while coaches and parents are more likely to sit girls if there is any question of concussion. In addition, more girls participate in base-line testing making it easier for trainers and doctors to recognize even mild concussion symptoms.
Physical Differences May Play a Part
Researchers do not believe that the difference is only a question of recognition or reporting. In general, women have thinner skulls and less developed neck muscles than men leading to greater injury from impacts to the head. The difference is less pronounced at the youth level but emerges once boys and girls reach puberty. Hormones, menstrual cycles, and brain structure may also play a role in the difference between how men’s and women’s brains respond to injury.
At the youth, collegiate, and Olympic levels, women are not permitted to body check so most head injuries stem from contact with the ice, an incredibly unforgiving surface. This type of collision can lead to a coup-contrecoup, a particularly devastating type of injury where the brain ricochets within the skull causing multiple points of impact.
Size Matters
Defense players on the women’s side tend to experience more concussions than offensive players, and more than defensive players on the men’s side. While the style of play between girls and boys at the youth, collegiate, and international elite level has become more similar, the size of the players is different. On the men’s side, defensive players are generally larger and taller than offensive players, protecting them from the greater impact they encounter. That is not true among women, where players on both sides of the puck are, on average, about the same height and weight.
What does this mean? A larger defenseman may take a hit on his very muscular shoulder or chest while the equivalent woman gets hit in the head.
So What Do We Do?
Proper equipment, like helmets and mouth guards, is key to protecting players. The first step is recognizing that women and girls are not smaller men. Equipment must be designed specifically for girls and fitted properly to their bodies. Helmets are being studied on both male and female players which is an excellent starting point. Researchers have found that boys and girls have different head shapes so size is not the only consideration when choosing a helmet for female players.
In 2024, hockey equipment manufacturer CCM debuted a complete line of equipment, including helmets and face guards, designed specifically for women. More manufacturers need to follow suit.
We must continue to educate coaches, trainers, parents, and athletes about the effects of head injuries. Studies have also revealed that boys and girls may display different concussion symptoms. Boys are much more likely to lose consciousness from an impact to the head than girls. Girls report more emotional changes and sensitivity to light and noise. Boys display more amnesia and confusion. We need to recognize all these as signs of a significant brain injury.
For fans, it is crucial to recognize that “playing through the pain” is not the standard when it comes to concussions. Permanent brain injury should not be the price players pay so we can enjoy the game.
Author’s note: I have used the term “girls” or “boys” when referring to individuals of college age or younger. I use the terms “women” or “men” when referring to adults. “Female” and “male” can refer to any age.
