Editor’s note: This article originally appeared in the Denver Post on Jan. 9, 2001.
During an October practice, Stanford sophomore guard Jamie Carey tangled her feet, slid across the lane and hit her head on a teammate’s shin. The contact was nothing out of the ordinary, but it was enough to cause a concussion.
Things suddenly took a turn for the worse. She became dizzy, and she felt headaches. Then, she had trouble remembering simple details.
Soon, one of Colorado’s most celebrated high school girls basketball players was sent to see a trio of doctors, including Stanford neurosurgeon Gary Steinberg, who had examined and advised former San Francisco 49ers quarterback Steve Young for similar problems.
Concussions too numerous to count since the seventh grade finally caught up to Carey, and the full ramifications of her injuries finally were realized. A battery of tests revealed that for Carey to lead a normal life without the possibility of brain damage, last season’s Pacific-10 Conference women’s basketball freshman of the year never could play competitive basketball again.
“I was trying as hard as I could not to cry,” Carey, a former Horizon High School star, said of the moment she was told at age 19 to quit a game she had grown up playing. “There was not a lot I could say, when some of the best doctors in the country were telling me I can’t play.”
Carey was devastated, but her departure from the nationally ranked Cardinal was no fluke. Hers is not a singular case of bad luck with concussions.
Studies indicate the affects of traumatic brain injuries are more serious when suffered by women. And concussions make up a greater percentage of injuries suffered by women athletes when compared with certain contact sports, including basketball and soccer.
An increase in weight room training and the evolution of a more physical women’s game have resulted in a marked increase in concussions in women’s athletics.
“The game is definitely more physical,” said Dr. Elaine Lambert, the Stanford women’s basketball and volleyball team doctor who worked with Carey. “If you’ve watched basketball over the past 10 years, it’s become a very physical game. There’s a big difference in the size of the players.”
A person who suffers even a single concussion is four to six times more likely to suffer a second concussion. So it stands to reason that with the number of concussions Carey has had, even incidental contact, like in October, could bring another one. And concussions can be life-threatening. According to the Centers for Disease Control, there are an estimated 900 sports-related traumatic brain-injury deaths every year.
“After working with Jamie, I found out that a number of collegiate athletes have retired because of concussions,” Lambert said. “It’s a bigger problem than I thought.”
And gender differences in the incidence of concussions suffered by men and women are clear. According to a study led by Dr. Jess F. Kraus at the UCLA Brain Injury Research Center, fatality rates and severe disability were significantly higher for women. These findings were echoed in a report from the Department of Neurosurgery at the University of Virginia, where the outcome of traumatic brain injury was found to be worse in women.
According to the NCAA, 11 percent of all college women’s soccer injuries in 1999 were concussions, compared with 7 percent of all men’s injuries. Also, an American Academy of Neurology study said 15 concussions occur in women’s college basketball for every 100,000 games or practices, three more than with men.
“The head is a very serious thing,” said Carey, who still is experiencing post-concussion problems with memory, dizziness and headaches. “When there’s memory loss and the symptoms that I’m having that affect everyday life, one more concussion and it’s going to be a lot worse. You can only take so many hits. After that it starts affecting the brain, and that’s where I’m at. It’s affecting my brain.”
Symptoms of a concussion range from dizziness, headaches and nausea to blurred vision, short-term memory problems and seizures. But while there is no consensus for categorizing the severity of concussion, the old adage that an athlete can “shake out the cobwebs” to recover from a head injury no longer applies.
“It’s a very gray area,” Carey said. “The brain is just so complex. You never know exactly what will happen until you get that hit again, but that hit can leave you where you can’t function in everyday life. One of my big concerns was the fact that my last concussion I wasn’t hit that hard, but I’m still feeling symptoms to this day.”
Yet her retirement surprised many, especially Stanford coach Tara VanDerveer.
“I think we’re all really in shock,” VanDerveer said at a news conference announcing Carey’s retirement. “But I’ve never heard of a basketball player – male, female, college, high school or pro – not being able to play because of it. Maybe it just had never happened before. I know that maybe it could, obviously, and it did. But it wasn’t something that was real until this week for me.”
However, no one can question Carey’s decision to leave the game.
“She definitely made the right decision,” said Steinberg, the chairman of the neurosurgery department at Stanford. “I suspect she’ll make a complete recovery, but it was pretty clear that she needs to let her brain recover and remove any chance for future brain damage.”
Carey is not alone. Mandy White, the leading scorer for James Madison University in the 1999-2000 season, ended her basketball career during her senior season after suffering several concussions and enduring post-concussion syndrome.
Still, many athletes who have suffered concussions choose to continue playing. In the Pac-10 last year, at least three women’s basketball players kept playing after having head injuries: Oregon’s Lindsey Dion, California’s Courtney Johnson and UCLA’s Michelle Greco, who had four concussions in her senior season alone, but still finished the year.
Concussions occur more frequently in soccer than basketball. According to the AAN study, concussions happen nearly as frequently in soccer as in football.
Wyoming senior Anne Maddock finished her soccer career despite suffering post-concussion symptoms that would cause her arms and legs to go numb occasionally.
“I was definitely worried,” Maddock, 21, said of her injuries. “I didn’t understand the extent of what was going on. (Doctors) didn’t know what was going on. They had never seen a case like this.”
Like Carey, Maddock still faces problems with post-concussion syndrome, including headaches, numbness and dizziness.
“There’s quite a lot of variation and no hard and fast rule. That’s what makes it so hard,” Lambert said of categorizing the severity of concussions.
“More and more people are trying to adopt a standard, and everybody’s looking for guidelines because we all want to protect the athletes.”
Teams looking to protect athletes from prolonged head injuries might need to look to professional sports for the answer. The NFL and NHL have adopted policies to pre-screen athletes for head injuries, so that doctors can more easily identify concussions and better help athletes to recover.
“We may try to adopt the same policy,” Lambert said. “We have discussed it and we may try to incorporate this.”
According to Dr. Thomas Hardey, a neuropsychologist and consultant to the NFL Concussion Committee and the 49ers and Oakland Raiders, the pre-screening policy of the NFL and NHL has been successful.
“It’s very clear that the screening program is really helpful,” Hardey said.
The policy, in effect since 1994, requires that each player be tested as part of his physical. Then if a concussion is suspected, tests are repeated and if there is a problem, the player is sent to talk to a physician and trainers, according to Hardey.
But in the end, it is the nature of competitors to play through pain, and the reality of having to seek help or even walk away can be difficult to accept.
“I never thought it would get to this point, but it did,” Carey said. “If I had it to do over again, I wouldn’t do it any differently. That’s how I play. I play hard. I’ve always said, if I can’t play hard, then I need to hang up the shoes. If I had to go out there right now, I would take a charge. I wouldn’t have changed the way I played.”
Nick Groke can be reached at 303-954-1015 or ngroke@denverpost.com
