Gender differences in injury rates

Girls suffer sports concussions at a higher rate than boys. Why is that overlooked?
In a study of collegiate athletes, the highest rate of concussions was reported not by male football players, but by female ice hockey players.
By Marjorie A. Snyder
Marjorie A. Snyder is senior director of research for the Women's Sports Foundation.
Washington Post, 2015-02-10

The flood of media attention highlighting damaged brains, dementia and suicides in retired NFL players has made concussions synonymous with football. That attention was greatly needed; the debilitating consequences of brain injuries in football players of all ages has been severely overlooked. But the focus of this controversy has been far too narrow. It’s true that young players need better equipment and stricter safety standards on the gridiron. But in many of the most popular sports, boys aren’t the ones most likely to be afflicted by concussions. Girls are.

Recent studies of high school and collegiate athletes have shown that girls and women suffer from concussions at higher rates than boys and men in similar sports — often significantly higher. For instance, in a recent analysis of college athletic injuries, female softball players experienced concussions at double the rate of male baseball players. Women also experienced higher rates of concussions than men in basketball and soccer. Across all sports in the study, the highest rate of concussions was reported not by male football players, but by female ice hockey players. In that sport, a woman experienced a concussion once every 1,100 games or practices — nearly three times the rate experienced in football. The gender disparity exists in high school sports, too. One study, analyzing concussion data for athletes in 25 high schools, found that in soccer, girls experienced concussions at twice the rate of boys.


We also need more and better science on the gender differences in concussions. There is painfully little research on why female athletes are so susceptible to athletic brain injuries and how to better protect them. For instance, helmets are mandated in boys’ lacrosse, but not in girls’. Without better science, debate rages over whether helmets would make girls less susceptible to concussions, or simply encourage them to be more aggressive on the field, making them more susceptible. And in ice hockey, it’s hard to explain why girls are suffering a higher rate of concussions than boys even though intentional body checking is prohibited in the girls’ game.

There are many possible explanations for why female athletes experience higher rates of concussions. The greatest attention has been directed to their head and neck size and musculature; researchers speculate that girls have smaller, weaker necks than boys, making their heads more susceptible to trauma. Hormones also could play a role. If a woman suffers a concussion in the premenstrual phase, when progesterone levels are high, there’s an abrupt drop in the hormone. That could cause a kind of withdrawal that either contributes to or worsens symptoms like headache, nausea, dizziness and trouble concentrating. This may be why women have more severe or longer-lasting symptoms than men, who have low pre-injury levels of progesterone. It’s also possible that, if girls feel the effects of concussions more severely, they are simply more likely to report them and doctors more easily diagnose them than in male patients. But for all of these theories, there is little consensus on how they actually play into the mechanism of brain injuries in girls and women.


We have some evidence that the brains of female athletes are more susceptible — or, at least, react differently — to injury compared to their male counterparts. We should stop assuming that concussions are a men’s issue. We shouldn’t simply accept that the best practices for boys’ and men’s sports will protect girls and women in the same way. The bodies of female athletes are different and their brains deserve just as much attention.​

[You know the Navy Secretary is a real dirtbag
when he ignores statistics such as this.
Shame on you, Ray "Dirtbag" Mabus.]

Marine experiment finds women get injured more frequently, shoot less accurately than men
By Dan Lamothe
Washington Post, 2015-09-10

Women in a new Marine Corps unit created to assess how female service members perform in combat were injured twice as often as men, less accurate with infantry weapons and not as good at removing wounded troops from the battlefield, according to the results of a long-awaited study produced by the service.

The research was carried out by the service in a nine-month long experiment at both Camp Lejeune, N.C., and Twentynine Palms, Calif. About 400 Marines, including 100 women, volunteered to join the Ground Combat Element Integrated Task Force, the unit the Marine Corps created to compare how men and women do in a combat environment.

“This is unprecedented research across the services,” said Marine Col. Anne Weinberg, the deputy director of the Marine Corps Force Innovation Office. “What we tried to get to is what is that individual’s contribution to the collective unit. We all fight as units… We’re more interested in how the Marine Corps fights as units and how that combat effectiveness is either advanced or degraded.”

The study, an executive summary of which was released Thursday, was carried out as all the services prepare to submit recommendations to Defense Secretary Ashton B. Carter this fall on whether any jobs should be kept closed to women. In a landmark decision in January 2013, then-Defense Secretary Leon Panetta rescinded a decades-old ban on women serving in combat jobs like infantry, but gave the services until this fall to research how they wanted to better integrate women and if any jobs should be kept closed.


The Marine Corps’ research will serve as fodder for those who are against fully integrating women. It found that all-male squads, teams and crews demonstrated better performance on 93 of 134 tasks evaluated (69 percent) than units with women in them. Units comprising all men also were faster than units with women while completing tactical movements in combat situations, especially in units with large “crew-served” weapons like heavy machine guns and mortars, the study found.

Infantry squads comprising men only also had better accuracy than squads with women in them, with “a notable difference between genders for every individual weapons system” used by infantry rifleman units. They include the M4 carbine, the M27 infantry automatic rifle (IAR) and the M203, a single-shot grenade launcher mounted to rifles, the study found.

The research also found that male Marines who have not received infantry training were still more accurate using firearms than women who have. And in removing wounded troops from the battlefield, there “were notable differences in execution times between all-male and gender-integrated groups,” with the exception being when a single person—”most often a male Marine” — carried someone away, the study found.

The full study is more than a thousand pages long, Marine officials said. They anticipated publishing it online in coming days.

A physiological assessment carried out by the University of Pittsburgh’s Neuromuscular Research Laboratory found that the average man in the experimental integrated unit weighed 178 pounds with 20 percent body fat, while the average woman weighed 142 pounds with 24 percent body fat.

Researchers hooked men and women alike up to a variety of monitors, and found that the top 25th percentile of women overlapped with the bottom 25th percentile of men when it came to anaerobic power, a measure of strength, Marine officials said. Those numbers were expected to a degree given the general size difference between the average man and woman.

The gender-integrated unit’s assessment also found that
40.5 percent of women participating suffered some form of musculoskeletal injury,
while 18.8 percent of men did.

Twenty-one women lost time in the unit due to injuries,
19 of whom suffered injuries to their lower extremities.
Of those,
16 women were injured while while carrying heavy loads in an organized movement,
like a march, the study found.

The kinds of injuries varied, too: The majority of women in the unit who lost time due to injuries suffered through hip problems, with foot and toe injuries also problematic. In men, the most common injuries were to the feet and toes, followed by the ankles, Weinberg said.

The research raises the question whether the Marine Corps may press to keep the infantry and Special Operations, in particular, closed to women. If they do so, they could face resistance from above: Navy Secretary Ray Mabus, who oversees both the Navy and Marine Corps, already has indicated that he sees no reason to keep the infantry closed to women.

“That’s still my call, and I’ve been very public,” Mabus said in a Sept. 1 interview with the independent Navy Times. “I do not see a reason for an exemption.”

Ellen Haring, a reserve Army colonel and vocal advocate for fully integrating the military, said the results of the Marine Corps’ research are not surprising. The service was told to assess how individual women do in combat situations, but the task force instead assessed groups with average female Marines — rather than high performers — in them.

“They’re always coming up with these averages,” Haring said. “‘The average woman can’t do what the average man does. I don’t think that’s a surprise to any of us. But they weren’t told to do this based on averages. It has to be based on individual capabilities.”

A Marine Corps veteran who has advocated for full integration, Katelyn van Dam, also took issue with the study, saying it is time to stop asking if women can “hack it” in combat units and instead focus on developing gender-neutral standards that apply to all. She is a spokesman for the Truman Project and Center’s No Exceptions initiative, which calls for opening all military jobs to women immediately.

“It has been scientifically proven that overall physical fitness — not gender — correlates to injury,” she said. “While the methodology and data from the Task Force has not been made available to us, we do know that female participants only had to meet the physical requirement of passing a third-class male physical fitness test, and that most came directly from the schoolhouse or non-combat jobs. Thus, their participation was based on old standards.”


Marine Corps gender integration research executive summary


Navy Secretary Believes Combat Positions Should Be Open To Qualified Women
David Greene interview with Navy Secretary Ray Mabus
NPR, 2015-09-11

To hear the interview, click here.

[The web page linked to by title
includes an evidently complete transcript of the interview,
which includes the following remark, evidently from a previous inteview:

RAY MABUS: A more diverse force is a stronger force.
A more diverse mindset makes you a stronger force.
If you have the same outlook, if you have the same mindset,
you don't get much innovation.

[The first phases (Army ROTC and Army IOBC)
of Army training I went through in the 1960s and 70s
largely focused on what was needed to fight as infantry,
and how to lead such a fight.
The stress was most certainly not on "innovation".
Indeed, one of the characteristic slogans we received as Army trainees was
"There's the right way, the wrong way, and the Army way."
(Another popular cadence call was:
"It's not ours to reason why, it's but ours to do or die.!)
The point was, the U.S. Army, in its evolution from its beginnings in 1775
to, at least, the 1970s (when my training ended),
had experienced a wide range of very, very difficult situations,
such as at the Ardennes in WWII, Choisin Reservoir in Korea, and Ia Drang in Vietnam,
to name a few.
Its soldiers and leaders had learned a number of lessons, the hard way,
from these experiences.
What I, and my fellow trainees in the 1960s and 1970s, were being taught
was the distillation of those experiences.
Some things from the civilian world were still applicable,
but some were not.
Infantry combat is an experience with few, if any, parallels in the civilian world.

"Innovation" in the military, while not necessarily bad,
must be looked at with considerable skepticism.
How will new methods play out in the wide range of challenging combat situations?

If Mabus places innovation at the center of his goal list,
he likely is doing more harm than good to the ability of the military
to carry out its traditional missions.]

The comments to this interview,
at least as of 2015-09-17,
point out some inaccuracies (perhaps more accurately called lies)
in Mabus's remarks.
What a shame our political system
puts lying PC dirtbags like Mabus in positions of power.]

Navy secretary criticizes controversial Marine Corps gender integration study
By Dan Lamothe
Washington Post Checkpoint, 2015-09-11

Navy secretary threw us ‘under the bus,’ say Marines in gender-integrated infantry unit
By Thomas Gibbons-Neff
Thomas Gibbons-Neff is a staff writer and a former Marine infantryman.
Washington Post Checkpoint, 2015-09-14

Marines involved in a controversial experiment evaluating a gender-integrated infantry unit say they feel betrayed by Navy Secretary Ray Mabus after he criticized the results of a nine-month study that found women are injured more frequently and shoot less accurately in simulated combat conditions.

“Our secretary of the Navy completely rolled the Marine Corps and the entire staff that was involved in putting this [experiment] in place under the bus,” said Sgt. Danielle Beck, a female anti-armor gunner with the task force.

Mabus questioned the findings of the research after a four-page summary of the results was released Thursday, saying he still thinks all jobs in the Marine Corps should be opened to women. He said results that found women were more than twice as likely to be injured and ultimately compromise a unit’s combat effectiveness were an “extrapolation based on injury rates, and I’m not sure that’s right,” he told NPR.

Sgt. Joe Frommling, one of the Marines who acted as one of Beck’s monitors for the experiment, said he was frustrated with the secretary’s comments.

“What Mabus said went completely against what the command was saying the whole time,” said Frommling. “They said, ‘Hey, no matter what your opinion is, go out there and give it your best and let the chips fall where they may.’”

“All the work that the task force did, the rounds that we shot, didn’t mean anything if he had already made up his mind,” he added.

Capt. Patrick McNally, a spokesman for the secretary, said Mabus had no further comment beyond his earlier remarks and “remains committed to opening combat fields to women.”

Last week, the Marine Corps released the results of the nine-month experiment, known as the Ground Combat Element Integrated Task Force, which examined and tested the effectiveness of a gender-integrated infantry unit. The results, in short, determined that women were injured at a higher rate and did not do nearly as well as their male counterparts in the majority of the tested areas.

“It started out with a fairly large component of the men thinking ‘This is not a good idea’ and ‘Women will never be able to do this,'” Mabus said in the Friday interview with NPR. “When you start out with that mind-set, you’re almost presupposing the outcome.”

The task force was stood up in October 2014 and consisted of roughly 300 men and 100 women broken down into a number of smaller units. Each job that is currently closed to women, known as combat arms, was represented. Artillery, tanks, amphibious and armored vehicles all had a component. The task force then conducted training exercises like any other. Its mission was to hold a number of trials that would evaluate the performance of a female-integrated ground task force.

“If you were to look at our training plan and how we progressed from October to February, you’re not going to find any evidence of institutional bias or some way we built this for females to fail,” said one Marine officer who participated in the experiment.

The officer, who asked to remain anonymous because of his active-duty status, explained that for the first five months of the experiment the Marines of the task force trained as a unit in North Carolina to prepare for the testing phase in California. This phase of training is known as “the work-up,” with the second phase in California — where the trials would be held — acting as the deployment.

“We consulted physical trainers from [the school of infantry] to help develop an appropriate hike plan, and we fired roughly a year’s worth of ammo for a regiment in a quarter,” the officer said, referring to the massive amounts of ammunition used to train the relatively small task force at Camp Lejeune. “In the time that we had, there wasn’t a day wasted when it came to training for California . . . From the top down, we were trying to level the playing field.”

The main components of the task force were Alpha and Weapons companies. Alpha would be a female-integrated rifle company, or “line” company, while the Weapons company would consist of three female-integrated sections: mortars, machine guns and an anti-armor section.

A weapons company in an infantry battalion, arguably, has the most rigorous set of requirement in combat. Each section in the company is dedicated to hauling a weapons system that regular rifle companies don’t have to carry—from 90-pound 81mm mortars to 85-pound .50-caliber machine guns.

Beck, a Weapons Company Marine in the Task Force, was one of 17 women and 21 men who were left in the company at the experiment’s conclusion in August. According to Marines involved in the experiment, numbers fluctuated frequently as those who volunteered to participate could drop at any time. A large number of men in the company dropped because they were promised an assignment to any unit in the Marine Corps for participating in the experiment. This caused the company to shrink considerably from its initial strength of around 90 volunteers in October.

“Every day we were training,” said Beck. “We didn’t know what we were going to expect when we got to Twentynine Palms, but the training that we did do got us physically ready and mentally in the mind-set for what we’re going to do.”

Though the entirety of Weapons Company, men and women, trained to the same standard before deploying to California for the evaluation period of the test, another criticism leveled by Mabus was that the women probably should have had a “higher bar to cross” to join the task force.

To Beck, a 30 year-old who was one of the strongest women in the company, Mabus’s remarks were insulting.

“Everyone that was involved did the job and completed the mission
to the best of their abilities,”
said Beck, adding that
Mabus’s remarks about the type of women in the experiment were
a “slap in the face.”

“The caliber of the women in Weapons Company are few and far between in the Marine Corps,”
she added.
“They are probably some of the most professional women
that anybody will ever have chance to work with,
and the heart and drive and determination that they had
is incomparable to most women in the Marine Corps.”

Of the men and women who were in Weapons Company and participated in the majority of the experiment’s trials, the women performed better than the men on the Marine Corps-wide physical-fitness test. The average score for the men in Weapons Company was 244 out of 300 while the women’s average was 283, according to documents obtained by The Washington Post. For an average all-male infantry unit, physical-fitness scores are usually in the 260s.

In Weapons Company, all of the women who were evaluated against their male infantry counterparts had passed the same School of Infantry the men had attended.

In 2013, the Marine Corps opened its enlisted infantry school to female volunteers. From September 2013 to June 2015, 144 of the 401 females volunteers had passed the once male-only school.