Diagnosing head injuries, mental health -- especially for female athletes -- is crucial | Opinion

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Feb. 21—Not every battle is waged in plain sight.

The most internal are more times than not the most difficult.

Tragically at times, those battles end with unimaginable outcomes.

A recent CNN piece profiled two world-class female athletes: Kelly Catlin, an Olympic track cyclist, and Ellie Soutter, a teenage British snowboarder who was tipped to potentially compete in the 2024 Winter Olympics.

Both athletes suffered head injuries. Both had lingering effects. Both sought assistance.

Both ultimately died by suicide.

Without repeating too much of the CNN profile out of respect to its reporting, the sorrow of their parents sharing their daughters' journeys would make anyone feel their heartache.

Some of the connected facts that went into these journeys are devastating as well.

According to a study from the Orthopaedic Journal of Sports Medicine, female athletes are "more susceptible" to concussion and have "worse and prolonged symptoms" than their male counterparts.

Clinical data of female athletes is severely underrepresented vs. males.

A study of 80,000 female high school soccer players found they are nearly twice as likely to suffer concussions as boys while playing the sport.

Repeated head injury, including concussion, can lead to increased risk of chronic traumatic encephalopathy, commonly known as CTE.

As noted last week in my opinion piece about the incident with the Oregon social-media influencer and allegations of inappropriate behavior, even broaching the subject of female vs. male sports is tricky.

When you discuss disparity, whatever that means, there will inevitably be those who aggressively push back.

It'll be some form of "I don't care about female sports and no one else does either," as if that should be justification for the heinous nature and extent to which those sports and athletes are attacked in some circles.

But even if you are someone who views it strictly as a issue of spotlight or lack thereof.

Even if you are someone who finds female sports "lesser than," however that may be defined.

Even if you are one of those vile "stay in the kitchen" types.

Perhaps we can all agree a female athlete should receive the same care, attention and diagnosis for their health as any male athlete.

That includes diagnosis of concussions and long-term care for mental health.

Part of the issue we have in this day and age — one improving incrementally — is the perception of toughness in sports.

To an extent, toughness was defined in part by the ability to compete through injury.

Basically, if you could stand upright, you could continue.

We have gotten much better with that — obviously, with responsible athletic trainers embedded at all sporting events today, it's not 1960. If you're hurt, you're not going back out there.

But it's not just "shaking it off" in and of itself.

There is pressure to return from injury. It may jeopardize a team's goals or briefly derail the quest for a college scholarship. It may impede a competitive advantage over an opponent.

It may be unspoken. It may be unnecessary. But it is there.

The soccer trend mentioned above about girls high school players being more likely to be concussed than boys is one that hits close to home, given my long involvement with the sport.

Without citing specific names and schools for all the obvious reasons, I think back to one Saturday afternoon girls soccer match many years ago. Two players went up for a 50-50 header and made head contact with one another. We had a photographer covering the match, who captured the moment of collision.

At the time, all parties involved marveled at the quality of the picture. The reason, though, was more because it defined competitive nature — i.e. both student-athletes being willing to do "whatever it takes" to win.

Retrospect is a powerful thing. If, in passing, I come across that picture today, I cringe — and I don't doubt the other principals involved that day would arrive at the same conclusion, knowing what we know now.

In the fall, we need to have a real conversation in high school soccer. If we're not going to outlaw headers altogether, which we're not, we probably need to at least consider making protective headbands mandatory. That data and impact is all too clear.

Competitive nature and competitive edge is not more important than mental health and general wellbeing.

At every juncture, we need to have proper resources available to athletes to manage head injuries and their aftereffects.

We've made great strides in high school sports with caring for those types of situations, not permitting student-athletes back into a competitive avenue until stated protocols have been met.

In soccer, we're incorporating more trapping if applicable in technical skill.

In hockey, we've instituted head-contact penalties to discourage its use. And so on.

But we still have a ways to go.

Clinical data and studies should be more prevalent.

Access to health care and, if needed, mental health professionals shouldn't be impeded.

Certainly not on a basis of gender.

Say what you want about female sports — and some people will.

No one should ever endure what Catlin's and Soutter's families have.

After his daughter's suicide, Tony Soutter was asked by the UNITE Brain Bank to study Ellie's brain.

Of that brain bank's collection of more than 12,000, 3% belonged to females.

"It was quite obvious to me that there was a definite link in her starting to get into dark places and feeling bad and anxious and not sleeping properly," Tony Soutter told CNN. "All of those symptoms ... Every one that's involved in CTE was part of Ellie's life.

"I truly believe today that my daughter would be alive had I had any inkling, you know, even the smallest bit of information."

No, not every case ends as tragically as Catlin's or Soutter's did.

But every internal battle like theirs has significance and consequence.

Taking smart, proactive and equal action every step of the way, as Tony Soutter so heartbreakingly described, does as well.