Q&A with author Joanne Gerstner about her new book on concussions

Joanne Gerster is a sports journalist in-residence at Michigan State's College of Communication Arts and Sciences. Kathleen Galligan

Concussions have been a front-and-center issue in sports for a few years, but generally the conversation has been focused on professional football. However, the injury is just as likely to affect female athletes, even in noncontact sports.

Joanne Gerstner, a sports journalist in-residence at Michigan State's College of Communication Arts and Sciences, alongside sports neurologist Jeffrey S. Kutcher, has written a book that examines the breadth of the concussion problem and gives practical advice for youth athletes and their parents.

We asked Gerstner about the book "Back in the Game: Why Concussion Doesn't Have to End Your Athletic Career".

Note: Gerstner is a former editor for espnW.

espnW: What was your goal with the book?

Joanne Gerstner: We're trying to move people from fear of concussions [and] not acknowledging concussions to a more sophisticated conversation where we acknowledge the risk, but also the benefit of sport and look at the best ways for all of us to proceed safely and have fun.

espnW: How do you frame the concussion issue in terms of women and girls?

JG: I'm really learning that the discussion about concussion in the general public's mind is a very male-dominated thing. They hear concussions being talked about in terms of football or hockey or boxing. But now, being out talking to people, I'm hearing, "Oh my gosh I didn't realize could get concussions like guys can."

At first I was like, "Hmm, we all have brains, we can get concussions." But people don't watch women's sports like they watch men's sports. The lawsuits have been directed more at men's entities than women's entities. It stands to reason they would associate concussions with a guy's thing, but it's really not.

espnW: Don't girls and women get more concussions, statistically?

JG: Physiologically we're different from men, especially in terms of neck strength, especially during the teenage years. So if we are in a collision, say for soccer or basketball, our necks and our heads might jostle more than a guy's would. A hormonal state, say the time of the month, can affect your susceptibility to concussions. And women tend to get more migraines than men.

Add that all together and there are factors that show women might have a propensity to have concussions. It all comes down to, who are you, what sport are you playing and where is your body in all of this? Because we are all truly individuals and I try to shy away from general statements, but girls can get concussions during cheerleading, gymnastics, soccer, basketball -- so the risk is there and we need to be aware of it.

espnW: How do we balance wanting our kids to develop independence and a spirit of adventure while still mitigating the risk of concussions?

JG: I think you should be worrying about it as much as we worry about anything else with your child. Obviously you don't want your child falling out of a tree and breaking her arm. If she's playing lacrosse, you want to make sure she has proper equipment and good coaching and awareness.

And it's not just awareness, it's that we are going to act on concussion. So if someone is suspected of being hurt, we take them out that we evaluate them. And if your daughter does get hurt, that she has the empowerment and the courage to say, "Hey, I don't feel right, take me out?" Or if she has a teammate she can say, "Hey, Coach, my teammate doesn't seem right, can we take a look at her?"

It's about taking care of each other and not saying it's a bump on the head or feeling obligated to play because Mom and Dad really want me to play. It's about moving away from fear of concussion to looking at it critically and being prepared for it.

espnW: Did anything surprising pop up in the reporting for the book?

JG: To me the most revelatory thing was talking to the parents about how nuanced a concussion is. I never knew people could have a concussion and not present with any symptoms because that's the way their body works.

espnW: Cheerleading -- is that the sport where female athletes suffer the greatest number of injuries?

JG: It's murky because a lot of states don't acknowledge cheer as a varsity sport. So getting numbers on cheerleading is challenging compared to basketball, where everyone acknowledges it's a sport for both genders.

Anecdotally the numbers for cheerleading are high. And just think about the stunting, where you throw a flier up five, 10 feet in the air, you do a flip, you come down. Arms, legs and heads can collide, so it's not safe. It's really been fascinating to me -- some people are like, "Oh, it's cheerleading, how can they get hurt?" Have you watched cheerleading lately? It's gymnastics mixed with high-level dance mixed with Cirque du Soleil. Absolutely they can get hurt.

I've talked to cheerleaders at the college level and the pressure on them to do bigger, badder tricks is there.