Concussions in women: New research underway on impact on female athletes

When the final whistle blew for the 2014 Women's Rugby World Cup final, Cat Merchant was thrilled for many reasons.

Not only did Merchant win his second trophy with his England teammates by defeating Canada, he also knew it would be his last appearance in an England shirt.

Wing Merchant suffered numerous concussions from the age of 16 to 28, “probably in his 30s.”

“There's a great picture someone took of my face and it looks like I have 20,000 emotions coming up,” Merchant told BBC Sport.

“I started crying and thought, 'I'm never going to play rugby again.' I had no intention of wearing cleats.

“I was 28 years old and still at the top level, so I thought this would never happen again. I was really excited to win, but it was bittersweet.”

Concussions and their effects have become more of a topic of discussion in recent years, particularly in rugby and football. However, there is little research on the specific effects on women.

Some suggest that women are at higher risk for concussions and may take longer to recover. However, data is sparse. One sports scientist estimates that in 2021, only 6% of the entire sports science literature used female-only participants.

However, the situation is gradually changing. BBC Sport investigates the impact of concussion on women in sport and what work is being done to understand it.

A concussion is a traumatic brain injury that affects mental function and can change the way a person thinks, feels, and remembers. Only about 10% of people lose consciousness.

For Merchant, the last concussion felt like a constant ferry ride. She developed a fencing reaction (her arm would sometimes be raised in the air in an unnatural position for a few seconds after the impact) and suffered from confusion for weeks and months afterwards.

“I was very confused that my family was there. They said the clothes weren't mine, so they wouldn't wear them,” she said.

“When I hear loud noises, I flinch. When I hear bright lights, I get a headache.

“I couldn't look at my phone or read a book. I just lay there in the dark. I was like that for four months, wondering when I would be okay again. Ta.”

One study found that men and women were more likely to report different symptoms after a concussion. For example, men are more likely to experience amnesia in the days and weeks that follow, while women report prolonged headaches, mental fatigue, and difficulty concentrating.

Other researchers suggest that women may be at greater risk depending on what stage they are in their menstrual cycle.

Governing body World Rugby said there was not enough research into concussions in the women's game in 2023.

Smart mouthguards have been introduced for women's and men's matches, sending a strong warning to independent matchday doctors. The device is also worn in training and helps coaches tailor sessions.

It's not just rugby. A 2021 study found that teenage girls who play soccer have nearly twice the risk of concussions compared to teenage boys, and girls are more likely to suffer a concussion from contact with the ball or goalposts. did.

There is never a one-size-fits-all panacea for every injury, but as Chelsea manager Emma Hayes has said, women are not small men.

As she said last August, “Just because the men's team's workload and gym duties are lumped together doesn't mean the women should have the same plan. .”

World Rugby is committed to funding gender equality research and if research is carried out on men, the same research will be carried out on women.

Smart mouthguards are being used in professional rugby to monitor head impacts during matches, while researchers are using cotton swabs to check for markers that indicate how the brain is working. Scientists behind a groundbreaking saliva-based test recently expanded their research to: women's rugby. All Premiership women's teams will take part.

Football's governing body FIFA has funded a research project being carried out at the Institute of Sport, Exercise and Health in London to focus on the impact of heading the ball on women's brain health. The study will also investigate whether menstrual cycles affect cognition.

Although men's and women's soccer are played on the same size pitch and with the same size ball, existing studies cannot attenuate physiological differences.

“Women's biomechanics are different. For example, women have different levels of neck strength,” said Dr. Flaminia Ronca, who led the project.

“What concerns us is that we know from other studies that women seem to progress and recover more slowly after head trauma.

“We don't really know whether the research we've seen in men can be applied to women and whether there may actually be an increase in disadvantage in women's football.”

West Brom's women's team are taking part in the project, which includes testing the use of mouthguards to monitor the impact players receive when heading the ball. The study aims to be published in the coming months.

Merchant is still dealing with some of the effects of the concussion. As a commentator, I limit the amount of work I do the day before to give my brain a rest.

“If your quads are sore, you can't sprint,” she says. “So if my brain is a little confused or confused, I'll give it the time it needs to process.”

Merchant also coaches and says attitudes toward dealing with concussions have changed over the past decade, with more education and more understanding.

“Concussions are not uncommon. It just didn't get a lot of attention because the girls weren't professional. We weren't playing as much,” she said.

“Just like you can hit your head and not get a concussion, you can hit your knee and not get injured.

“But we need to talk about it and understand it better so we can continue to play the game of contact rugby while still protecting our players.”