Category Archives: concussion

Concussions in women’s rugby: A cause for concern?

Authored by the ‘Team Unity’: Keaton Ager, Leah Bass, Laura Beet, Ethan Greenway, Meghan Hobbs, Daniel Hutchins and Chris Seymour-Henwood [E119 21J students].


This blog was written as part of a collaborative teamwork task by students studying E119. They had to select a topic and then decide on what roles each person would perform in the team, such as researcher, writer, editor, and leader. This blog was chosen as one of the best blogs from around 70 blogs that were produced.


In 2018, the Telegraph (Ellis, 2018) documented that women’s rugby is soaring in popularity. Almost 30,000 women and girls play rugby at club level, double the amount seen 4 years prior, with women now making up a quarter of players globally.

Increasing popularity brings in revenue, allowing governing bodies to provide additional funding into various aspects of the game, including research. With the higher revenue, research into the men’s game could be considered ‘the norm’, but more researchers are now looking into the women’s game and its positives and negatives – with concussions being one of the negatives.

What is a concussion and what is the research saying?

Physical differences between men and women seem to have an impact on the likelihood of concussions occurring. It is well documented that males are generally physically stronger than females. This point is echoed by Rugbypass’ Jess Hayden (2020), who states that although lower body strength between men and women is quite comparable, male rugby player’s upper body strength can typically be observed as three or four times greater than female players. This includes neck strength, which is a defining factor in concussions.

Dr Elisabeth Williams at Swansea University is a lead researcher into concussion in men’s and women’s rugby. Dr Williams (cited in Hayden, 2020) has found that a ‘whiplash’ motion is a leading cause of concussion in women’s rugby. So, what is a concussion? According to the Concussion Foundation (n.d.)…

A concussion is a brain injury occurring when the brain moves rapidly within the skull usually due to a blow to the head or body.

Research suggests (Neuro-Optometric Rehabilitation Association™ & PINK Concussions, n.d.) that concussions affect women and men differently, with women not only being at a higher risk of sport-related concussions, but also increased severity of symptoms as a result of concussion.

Neuro-Optometric Rehabilitation Association™ & PINK Concussions (n.d.) report that women often experience more severe and prolonged symptoms relating to:

  • Greater cognitive decline
  • Poorer reaction times
  • More frequent headaches
  • Extended periods of depression

Male and female brains differ both anatomically and chemically with female brains containing more delicate axons, a thin ‘cable’ that allows electrical impulses to pass from one neuron to others (The University of Queensland Australia, 2021). Lasting damage to neurons from concussion can lead to multiple issues, such as dizziness, vertigo, slower processing, memory loss, difficulty driving, focusing, and reading. Due to their axons being more delicate, females are more likely to damage these neuron connectors than males. This is one biological aspect that differentiates how each gender’s brains are affected by concussions.

Is neck strengthening the answer?

With biological and chemical differences altering concussions short- and long-term symptoms, is there any way women can help prevent concussion occurring?

Elaborating on Dr Elisabeth Williams’ (cited in Hayden, 2020) earlier point, she believes that there is a disparity in neck strength between men and women, stating that neck strength is “unfathomably low compared to men” resulting in women having less control over their heads during contact. This is one reason why the whiplash motion is so prominent in women’s rugby. According to Dr Williams (cited in Hayden, 2020), women naturally have less muscles and soft tissue in their necks than men. Whiplash initiated by head to ground or head to knee contact causes the brain to violently bounce around inside the skull.

More control over the head during contact can limit the whiplash motion reducing the probability of concussions occurring. Jess Hayden states that a senior player in the England Women’s Team informed her that they have been practising neck exercises to increase stability since 2014. This training has also been implemented by clubs in the Allianz Premier 15s.

Whilst neck strengthening can reduce the probability of a concussion happening as a result of whiplash, it will not prevent concussions altogether. Concussions are still prominent in the male game, with this type of injury being amongst the most common diagnoses. If disparities between neck strength alone defined whether a concussion happened, then in theory concussions should be less frequent in the men’s game. This, however, is not the case.

Dr Williams (cited in Hayden, 2020) believes neck strength needs to be a necessary part of women’s rugby training. With women’s rugby still developing and becoming more popular, many women do not start playing rugby until they reach university. Due to a lack of clubs at lower levels compared to the men’s game, Dr Williams (cited in Hayden, 2020) says that women grow up playing netball or football, even giving up sport, believing there is “nothing for them”. This means adult women often did not have the same opportunity to develop their skills over the years as men, including body positioning during contact. This could also play a part in the whiplash motion of the head, without the developed instinct to safely take contact and land.

Conclusion

For now, concussions pose a serious threat to female rugby players. However, the increasing popularity of women’s rugby will provide additional funding, allowing more research to be carried out on female players such as that being done by Dr Elisabeth Williams (cited in Hayden, 2020). Hopefully more research like hers will highlight areas of concern and make the game safer for all participants, especially since women tend to be more adversely affected by concussions. Also, with the growing popularity of the women’s game, there is potential for additional grassroots clubs to be founded. As a result, women will be able to develop essential awareness skills at a younger age where impacts are less forceful.

 

References

Concussion Foundation (n.d.) What is a Concussion? [Online]. Available at https://concussionfoundation.org/concussion-resources/what-is-concussion (Accessed 24 January 2022).

Ellis, S (2018) ‘How rugby can put a spring in your step’, The Telegraph, 8 June 2018 [Online]. Available at https://www.telegraph.co.uk/property/home-improvement-tips/benefits-of-rugby/ (Accessed 25 January 2022).

Hayden, J (2020) ‘Long-term brain damage likely a significantly bigger issue in women’s rugby than men’s, says lead concussion doctor’, Rugbypass, 14 December 2020 [Online]. https://www.rugbypass.com/news/long-term-brain-damage-could-be-a-significantly-bigger-issue-in-womens-rugby-than-mens-says-lead-concussion-doctor/ (Accessed 25 January 2022).

Neuro-Optometric Rehabilitation Association™ & PINK Concussions (n.d.) Women & Concussions [Online]. Available at http://ecp-uploads.s3.amazonaws.com/wp-content/uploads/sites/2704/2020/12/WomenConcussions_info.pdf (Accessed 24 January 2022).

The University of Queensland Australia (2021) Axons: the cable transmission of neurons [Online]. Available at https://qbi.uq.edu.au/brain/brain-anatomy/axons-cable-transmission-neurons (Accessed 25 January 2022).

Rugby – A Blow to the Head, a blow to the sport?

Tonight on BBC Panorama “Rugby and The Brain – Tackling the Truth” the Chief Medical Officer of the World Rugby, Martin Raftery, will announce plans to alter the laws of the game to limit the risk of players suffering concussion. He will confirm that there will be a specific focus on tackling. Only a few days ago, The Telegraph reported that “Jonathan Thomas quits with epilepsy caused by multiple concussion”. Following mild seizures and memory loss that he believes was the result of sustaining multiple concussions, the Worcester forward and former player for Wales, announced that he was retiring from rugby on medical advice. He is not alone, in the media this year, it has been reported that a number of high profile rugby players such as Rory Watt-Jones (Cardiff Blues) and Declan Fitzpatrick (Ulster and Ireland) have had to retire from the sport due to concussion related injuries.

Rugby World Cup (Land Rover MENA) Creative commons license https://creativecommons.org/licenses/by/2.0/legalcode Downloaded from https://www.flickr.com

Now in light of those stories, with the Rugby World Cup underway and all the excitement that has already been ignited, the pragmatic and perhaps more curmudgeon-like souls amongst us may turn our attention to the dangers associated with a sport that kindles our national passions. Of all the injuries that can occur in rugby, concussion is now the number one cause of missing matches through injury at elite levels.

Concussion can occur in any situation where a blow to the head occurs, such as in road traffic accidents (RTA) or as a result of a work-related accident, however, its incidence is becoming increasingly common in athletes who are prone to knocks to the head as part of their sport. Certain sports are more susceptible than others such as: rugby, NFL football, boxing, ice-hockey, rugby, football (soccer), equestrian sports, cycling, and diving. It is so topical an issue that in December a Hollywood blockbuster featuring Will Smith will be released simply entitled “Concussion”. In the United States there has been a prolonged debate about the health dangers of NFL football following the mounting evidence that repeated concussions can lead to degenerative brain disease (Chronic traumatic encephalopathy [CTE]). CTE is a neurodegenerative disorder that is characterised by a diminished ability to think critically, slower motor skills, and can lead to volatile mood swings. Unfortunately, at the current time CTE can only be definitively diagnosed post-mortem. These risks alongside the large financial settlements that have been awarded to former NFL players who have suffered multiple concussions should make us ponder whether rugby may be the next sport in the concussion spot light and whether the risks associated with rugby comprises a price worth paying.

But it is not all doom and gloom, although researchers have found that concussions in rugby are common, it has been found that concussion accounts for 29% of all injuries associated with illegal play, but only 9% of injuries sustained in legal play (Gardner, Iverson, Levi, Schofield, Kay-Lambkin et al., 2015). Accordingly, Roberts, Trewartha, England, and Stokes (2015) investigated collapsed scrums and collision tackles, and found that injury prevention in the tackle should focus on technique with strict enforcement of existing laws for illegal collision tackles. Furthermore, World Rugby is taking a proactive stance on concussion identification and management heading towards “a cross-sport and society approach to concussion to ensure consistency of research, education, prevention and management strategies to further protect athletes and members of the public”.

Sports such as rugby carry risks, but through legal play and active pitch side management of suspected head injuries, we can but hope that this World Cup is remembered for exciting play and home nation success rather than media reports of players with serious head-related injuries.

Concussion in Sport will be covered in a new OU Sport and Fitness module coming soon.