CONCUSSION in athletes is very much on the radar at the minute.
The NFL has gone all out on it, and so too has the IRFU, in terms of educating coaches and athletes, with the latter producing its own guide on the topic.
First off, concussion is a traumatic brain injury. It’s a complex process in which forces are transmitted to the brain and result in temporary impairment of brain function.
Concussion can have a significant impact on the short and long term health of player if not managed correctly, and the guidelines put in place by the IRFU state that concussion must be taken extremely seriously.
Every weekend we hear of some male GAA player or rugby player having suffered a concussion — for example Dublin footballer Rory O’Carroll, now an Acquired Brain Injury Ireland (ABI) ambassador, was concussed in the 2013 All-Ireland final against Mayo but was left wandering around Croke Park; and of course there’s the Johnny Sexton debate.
Prior to Ireland’s Six Nations game against France in the spring of 2015, journalist Laurent Bénézech was criticised for questioning the decision to select Sexton, leading to the IRFU issuing a statement — “Johnny has been symptom-free for two months. Johnny was cleared to return to play on Thursday, February 5 by: 1) Independent neurologists in France and Ireland; 2) The FFR concussion review committee; 3) The Racing Metro medical team; 4) The Ireland medical team.”
Fair enough says you. But, what you probably weren’t aware of was that, as all the above was kicking off, Irish senior women’s player Hannah Tyrell was withdrawn from the starting team against France in Ashbourne RFC due to a concussion injury she picked up during training, and consequently underwent the return to play protocols, returning for the game against England last week.
It made me think about how infrequently we hear of females suffering concussion, but, as it turns out, females are much more prone to this type of injury.
Initially it seemed that the focus was very much narrowed in on the NFL situation with the media across the pond highlighting damaged brains, dementia and suicides in retired NFL players, making concussions very much synonymous with American football.
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 college athletes in the United States showed that females suffer from concussions at higher rates than boys and men in similar sports — often significantly higher.
* For example, it stated that 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 three times the rate experienced in football.
* In a study carried out in 25 high schools, it was found that in soccer, girls experienced concussions at twice the rate of boys.
As I said earlier, you rarely hear of a female athlete suffering from concussion, but if these stats are applicable across the board, then it’s a serious issue that needs to be addressed here by female sporting organisations.
Women’s rugby is lucky in that it now falls under the IRFU umbrella, but other sports should perhaps seriously start putting procedures in place.
There’s very little research on why female athletes are so susceptible to ‘athletic brain injuries’, but 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.
According to the research however, for all of these theories, there is little consensus on how they actually play into the mechanism of brain injuries in girls and women.
This makes it difficult to know the best way to prevent concussions in girls and women – better equipment, more neck strength training, better referee calls, or stricter rules?
Hockey and lacrosse leagues in the United States have taken the latter approach, placing limits on body checking for young players and banning checking to the head and neck area at all levels. Other sports are putting in similar protections. Take girls’ soccer. Girls’ neck muscles are not fully developed until age 14. If heading were eliminated for girls below that age, that would prevent concussion without negatively affecting later elite competition prospects.
There is some evidence that brains of female athletes are more susceptible — or, at least, react differently — to injury compared to their male counterparts.
Therefore it shouldn’t be assumed that concussion is more of an issue in male-dominated sports.
This is just an eye-opener, but it’s something that needs to be more closely looked at by Irish sporting bodies.
For more, read Cork ladies football captain Ciara O’Sullivan’s account of concussion earlier this year, here.
Facts and research findings in the US on female athletes and concussion:
* Females participating in high school sports now have a higher incidence rate of sport-related concussions than do males.
* Among women’s sports, the highest incidence of concussions occurs in soccer.
* In a ranking of high school and college sports on the basis of concussions as a percentage of all injuries, women’s soccer and basketball ranked highest, followed by football and men’s soccer.
In soccer and basketball, at both high school and collegiate levels females sustain higher rates of concussions than males.
* Among collegiate ice hockey players, women sustain higher levels of concussions than men.
* Younger athletes appear to be at increased risk for concussions. This may be the result of younger brains being more susceptible to traumatic brain injury but there is no conclusive evidence on the reasons for the increased susceptibility.
* Research on risk factors for concussions is at a preliminary stage. In attempting to explain the observed sex differences in concussion rates, attention is being directed to biomechanical, neuroanatomical and neuromuscular factors but little is known about this topic.
Reference: Women’s Sports Foundation