Could study into head injuries change women's rugby?

ByAwen Mutembo

BBC Sport Wales

Former players have backed ground-breaking new research into the impact of concussion in women's rugby.

Repeated blows to the head have been found to affect women differently to men, with female athletes more susceptible to concussion and reporting longer recovery times.

Symptoms can also vary, with men more likely to experience amnesia, while a proportionately greater number of women report prolonged headaches, mental fatigue and difficulty concentrating.

But despite the findings, rugby's concussion guidelines are still largely based solely on the men's game - something ex-internationals say needs to change.

Cardiff University's medical engineering team is now aiming to create the first head impact assessment protocol designed specifically for female athletes.

The study followed 30 players from the university's women's rugby team, using specialised mouthguards, cognitive tests and MRI imaging.

Researchers hope to gather enough data by the end of the year to determine whether new guidelines can be set.

"The female brain is different from the male brain and women's rugby is different from male rugby, so if we were only to use the same safety threshold as we do for men, that would seem inconsistent with the evidence that we understand so far," said lead researcher Peter Theobald.

Elinor Snowsill, capped 76 times during a 14-year international career, is among those backing the female-focused research.

"We are not just mini versions of men," she said.

"It is so important to understand our bodies and that we have systems in place that are best suited for us, not just taken from the men's game.

"There is no game [of rugby] that is more important than your brain.

"It is the one thing you cannot replace. You can rehab any muscle or have a knee replacement, but you have to have your brain for the rest of your life. Nothing is more important than your health."

Uncertainty surrounds why women can experience concussion differently to men, although researchers point to brain structure and neck strength.

This is alongside differences in the way the game is played, in strength and conditioning and the later introduction of women to the sport.

But the lack of dedicated research into the women's game is not unique to rugby with only 6% of sports science research solely based on female athletes, according to PhD student Freya Butcher, part of the research team.

"We aim to contribute to that pool and gain a better understanding of the way that female physiology interacts with our sports," she said.

While welcoming their work, former Wales wing Caryl James says it is concerning that only now research is being done into female athletes.

"That really worries me and I feel women have definitely been let down over the years," she said.

The mouthguards being used by the university team are similar to those used by World Rugby in elite competitions.

They measure the force, speed and direction of head impacts, with medical staff alerted if they exceed a set threshold. Players are then required to leave the pitch for a head injury assessment (HIA).

However, part of the research aims to uncover whether those thresholds should be refined specifically to the women's game.

Cleo Pallister-Turley plays rugby for Cardiff University's rugby team and says the study has made the whole team more aware of concussion.

"Both on and off the pitch, the study has made the whole team a little bit more wary about head health, in a way that throughout my 13 years of playing rugby hasn't been spoken about," she said.

"The previous season I would have just got up after any hit to the head and thought it was fine to play on.

"But last season, you're a lot more aware of it, even though the data wasn't fed back to us."

Awareness was something that former Wales centre Alecs Donovan says was lacking during her playing career.

"It wasn't the coaches or the medical team that knew I was concussed because I carried on playing, it was at work a couple of days after," Donovan said.

"I worked as a medical rep. I was in operating theatre and one of the doctors there said he thought I was concussed, just because of how I was feeling."

Snowsill added: "I remember playing and thinking that one of the women had hit her head, but at the time other players didn't know how important it was.

"They just knew it would mean they wouldn't be able to play, so a lot of the players would try to hide it, and I would question whether I should report it.

"Although it's your friend, you want to do what's best for them even if they would be angry with you for doing so."

The impact of concussion has come to the forefront of rugby with hundreds of former players bringing legal action against the sport's governing bodies.

English World Cup-winners Steve Thompson, Mark Regan and Phil Vickery as well as Welsh British and Irish Lions Ryan Jones, Gavin Henson and Dafydd James claim authorities failed to protect them from the neurological consequences of repeated head impacts and concussions.

That six-year battle hangs in the balance following two days of High Court proceedings this week as the judge considers whether the claimants have complied with an order to provide documents surrounding the neurological testing process.

But despite the well-documented risks, Pallister-Turley hopes Cardiff's research will not deter people from playing rugby.

"The idea of this research is not to scaremonger, it's to invest in more research that allows you to make an educated and informed decision about your head health," she said.

"The sport is great in terms of friendships and camaraderie; it means so much to so many people."