Mark Reason: Sportswomen are the more likely victims of 'the silent epidemic'
This article is from www.stuff.co.nz/
OPINION: Congratulations to the Waikato women on their thoroughly deserved victory in the Farah Palmer Cup final although one hopes it doesn’t come at a grievous cost.
And no, I am not talking about the potential transmission of Covid to the South Island, although many people thought it was absurdly irresponsible to permit a bunch of rugby players to travel when so many with greater needs were locked down.
No, I am talking about “the silent epidemic”. I am talking about the ravages of concussion and the far greater dangers it presents to women than to men.
It was extremely worrying to watch Saturday’s final and the sadly typical leniency with which the officials approached high tackles. By my count there were around 20 in the match and yet it was not until the final minutes when referee Tiana Ngawati finally issued a card to Tenika Willison.
At this point the Waikato fullback might have justifiably asked; “Why me?”
Late in the first half Willison’s progress was slowed when the Canterbury fullback grabbed hold of her ponytail. It seems that John Key is not the only person with a penchant for such behaviour. Willison struggled on towards the line only to be hit in the head by Liv McGoverne, the Canterbury second five-eighth, as she covered across. Willison appealed, but despite a brief consultation, the two officials said they saw nothing. Not good enough, and why was the TMO never looking at foul play?
Mind you, McGoverne could have claimed that her tackle was payback. Earlier in the half she had left the field with blood gushing from her forehead after meeting Willison’s head in a tackle, when the Waikato fullback was dangerously high. It didn’t help matters when the Canterbury first five-eighth also dinged McGoverne’s head at the ensuing ruck. One wonders if McGoverne received an HIA before returning, or if everyone was too busy getting her stitched up.
These incidents should be of particular concern to the New Zealand authorities because sportswomen are being treated as second class citizens when it comes to concussion, despite being at a higher degree of risk. I asked Dr Willie Stewart, a neuropathologist who sits on World Rugby’s independent concussion advisory group, about this at the weekend.
He told me: “The fact is, concussion is a greater risk for female athletes in sports where the rules are the same for the sexes so, if anything, [our primary focus of] attention should be most to supporting the women's game.”
We should not take Stewart’s view lightly. The early research into the subject shows fairly conclusively that the risk of concussion to women in sport is almost double that of men. It also takes far longer for them to recover on average. And yet why are young athletes not more fully aware of the risks? And why is medical supervision not greater?
Not so long ago my daughter played in a national soccer tournament and one of her teammates suffered an horrendous concussion. Alarmingly there was not much help on hand other than that coming from concerned coaches and parents. Given what we are now finding out about female concussion, this sort of thing is not good enough.
Stewart was part of a research group that analysed three years of survey data from around 43,000 male and 39,000 female players from schools in Michigan. The chance of a girl being concussed was 1.88 times higher than boys. Just as worrying was the observation that boys were far more likely to be removed from the field of play after a concussion than the girls.
Stewart says: “If you’re twice as high risk of developing symptomatic brain injury, what does that mean many years down the line?”
The evidence also shows that females take longer to recover than males. Doug King, who works as a clinical nurse specialist in Hutt Hospital’s Emergency Department, undertook his PhD research into women’s concussion. He studied 40 Wellington women’s club rugby players over a season. After suffering a concussion, it took an average of 28.9 days before they were fit to play again.
King said: “The international consensus on concussion says 80 per cent will resolve in seven to 10 days. But here I’m finding this cohort of players – at 10 days they're at their worst. Everything is set on what’s been tested before and it’s always been tested on males.”
There are reasons why women may be more susceptible to concussion and take longer to recover. Medical imaging and brain-tissue show that axon fibres from the brains of female rats and humans are slimmer than those from males. There is also emerging evidence that the stage of the menstrual cycle has an effect on the length of time women take to recover from concussion.
If women are more susceptible to concussion and if the immediate consequences are greater, then surely that demands greater attention. At the moment women are almost a medical afterthought in the mad rush to achieve so-called sporting parity.
Would I personally want my daughter to play rugby? No, but then nor would I want her to head a soccer ball. Current research suggests that while sporting males tend to receive the majority of concussions in contact with an opponent or teammates, females tend to be more likely to be concussed by another object such as a ball or whiplash contact to the ground. It is possible their greater apparent level of risk accounts for that greater probability.
So when I watch terrific young rugby players like Jorja Miller of Canterbury and Kelsey Teneti of Waikato, I cannot help but worry. They are both still at high school and yet they are playing in an adult national final where the punishment for dangerous play close to the head was negligible. Maybe Miller is wise to express a preference for sevens and Teneti for hockey, because at the moment we are failing in our duty of care to these women.
As Stewart says; “There’s this general focus on male sport, male injury and male outcomes, and less on female. It’s terrible neglect.”
“These incidents should be of particular concern to the New Zealand authorities because sportswomen are being treated as second class citizens when it comes to concussion, despite being at a higher degree of risk.”