- By Amy Lofthouse and Katie Gornall
- ` Sport
42 minutes ago
video caption,
Kat Merchant: “There were dark times in dealing with concussions”
When the whistle blew at the end of the 2014 Women's Rugby World Cup final, Kat Merchant was overcome with emotion for more reasons than one.
Not only had she and her England teammates had just beaten Canada to lift the trophy for the second time, but Merchant also knew this would be her last appearance in the England jersey.
Wing Merchant struggled with the effects of a series of concussions between the ages of 16 and 28 – “probably in his 30s” overall.
“There's a great photo someone took of my face and I look like I have 20,000 emotions going on,” Merchant told ` Sport.
“I burst into tears because I thought, 'I'll never play rugby again'. I never intended to put on my football boots.”
“I was 28, still in pretty good shape, and I knew I wouldn't do it again. Although I was really happy about the win, it was bittersweet.”
Concussions and their effects have become more widely discussed 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 of concussions and may take longer to recover. But the data is sparse – one sports scientist estimates that in 2021 only 6% of all sports science literature included exclusively female participants.
However, things are slowly changing. ` Sport examines the impact of concussions on women in sport and what efforts are being made to understand this.
“Lying in the dark for four months”
A concussion is a traumatic brain injury that affects mental function and can change the way someone thinks, feels and remembers. Only about 10% result in loss of consciousness.
For Merchant, her last concussion felt like she was on a ferry and constantly moving. She had a fencing reaction – in which her arms were raised in the air in an unnatural position, sometimes several seconds after impact – and struggled with confusion in the weeks and months afterward.
“I was very confused about my family being there – I didn't want to put my clothes on because I said they weren't mine,” she said.
“I would physically cringe at loud noises. And in bright light I would get a headache.”
“I couldn’t look at my phone, couldn’t read a book. I just stayed there in the dark. It lasted four months and left me wondering when you’ll ever be well again.”
A study found that men and women are likely to report different symptoms after a concussion – for example, men are more likely to experience amnesia in the days and weeks afterward, while women report persistent headaches, mental fatigue and difficulty concentrating.
Another suggests that women may be at higher risk depending on what phase of their menstrual cycle they are in.
Governing body World Rugby said in 2023 that there had not been enough research into concussions in women's football.
Smart face masks have been introduced in women's and men's football that send high-power alerts to the independent matchday doctor. The devices are also worn during training and help trainers to customize training sessions.
It's not just rugby. A 2021 study found that the risk of concussion among teenage girls who play soccer is almost twice as high as among teenage boys, with girls more likely to suffer a concussion from contact with the ball or a goal post.
There will never be a one-size-fits-all solution to every injury, but as Chelsea manager Emma Hayes said, women are not little men.
As she put it last August, “Just because your men's team's workload or gym work is organized one way doesn't mean it should be planned the same way for women.”
World Rugby is committed to funding equal research for men and women – if a study is carried out on men, the same study will also be carried out on women.
Smart mouthguards are being used in professional rugby to monitor head impacts during play, while scientists behind a ground-breaking saliva test that involves taking a swab to allow researchers to examine markers of brain functioning recently expanded their study to have women's rugby. All Premiership women's teams take part.
Football's governing body Fifa has funded a research project taking place at the Institute of Sport Exercise and Health in London into the effects of heading the ball on women's brain health. The study will also examine whether the menstrual cycle influences cognition.
Men's and women's soccer are played on the same size fields and with the same size balls, but existing research cannot mitigate the differences in physiology.
“Female biomechanics are different – for example, neck strength is different in women,” said Dr. Flaminia Ronca, who leads the project.
“Our concern is that we know from other research that women appear to have poor outcome and recovery after head injuries.
“We don’t really know whether the research we see in men is transferable to women and whether there could actually be increased disadvantage in women’s football.”
West Brom's women's team is involved in the project, which includes testing wearing face masks to monitor the impact on a player when she heads the ball. The study is expected to be published in the coming months.
Merchant is still dealing with the effects of concussions. In her role as a commentator, she will limit her workload the day before to give her brain some rest.
“If you have sore quadriceps, you don’t sprint,” she said. “So if my brain is or has been a little muddled, I give it the time it needs to process.”
Merchant is also a coach and says she has seen a shift in attitudes toward concussions over the past decade, with more education leading to more understanding.
“Concussions are not uncommon – they just weren’t highlighted as much because women weren’t professional; “We didn’t play that often,” she said.
“You can hit your head without getting a concussion, just like you can hit your knee without hurting it.”
“But we need to talk about it and understand it better because then we can protect the players and still play contact rugby at the same time.”
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