Scientists are hoping to move a step closer to cracking the concussion code for female athletes before the end of the year.
Marker Diagnostics has developed a tool which can identify the “unique signature” for concussion in a male player’s saliva.
In 2021, a University of Birmingham study found the tool was able to accurately predict the outcome of 94 per cent of head injury assessments (HIAs) conducted on elite male rugby players.
Marker researchers are now working to establish whether the same test can also accurately and objectively diagnose concussion in female players, or if a female-specific test is required.
Testing has been going on in the English women’s top flight since 2018, at the Women’s World Cup and the Farah Palmer Cup in New Zealand last year and at the TikTok Six Nations last year and this year.
The study, jointly funded by World Rugby and Marker, is set to continue in the English elite game and in this summer’s Farah Palmer Cup, and potentially in other women’s competitions where HIAs are conducted.
All players who consent to participate are given a ‘baseline’ saliva swab and fill out a health questionnaire prior to competing. They are then retested if they undergo an HIA at any point during competition.
These tests are taken at each stage of the HIA – immediately after an impact during a match, immediately after the match and between 36 and 48 hours after the match.
Patrick O’Halloran, a senior medical adviser at Marker, told the PA news agency: “We’ve seen differences between men and women at baseline, the thing we should be able to uncover by the end of this year will be whether concussion expression is different in women or is it just diagnosed differently, and what happens after that concussion.
“It could be ‘OK, men and women look a bit different on the basis of these markers, but actually those differences are proportional and after a concussion, the test is still positive when we expect it to be.
“Or actually it could be that you need a different panel of biomarkers in women altogether.”
Asked why this study is so important, O’Halloran added: “This is a group of athletes playing at a unique time, when women’s sport is really exploding in terms of its popularity.
“The opportunities for women’s sports at the moment are really, really huge. Unfortunately, at the same time, there isn’t the same resource in women’s sport as there is in men’s. But women still get concussed.
“Medics in women’s sports still have that challenge of trying to objectively diagnose concussion in female athletes. So putting something in place that can bridge that gap in resource is going to be really powerful as women’s sport continues to expand and develop.
“This is providing additional information, unique information that wasn’t available before to make players safer.
“That’s what everyone wants – players, players’ representatives, coaches want more clarity and objectivity, and what leagues want is a more consistent standard of care and a consistency and objectivity to that too.
“What we’re looking for is that signature that is unique to concussion to enable medically informed treatment.”
Published research suggests female athletes suffer a higher rate of concussion, which may be accompanied by a wider range of more severe and prolonged symptoms compared to their male counterparts.
Dr Valentina Di Pietro, from the University of Birmingham, said: “Concussion can be difficult to diagnose, particularly in settings such as grassroots sports where evaluation by a specialist clinician is not possible.
“Consequently, some concussions may go undiagnosed. A non-invasive and accurate diagnostic test using saliva is a real game-changer and will provide an invaluable tool to help doctors diagnose concussions more consistently and accurately.”
Gatland 'still the best coach in the world', says Wales assistant Howley
Wales assistant Rob Howley described Warren Gatland as the "world's best coach" and insists the under-fire boss is going nowhere.
Wales have lost each of their last 11 Test matches, their longest ever run in men’s rugby, overtaking a 10-game stretch between November 2002 and August 2003.
Their most recent defeat came by 32 points (20-52 v Australia), their heaviest loss since a 36-point thrashing at home to South Africa in August last year (16-52).
And it is not going to get any easier with world champions South Africa the visitors to the Principality Stadium on Saturday for Wales' Autumn Nations Series finale.
South Africa have emerged victorious in six of their last seven Tests against Wales (L1) and have also won each of their last three games against Wales by margins of 16+ points.
Another triumph would see Wales going the calendar year without winning a Test, which has not happened since 1937, though Howley has no doubt that Wales are in safe hands.
"We've got the best coach in the world who has had a legacy of more than 13 years," said Howley.
"He's won Grand Slams and there is no better coach to have in your camp than Warren. He gives players the confidence and self-belief they need to go out and play."
During Gatland's first stint in charge from 2008 to 2019, Wales were World Cup semi-finalists, Six Nations champions and Grand Slam winners.
This time around, amid far more challenging circumstances and attempting to mould a new squad, Wales have won just six out of his 23 Tests at the helm.
Wales have also won just one of their last 11 Test matches at the Principality Stadium, last winning in Cardiff against Argentina in November 2023.
Howley was asked if he would take an interim head coach job if Gatland departed, but responded defiantly by saying, "Warren Gatland won't leave".
Howley insists Gatland's experiences can help turn Wales around, saying: "Warren is a hugely respected coach and has coached over a number of years.
"His legacy with different teams is a winning legacy. At the moment, we are in this spell where we are losing.
"We at some point know we will win, and I hope it will be the next game on Saturday. I think at the moment we've got the best coach who has got years of experience.
"We've been in changing rooms where we've won and lost, Lions changing rooms going into the series at 1-1 with everything on the line.
"He understands rugby, and I believe Wales have got the best coach in the world to get us out of this."
Farrell backs 'composed' Prendergast to shine on first Ireland start
Andy Farrell believes Sam Prendergast is ready to step up ahead of his first Ireland start against Fiji at the Aviva Stadium on Saturday.
Farrell has made seven changes to his team, handing first caps to Leinster's Gus McCarthy and Ulster's Cormac Izuchukwu for the penultimate game of the Autumn Nations Series.
The Ireland head coach has handed Prendergast the number 10 jersey for the first time after he was used off the bench in the closing stages of last week's win over Argentina.
Prendergast has only started eight games for Leinster, but Farrell had no hesitation in handing him a first start after he impressed on the Emerging Ireland tour of South Africa.
"I'm confident from what we've seen. We took him on the Emerging [Ireland] and he played in all of those games," said Farrell.
"The aim of that was to grab hold of that team and make sure that he treated it like it was his own, as though he was in charge, and he did that in spades.
"This week we've seen the benefit of that, but we need to see it transfer, obviously.
"Yes, his character is composed, confident but yet not over-confident. He's assertive in what he wants, and he has a nice way about how he goes about his business.”
Farrell also had a glowing review for Izuchukwu, saying: "Izzy has been in and around the squad for a while. The first Emerging Ireland tour was when we first came across his ability, his athleticism, his point of difference.
"That was a couple of years ago but the improvement in his maturity of his game, because he was young in the 15-a-side game when the first tour was on, but the difference between the first and second tour was like chalk and cheese.
"His ability and potential with that maturity, he deserves a shot to show us all what he's got."
On McCarthy, who captained the Ireland Under-20s to a Six Nations Grand Slam in 2023, Farrell said: "He's been a captain and you can see why because his maturity in how he goes about the game."
He added: "We took him on the training week [to Portugal] as a development player and he showed up unbelievably well. He forced our hand to keep him in the squad first and foremost and he deserves a shot to see what he can do as well."
Ciaran Frawley also returns to the bench after missing out last weekend on the back of a poor outing against New Zealand.
And Cian Healy must wait another week for a record-breaking 134th cap - having drawn level with Brian O'Driscoll against Argentina - after the prop was left out of the 23.
Ireland team to play Fiji
Jamie Osborne; Mack Hansen, Robbie Henshaw, Bundee Aki, Jacob Stockdale; Sam Prendergast, Craig Casey; Andrew Porter, Gus McCarthy, Finlay Bealham; Joe McCarthy, Tadhg Beirne; Cormac Izuchukwu, Josh van der Flier, Caelan Doris (capt).
Replacements: Rob Herring, Tom O'Toole, Thomas Clarkson, Iain Henderson, Cian Prendergast, Conor Murray, Ciaran Frawley, Stuart McCloskey.
'World-class' Scotland will provide Wallabies' sternest test – Skelton
Australia will face their sternest test to date when they continue their autumn tour against a "world-class" Scotland team at Murrayfield on Sunday.
That is the view of forward Will Skelton, who believes the Wallabies' victories in England and Wales have brought a new energy and confidence to their camp.
Having crashed out in the pool stage at last year's World Cup in France before finishing last in the Rugby Championship, Australia have looked a team reborn in recent weeks.
A first victory at Twickenham since 2015 and a 52-20 rout of Wales – their biggest-ever away win in matches between the teams – have made it an excellent tour to date for Joe Schmidt's side.
But La Rochelle lock Skelton feels their toughest assignment is to come this week, saying: "We've won two games, we're very aware of that.
"The Test against Scotland is going to be the hardest one yet. We're excited about this weekend and we're looking forward to ripping into it.
"Physically they're up there with the top five in the world. I think set-piece wise they're really strong.
"You've got a guy like Finn Russell who's a maestro at the back there. I think it's going be a close one and we'll be up for it.
"There's some class players in the Scottish team and, when they're at it they're world-class, so we're going to have to be on top of our game."
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