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.”
Smith not pinning blame on Ford for England loss
Marcus Smith does not blame England's narrow defeat to New Zealand on Saturday on George Ford, despite his late missed kicks.
Ford replaced Smith, who had scored 17 points and set up England's only try in their 24-22 loss, hitting a potential match-winning penalty against the post before narrowly missing a drop goal.
England had held an eight-point advantage when Smith left the field, but Mark Tele'a's 76th-minute try before Damian McKenzie added five late points proved enough to get the All Blacks over the line.
The hosts' autumn series got off to a losing start as Ford struggled to find his clinical edge in the dying moments, but Smith does not lay any blame at his team-mate's feet.
"Sometimes that's the life of a kicker, we've all experienced that. It's part and parcel of the job," said Smith.
"I've learned so much off George. He's an unbelievable kicker, both off the tee and out of hand. It was one of those days.
"It's nothing to do with him why we didn't win the game. It's a team effort. Every kicker in the world has experienced that.
"We practise [drop-goals] as kickers every single day, but sometimes it doesn't go for you. We're all human and people miss."
Saturday marked a third consecutive narrow loss to New Zealand for England, with their last win an emphatic victory over Japan in June.
Despite that run, Smith remains confident that England can take lessons from these defeats to set themselves up for success in the future.
"International rugby is very different to the Premiership and the experiences we're experiencing now are very painful, but we'll be better for them," Smith added.
"Keep the faith. We've fallen again on the wrong side of the result, but we'll learn from it 100%.
"These experiences will tighten us as a group, and it will be worth it in the long run. We will be better for it."
England 'banging on the door' of rugby's elite, says proud Borthwick
Steve Borthwick reckons England are "banging on the door" of the elite nations after their close loss to New Zealand.
England went down 24-22 to the All Blacks in Saturday's Test match at Twickenham.
Mark Tele'a scored the decisive try for New Zealand, who beat England twice in July, in the 76th minute.
England missed the chance to win it late on when George Ford missed a drop-goal attempt, after he had struck the post with a penalty.
But coach Borthwick, who was immensely proud of his team, feels England showed they are capable of mixing it with the best teams in the world, despite losing four of their last five Tests.
"It is a mixture of immense pride at the performance against a very tough New Zealand team and one of incredible disappointment," Borthwick told BBC Radio 5 Live.
"They are the emotions we balance and will work through over the next few days.
"When we started two years ago we wanted to get England right to the top of world rugby again. You can see the team banging on the door."
With the pre-match build-up having been dominated by Joe Marler's jibe at New Zealand's pre-match haka routine, tries from Tele'a and Will Jordan put New Zealand in control.
Marcus Smith's penalties kept England in contention, though, and he set up the hosts' only try when he intercepted a loose pass and teed up Immanuel Feyi-Waboso.
Yet England ultimately failed to hold on to an eight-point advantage, with Ford having to be consoled by his team-mates after the match.
Next up for England are Australia, with fixtures against South Africa and Japan also in store.
"We really have to find a way of winning these close ones," said captain Jamie George. "We put ourselves in a really good position after 60 minutes.
"Eight points is a lot in Test match rugby but we probably went chasing the game a bit and gave away too many penalties. We have to be smarter in that respect."
England walked up to the halfway line to face the haka, something George explained was planned prior to Marler's comments.
"That was always our plan before Joe's comments but we did it in a respectful way," said George. "I saw a smile on Scott Barrett’s face, I was smiling, and it was done in good spirits."
England aiming to be one of 'world's best' teams, says Earl
England have aspirations of greatness, asserted Ben Earl as he prepares to face New Zealand in a friendly at Twickenham.
The 26-year-old was optimistic about the progress England had made under Steve Borthwick despite registering two losses at the hands of the All Blacks in July.
England will be seeking revenge after losing the second match of the test in a devastatingly close 16-15 defeat. Immanuel Feyi-Waboso had scored a try to put England ahead after scores had been tied 10-10 at half-time, but two penalty kicks from Damian McKenzie ended their hopes.
Earl, however, believes the heartbreak has given his country an opportunity to develop.
“I think it’s an experience all the big teams go through, you have to go through some heartache to get over the line,” he told TNT Sports.
“It just feels like it’s the evolution of all the top teams, and we are a team that wants to be known as a great team, some of the world’s best.
“So we know the heartache is good for a while, but it’s time to go and do it at the right time. We got a glimpse of it against Ireland last year, and we feel we are due one, and we have learnt some really hard lessons over the summer, so we feel we are in a better place for it.
“We have always said you don’t win easily against us and that’s something we have developed over the last 18 months with Steve’s mindset and the boys getting hold of it, and now I feel it’s time to get over the line in one of these big games.”
New Zealand have won their last three matches, having defeated Japan and secured a double over Australia. They struggled against reigning world champions South Africa, however, as they failed to exact revenge on the Springboks in late summer tests falling to defeat twice.
Undoubtedly, the All Blacks still represent some of the best talent in the world, with Earl expected to line up opposite New Zealand’s superstar Wallace Sititi.
“There’s stardust littered all over the pitch isn’t there? There’s some pretty cool match-ups; it just feels like a game that isn’t going to disappoint,” he said.
England won’t be overawed, though. Instead, they aim to make their west London home a fortress for visiting sides to travel to.
“[Twickenham is] a place where we want to be really, really hard to beat. And we’ve always said in the camp, if you want to beat us at Twickenham you are going to have to be over and above the norm,” Earl said.
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