Scotland to acknowledge concussion difference in males and females

•  Currently, only Australia and New Zealand mention a difference between the sexes in national concussion guidelines
•  Mail sport understands the literature will highlight the fact that women may be at higher risk of concussion
• The Scottish Government confirmed to Mail Sport that change was imminent, admitting that ‘updated concussion guidance is due to be published shortly’ 

Scotland will become one of the first countries in the world to acknowledge a difference between males and females in national concussion protocol, when new guidelines for sport are announced later this month.

The groundbreaking move will see sportscotland refer to studies which identify a variation in risk and recovery.

Currently, only Australia and New Zealand mention a difference between the sexes in national concussion guidelines.

Mail sport understands the literature will highlight the fact that women may be at higher risk of concussion – with a requirement for a longer period of recovery. It follows growing evidence which shows that women may have to be treated differently when it comes to recovery and management of traumatic brain injury.

The Scottish Government confirmed to Mail Sport that change was imminent – admitting that ‘updated concussion guidance is due to be published shortly’.

In a statement, Sports Minister Maree Todd said this would ‘include specific references to the impact of concussion on female athletes.’

 This advances significantly on UK-wide guidelines for grassroots sport, which were published last year by the Department of Culture, Media and Sport – where there is no delineation between males and females. However, Mail Sport understands that UK guidelines are likely to follow suit, and fall in line with Scotland’s latest update.

It’s understood the ‘If In Doubt, Sit Them Out – Scottish Sports Concussion Guidance’ has been created collaboratively with the Scottish Government and with a range of authorities – including Scottish Rugby and the SFA. Currently, neither organisation has specific guidance for women – despite a heightened awareness of the issue.

Debate around female concussion has become more prevalent in recent years, following the tragic death of former Scotland rugby international, Siobhan Cattigan. The player passed away at the age of 26, following a series of concussions.

Her family believe this lead to traumatic brain injuries during her playing career -which dramatically altered her behaviour. Her parents – Neil and Morven Cattigan – met recently with the Sports Minister, Maree Todd, to discuss their concerns over the lack of awareness around female concussion.

The Cattigans told Mail Sport they welcomed the news and were ‘extremely encouraged that female-specific changes relating to brain injuries within sport have been updated and added to guidance literature.’

‘Upon approaching the Government to request a meeting, our main objective, as Siobhan’s legacy and in her memory, was to implore them to instigate female specific research, guidance, education and awareness, and to do it now – not in 10 years’ time.

‘We highlighted the necessity for equality with male counterparts and adequate provision for female specific needs.

‘Government experts were relayed the tragic circumstances surrounding Siobhan’s passing and advised that, as her voice, and as she herself would have championed, the protection and wellbeing of all sports participants is paramount.

‘We fear that there will be another Siobhan, that another player will suffer horrifically as she did, and a family endure this existence which is not something we can sit back and allow to happen. The tragic irony for us, her parents is, had we known or more importantly had she, (as a professional player) been made aware of the potentially catastrophic effects of brain injuries and associated symptoms, she most definitely would still be with us.. There was no awareness. No education. No knowledge.

‘We have lost our beautiful daughter. However, we will continue this agonisingly painful, exhausting road to create a legacy worthy of bearing her name and push for increased safety, transparency and awareness for all participants. Siobhan loved sport and we hope her legacy will inspire positive change with welfare and safety the overriding priority.’

Crucially, the new guidelines will allow women to make an informed choice as to their participation in sport – and, it’s hoped, lay a path to a greater understanding of concussion in females.

Though more research still needs to be done in the field of female concussion, a growing body of evidence points to a difference between the sexes, in terms of impact and recovery.

One study, involving Professor Willie Stewart from the University of Glasgow and researchers at the University of Pennsylvania and Michigan State University – reviewed three years of data for 40,000 female high school footballers in the Michigan High School Athletic Association and compared it to data for a similar number of male footballers.

The study confirmed findings from previous research that, overall, risk of sports related concussion among female footballers was almost double that of males. They also identified several sex-associated differences in sports concussion mechanism and management.

In August 2022, Aberdeen Grammar Rugby club took matters into their own hands by commissioning an independent report into the enhanced risks for females – eventually asking all players to sign a legal waiver before engaging in contact rugby.

In a Mail Sport exclusive, Dr Marshall Garrett (who wrote the report) and the Aberdeen Grammar chairman, Gordon Thomson, accused both World Rugby and Scottish Rugby of ‘putting money before the safety of female rugby players’ by failing to act on increasing evidence that women are more at risk of concussions.

Dr Garrett welcomed the news that changes are afoot in Scottish guidance – insisting ‘there is no doubt that there are inherent differences in susceptibility and likelihood of longer symptoms in women and this needs to be highlighted and acted on where appropriate.’

However, he called on sportscotland to ‘ actively follow-up this new guidance with an educational initiative and if this is done it will really help raise awareness of female specific concussion issues.’