With concussion in women's rugby under a spotlight, the Black Ferns are chipping in this weekend by wearing high-tech mouthguards, in a world-first tracking of head knocks in the international game.
When the Black Ferns take the field in their 100th test against England, take a closer look at their mouths. They'll tell a ground-breaking story in sports history, in the mission to better understand and prevent head injuries in rugby.
As the Black Ferns throw themselves into tackles, engage in scrums, or hit the ground in Monday morning’s clash, their custom-made mouthguards will send critical information directly back to New Zealand.
The data collected from their two tests against the Red Roses – and from every training on the Black Ferns’ northern tour - is part of an ongoing World Rugby head impact study, pioneered in Dunedin, that will help form new prevention measures for head injuries and concussion in rugby worldwide. And most likely it will help other sports, too.
Why is this test important (other than being the New Zealanders' first international in two years)? Because the Black Ferns and their English opponents are the first international teams in the world – male or female - to take part in World Rugby’s player welfare study, understood to be the largest of its kind in world sport.
It’s especially crucial as global research reveals female athletes are at almost twice the risk of suffering concussion than male athletes, and women and girls take longer to recover from a head injury.
New Zealand Rugby’s research scientist in concussion, Dr Danielle Salmon, says the Black Ferns’ involvement is a critical piece in the full puzzle around understanding concussion in rugby - especially for female players.
“I don’t think you’ll ever see concussions disappear. Unfortunately, things happen that you have no control over. But with this research, we’ll be doing the best that we can to limit those events happening,” she says.
“It’s really cool to see the willingness of women’s teams to be involved in something like this. It’s pretty special.”
Black Ferns captain Les Elder is happy her team are involved and helping to “improve the knowledge around female rugby players” through the head-collision data. “We’re also proud to be playing a role in improving the game and making it safer for everyone, from young girls and boys to professional teams,” she said from England, preparing for the historic test at Exeter.
The findings from these international games will be combined with research undertaken by the University of Otago, who’ve used the same technology on club players in Dunedin and elite players at Farah Palmer Cup level.
The Auckland Storm and Otago Spirit women’s sides agreed to wear the mouthguards as part of the study.
Auckland Storm player Taylor Curtis says the specialist mouthguards felt a little bulkier than their usual custom-made versions, but not uncomfortable.
“We wore them in trainings, too, and we all got used to them,” she says. “Even when we were just running around, they wanted to collect all the data as a baseline.
“It was like a no-brainer to be involved. It’s cool to support research into women’s rugby.”
Concussion remains a serious issue in sport in New Zealand. Rugby leads the way in ACC claims for concussion – in 2019, there were 2643 players who made claims. The next highest sport for head injuries was football, with 723 claims.
“I personally haven’t had a head injury, but a couple of my friends have had to deal with concussion, and they’ve been out for weeks,” Curtis says. “It’s not great for a player's mental health, because it takes a long time to return to play, and they feel like they’re out of the loop while they’re training to get back to the field."
The instrumented mouthguards, made by American company Prevent Biometrics, contain an impact monitoring system that collects and transmits data every time there’s a collision between players or when a player hits the ground.
Embedded in the mouthguard is an accelerometer, similar to that used in a mobile phone to track steps; this one tracks acceleration forces. And there’s a type of mini gyroscope which gives an indication of the position of the player’s head in space.
The players are videoed at the same time so the impacts can be time-coded for analysis.
“All they have to do is wear the mouthguard,” Salmon says. “We go in after their trainings and games and use the video to identify when the mouthguard triggered an event. Whether they take a bump to the head or have acceleration or deceleration.
“It creates a time-stamp, and we match that with what was happening on the field. Like at 8.13 one of the Black Ferns made a tackle, or she just pulled her mouthguard out and stuck it into her sock.”
The University of Otago study, led by Associate Professor Melanie Bussey, has finished collecting data from 623 female and male rugby players – from U13 grades through to NPC and FPC level – and are at the point of cross-referencing 40,000 head impacts with 400 hours of video footage.
“We’ve been able to capture a few concussions on the community side of the study and want to be able to understand if there's a pattern or a profile to these concussions,” Salmon says. “Then we can we use this data to understand if there’s a critical threshold or a specific set of actions where you go into a tackle and you’re upright and very exposed, when we see the bigger accelerations.
“If that’s the case, can we use that information to say ‘Can we spend more time focusing on tackle technique and then reduce the occurrence of those?’”
Salmon says this data, on top of international research, shows female rugby players tend to be at a higher risk of concussion than male. “From the work we’ve done in the community space in the last three years, we know that our concussion rates for men sits at around 13.8 suspected concussions per thousand playing hours, and in the women’s game it sits at about 20.8.”
There's a similar outcome showing up in other sports, too. A study of more than 80,000 secondary school soccer players in Michigan found girls were nearly twice as likely as boys to experience concussion.
“In rugby, we know girls often start to play later in high school, around 14 or 15, so they haven’t had that skill development that we’d see with their male counterparts who started at eight or nine,” Salmon says.
International research is also looking at whether anatomical and hormonal factors increase the risk of concussion for females.
“It’s really critical to understand what the factors are and why it appears women are more symptomatic with concussion. The nerve fibres in the brain tend to be finer in women, which could play a role, and it may also depend on where a woman is in her menstrual cycle,” says Salmon.
There are societal and social factors, too. Women tend to report more symptoms in a concussion assessment than men do. And, Salmon says, women tend to have more knowledge about concussions and better attitudes towards reporting head injuries.
Data gleaned from the Black Ferns and Red Roses in their two tests will be added to information collected from the Otago Rugby community head impact detection study, and the professional men’s club sides of Leinster, Claremont Auvergne and Benetton Treviso.
That’s more than 1000 players contributing to the largest study of its kind. World Rugby is calling it the “cornerstone” of its recently launched six-point plan to cement rugby as the leading sport on player welfare, with part of its focus on the women’s game.
“It’s phenomenal,” Salmon says, “and maybe reflects that while there’s an increased risk for women, they’re not burying their heads in the sand and pretending it’s a problem that will go away. I think it’s a testament to ensuring they want the sport to grow.”
Getting the Black Ferns on board was a game-changer, Salmon says.
At the week-long training camp before they left New Zealand, 34 of the 35 Black Ferns had their teeth 3-D scanned (one player had a false tooth so stuck with her own special mouthguard).
“There was real support and buy-in," says Salmon, "which is a testament to how invested these women are to making sure the game is safer for everybody to play.”
* The Black Ferns' first test against the English Red Roses will be live on Sky Sport 1 on Monday at 3.15am.
You can watch the full version of All Access: The Black Ferns on demand at Sky Go and Sky Sport Now.
