Disclosure of possible concussions in National Rugby League Women's Premiership players

Shreya McLeod; Stephen W. West; Kathryn Dane; Daniel Tadmor; Ben Jones; Jinho Lee; Grant L. Iverson; Andrew J. Gardner

doi:10.1016/j.jsams.2025.04.002

Disclosure of possible concussions in National Rugby League Women's Premiership players

Shreya McLeod, Stephen W. West, Kathryn Dane, Daniel Tadmor, Ben Jones, Jinho Lee, Grant L. Iverson, Andrew J. Gardner

Research output: Contribution to journal › Article › peer-review

Abstract

Objectives: This study investigated the disclosure and reasons for non-disclosure of possible concussions and their symptoms in National Rugby League Women's (NRLW) Premiership players in Australia. Design: Cross sectional survey. Methods: During the 2022 NRLW season, NRLW players were invited to participate in a voluntary, anonymous, online survey exploring (i) player demographics, (ii) rugby playing history, (iii) concussion disclosure, and (iv) instances of, and reasons for, non-disclosure of possible concussions to medical staff during the past two seasons. Logistic regression analyses were used to identify reasons for non-disclosure of possible concussions in NRLW players. Results: Of the 132 eligible participants, 86 players responded to the survey and 63 % (n = 54/86) reported that they always disclosed a possible concussion during the past two seasons. A substantial number of NRLW players surveyed (n = 32/86, 37 %) did not disclose a possible concussion to their team or medical staff on one or more occasions. Sixty-three players (73 %) always reported symptoms during a medical assessment. Twenty-three players (27 %) did not disclose their symptoms during a medical assessment, primarily during or after a game or training session (n = 12/23, 52 %). Of the players who did not disclose their possible concussion symptoms, the two main reasons for non-disclosure were ‘not wanting to be ruled out of the game or training session’ (n = 8/23,35 %) and not being ‘sure if the symptoms were related to concussion’ (n = 8/23, 35 %). Most surveyed players (n = 74/86, 86 %) reported attending mandatory concussion education sessions at their respective clubs. Conclusion: We found high rates of non-disclosure amongst NRLW players, which is inconsistent with previous research suggesting that women are more aware of their symptoms than men and more likely to disclose their concussions. Not wanting to be ruled out of the game or training session and being unsure if the symptoms were related to concussion were the two most common reasons for nondisclosure. Concussion education initiatives could promote a supportive culture fostering disclosure amongst all stakeholders to ensure optimal player welfare.

Original language	English
Journal	Journal of Science and Medicine in Sport
Early online date	15 Apr 2025
DOIs	https://doi.org/10.1016/j.jsams.2025.04.002
Publication status	E-pub ahead of print - 15 Apr 2025

Data Availability Statement

The data that support the findings of this study are included in this
paper. Additional data relating to individual athletes is not available.

Acknowledgements

The authors thank team physicians, medical staff, and Wellbeing Officers at each of the NRLW clubs for facilitating survey distribution and the National Rugby League research committee for supporting this study. The authors express their deep gratitude to the NRLW, reserve grade, and under 20s players who completed the survey. The authors would also like to thank Dr. Thomas Longworth for input into the survey conducted in the men's NRL competition, Mr. Oliver Smith for his assistance with setup of the survey on REDCap, and Dr. Peter Goodin, Chief Scientist at HitIQ Ltd, for his assistance with statistics.

Funding

SM was supported by funding from the Australian Government Research Training Scheme for her PhD studies. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. No entity was involved in study design; the collection, analysis, and interpretation of data; the writing of the report; or the decision to submit the manuscript for publication. No honorarium, grant, or other form of payment was given to anyone to produce the manuscript. AJG and GLI acknowledge philanthropic support from the National Rugby League. GLI acknowledges philanthropic support from ImPACT Applications, Inc., the Mooney-Reed Charitable Foundation, and the Schoen Adams Research Institute at Spaulding Rehabilitation.

Keywords

Concussion
Disclosure
Female athlete
Player welfare
Rugby
Women's sport

ASJC Scopus subject areas

Orthopedics and Sports Medicine
Physical Therapy, Sports Therapy and Rehabilitation

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Cite this

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title = "Disclosure of possible concussions in National Rugby League Women's Premiership players",

abstract = "Objectives: This study investigated the disclosure and reasons for non-disclosure of possible concussions and their symptoms in National Rugby League Women's (NRLW) Premiership players in Australia. Design: Cross sectional survey. Methods: During the 2022 NRLW season, NRLW players were invited to participate in a voluntary, anonymous, online survey exploring (i) player demographics, (ii) rugby playing history, (iii) concussion disclosure, and (iv) instances of, and reasons for, non-disclosure of possible concussions to medical staff during the past two seasons. Logistic regression analyses were used to identify reasons for non-disclosure of possible concussions in NRLW players. Results: Of the 132 eligible participants, 86 players responded to the survey and 63 % (n = 54/86) reported that they always disclosed a possible concussion during the past two seasons. A substantial number of NRLW players surveyed (n = 32/86, 37 %) did not disclose a possible concussion to their team or medical staff on one or more occasions. Sixty-three players (73 %) always reported symptoms during a medical assessment. Twenty-three players (27 %) did not disclose their symptoms during a medical assessment, primarily during or after a game or training session (n = 12/23, 52 %). Of the players who did not disclose their possible concussion symptoms, the two main reasons for non-disclosure were {\textquoteleft}not wanting to be ruled out of the game or training session{\textquoteright} (n = 8/23,35 %) and not being {\textquoteleft}sure if the symptoms were related to concussion{\textquoteright} (n = 8/23, 35 %). Most surveyed players (n = 74/86, 86 %) reported attending mandatory concussion education sessions at their respective clubs. Conclusion: We found high rates of non-disclosure amongst NRLW players, which is inconsistent with previous research suggesting that women are more aware of their symptoms than men and more likely to disclose their concussions. Not wanting to be ruled out of the game or training session and being unsure if the symptoms were related to concussion were the two most common reasons for nondisclosure. Concussion education initiatives could promote a supportive culture fostering disclosure amongst all stakeholders to ensure optimal player welfare.",

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author = "Shreya McLeod and West, {Stephen W.} and Kathryn Dane and Daniel Tadmor and Ben Jones and Jinho Lee and Iverson, {Grant L.} and Gardner, {Andrew J.}",

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AU - McLeod, Shreya

AU - West, Stephen W.

AU - Dane, Kathryn

AU - Tadmor, Daniel

AU - Jones, Ben

AU - Lee, Jinho

AU - Iverson, Grant L.

AU - Gardner, Andrew J.

PY - 2025/4/15

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N2 - Objectives: This study investigated the disclosure and reasons for non-disclosure of possible concussions and their symptoms in National Rugby League Women's (NRLW) Premiership players in Australia. Design: Cross sectional survey. Methods: During the 2022 NRLW season, NRLW players were invited to participate in a voluntary, anonymous, online survey exploring (i) player demographics, (ii) rugby playing history, (iii) concussion disclosure, and (iv) instances of, and reasons for, non-disclosure of possible concussions to medical staff during the past two seasons. Logistic regression analyses were used to identify reasons for non-disclosure of possible concussions in NRLW players. Results: Of the 132 eligible participants, 86 players responded to the survey and 63 % (n = 54/86) reported that they always disclosed a possible concussion during the past two seasons. A substantial number of NRLW players surveyed (n = 32/86, 37 %) did not disclose a possible concussion to their team or medical staff on one or more occasions. Sixty-three players (73 %) always reported symptoms during a medical assessment. Twenty-three players (27 %) did not disclose their symptoms during a medical assessment, primarily during or after a game or training session (n = 12/23, 52 %). Of the players who did not disclose their possible concussion symptoms, the two main reasons for non-disclosure were ‘not wanting to be ruled out of the game or training session’ (n = 8/23,35 %) and not being ‘sure if the symptoms were related to concussion’ (n = 8/23, 35 %). Most surveyed players (n = 74/86, 86 %) reported attending mandatory concussion education sessions at their respective clubs. Conclusion: We found high rates of non-disclosure amongst NRLW players, which is inconsistent with previous research suggesting that women are more aware of their symptoms than men and more likely to disclose their concussions. Not wanting to be ruled out of the game or training session and being unsure if the symptoms were related to concussion were the two most common reasons for nondisclosure. Concussion education initiatives could promote a supportive culture fostering disclosure amongst all stakeholders to ensure optimal player welfare.

AB - Objectives: This study investigated the disclosure and reasons for non-disclosure of possible concussions and their symptoms in National Rugby League Women's (NRLW) Premiership players in Australia. Design: Cross sectional survey. Methods: During the 2022 NRLW season, NRLW players were invited to participate in a voluntary, anonymous, online survey exploring (i) player demographics, (ii) rugby playing history, (iii) concussion disclosure, and (iv) instances of, and reasons for, non-disclosure of possible concussions to medical staff during the past two seasons. Logistic regression analyses were used to identify reasons for non-disclosure of possible concussions in NRLW players. Results: Of the 132 eligible participants, 86 players responded to the survey and 63 % (n = 54/86) reported that they always disclosed a possible concussion during the past two seasons. A substantial number of NRLW players surveyed (n = 32/86, 37 %) did not disclose a possible concussion to their team or medical staff on one or more occasions. Sixty-three players (73 %) always reported symptoms during a medical assessment. Twenty-three players (27 %) did not disclose their symptoms during a medical assessment, primarily during or after a game or training session (n = 12/23, 52 %). Of the players who did not disclose their possible concussion symptoms, the two main reasons for non-disclosure were ‘not wanting to be ruled out of the game or training session’ (n = 8/23,35 %) and not being ‘sure if the symptoms were related to concussion’ (n = 8/23, 35 %). Most surveyed players (n = 74/86, 86 %) reported attending mandatory concussion education sessions at their respective clubs. Conclusion: We found high rates of non-disclosure amongst NRLW players, which is inconsistent with previous research suggesting that women are more aware of their symptoms than men and more likely to disclose their concussions. Not wanting to be ruled out of the game or training session and being unsure if the symptoms were related to concussion were the two most common reasons for nondisclosure. Concussion education initiatives could promote a supportive culture fostering disclosure amongst all stakeholders to ensure optimal player welfare.

KW - Concussion

KW - Disclosure

KW - Female athlete

KW - Player welfare

KW - Rugby

KW - Women's sport

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Disclosure of possible concussions in National Rugby League Women's Premiership players

Abstract

Data Availability Statement

Acknowledgements

Funding

Keywords

ASJC Scopus subject areas

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