Student Blog 02: Adding an Irish Sporting Context to Female Concussion Research
Ayrton Walshe: “I started out in Sports and Exercise Science at GMIT (now ATU Galway) back in 2016. Fast forward to 2024 and I’m aiming to be in the final stages of a PhD exploring concussion in female sport. I’m still at ATU Galway, though a little older and a little bit balder. My interests lie in athlete welfare, exercise for physical and mental health, and sports nutrition. I’m an NSCA Certified Strength and Conditioning Coach (NSCA CSCS), ACSM Certified Personal Trainer (ACSM-CPT), and for my crimes I’m also an avid Brazilian Jiu Jitsu athlete - currently a blue belt at Shaolin MMA Galway.”
I applied to undertake a research masters programme under Dr Lisa Ryan and Dr Ed Daly in 2020 to explore sport-related concussions (SRCs) in female sport. Admittedly I had a vague understanding of the area prior to my interview, knowing concussions were ‘important’ (as if pre-programmed to say so) but knowing little about the reality of the injury, the research climate, and the role of sex in this injury. The pre-interview speed run of the available literature quickly highlighted this area was worth investigating. In particular, the research suggested female athletes experienced greater risk and burden from the injury, there were numerous gaps in this population within the literature, and these athletes are often under-resourced compared to their male counterparts.
The initial project had three key issues to address: (1) determine the concussion incidence in female contact and collision sport, (2) evaluate if a brief in-house concussion education tool (developed by Dr Caomhan Conaghan) can improve female athletes’ knowledge and attitudes toward the injury, and (3) validate a novel eye tracking device as an objective return to play (RTP) tool compared to current concussion return to play protocols. Over the past two and half years, the project has expanded to address additional gaps as is the nature of the PhD endeavour. Address one gap in the literature, and you open a door for three more.
To date, we have; published two studies from the project, completed another two which are currently under peer review, completed two more which are currently in write up, and one final study is underway. Our current and future published work from the project will be available via my ResearchGate account, so please feel free to connect on there (see author bio). However, in the interim here are some of our key findings to date:
Our systematic review found female rugby union, association football (soccer), and Gaelic football had the highest sport-related concussions (SRC) rates in published literature.
Gaelic football (200,000 athletes) and camogie (100,000 athletes) had minimal data available with only 11 and two diagnosed SRCs reported respectively across 10 years.
Concussion RTP knowledge and implementation is poor in amateur female sport. Barriers to SRC-RTP were stakeholder inaction, biopsychosocial norms, and practitioner effectiveness.
Sports science and medicine proved difficult to implement in amateur female sport. Barriers included resource capital, education, and female-specific challenges. Facilitators included developing communication and relationships, outsourcing responsibility, and access to exposure to elite sport or national governing body protocols.
A four-minute animated video improved SRC knowledge and attitudes immediately post-intervention in female athletes. Knowledge was also improved at six-months but the effect on attitudes was unclear.
Initial findings indicate that baseline intra and inter-session reliability of the novel eye tracking tool for SRCs was poor and scores were significantly affected by just three minutes of high-intensity intermittent exercise limiting the tools utility pitch side. This scoring did revert to baseline within 10 minutes of exercise cessation however.
Ultimately it is hoped that this research adds both an Irish and much needed female-specific body of literature in SRCs and especially RTP. Our research has attempted to provide sufficient evidence to support greater focus on female SRC epidemiology and support during the return to play process, problem solve SRC education, and evaluated emerging technology as an alternative to current RTP processes. With this in mind, two key future research studies can build on this body of work by investigating to feasibility of SRC-RTP education tools and by developing ‘concussion passport’ tools for monitoring of SRCs within and between amateur Irish sports. Further actionable information from this work would also include a push for parity in resourcing and equality between male and female sporting codes in Irish amateur sport to ensure all athletes are exposed to the highest level of high-quality athletic performance, athlete welfare, and athlete wellbeing initiatives.
Personal Reflective Insights:
The PhD journey is long and can take its toll if you let it. Here are a list of non-negotiables I would share with my past-self if I could:
Overworking is counter-productive and is a sure-fire way to poor quality work and an unhappy work-life balance. Set structured and realistic work hours that you adhere to at least 90% of the time (deadlines may need some adjustments).
You are on the road to a PhD, the key words there being ‘on the road’. We all have personal strengths and weaknesses, and weaknesses are good -if you didn’t have any, a PhD would be pretty pointless, wouldn’t it? You can fast track your progress and ensure your growth if you are vulnerable and ask as many questions as you can. Reach out to your supervisors, fellow PhDs, and researchers in your space.
Do not ignore stress. All PhD students want to graft and push themselves, but that can be all-consuming. This is before the financial pressures, and social consequences that come with the journey. Reach out to friends, family and supervisors if you need help and prioritize time for exercise, good home cooking and getting outdoors. I’ve also become a big fan of brain dumps this past year, if the mind get’s too busy be sure to give them a try.
Stay connected! The academic bubble can envelop you if you aren’t careful, and guilt for enjoying leisures is real. Keep going and you’ll find yourself on a one-way ticket to disconnecting from your friends and loved ones. So do set time aside for fun, and do make plans at least once a week. Your monitor and excel sheet will still be there when you get home.