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

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.

Cross sectional survey.

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.

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.

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.