Women, concussion and disputing an old myth: the game of football is not 'unsuitable for females

Despite the popularity of women’s football (soccer), in 1921 the Football Association in England outlawed women from playing on association members’ pitches and stated that ‘the game of football is quite unsuitable for females and ought not to be encouraged.’1 Many countries followed suit, with the ‘ban’ remaining in place for almost 50 years until the English Women’s Football Association was formed in 1969.1

Was the ‘ban’ justified to ‘protect’ players of the female sex? (NB: sex refers to a set of biological attributes that are associated with physical and physiological features and usually expressed as male or female).2 When it comes to concussion, some might argue that it was justified. Female players are around 50% more likely to sustain a concussion playing football than their male counterparts,3 with evidence suggesting that female football players also report more symptoms.4 5 While the mechanism of concussion in football in both male and female players is more likely from player to player contact when two or more players are competing for an aerial ball (eg, elbow-head impacts), female players appear more likely to be injured by the ball itself.4 6 However, there is a paucity of female-specific data; to date, over 80% of sports-related concussion research has been completed in male athletes, with 40% of studies included within concussion consensus and position papers containing no female participants.7 These male-biased research findings are often directly applied to female athletes, with any observed differences blindly attributed to sex differences (rather than taking into consideration sociocultural factors such as a …

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