Major study highlights a critical concussion “tipping point” in women’s football

A major new international study has brought fresh clarity to an issue that’s been gaining momentum across women’s football: the real impact of concussions on players’ cognitive health. While the results offer reassurance in many areas, they also highlight a clear warning signal that clubs, players and decision‑makers can’t afford to overlook.

This conversation has renewed urgency following the inquest into former Scotland, Manchester United and Leeds defender Gordon McQueen, where repeated heading was found to have “likely” contributed to the chronic traumatic encephalopathy (CTE) and vascular dementia involved in his death. His case has intensified scrutiny across the sport — not only in the men’s game, but also in the rapidly expanding women’s game, where concussion rates are already higher and physiological risks may differ.

While men’s football has long benefited from established campaigning and support, women’s football is only now building the evidence base on concussion-related cognitive risk. This new study takes an important step by identifying a potential “tipping point” at three concussions, underscoring the need for tailored research, funding and welfare protections that keep pace with the women’s game’s rapid growth.

Here, trusted national health commentator Thorrun Govind, sports safeguarding expert Catherine Forshaw and Georgina Rothwell explore the key findings and outline what they mean for clubs, governing bodies and others responsible for player welfare.

What the study looked at

The aim of the study was to understand whether repeated head impacts or a history of diagnosed concussions was linked to changes in cognitive function.

Researchers assessed the neurocognitive abilities (i.e., thinking and processing) of 68 professional women footballers using a series of digital cognitive tests, examining areas including:

• Memory.
• Attention.
• Processing speed.
• Decision‑making.
• Reaction time.

Three key findings from the study

1. Reassuring results for most players

When compared with the general population, players demonstrated normal cognitive performance across almost all areas assessed. Motor speed was higher than average, aligning with the physical and performance demands of elite‑level football.

These results suggest that there’s no clear evidence of widespread cognitive impairment for most female professional footballers.

2. A red flag is raised at three concussions

More concerning results emerged among players with a history of three concussions. These players showed a significant decline in simple attention — a core cognitive skill that affects reaction time, decision‑making and everyday functioning. 

Notably:

• This association didn’t appear in players with one or two concussions.
• The pattern was non‑linear, meaning that the ‘drop‑off’ only became clear at three.
• Players with four or five concussions didn’t show the same statistical effect, though this may be due to the very small sample size in those groups.

These findings suggest that three concussions may represent a critical threshold for measurable cognitive change.

3. Defenders most affected

Defenders reported the highest concussion rates, with 64% reporting at least one concussion during their career, consistent with the physical nature of the position and higher frequency of aerial challenges. 

Implications for players, clubs & governing bodies

Although the study doesn’t suggest a crisis in neurocognitive health among women footballers, it does highlight a key preventative message:

Three concussions appear to mark a critical tipping point where measurable cognitive decline begins to emerge in female players.

For stakeholders, this has important implications:

• For players, it encourages early reporting of symptoms and reinforces the need for adequate recovery time after a head injury
• For clubs and medical teams, it supports the value of routine baseline and follow‑up cognitive testing and highlights the importance of tailored return‑to‑play protocols.
• For governing bodies & policymakers, it strengthens the case for continued research in the women’s game and underscores the need for consistent concussion reporting and monitoring. 

As scientific understanding of concussion risk develops, organisations responsible for player welfare are increasingly expected to reflect that evidence in their policies, training environments and medical decision‑making. In this context, the researchers emphasise the need for larger, long‑term studies and improved methods of recording concussion history, recognising the limitations of self‑reported data.

How concussion research translates into legal responsibility

Professional football operates within a well‑established framework that places clear responsibilities on those involved in managing and employing players.

Clubs, leagues and governing bodies owe duties of care to players under a combination of common law negligence principles, employment law obligations and health and safety legislation. In practical terms, this means taking reasonable steps to protect players from foreseeable harm, including harm arising from injury risk inherent in the sport.

What constitutes ’reasonable steps‘ isn’t fixed. The legal standard evolves alongside scientific knowledge and industry practice. As the evidence base around concussion and brain health grows, so too does the expectation that organisations will respond to that evidence by reviewing and — where necessary — updating their approach to risk management.

Research identifying a potential concussion tipping point is therefore legally significant. Where risks become clearer and more measurable, they’re more likely to be regarded as foreseeable. This can affect how decision‑making is judged in hindsight when assessing the adequacy of medical protocols, return‑to‑play decisions, training practices or long‑term monitoring arrangements.

In the context of women’s football, these issues take on additional importance. The women’s game is rapidly professionalising, yet many governance, safeguarding and medical frameworks are still in the process of developing. There’s increasing scrutiny on whether systems designed historically around the men’s game sufficiently account for sex‑specific risk, higher concussion rates and differing physiological responses.

As a result, clubs and governing bodies can’t assume that existing policies will remain adequate simply because they’re long‑standing or widely used. Evidence‑based differentiation, particularly where research highlights risks specific to women players, is becoming an important part of demonstrating compliance with legal and regulatory expectations.

Regulatory & governance considerations

Alongside general legal duties, concussion management sits within a broader regulatory and governance landscape.

Governing bodies are responsible for setting rules, medical guidance and welfare standards, while clubs are responsible for implementing those standards in practice. Where research highlights emerging risks, regulators may face pressure to update guidance, enhance monitoring requirements or introduce more formalised concussion management frameworks.

From a governance perspective, this places increasing emphasis on:

• Documented medical protocols.
• Clear decision‑making structures.
• Consistency of approach across competitions.
• Effective record‑keeping around injury history and recovery.

Failings in these areas can create exposure not only to civil claims but also to regulatory action and reputational harm, particularly in a climate where player welfare and brain health are under growing public and media scrutiny.

How we can help

This study provides reassurance that women professional footballers generally demonstrate healthy cognitive function. However, the clear association found at three concussions signals a need for proactive monitoring, robust medical assessment and continued investment in player welfare. 

If your organisation works with players, clubs or sporting bodies, understanding these emerging risks is essential — not only for safeguarding wellbeing, but also for managing legal, contractual and operational exposure.

Our award-winning sports law team can support you by:

• Advising clubs, leagues and sporting bodies on the legal implications of emerging concussion research and evolving standards of care.
• Reviewing and strengthening concussion management, monitoring and return‑to‑play frameworks to ensure that they remain legally robust and evidence‑led.
• Supporting organisations to manage legal, contractual and operational risk arising from player injury history and long‑term health considerations.
• Advising on governance, safeguarding and regulatory responsibilities where player welfare and brain health are under increased scrutiny. 

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