Her work has already provided new insights into brain injuries suffered by young female athletes. Now, thanks to one of the province’s most competitive scholarships, Alexandra Harriss looks to head off those injuries sooner, perhaps even changing how the most popular sport on the planet is played and coached.
Harriss, a Health Sciences doctoral candidate in the combined MPT/PhD program, was among only nine Ontario university scholars to earn a 2019-20 Women’s Health Scholars Award. Funded by the Ontario Ministry of Health and Long-Term Care, the program was established to ensure that Ontario attracts and retains pre-eminent women’s health scholars.
“This was quite a shock,” Harriss said. She was one of only two doctoral students to earn the honour. “I knew I put my best foot forward, but I wasn’t holding my breath. I am elated, overjoyed. It is incredible. This is going to help me be able to balance my research world, with PT, and being able to move forward as a graduate student.”
While a growing body of evidence shows concussions and other head injuries can lead to later cognitive harm, including Alzheimer’s disease and chronic traumatic encephalopathy (CTE), most research has focused on male American football players, with little eying how these injuries affect females or adolescents.
However, females have a higher rate of head injury compared to males, and report more severe and prolonged symptoms affecting mental and physical well-being.
Harris, who captained the University of Guelph varsity women’s soccer team, has been working to address this knowledge gap through her PhD research.
In 2016, she teamed up with the Ontario Player Development League and Burlington Youth Soccer Club on the largest and most comprehensive study assessing repetitive head injury in female adolescents. Using specialized sensors players wore as headbands, she explored changes in brain function that occur as a result of head-to-head, head-to-ground and head-to-ball impacts during practice and game play.
Her initial work showed that female teenagers frequently experience head impacts during soccer games, many of them comparable to those in American football.
Harriss was particularly interested in subconcussive hits – those hits below the concussion threshold where the brain is shaken, but not so violently that the damage is severe enough to see through symptoms. Despite the lack of obvious outward signs, the accumulation of these hits can result in damage over time.
How much? How long? Does technique matter? Would rule changes help? With two journal articles published out of that work thus far, Harriss hopes to clarify some of those questions thanks to further research made possible by the award.
Next summer, she will revisit the teams with hopes the additional data will help develop criteria to reduce the risk of brain injury – including possible new ways to coach and play the game – as well as ways to identify risks for specific players.
“We really want to find those players at risk for potential subclinical cognitive impairments,” she explained.
Subconcussions can be tricky. When the body is at rest, they tend to hide. But physical and mental exertion tend to bring them forward.
“Think of the player cleared to go to practice,” Harriss said. “So often we see them, once back practice, they have this re-emergence of symptoms. All of a sudden, they have that headache, that dizziness, that nausea again. With these subconcussions, I thought maybe we weren’t seeing any signs because we weren’t stressing the systems enough.”
Her idea is to have players stress their bodies as part of a way of finding the damage earlier – think riding a bike while doing a computerized test and seeing how you feel afterward.
“We have this understanding, this model we can use thanks to the previous research,” she said. “OK, now, how can we identify these players on the individual level? How can we ensure that if you, say, have a soccer career of X-number of years, how do we protect you?
“In the end, we are looking out for players’ health first and foremost.”