Thornton, Jane S.Hewitt, ChloeKhan, Karim M.Speechley, MarkAmbrose, AshleyReilly, KristenMountjoy, MargoGouttebarge, VincentCrossley, Kay2024-10-092024-10-092024-08Thornton, J.S., Hewitt, C., Khan, K., et al. Hang up your cleats and hope for the best? A cross-sectional study of five health domains in retired elite female rugby players. BMJ Open Sport & Exercise Medicine 2024;10:e001999. doi:10.1136/bmjsem-2024-001999.2055-7647 (online)10.1136/bmjsem-2024-001999http://hdl.handle.net/2263/98551SUPPORTING INFORMATION: FILE S1: Additional supplemental material is published online only. To view, please visit the journal online (https://doi. org/10.1136/bmjsem-2024- 001999).DATA AVAILABITY STATEMENT: Data are available upon reasonable request. Data can be shared upon reasonable request.OBJECTIVES: To investigate retired elite female rugby players’ health outcomes (and their relationships) in five key areas (musculoskeletal, cognitive, mental, reproductive/endocrinological and cardiovascular) and how those compare with the general population. METHODS: Female rugby players aged ≥18 years old and retired from elite competition ≥2 years were recruited via email or social media to complete a 179-item online questionnaire and neurocognitive assessment. Data from general population controls (matched for age and sex) were obtained where available. RESULTS: 159 participants responded (average age 43 (±5) years). 156 (98%) reported a hip/groin, knee, foot/ankle or lower back injury during their career, of which 104 (67%) reported ongoing pain. Participants reported worse hip and knee outcomes compared with the general population (p<0.0001). 146 (92%) reported sustaining one or more concussions. History of concussion was associated with lower-than-average scores on neurocognitive assessment. Compared with general population data, retired female rugby players reported less anxiety (OR=0.079 (95% CI 0.03 to 0.19)), depression (OR=0.67 (95% CI 0.57 to 0.78)) and distress (OR=0.17 (95% CI 0.15 to 0.19)). Amenorrhoea rates were higher compared with matched controls, and the age at menopause was younger. The prevalence of hypertension was higher. The rugby players perceived that their health decreased in retirement and cited a lack of physical activity as a main contributor. CONCLUSION: Our findings point to the potential value of screening and monitoring, and identifying preventative measures during sporting careers to promote health and long-term quality of life for athletes.en© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC.Retired elite female rugby playersMusculoskeletal injuriesConcussionNeurocognitive assessmentSDG-03: Good health and well-beingSDG-05: Gender equalityArticle