Disturbing link in deaths of young female athletes

1 year ago 40

Kelly Catlin and Ellie Soutter ne'er met, but they had a batch successful common.

Both were commanding athletes: Catlin, a US way cyclist, was a three-times satellite champion and Olympic metallic medallist, and Soutter, a snowboarder, was tipped to beryllium 1 of Team Great Britain's strongest contenders for the 2022 Winter Olympics, having already won a bronze medal astatine the 2017 European Youth Olympic Festival.

Both were incredibly astute -- Catlin was studying for a master's grade successful computational and mathematical engineering astatine Stanford University, portion Soutter learned to talk French successful astir six months, according to her father.

At times they astir seemed superhuman. In 2013, aft lone 3 weeks of ceremonial grooming and having breached her wrist, Soutter became British Champion with her limb successful a cast. Meanwhile, Catlin, who had a tenderness for children, erstwhile rode 130 kilometres done sleet and snowfall to talk to a people schoolhouse astir her Olympic experience.

Yet these 2 women's lives were tragically chopped abbreviated aft they sustained superior caput injuries successful their pursuit of sporting greatness and past took their ain lives. Catlin was 23, portion Soutter died by termination connected her 18th birthday.

Females whitethorn beryllium much susceptible to concussion, and they besides person worse and prolonged symptoms aft their wounded than men, according to a reappraisal of 25 studies of sport-related concussion published successful the Orthopaedic Journal of Sports Medicine.

However, women stay importantly underrepresented wrong athletics and workout subject research. This, starring experts warn, means they often bash not get the attraction oregon aftercare they request pursuing a caput injury.

Women's sports person historically not received the aforesaid attraction oregon backing arsenic men's sports, Dr Ann McKee, Director of the Boston University Chronic Traumatic Encephalopathy (CTE) Center told CNN.

"It's been shown that women athletes are much apt to get a concussion, they thin to person longer betterment periods," McKee added.

"We bash not person capable accusation astir what happens successful the pistillate brain. We don't cognize if women are biologically much susceptible to these injuries," she said, adding that immoderate probe suggests the size and musculature of women's necks could play a part.

Kelly

Before becoming a way cyclist, Catlin, a triplet, was a nationalist champion roadworthy cyclist and clip proceedings nationalist champion, her begetter Mark, told CNN. After winning a Canadian planetary contention astatine 17 she was invited to an Olympic grooming campy for a effort out, where, impressed by her show numbers, coaches instantly offered her a presumption connected the way pursuit team.

Catlin's father, Mark, told CNN, that his girl was "intense" and "ambitious," attributes she channelled into her sporting life.

Her beingness changed irrevocably successful January 2019. Practicing accelerated downhill descents successful the hills adjacent Los Angeles, she crashed and went skidding down the road. Despite suffering roadworthy rash, Catlin got backmost connected her bike, and finished the ride. It wasn't her archetypal clang -- she had experienced 4 oregon 5 hard crashes earlier this, her begetter said, and aft the latest, she didn't person immoderate symptoms astatine the time.

But soon after, astatine a World Cup way lawsuit successful Berlin, Catlin was gripped by a abrupt and terrible headache.

"She couldn't compete," her begetter said. "Kelly is benignant of this stoical individual. And if she's rolling astir connected the ground, clutching her head, it has to beryllium a terrible thing."

On person inspection, Catlin's helmet from LA had dents successful it. Her begetter told CNN that this, coupled with her symptoms, caused her household to go alert she had suffered a concussion, which was aboriginal confirmed with a diagnosis from Stanford's Health Center.

A concussion is simply a encephalon wounded which happens aft a deed to the caput oregon assemblage causes the encephalon to determination backmost and distant wrong the skull, according to the CDC.

When Catlin returned to the US, her begetter says she was examined by the way grooming centre successful Colorado. It was confirmed she suffered a concussion, and a instrumentality to grooming protocol was advised, but not implemented oregon communicated to her coach, helium said.

"There wasn't immoderate follow-up from Colorado aft this. I judge they assumed she would question attraction astatine Stanford," helium told CNN.

CNN has reached retired to Stanford and USA Cycling for comment.

Catlin's symptoms didn't improve, and successful play telephone calls with her parents, she admitted she was struggling with schoolwork and was incapable to concentrate.

Stanford Health Center, having diagnosed Catlin with concussion with ongoing symptoms, recommended that she alteration her grooming for 2 weeks and past gradually physique backmost up and commencement sessions with an diversion trainer, aesculapian documents sent to CNN by her begetter show. She was referred to a concussion specialist, the papers adds.

She tried to train, but "she would person to halt due to the fact that she got a terrible headache conscionable from walking," according to her father. Her bosom complaint would besides accelerate rapidly from adjacent the smallest exertion, leaving her with "no workout tolerance whatsoever," helium added.

Her wounded had different consequences.

"As acold arsenic we knew she was ne'er a idiosyncratic that suffered from depression. She had an absorbing consciousness of humour. She was ever upbeat and bubbly astir things," her begetter told CNN.

"She fundamentally thought her beingness was over. She was nary longer capable to beryllium the jock that she was, she was failing her teammates. And she wasn't capable to win successful schoolhouse now. And I deliberation ultimately, that's wherefore she took her life, due to the fact that she thought her beingness was over," helium added.

At the extremity of January, Catlin made a superior but non-fatal termination attempt, and was involuntarily admitted to the locked psychiatric ward astatine Stanford, her begetter told CNN.

A period aft that attempt, she took her ain life.

Ellie

Soutter's begetter Tony said determination were galore dimensions to his young girl -- not lone was she an "adrenaline junkie," but she was "very conscientious" and excelled successful school, adjacent aft moving from England to France.

Aged 12, Soutter took up snowboarding astatine schoolhouse -- and conscionable months later, she was spotted successful her hometown edifice of Les Gets and trialled by Team Great Britain successful February 2013.

"It was rather evident wherefore she kept winning competitions due to the fact that she conscionable made it easy," her begetter said. "She conscionable made it look graceful and beautiful."

But grooming took its toll -- Soutter told CNN that his girl suffered 7 large concussions successful 5 years, betwixt 2013 and 2018.

"I was being advised by doctors "Oh, don't worry, she's young capable she'll bounce back. As she progressed, becoming an elite jock starting connected the World Cup circuit, each clip she had different concussion, they got worse, and they took longer to retrieve from," helium told CNN.

"With each concussion, with the objection of a fewer insignificant knocks, Ellie saw a doc successful person," helium added. "I was ever told that she was young capable to bounce backmost to afloat wellness aft each lawsuit and truthful ne'er consulted with the doctors that I met, astir immoderate erstwhile concussions."

But Soutter's last concussion was truthful "huge" that she spent 2 nights successful the hospital.

"When I got there, she didn't adjacent cognize who I was oregon wherever she was," her begetter said.

Soutter was past selected for the Junior Snowboard World Championships successful New Zealand August 2018. But a period earlier the competition, she died by suicide.

Her begetter said a neurologist conducted a CT scan of her encephalon and absorption tests 3 months aft her last concussion, but said she was "absolutely fine" and could proceed competing.

Like Catlin, Soutter had issues with studying and concentrating, becoming much insular arsenic she suffered from crippling headaches. She besides started suffering from insomnia.

"She would virtually beryllium with the tutor a bully period aft a concussion, and suddenly, she'd spell blind. She'd not beryllium capable to spot -- everything would spell achromatic and dark," her begetter said.

After missing a formation to snowboard training, Soutter died by termination connected her 18th birthday.

Team GB referred CNN to GB Snowsport erstwhile approached for comment, adding that Ellie lone competed for Team GB astatine 1 event.

In bid to correspond Britain successful planetary competitions, GB Snowsport says athletes oregon their coaches are required to show that the jock has reached established show criteria, is of the applicable method quality to compete, and has due aesculapian clearance to compete. A ample fig of athletes tin correspond Britain astatine antithetic levels of planetary contention but are not portion of a programme delivered and overseen by GB Snowsport.

"As Ellie was not portion of the GB Snowsport programme, we were incapable to instrumentality a personalised betterment and absorption programme for Ellie," a spokesperson for GB Snowsport told CNN successful an email.

"She was, however, covered by nationalist policies and protocols astir fittingness to compete, and would not person been cleared for immoderate enactment -- grooming oregon contention -- overseen by GB Snowsport without being capable to show due aesculapian sign-off," they added.

The spokesperson for GB Snowsport told CNN: "We instrumentality concussions and caput injuries incredibly seriously, and successful reviewing contemporaneous records from the clip that Ellie was progressive successful snowsport we are assured that GB Snowsport unit applied and followed each due process."

Catlin and Soutter aren't the lone young sporting women whose lives person been chopped abbreviated successful this way.

After 29-year-old Australian rules shot subordinate Jacinda Barclay took her beingness successful 2020, post-mortem probe by scientists recovered that she had degradation to her cerebral achromatic substance antithetic for idiosyncratic her age.

"For idiosyncratic her age, you would expect to spot beauteous pristine achromatic matter, and hers looked similar she was an aged pistillate successful that it was fundamentally degraded," Michael Buckland, laminitis and Executive Director of the Australian Sports Brain Bank, who studied Barclay's brain, told CNN.

"We haven't gone backmost and done circumstantial achromatic substance studies connected our donors," helium told CNN, adding that the slope hasn't done adjacent reviewed probe connected this. "But what struck me, conscionable arsenic idiosyncratic that sees a batch of brains -- this is not mean for idiosyncratic of that age."

Damage to achromatic substance has been associated with dementia, according to probe published successful the Journal of the American Medical Association.

Opportunities missed

Suicide aft concussion is rare. However patients diagnosed with concussion oregon mild traumatic encephalon wounded had treble the hazard of termination and a higher hazard of termination attempts and suicidal thoughts than radical without encephalon injuries, a 2018 survey from researchers astatine the University of Harvard published successful JAMA Neurology found.

Dr Robert Cantu, objective prof of neurology astatine the Center for the Study of Traumatic Encephalopathy astatine Boston University School of Medicine told CNN that determination are respective theories arsenic to wherefore incidence of termination is higher successful radical who person suffered concussion.

One theory, helium explained, is that those suffering from persistent post-concussion symptoms whitethorn person structural oregon functional encephalon harm and could beryllium experiencing "behavioural dysregulation: abbreviated fuse, irritability, [and] can't suppress impulses the mode you usually could."

With these affectional problems, "they would beryllium much prone to possibly bash thing impulsive, similar perpetrate suicide," Cantu, aesculapian manager of the Concussion Legacy Foundation, told CNN.

A 2nd theory, Cantu noted, is that post-concussive symptoms forestall radical from getting backmost into their athletics and halt them "from being the idiosyncratic that they were earlier their injury."

Neither mentation is proven to the exclusion of the other, Cantu said, adding helium thinks accrued suicidality was "a combined origin involving some successful many, if not astir cases."

There are besides differences successful the mode encephalon injuries impact women.

A survey of pistillate shot players crossed US precocious schools recovered they are astir doubly arsenic apt to endure concussion arsenic their antheral counterparts, according to probe that looked astatine implicit 80,000 teen athletes, published successful the diary JAMA Network Open.

Women stay importantly underrepresented wrong athletics and workout subject research: a 2021 survey examining papers from immoderate of the astir influential sports aesculapian journals recovered that lone 6 percent of the studies were solely focused connected women, compared with 31 percent of studies that included conscionable men.

Other researchers person pointed to pistillate enactment hormones, with hazard of concussion changing with hormone levels during a menstrual cycle.

McKee said each athletes tin besides acquisition "non-concussive" injuries: "hits to the caput that tin beryllium of the aforesaid magnitude arsenic concussion, but they don't emergence to the level of symptoms for immoderate reason, truthful a subordinate tends to play close done it."

Cumulative vulnerability to repetitive caput impacts -- including concussion and non- concussive injuries -- increases the hazard for the neurodegenerative encephalon illness chronic traumatic encephalopathy, known arsenic CTE, McKee said.

The disease, which tin lone beryllium formally diagnosed with an autopsy, has mostly been seen successful either veterans oregon radical who played interaction sports, peculiarly American football, accidental researchers. The illness occurs erstwhile the encephalon starts to degenerate apt owed to repeated caput traumas, according to the Mayo Clinic, which notes CTE is "associated with recurrent concussions."

But scientists aren't lone acrophobic astir concussions.

Previous studies person shown subconcussive caput impacts -- repetitive hits to the caput and assemblage that bash not origin symptoms -- tin inactive effect successful semipermanent neurological disease.

According to The Concussion Legacy Foundation, "the champion disposable grounds suggests that subconcussive impacts, not concussions, are the driving unit down CTE."

There person been cases of CTE discovered successful athletes who person ne'er been diagnosed with a concussion, according to the Concussion Legacy Foundation.

And different changes successful the encephalon aft repetitive caput impacts speech from CTE are apt "equally important," McKee said.

"We besides spot harm to the achromatic matter. And that appears to beryllium mostly successful the frontal lobe, but besides successful the temporal lobes," she said.

"We're trying to recognize the narration of those achromatic substance changes to behavioural and temper symptoms, possibly adjacent suicidality," she said.

McKee stressed that concussion absorption is important, but physicians and athletes should besides beryllium alert of different injuries.

"The occupation is the subclinical hits -- the non-concussive injuries that aren't detected, you don't propulsion the subordinate disconnected the tract -- and they tin beryllium successful the hundreds oregon adjacent the 1000s successful a azygous season," she explained.

Lack of research

Though a increasing assemblage of information suggests women successful athletics are much apt to prolong a concussion, person much terrible symptoms, and to instrumentality longer to recover, astir sports-related concussions protocols are based connected information from men.

In a reappraisal successful the British Journal of Sports Medicine, researchers looked astatine 171 concussion studies written since 1967 which are utilized to pass the astir influential statement and presumption statements successful treating sports-related concussions.

Clinicians trust connected these documents to usher their aesculapian signifier erstwhile treating athletes -- but astir of the studies are focused connected men. Only 1 per cent of them was looking exclusively astatine concussions successful women and 40 per cent of them didn't person immoderate women successful a illustration of participants astatine all.

There is different hazard origin for women successful athletics erstwhile they prolong caput injuries, Katherine Snedaker, laminitis and enforcement manager of PINK Concussions, a non-profit dedicated to women's wellness and encephalon injury, told CNN.

There is simply a gulf of millions of dollars separating women and men erstwhile it comes to mean yearly salaries successful astir nonrecreational sports.

Outside of elite sport, Snedaker says, pistillate athletes often don't person entree to the aforesaid aesculapian attraction arsenic men, meaning caput injuries aren't spotted arsenic routinely.

"They thin to propulsion truly hard done the injury," she said.

And galore women can't spend to instrumentality clip retired to recover: adjacent nonrecreational athletes volition supplement their sports income with different jobs, she added, and galore are caregivers.

"When they truly crater, it's a mates of days oregon weeks later."

Snedaker said pistillate athletes often weren't alert they had suffered a caput injury.

If they were, she said, determination were nary due aesculapian oregon sporting unit to inform.

Not capable support

The families of Catlin and Soutter consciousness the young women didn't get capable enactment aft their injuries.

After Catlin's archetypal termination attempt, she was released from an involuntary admittance to the psychiatric ward aft threatening ineligible action, and a league betwixt psychiatrists, her manager and her parents.

She attended therapy sessions, which she agreed to be during the conference, but recovered "they were geared toward suicidal freshman with a full acceptable of antithetic issues than an elite Olympic athlete," her begetter told CNN.

She got a referral to a sports scientist that worked with the Stanford diversion department, but the section forbade the scientist from seeing Catlin due to the fact that she was not a varsity athlete, her begetter added.

She contacted the bureau of a sports scientist with whom she had developed a rapport portion successful the infirmary -- but, his assignment caput said helium had nary openings for six months, her begetter told CNN.

"Wherever she turned she could not find help," helium said, adding that his girl tried a termination hotline respective times: she was erstwhile enactment connected clasp and erstwhile received nary answer.

Catlin described his girl arsenic a "stoic, pistillate warrior benignant idiosyncratic that isn't going to admit that she's struggling."

"She needed a sports psychiatrist that truly could recognize what she was going done and recognize the rigours of her beingness successful presumption of mentation for competitions and the diversion broadside of it and what it could perchance bash to you."

Her begetter said a large origin successful his daughter's decease was "a deficiency of connection betwixt the facilities that were progressive successful Kelly's care. No 1 was successful complaint and they assumed the different institutions were pursuing up erstwhile they weren't," helium added.

In a connection sent to CNN, Luisa Rapport, manager of exigency communications and media relations astatine Stanford University did not code immoderate of the circumstantial allegations made by Catlin's family. She said portion the assemblage does not sermon successful the media the details of idiosyncratic students' experiences, "supporting the intelligence and affectional wellness of students is simply a captious precedence for Stanford."

"Students successful request of intelligence wellness situation assistance -- including students having suicidal thoughts -- and those who are acrophobic astir students successful request of assistance, tin interaction the University's Counseling and Psychological Services (CAPS) 24 hours-a-day, 7 days-a-week," she added.

Rapport said that successful summation to this, "there are aggregate places wherever intelligence services whitethorn beryllium provided for students depending connected individualised request and attraction recommendations, including, for example, affiliated infirmary services and clinics done Stanford's Department of Psychiatry and Behavioural Sciences, and intelligence wellness programs and clinicians successful the community."

In a connection sent to CNN, USA Cycling said it was "devastated" by Catlin's death, adding: "She brought absorption and determination to everything she did, and served arsenic an inspiration to everyone who knew her.

"As the National Governing Body for the athletics of cycling, USA Cycling prioritises the holistic wellbeing of the riders connected the US National Team and has a longstanding committedness to providing some carnal and intelligence wellness resources to members of the team," a typical for USA Cycling added.

After his girl Ellie's death, Soutter was contacted by the UNITE Brain Bank, who wanted to survey her encephalon arsenic portion of their probe into CTE.

But adjacent successful that installation -- the biggest of its benignant successful the satellite -- of immoderate 1,300 brains, lone 3 per cent belonged to women, Ann McKee, Director of the Boston University Chronic Traumatic Encephalopathy (CTE) Center told CNN.

"When I really started looking into CTE -- each of the enactment that they've done with the footballers successful America, she had each azygous grounds and more," Soutter told CNN.

"It was rather evident to maine that determination was a definite nexus successful her starting to get into acheronian places and feeling atrocious and anxious and not sleeping properly. All of those symptoms ... Every 1 that's progressive successful CTE was portion of Ellie's life," helium added.

"I genuinely judge contiguous that my girl would beryllium live had I had immoderate inkling, you know, adjacent the smallest spot of information."

If you oregon anyone you cognize needs contiguous support, interaction Lifeline connected 13 11 14 oregon via lifeline.org.au. In an emergency, telephone 000.

For a regular dose of the champion of the breaking quality and exclusive contented from Wide World of Sports, subscribe to our newsletter by clicking here!