Footy and Concussion – A Grey Matter

A “speccy” on Grand Final day, one of the easiest ways to give yourself a concussion in your own backyard. Photo: Paul Hanley

I am a massive footy tragic. I go to all my teams games, I watch every other game each weekend, I listen to the podcasts, watch the analysis shows and love chatting about footy to anyone willing to listen. Forget Christmas, New Years or even my own birthday, the Grand Final is my most anticipated day of the year. Despite my team not making it this year, I am very excited.

I’m not here to justify my (arguably) unhealthy obsession. This piece by Melbourne University academics does a much more compelling job (which is made all the more relevant after Richmond finally broke their grand final drought on the weekend).

Instead, I want to explore an issue that may threaten the games future in the long-term, an issue that is relevant to all contact sports worldwide, concussion.

Explainer – Aussie Rules Footy

This is a blog post and not a thesis, so I won’t explain all the rules of Australian Rules football.

All you need to know is that matches involve many contests for ball possession and repetitive contact between players, who tackle, wrestle and bump into each other. This is often done at very high speeds.

There is no offside in footy, so it is a 360 game, meaning you can get hit or tackled from the side, front or from behind. With all this tackling, putting your head in danger to pick the ball and leaping on each other and thudding into the ground to mark the ball, there are so many opportunities for players to hit their head incredibly hard, leading to concussions.

What is a concussion?

A concussion is also known as mild traumatic brain injury and it is typically defined as a head injury with temporary loss of brain function. Concussions can be caused by impact forces, when the head is struck by something, or impulsive forces, where the heads moves without being hit itself (i.e whiplash in a car accident).

The biomechanics of what causes concussions is still being studied. The amount of G force in the impact is a big factor in if a collision results in concussion, as well as the amount of angular acceleration and rotation of the head, plus what part of head is hit, determines the extent of the injury.

Rotation of the head is thought to cause more shear strain in the brain tissue, disrupting more neurons, resulting in the symptoms of concussion.

These symptoms can include headaches, amnesia, irritability, difficulty concentrating, loss of consciousness, nausea/vomiting and/ or sleep disturbance.

This video explains the issue extremely well:

How big is the problem in Aussie Rules/ AFL?

One study, that followed the AFL team the Sydney Swans over a 14 year period, found that on average a player will be concussed every 52.3 games and the more games you play the more likely it is you will suffer more concussions. This equates to 17.6 concussions for every 1000 hours played. The NFL, where concussion is such a hot topic that it spurred a big budget film has similar levels at 18.1, while Australia’s second biggest code the NRL has alarming figures of 28.3 concussions (which has been increasing) for every 1000 hours played.

The AFL has taken measures to prevent concussions by developing protocols that better identify suspected concussions on the field and mandate removing the player from the game to be assessed by a doctor. Rules to reduce head high contact have also been brought in and If a concussion is diagnosed the player cannot finish the game.

What is uncertain is how long a player needs to be sidelined to be safe to play again. Each concussion needs to be assessed on a case-by-case basis. New methods such as Transcranial magnetic simulation, which seek to measure longer- changes in the brain, and sensors within helmets, that can measure force in real time and alert physicians to potential injury, are being developed to manage the symptoms better. However, complete prevention, still remains illusive.

Long-term health effects

The major concerns around concussions are that they will result in long-term brain injury. Chronic Traumatic Encephalopathy (CTE) in a neurodegenerative disease that has been linked to repeated concussions and head knocks. The symptoms include depression, confusion, memory loss, anger issues, impaired judgment and other health issues.

CTE can only be diagnosed after death, by examining the amount of a particular protein in the brain, which indicates brain degeneration. Promising new research may be able to find the disease in living patients, using a different protein that can be detected through head scans.

CTE is a degenerative disease that only gets worse with time, while concussion is currently thought of as an acute injury. Researchers are not certain that multiple concussions will always lead to CTE.

Studies into CTE of deceased Australian Rules players is lacking. While other studies on retired players have shown no link between concussion history and cognitive and psychological function, so the issue is complex.

Concussions are rightly being treated more seriously in footy these days as scientists are learning more about the potential effects.

Whether or not technology can be used for prevention or if the way the game is played needs to be changed is not yet certain.

There will be 100,000 screaming fans at the MCG this Saturday, but if new findings reveal alarming long-term impacts for the players then the popularity of our native sport is sure to be in trouble.

3 Responses to “Footy and Concussion – A Grey Matter”

  1. Nicholas Fawcett says:

    Good work for tackling (yep) a complex issue Paul! I think that the topic of concussions and brain injury in sports can be difficult for many people, as obsessions with sport teams are possibly one of the most cherished loyalties a person can have.
    Having said that, the issue definitely needs to be highlighted more in mainstream media and addressed by the sports bodies themselves to combat the potential problems they may run into in the future. Players that people love may some day die to these injuries, which could see the sports we so love brought to account.
    Anyway, great article and I reckon you’re a Footscray nut like me so GO DOGS!

  2. Rob Dabal says:

    Hi Paul, nicely written blog. It conveyed an obvious and genuine passion for the game while providing a thought provoking insight into the wider health implications for participants. Well played.

    Watching those big bumps really made me grimace quite a few times. Shoulders and heads colliding at full pace.

  3. Chris says:

    Thanks for the post Paul! I saw the title and had to give it a read! It’s really unfortunate that CTE can only be diagnosed after death. If the head scan method is able to verify CTE while the patient is still alive, do we know if there’s a potential way to treat the degenerative disease?