IN THE VERY EARLY stages of Essendon’s first round clash against North Melbourne, Bombers onballer Heath Hocking was concussed by a football kicked into his head. In line with AFL guidelines, he was immediately substituted after showing clear symptoms. After the game, it is understood that, when quizzed by his team mates, he could not recall what year it was.
As a result of the AFL’s policy on concussion, Hocking faced testing last week to ensure that he had fully recovered by the time Essendon played Port Adelaide last Saturday.
He was not given the all-clear to play.
In previous years, Hocking most likely would not have faced testing during the week after, and may likely have been allowed to come back on and complete the game against North Melbourne. He most likely would have wanted to.
Concussion is a huge talking point at the moment, not just in the AFL but in other heavy contact sports around the globe. Its occurrence is extraordinarily prominent in rugby, American football news and ice hockey news, in line with the growing concern about its potential long-term effect on players as identified in an extensive study by Boston University .
Overseas in the NHL, season 2011-12 is in the headlines, being labelled the “Season of Concussion” with nearly 90 players sitting out games (equalling almost 1700 games between them) in the regular season due to concussion-related symptoms.
The NFL is currently amidst a storm surge of pressure from several hundred former players suing them for not providing ample information about head injury. The former players claim that the league did not do enough to protect them from concussions during their playing careers, did not educate them about recovery and is not doing enough to assist them in their struggles today.
A bit closer to home, former Canterbury Bulldogs and Australian Kangaroos team doctor Hugh Hazard yesteday renewed calls for the shoulder charge to be outlawed in the NRL citing the risk of concussion to both the ball carrier and the defender.
So what are the identified long-term consequences of repeated concussion?
According to the Boston University’s The Center for the Study of Traumatic Encephalopathy, “CTE (is) a progressive degenerative disease similar to Alzheimer’s in its symptoms – memory loss, irritability, mood changes – but with its own distinct pathology”.
The disease was actually first described in 1928 and for many years was thought to be restricted to boxers. However, in more recent years, it has come to be seen as a danger to anyone who suffers repetitive concussions, and for this reason, AFL players must be considered at risk.
One former NFL player Dave Duerson is a noteworthy example of the lasting and horrifying effects of CTE.
After suffering concussions repeatedly during his playing days, Duerson’s family claim that his personality and behaviour transformed entirely in his later years, becoming extremely forgetful and violent. Duerson feared that both his mental and physical decline might not be coincidental, that they might have been caused by injuries to his brain suffered playing the game he loved so much – football.
In February 2011, he shockingly committed suicide by gunshot to the heart, stating in a text message left to his family that he wanted his brain to be used for medical research.
Months later, Duerson’s suspicions there was a link between the repeat concussion he had suffered as a player and his deteriorating mental state were proven. Dr. Ann McKee, who autopsied Duerson’s brain at the Center said there was indisputable evidence of C.T.E. in the tissue samples. It has already been diagnosed in more than twenty deceased players.
There are parallels in attitudes towards injury in both the AFL and the NFL. Part of the problem is that both games are historically and intrinsically tough, both physically and mentally. ”Put your body on the line” is a staple piece of advice from junior coaches around the country. Our junior footballers watch their favourite AFL players get bashed around every week. Amateur players emulate their favourite players from their childhood and today.
When players grow up playing a sport that is saturated with this attitude, it will uniformly affect a player’s instinctive reaction to injury and particularly concussion. The NFL is no different.
Duerson’s wife recalls how in his playing days, “if a player took a knock, the coach would hold up two fingers and say “how many can you count?”, the player would say “three” and the coach would send them back on to the field”.
The late Jim Stynes remembered concussion much the same way. ”I know when I was playing, you’d do anything to get back onto the ground and you don’t always know if it’s the best thing for you.”
In those days, most players would do everything in their power to play, regardless of injury.
It seems the attitude still exists. A lot of the time it is the player’s themselves that are the biggest obstacles, under-reporting their injuries in general. It is this attitude that the new concussion guidelines are trying to curb, attempting to educate player’s on the potential ramifications, particularly with concussion.
The guidelines stipulate that players who show any immediate sign of concussion after a collision, such as unconsciousness, confusion and memory lapse, will be unable to return to the field of play. If the effects are not as clear cut, the player will be monitored for up to ten minutes, and only if the player is given the all-clear from the club doctor will they be able to return. Should a player be deemed to have concussion, they would be assessed until the doctor gives them the all clear, unable to train or play in the interim, ensuring the brain is given time to recover before being put at risk of further injury.
One incident that showed the concussion system working was Richmond forward Jack Riewoldt’s concussion that he obtained after landing awkwardly against St Kilda in their Round 2 clash last year. He was clearly concussed and was stumbling around after the fall.
Richmond’s medical staff decided he was unfit to return to the field of play and he was substituted, much to Riewold’s agitation. The next day he admitted that the Richmond doctor had made “the right call”, as he had had an interrupted night with post-concussion symptoms.
Understandably, the AFLPA were very much in support of the concussion guidelines, pointing to “the medical needs of the players, and putting the long-term and short-term interests of players’ health as their highest priority.”
Some argue that the player’s are willing combatants, that they should be aware of the dangers they face in heavy contact competitions like the AFL, and that they are compensated appropriately with high incomes.
This may be true, but it cannot be forgotten, that injuries, particularly concussions, are not confined to the AFL. Perhaps where the biggest effects of injury is felt could be in junior or amateur competitions where medical treatment and advice is incredibly expensive and often unavailable. If junior or amateur players see the professionals taking weeks time off to recover, then they are more likely to follow suit.
This is a step in the right direction for the protection of AFL players as prompt and proper management of a concussion is pivotal to protect long-term and permanent damage and if anything, what this does is put the issue of concussions under the spotlight.
If AFL players understand the potential ramifications that repetitive head injury can cause on a brain, then they are more likely to step away from the ingrained attitude to under represent their symptoms in order to keep playing or to return to the field.
In previous years, players like Dave Duerson did everything in their power to keep playing with concussion, to return to the field concussed. As a result, he was left with lasting damage and his life destroyed. With further education and new and more advanced research into the long-term severity of concussion, we should arrive at an environment where players will take more concussion seriously and allow themselves to fully recover before putting themselves at risk again. Hopefully then, this attitude will trickle down to the amateur and junior competitions. As AFLPA CEO Matt Finnis iterated after the guidelines were announced, “when it comes to matters involving collisions, and potential head injuries, we can’t be too careful”.
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