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Sportscover’s David Lamb: clubs that bring players back too quickly will face more claims Sports physician Peter Larkins: concussion does not necessarily lead to long-term problems if it’s managed
League lawsuit launched in 2011 that alleged the league and helmet manufacturer Riddell knew of the long-term risks of concussion and failed to warn players. Lawsuits have also been filed against North America’s National Hockey League, while in July the US National Collegiate Athletic Association agreed to provide $US70 million for concussion testing and diagnosis as part of a class action settlement. Clashing helmets was once a defining image of American football. Now, autopsies on several former players have found evidence of chronic traumatic encephalopathy (CTE) – a degenerative disease associated with repetitive brain trauma that has been linked to boxers since the 1920s, according to the Boston University CTE Centre. In Australia football codes are played differently, but they have their own dangers. Past players including Carlton premiership champion Greg Williams have spoken of memory problems and their history of head injuries. Last year Deakin University in Victoria published a study of brain functions in 40 retired elite and amateur Australian rules footballers who suffered concussion while playing. Overall, the footballers performed worse at fine movement control and reaction time tests than age-matched people who had never played contact sport. The study showed no difference in memory and association learning. The AFL has teamed up with the Florey Institute of Neuroscience and Mental Health to study the issue in current and former players. Dr Larkins says many experts, including neurologists and neurosurgeons, believe concussion was probably previously underestimated but does not necessarily lead to long-term problems if correctly managed. However, more information is required on issues such as the effect of repeat incidents. “What we are trying to establish is, if you have two concussions or three concussions and they are managed properly, is that fine – is there not going to be a problem?” he says. “There is no magic number… that says, if you get this many concussions you are going to have some form of permanent effect on your cognitive function.” 46
Football administrators now take a tougher approach to head-high contact on the field and, compared with past decades, there is closer scrutiny of players by umpires and via video. However, any perceived softening of contact sports can prompt protests, while the evolution of football codes and the athleticism of participants can lead to playing styles that increase the dangers. “It’s all about getting bigger, faster and stronger, and the collisions are getting bigger,” former Australian international rugby union player Elton Flatley told a recent sports summit in Sydney. “With rugby [union], they are trying to keep the ball in play to make it more entertaining, like they are doing in rugby league, so it is going to be quicker and there is more scope for those concussions to happen.” Mr Flatley, who retired due to concussion, says the potential for incidents will not go away and the key is management and wider education, particu-
“If you have two concussions or three concussions and they are managed properly, is that fine – is there not going to be a problem?” larly at the community level. Sportscover’s Mr Lamb says testing programs should be viewed like any other requirement, such as the right boots, clothing and protective items including mouth guards. But it can be difficult to convince players of the necessity. “The person at the centre of this is the person who runs on each week to play and that person could be nine years old or 69 years old,” he says. “We want to make sure they have the best possible care, and managing their time out of the game due to potential brain injury has got to be * number one.”
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October/November 2014