Written by: Niki Holding (Accredited Exercise Physiologist)
The AFL world has been recently experienced several athletes who have retired prematurely due to repeated concussions. Concussion has become a major focus within the Australia media and has the potential for wide reaching consequences for how the sport is played.
The most recent and high-profile AFL athletes who have been forced into early retirement are Angus Brayshaw and Nathan Murphy. Both athletes experienced multiple concussions throughout their careers and experienced concussion symptoms such as memory loss and ongoing headaches.
Managing (and avoiding!) concussions has become a vital issue for the AFL to protect the health and wellbeing of players. Concussion is also an important issue for AFL at lower levels: including for the protection of kids at the junior levels.
In this article we explore the issue of concussion and outline the recent protocols that have been implemented within the AFL and AFLW for the ongoing protection of football players.
What is Concussion?
A concussion is a type of traumatic brain injury (TBI) that occurs when the brain experiences sudden and intense movement within the skull. This movement can be caused by either a direct or indirect blow to the head, face, neck or body. Concussions can result in a range of symptoms and effects on cognitive and neurological function and it is important to recognise and safely manage someone with a concussion.
In October 2022 the 6th International Conference on Concussion in Sport was held and was the culmination of a 5 year process. Following on from the conference, in January 2024 new guidelines on dealing with concussion in community sport have been released.
Signs and Symptoms of Concussion?
Some common signs and symptoms of a concussion include:
- Headache
- Dizziness
- Blurry Vision
- Nausea
- Balance problems
- Trouble remembering eg. Where are we today
- Confusion
- More emotional
- Sensitivity to light and/or noise
More serious symptoms that require immediate medical attention include:
- Neck pain or tenderness
- Seizure or convulsion
- Loss of consciousness
- Vomiting
- Deterioration of conscious state
- Server or increasing headache
- Visible deformity of the skull
Return to Sport Protocols for Concussion:
Returning to play after a concussion is a critical process that should be approached cautiously to ensure the safety and well-being of the individual. It is essential to follow a step-by-step protocol, typically guided by healthcare professional. Recovering from a concussion varies from person to person, and the severity of the injury plays a significant role in the recovery process. The specific steps may vary, but the general guidelines often include:
The AIS return to sport protocol for community and youth sport includes;
- Introduction of light exercise after an initial 24–48 hours of relative rest
- Several checkpoints to be cleared prior to progression
- At least 14 days symptom free (at rest) before return to contact/collision training. The temporary exacerbation of mild symptoms with exercise is acceptable, as long as the symptoms quickly resolve at the completion of exercise, and as long as the exercise-related symptoms have completely resolved before resumption of contact training.
- A minimum period of 21 days until the resumption of competitive contact/collision sport (this is an increase to the 12 day recommendation originally set)
- Consideration of all domains throughout the recovery process.
- Children and adolescents take longer to recover from concussion than adults. A more conservative approach should be taken with those aged 18 years or younger.
As Exercise Physiologists we are passionate about the role of sport in maintaining the health of our community. Remaining Injury free is an important role we play as Allied Health Professionals with junior and senior athletes; so all athletes can continue playing and enjoying the benefits of sport.
Concussion resources:
Pocket SCAT:
https://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097508CRT5.full.pdf
Concussion in sport position statement: https://www.sportaus.gov.au/__data/assets/pdf_file/0005/683501/February_2019_-_Concussion_Position_Statement_AC.pdf
Return to Learn:
https://www.concussioninsport.gov.au/__data/assets/pdf_file/0020/1133471/RETURN-TO-LEARN.pdf