The more football does to combat concussion, the worse it gets

LEADING international concussion expert Kerry Goulet has seen it all before, and it is with grave concern that he takes in what is happening in Australian football.

Greater Western Sydney's Jeremy Cameron hits heads with Brisbane Lions' Justin Clarke. Picture: Phil Hillyard.

LEADING international concussion expert Kerry Goulet has seen it all before, and it is with grave concern that he takes in what is happening in Australian football.

Goulet, a Canadian former professional ice hockey player, has seen how well-intentioned rule changes and improvement in equipment has increased rather than reduced the amount of concussions in contact sport.

It was the case in ice hockey and now appear to be an issue in Australian football — the more the law makers try to do to reduce the problem of concussion, the worse it gets.

Much of it can be put down to human nature; the more protected we feel, the braver we get.

Goulet, who was in Adelaide this week to promote a Wayne Gretzky exhibition ice hocky match on June 24, talked about how equipment and rule changes had made matters worse in ice hockey despite the best of intentions.

“There was a really good study done in the National Hockey League,” Goulet said. “In the 1960s, you didn’t have to wear a helmet.

CONCUSSION SYMPTOMS BELOW

“So what happened was that all the body-checking came below the waist; everybody got hip-checked.

“Once they included the helmet, 65 per cent of hits were above the waist.

“And once the masks were introduced, 85 per cent of hits were above the waist.

“So even though we thought that helmets would prevent certain injuries, you got the worst of them.

“Now, instead of getting a lot of losing teeth, we’re damaging our brains. That’s a whole different animal.”

Goulet, who now heads stopconcussion.com and works to address the issue worldwide, sees a similar dilemma in Australian football. Both sports are full of risk-takers and the safer they feel, the more they will push the boundaries.

Andrew Gaff unconscious after being hit by Tom Jonas. Picture: Mark Brake.

Players can feel safer because of equipment or rule interpretations. In football, the emphasis on making the head “sacrosanct” or untouchable has led to players learning that leading with the head or dropping the head can be advantageous both in winning the ball and drawing a free kick. If it results in a concussion, it is hardly a fair trade, but players often think about consequences later.

Carlton’s 1987 Norm Smith Medallist David Rhys-Jones, who played in one of football’s most violent eras, shakes his head about how some players go about it today.

“They just don’t know how to protect themselves,” he said, suggesting they would be taken out on a weekly basis in his day.

And the stats now are concerning.

AFL injury reports say the prevalence of concussion, in terms of missed games, has tripled since 2005 from 0.5 to 1.6 in 2014 and the incidence — the amount of new concussions at a club — has gone from 0.4 to 1.3 in the same time frame.

What’s worse, last week’s club injury lists had 12 players across the competition listed as being in doubt because of concussion. Those who miss a game will be included in the statistics for this season, those who don’t will not be counted.

The game is only lifting the lid on the problem.

Goulet was suicidal and suffered depression after his brutal sporting career and has been researching concussions for decades. Now, as he’s travelling the world to help athletes and raise funds, Goulet noted ice hockey and Australian football have similarities.

Players who have retired because of headknocks in recent years include Adelaide’s Scott Stevens, Brisbane’s Jonathan Brown, former Saint and Lion Matt McGuire, ex-Demon Sam Blease, North Melbourne’s Leigh Adams and Brisbane’s Justin Clarke.

Swans' Kieren Jack bumps Western Bulldogs' Lin Jong out and off the ball. Picture: Toby Zerna.

Blease and McGuire have launched legal action against the league for compensation.

Clarke gave a chilling report on his condition when announcing his retirement.

Like Adelaide’s Stevens, it took a while for him to reach his decision, with his club placing him on the injury list for an “indefinite” time frame.

“I was on my way to uni and I completely forgot the route that I was going to take,” Clarke said.

“It takes me through the Gabba area (Brisbane’s home ground) and I should know exactly where I was going, what I was going to do, the roads I was going to take, and that’s the type of thing I’ve always been pretty good with.

“I found myself at an intersection and I had no idea where to go. And that scared me.”

The AIS and the AMA have established an online resource to address growing health concerns about concussion.

The bodies point to a 60 per cent rise in hospital admissions for sports-related concussion over the past 10 years, much of it from community sport.

AIS chief medical officer Dr David Hughes said there was also a high number of unreported concussions, which made the issue more difficult to assess.

“It’s a growing health concern,” Hughes said.

“And it affects participants at all levels, from children through to elite athletes.”

JUST ONE SOLID BUMP TO THE HEAD CAN CHANGE EVERYTHING

IT began as an innocuous “how are you?” as her son turned up for his sister’s wedding preparations, and led to a sleepless night studying MRI results at hospital.

Tracey Varriccio, the mother of Luke, 16, still shudders when she thinks of when she first realised how serious a whack to the head in suburban junior football had the potential to change a young man’s life.

He had come home from a game and didn’t seem himself, but Tracey could have had no idea how the next two days would pan out.

“That day he came home, we had all the bridal party here for a luncheon because some of them didn’t know each other,” Tracey said. “Luke comes home and says, ‘Mum, I got hit today’. I asked if he was all right and he didn’t make a big deal of it.

“The next day, he said he had a migraine. It wasn’t until the next day around 5pm that he started vomiting and I got a locum in.

“He had a look and said we needed to take him to hospital.

“I took him to Queen Elizabeth, got there at 7pm and at 1.30am in the morning they decided to do an MRI scan. He had swelling on the brain.

“Whenever they vomit, that tells them that something’s wrong.”

Luke returned to playing two weeks later and subsequently copped another head knock, which wasn’t as serious but still set off alarm bells.

From here, Luke has warmed to the idea of wearing a helmet as he continues to play the game he cherishes. His initial reaction had been that of a typical teenager: “But Mum, I’m going to look like a d ... head.”

His club, the successful Henley Sharks, will take no risks in playing him.

His coach Bryan Birchall follows a strict protocol of taking no risks, valuing his players more as people than potential matchwinners.

There is one school of thought that says helmets do nothing to stop concussions — the brain can still be shaken inside the skull — but another that suggests soft helmets can help cushion the impact.

The Varriccios are leaning towards taking up the latter advice, because if there is any chance a helmet will help, it’s worth trying.

“It must help some things,” Tracey said. “At the end of the day, I’d rather he wears one than not because it must provide some protection.

“He doesn’t mind wearing one now because I think the second time really made him think.”

CONCUSSION — MEETING IT HEAD ON

1. When a footballer takes a hit to the head it is more often to the side than from in front or behind — and to the lower half of the face.

2. The impact passes through the bran and bounces back off the skull. The concussion often occurs on the opposite side of where the player was hit — where the brain hit the skull.

3. It can lead to the tearing of blood vessels, bruising of the brain and nerve damage.

4. The consequences can lead to vomiting, dizziness and neurodegenerative conditions later in life — all of which mean the brain is not functioning as normal.

OBVIOUS SYMPTOMS

— Loss of consciousness

— No protective action while falling to the ground

— Seizure

— Confusion, disorientation

— Memory impairment

— Balance disturbance

— Dazed, blank/vacant stare or not their normal selves

— Behaviour change atypical of the athlete

CRITICAL SYMPTOMS/SIGNS

If an athlete displays these signs they may have a more serious injury. They should be immediately taken to the nearest emergency department.

— Neck pain

— Increasing confusion or irritability

— Repeated vomiting

— Seizure or convulsion

— Weakness or tingling/burning in the arms or legs

— Deteriorating conscious state

— Severe or increasing headache

— Unusual behavioural change

— Double vision

*From AIS/AMA report

SANFL JUNIOR CONCUSSION POLICY

IF IN DOUBT, SIT THEM OUT

* There should be a trained first aider at every game and the principles of first aid should be used when dealing with any player who is unconscious or injured.

* The child is not to return to play sport until they have successfully returned to school/learning without worsening of symptoms. Symptom assessment in the child often requires the addition of parent and/or teacher input.

* It is reasonable for a child to miss a day or two of school after concussion, but extended absence is uncommon.

KNOCKED OUT

Players who have given the game away because of concussions in recent years include:

Scott Stevens, Adelaide

Jonathan Brown, Brisbane

Matt McGuire, St Kilda and Brisbane

Sam Blease, Melbourne and Geelong

Leigh Adams, North Melbourne

Justin Clarke, Brisbane

STATISTICS

AFL injury reports a rise in both prevalence — games missed per club — and incidence, which is how often a club has reported a new concussion each year.

The prevalence has risen from 0.5 to 1.6 per club per season from 2005- 2014 while the incidence has risen from 0.4 to 1.3 in the same years.

Originally published as The more football does to combat concussion, the worse it gets