‘If in doubt, rule them out:’ The new rule changing local footy

“One more, and I’m done,” the former Collingwood footballer said to his family after he was concussed. When the next time came, he said it again. And again.

This player isn’t Nathan Murphy, the Magpies premiership defender forced into medical retirement this week, aged just 24, after a 10th concussion in last year’s AFL grand final.

Repeated concussions forced Rourke Fischer to retire from football at just 26.Credit: Eddie Jim

His name is Rourke Fischer, who was one of the 500,000-plus registered Australian football participants around the country playing in the 232 leagues and 2583 clubs that the AFL say are the “lifeblood” of communities across Australia.

At the age of 26, Fischer last year made the agonising call to stop playing the game he has loved since childhood. An accomplished local footballer, Fischer reached as far as the VFL, where he played for Frankston and his beloved Collingwood. But while some of his teammates in his only game for the Pies – Jordan De Goey, Mason Cox and Brayden Maynard – and the coach of that 2015 team, Craig McRae, went on to win an AFL premiership in 2023, injuries forged a different path for Fischer.

But it was his long history of concussions, going back to his junior days, that ended his time in the game. While that came earlier than he would have liked, he acknowledged now it came later than it should have.

“I know it sounds bad to say. My family were pushing me to give it up, but I felt alright,” he said. “I’d say, ‘If I have one more I’ll give it up’ – and I had three more.”

Demons player Angus Brayshaw retired after a series of concussions.Credit: Getty Images.

His is one of the many untold stories of concussion in grassroots football, but it is no less important than those of Murphy’s or former Melbourne midfielder Angus Brayshaw, who was also forced into premature retirement.

The AFL last month unveiled tighter protocols mandating a minimum 21-day rest for concussed players outside the elite levels. But suburban and country football clubs spoken to by this masthead have expressed reservations about aspects of the community guidelines, even if there is broad acceptance the move is a step forward.

A primary concern for many clubs, particularly in the bush, is the difficulty to find doctors or medical professionals to enforce the protocols, and the strain it then places on underqualified and inexperienced volunteers.

There are also worries the 21-day break will have the unintended consequence of deterring players from self-reporting to keep playing and, in some cases, protect match payments that for some can be the equivalent of half a week’s wage.

Rourke with his Collingwood VFL teammates in 2015.

Then there is the cynicism that coaches and clubs can suppress their competitive urges to ensure player welfare comes first.

Fischer and his wife Adriana, who are expecting their first child in September, have gone public with their deeply personal experience to highlight the effects of concussion on day-to-day life and how it’s not an issue exclusive to footballers at the elite level. “If someone’s feeling the way I’m feeling, you’re not alone,” Fischer said. “I’d like to help, be able to shed light on my experience.”

“You don’t hear about the home side, and the impact on family and friends,” Adriana said. “The mental health side of it and strain on relationships. It affects every bit of your life, and that doesn’t get spoken about enough.”

The crunch came for Fischer early last season when he had a head clash with an opponent while playing at home for the Sorrento Sharks. Fischer was able to run off the field and told trainers he was fine. After he was assessed by trainers as not showing symptoms of concussion he rejoined the play.

But Fischer had suffered delayed concussion, soon finding himself confused on the field and wondering where he was.

It was his 13th football-related concussion, and the fallout this time was frightening. He stayed in Sorrento with his parents and didn’t understand why they had not allowed him to drive home to Melbourne.

After returning home to Glen Iris the next day he had memory blanks. “He couldn’t even remember driving home,” Adriana said.

The memory loss lingered. Unable to remember even basic details such as what he had for breakfast or the surnames of long-time friends, Fischer became frustrated and confused. Often, he would burst into tears for no apparent reason. His relationships with Adriana and immediate family were affected. It took him six months to see a noticeable improvement, Fischer said, but he still feels “foggy” at times. He suffers from anxiety, although he is not sure whether that is related to concussion.

“I had dizziness, felt off-balance, memory loss,” Fischer said. “I’ve gradually gotten better now. Last year, that shocked me.

“I was very aggressive, confused. When I say aggressive, I was frustrated, I was forgetting things. I had to leave most things to her [Adriana] to do. I’m so grateful I had her.

“I’d forget restaurant bookings. I’d forget I went to the gym in the morning. I’d speak to my wife and she’d re-jog my memory on how I was. My memory was not up to scratch at all. I was off with the fairies most of the time.

“I’d also forget how I was to her. She’d say, ‘You did this,’ and I’d go, ‘Gee, I can’t remember that.’ ”

Still coming to terms with the fact he cannot play football again, Fischer says he will not watch his old teammates this season, to look after his mental health.

“This past year emotion-wise, I’ve not been the best to live with,” Fischer said. “I’d come home and be angry I’m not playing.″⁣

Fischer’s doctor, Adrian Murrie, who has served as a club doctor for seven years with Sorrento, suspects there would be “one or two” players at every club who have had similar histories of on-field head injuries to Nathan Murphy and Angus Brayshaw.

“Whatever number we say, we’re well underestimating it,” Murrie said.

Doctors are hard to find

As respected sports doctor Peter Brukner wrote last year, if being an AFL club doctor is a labour of love, due to the considerable time commitments at the financial expense of growing their own clinical practice, then what hope for local and country clubs?

Ross Mulquiney is the president of Yarrawonga, the club Geelong great Steve Johnson coached to a premiership last year in one of the strongest competitions in the country – the Ovens and Murray league. In a town where it’s not easy to see a doctor when you’re sick, he says clubs are struggling to find medical staff at games.

“We’re lucky that we have a couple of people at the club that are medically trained,” Mulquiney said. “They’ve got a daughter playing netball, or are a footballer or netballer themselves. Our trainers are people who do training off their own bat and come and help us.

“They’re wonderful people and volunteers, but they’re not medically trained. All clubs are battling to find resources and people.”

Without experienced medical staff, many clubs are taking a conservative approach that can be best summed up as “if in doubt, rule them out”.

There are also fears the 21-day stand-down period will be a barrier for volunteers. Who wants to be the person, clubs say, telling a player they cannot play for three weeks?

A concussed Nathan Murphy before he was subbed out of the 2023 grand final.Credit: Paul Rovere

“People won’t want to be the one on the hook making that decision,” Mulquiney said. “I’m concerned about that. Volunteers are impossible to find, and any barrier to them is not ideal, and at this stage, like all regulatory bodies, leagues are making it harder for volunteers, not easier.”

Paul Visentini, a father of two AFL-listed players (Dante Visentini at Port Adelaide, and Vigo Visentini at Essendon), is a director of the Physiosports Group in Brighton, which provides physiotherapists for eight local clubs (five seniors, three juniors). He empathises with the university student gaining work experience at a club who has the unenviable task of telling the big forward with tattoos over his arms that his day is done because he was briefly proppy after a heavy hit.

“In theory, that’s concussion, he or she has to be robust and say, ‘You’re out.’ If the culture of the club, individual, isn’t there, it’s really hard to stop those guys. Do they have the life skills to tell an older person to come off the field and not play?”

Will players self-report?

The prospect of missing three home-and-away games, let alone finals, is unpalatable for many local footballers who just want to play. Money adds another layer of complexity.

One president of a club in a country league, who describes the protocols as an “arse-covering exercise” by the AFL, is sceptical a player would give up match payments to follow the guidelines.

“He’s not likely to want to let anyone know because he’s getting paid, often cash, tax-free money every week,” the club president said on the condition of anonymity so he could speak more freely.

“If he misses three weeks, it’s equivalent of a week’s wage for some guys. It’s highly unlikely they will self-report.

“The awareness is getting better but if there’s a financial impact, there will always be people trying to get around it.”

The same could be said for missing finals and grand finals.

“Put simply, players will likely self-report in June and July, they won’t in September,” Mulquiney said.

”They’ll go, ‘Hold on, I’m not sitting out two finals because I’m concussed, and if I get a little clip in round 18 I’m not going to tell anyone about that.’ It will happen.“

Grace Fitzsimmons, a corporate broking manager in her fourth year as a trainer for a junior team with the Yarraville-Seddon Eagles, said players attempting to conceal their concussion was a talking point among counterparts at a recent training course she attended.

She has not encountered such issues with her teams but has been assured by her club she has their total support if they arose.

“I’m going into this season sticking to my guns with my gut feeling, knowing I have their support with the decisions I make,” Fitzsimmons said.

Education

Neurophysiologist Dr Alan Pearce, who has conducted extensive research on concussion in sport, says education is the key to shifting player views away from when they can play next.

“We have to educate clubs that multiple concussions can lead to longer-term impairment cognitively,” Pearce said. “It might not be an issue for CTE (Chronic Traumatic Encephalopathy), but we have good data that if someone has three concussions their risk of memory problems, concentration is at greater risk.

“As you get more symptoms, other aspects of cognition are more impaired. We have to make sure clubs are really looking after their players.”

But how? The AFL made much fanfare leading into the season of its $1 billion investment over the next 10 years to grow the game at grassroots level and double the number of registered participants to more than one million. Officials at local clubs, who don’t have the luxury of instant replays to review a hit, have told this masthead they want AFL funding to help them deal with concussion.

One senior coach, Leigh Poholke of Sorrento, wants to see the AFL provide for a doctor at every match to show they are “fair dinkum” about the issue, although it would come at a considerable expense. Another suggestion is for more education for physios, trainers and even supporters in the crowd who could act as concussion “spotters”, informing busy medical staff of any incidents they see.

“From learning what I have, I would be certainly making recommendations for physios to assess a player if I see something behind the play from the sidelines because I care for their wellbeing,” said Dale O’Neil, who served as president for Seaford for 10 years.

Players and officials at his club, where Fischer has also played, are more cognisant than most of the issue, having had a film crew follow them for a documentary on CTE last year.

The AFL said the shorter return-to-play protocol of 12 days in the AFL and AFLW reflected the greater level of medical resources available at the top, though critics like Dr Pearce said that this was a “redundant argument” as doctors could not speed up the recovery process for elite players.

As part of the league’s education for community clubs, the AFL requires coaches to take part in a mandatory online concussion education module before they are accredited, and has set up online webinars. It has also set up a sports trainers registration database, and is moving to ensure games cannot begin without a medical officer added to a team sheet.

Visentini said now was a “great time” for his sons to be playing in the AFL due to the increased awareness of concussion.

“Never before has there been so much push for player safety,” Visentini said. “The culture is changing and that’s not a bad thing.”

As much as Fischer loves the game, he wonders what may have been if he knew then what he knows now about concussion.

“It probably would have changed my decision,” Fischer said. “Everyone wants to play, but it is local football. We do it for the enjoyment, not to put ourselves at risk.”

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