How the alarming science behind concussions is changing local sport
Yann Gambin spends a lot of time thinking about the brain.
In his day job as a molecular biologist, he inspects microscopic clumps of proteins to find evidence of Parkinson’s disease. In his other role, as the coach of the Coogee Seahorses under-eights rugby team, it is the long-term effects of repeated head injuries he is most concerned about.
“From time to time we would have a kid going off with a head injury,” he said. “As our kids entered into the tackling stage, we wondered what we could do to reduce these incidents.”
Gambin scoured the literature for studies testing the effectiveness of different types of headgear, eventually importing soft-shell helmets from the United States for each of his budding athletes.
He is one of thousands of grassroots volunteers and parents responding to growing evidence linking repeated head injuries in contact sport with long-term neurological conditions.
Most research has focused on professional athletes, but an analysis of the lifetime concussion histories of 15,000 people, published on Wednesday, made a surprising and controversial finding: 50- to 90-year-olds who reported suffering one concussion while playing amateur sport performed better on cognitive tests than those who reported no concussions.
Lead author Matthew Lennon, a researcher at the University of NSW’s Centre for Healthy Brain Ageing, said the consequences of brain injuries were serious, but parents should also consider the benefits of physical activity for long-term cognitive health when they are making decisions about whether to let their children play contact sport.
“If you’ve been concussed three or four times, then you should probably start to consider something that is less impactful,” he said. “[But] even if you have had two and maybe even three concussions playing sport, we didn’t find that there was any significant long-term difference in your cognitive or behavioral outcomes.”
The authors noted a number of limitations, including the potential for respondents to under-report concussions often suffered decades ago, “particularly given that concussion is linked to memory loss”.
The study did not include people with diagnosed dementia, a condition that has been linked with repetitive brain injuries in athletes, or anyone who had suffered a moderate to severe traumatic brain injury (losing consciousness for at least 30 minutes).
Reidar Lystad, an injury epidemiologist at Macquarie University, said the study’s main conclusion – that playing sport may have long-term cognitive benefits – was a “sleight of hand” given it did not directly compare people who played sport with people who did not.
Lystad said the main concern to emerge from recent studies was the cumulative effect of repeated head trauma on the brains of athletes, and “not necessarily single concussion events”.
Tom Robertson, president of the Rugby Union Players’ Association, said there had been substantial research into the professional game, including microchips placed in mouthguards to measure force, but a lack of research into community-level sport had left athletes and families without the information needed to make an informed decision.
“Hopefully, this study, particularly in the grassroots game, will get people starting to ask questions,” he said.
At South Coogee’s Latham Park, Gambin said the helmets his team wore every weekend had sparked plenty of conversations with curious rival parents.
While some headgear can reduce the force of impact in the laboratory, concussion experts say wearing a helmet does not stop the movement of the brain inside the skull – the “shearing and stretching” that leads to concussive and subconcussive injuries.
Advocates also argue wearing a helmet can lull players into feeling invincible on the field.
Gambin said the helmets were part of a wider approach to head safety, including training sessions focused on safe tackling techniques.
“Long term, there needs to be a switch in mentality,” he said. “I want to see that generation going to real sports later, but with the reflex of having good protection.”
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