Focus on Sport Concussions Moves to Australia

By DENNIS PASSA | March 11, 2013

Concern over sports-related concussions has moved Down Under, where one of the country’s top former Australian rules football players says he has a degenerative brain disease after sustaining four serious head injuries during his career.

Representatives from the four main variations of football in this country – Australian rules, rugby league, rugby union and soccer – will take part in a two-day conference this month to discuss the long-term effects of brain injuries to their athletes.

And Melbourne’s Deakin University has begun a study involving 30 Australian Football League and National Rugby League players. Among them is Greg Williams, a two-time winner of the Brownlow Medal as the AFL’s “best and fairest” player, who says he can’t remember large chunks of his career.

Williams is one of seven players in the Deakin study who are showing symptoms of the brain disease chronic traumatic encephalopathy (CTE), a degenerative condition which has affected some athletes who have had a history of concussions and other head traumas.

Dr. Alan Pearce, who is directing the study, says there are valid comparisons in Australia with the National Football League, where an Associated Press review in November found that more than 3,800 players have sued the NFL over head injuries in at least 175 cases as the concussion issue has gained attention in recent years.

“To put it into context, some have said the AFL cannot have a similar problem as the NFL, but the situation is similar,” Pearce said in a telephone interview. “We are seeing smilar long-term effects on some of the players.”

Junior Seau, a former NFL linebacker, died at age 43 of a self-inflicted gunshot last May. He was diagnosed with CTE, based on posthumous tests, in January. His ex-wife, Gina, and four children are suing the league, saying Seau’s suicide was the result of brain disease caused by violent hits he sustained while playing football.

In Australia, Williams was part of Carlton’s 1995 premiership team and played 250 senior matches with three clubs between 1984 and 1997. His wife, Mary, has been quoted in Australian media as saying that her husband, now 49, is prone to forgetfulness and often loses his temper.

“We are noticing similar symptoms coming through,” Pearce says of the Deakin study, without referring to Williams specifically.

“Depression, detachment, all of which sounds very similar to other cases here and overseas,” he said. “Anyone suffering from those symptoms needs to get to a neurologist.”

Dr. Barry Jordan is director of the brain injury program and memory evaluation treatment at the Burke Rehabilitation Hospital in White Plains, New York.

“Behavioral changes are one of the earlier danger signs – the brain controls memory and thinking, but it also controls behavior,” says Jordan, a neurologist who works with the U.S. national boxing team.

“We are making headway into educating the general community, athletes and fans to recognize concussions, and people are much more aware,” Jordan said in a telephone interview.

Williams believes that playing too soon after a concussion is part of the reason for his memory loss and other issues.

“There are different levels of concussion and if you’re a certain level and you get knocked out, there’s got to be a one-month, two-month lay-off,” Williams told Melbourne’s SEN radio. “They’ve got to get treatment and they’ve got to make sure that they’re (OK) before they come back.

“I know I started ’84 at Geelong … but the specifics, like the grand final after the game in the (changing) rooms, I remember nothing about that.”

Since Williams went public with his concerns in a television interview, Pearce said he has received several calls from former players expressing similar issues.

“A lot of players have been swayed in their thinking, that (CTE) was the in NFL and we are the AFL, and we don’t do the same things they do,” he said.

Despite the extra attention on potential for longer term injuries, participation rates are increasing across all major styles of football in Australia.

Football administrators are reacting to the recent medical research by introducing new protocols to assess concussion.

For instance, rugby union this season implemented the Pitch Side Concussion Assessment (PSCA) policy.

In the second round of the Super 15 tournament two weeks ago, Melbourne Rebels fullback James O’Connor – one of the biggest stars in the sport – was not allowed back on the field in a match against the ACT Brumbies because he failed the sideline concussion monitoring test after hitting his head during a tackle. He argued the point, but his protests were rejected and he sat out the remainder of the match.

A Concussion in Sport conference to be held in Melbourne from March 20-21 will provide the football sports with up-to-date information on head injuries just a week after the release of new guidelines on managing sports concussions following last year’s Zurich International Consensus Conference on Concussion.

Part of the Melbourne conference will discuss the introduction of helmets for players, something veteran AFL coach Mick Malthouse would like to see explored.

Many visitors to Australia, and those watching worldwide on television, are surprised that players in the high-contact sports of AFL, rugby league and rugby union rarely wear protective headgear.

“It’s going to have to come back at some stage to the medical people to say ‘we have now developed a helmet that fits over the head that softens the blow,”‘ said Malthouse, now Carlton’s coach.

Jordan, who from his White Plains hospital base serves on two NFL committees – one for the league, the other with the players association – says helmets won’t necessarily reduce the number of concussions, but can reduce head bruising and contusions.

“With the acceleration, deceleration of the brain inside a helmet, injuries will still occur, like they do in the NFL, even though they wear helmets,” he said.

Jordan said he’s seen a large number of concussions in soccer at the elite level, even though it’s not considered a collision sport. “It’s from head-to-head, head-to-goal posts hits,” he said, adding that the

“Jury is still out” on whether frequent headers in the sport cause any major brain injury.

Malthouse and Williams think that the mindset on head injuries in general must change if players are to be better protected.

“You used to say to blokes, ‘Grow up, get out there again’,” said Malthouse, who has spent four decades at the top level as either a player or coach, admitting he was among those who didn’t understand the potential repercussions of serious head knocks to players.

Williams agrees, saying there were no rules regarding concussions in his playing days. If you were knocked out and you recovered, you were sent back on.

“If you didn’t you were (considered) a wimp,” Williams says. “It was just tradition. You got up and kept going.”

(AP Pro Football Writer Barry Wilner contributed to this report.)

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