Amateur players need to beware of long term effects of concussion

March 7, 2013, Monash University

Well timed to coincide with the Super Bowl, the US football final that seems to obsess the nation, President Obama raised the issue of the effects of long term damage caused by concussion in the game. In an interview with The New Republic, the President said: "I have to tell you, if I had a son, I'd have to think long and hard before I let him play football."

In the US there are more than 4,000 damage suits currently underway by former players who blame authorities for not reducing their risk of on the field from repeated concussions.

The issue of long term brain injury due to sport – whether professional or amateur – again hit the headlines this week when Brownlow medallist and AFL premiership player Greg Williams told Seven News that he believes his failing memory can be traced back to the heavy knocks he took while playing football. While it's important to recognise the risk of brain injury in our elite hockey, rugby, AFL, rugby union, etc players – it's also critically important to recognise these same injuries can be happening to our kids every weekend, with much more serious results.

In December last year the international journal, Brain, published a study showing evidence of an increased risk brain injury amongst athletes, and others who absorbed repeated hits to the head.

The study, which included brain samples taken posthumously from 85 people who had histories of repeated , adds to a rapidly increasing body of research indicating that even mild head trauma can result in long-term .

Of the group of 85 people, 80 per cent (68 men)—nearly all of whom played sports—showed evidence of (CTE), a degenerative and whose symptoms can include memory loss, depression and dementia.

The Monash Injury Research Institute in association with the University of and the George Institute conducted a three year study looking at the incidence of mild or in rugby players. Our findings showed high numbers of concussions and relatively poor injury management. This is particularly true when you step away from the professional league. While there is an awareness of the need to rest players after a concussion at the elite level, this same caution has not flowed through to the amateur ranks.

In boxers, it's called 'punch-drunk syndrome' or dementia pugilistica, whereby repeated blows or knocks to the head can cause symptoms such as depression, , personality changes such as increased irritability, paranoia and aggression, and the early onset of dementia. Media reports in recent years have highlighted ongoing health problems in professional contact sports like rugby, gridiron, wrestling, ice hockey and even soccer (attributed to 'heading' the ball).

The effects of repeated mild traumatic brain injuries culminate in CTE; abnormal proteins accumulate in the brain, causing a degeneration of brain tissue and reduced cognitive functioning. CTE does not show up during brain scans and can only be diagnosed using specific identification techniques post mortem.

Our study followed almost 3000 Sydney school-grade and suburban rugby union players aged 15 to 48 for between one and three seasons to evaluate the frequency of concussions, injury management, and the impact on player brain function in subsequent days and weeks.

We found a high incidence of concussion among players – seven per cent of players sustained a concussion within 10 hours of play. This is about half the length of an average adult rugby union season. The incidence doubled to 14 per cent with 20 hours of play. And players who sustained one concussion were twice as likely to sustain a second.

Players with a lower body mass index were 10 per cent more likely to sustain a concussion, and those who trained for less than three hours a week were 20 per cent more likely to be concussed than those who spent more time training.

Coaches, sports doctors and physiotherapists were among those who assisted the research, recording concussion incidents during games. According to their reports, 48 per cent of players who sustained a concussion returned to play in the same game, and 34 per cent did not leave the field at all.

This is despite a recommendation from the International Rugby Union Board, supported by the Australian Rugby Union, that players who suffer a concussion take a three-week break from training and play. This regulation is mandatory for all international age-graded players under 19 years. Other players may return to play within three weeks if found to be symptom free and declared fit to play by a recognised neurological specialist.

Players who suffer some loss of cognitive function and who return to the play without fully recovering may increase their risks of further injury.

Alarmingly, only 22 per cent of players identified as receiving a concussion in the study reported receiving any return-to-play advice. And 75 per cent of those players did not comply with the three-week stand-down period. No player in the study who received the recommended post-concussion advice complied - with 87 per cent of concussed players returned to either training or competition within one week and 95 per cent had returned within three weeks of injury.

While it appears there was a relatively low level of awareness of the international concussion regulations, the failure of players to follow advice presented a serious barrier to identifying and better managing mild brain injuries.

These findings indicate that return-to-play decisions and the management of sport-related concussion is a challenge for , support staff and the sporting community in general. There is a real need for sporting organisations and their regulatory bodies to ensure adequate management, particularly as there is limited information on the long-term impact of mild traumatic brain injuries.

Australians love their sport. And we have fantastic organisations, filled with volunteers that manage thousands of sports games all weekend. While we salute those mums and dads on the sidelines with a bag of ice for injuries, there has to be greater recognition that sports injuries can be very serious, with potential long term sequelae and need to be properly managed. In the absence of these risks being managed, more and more parents like the Obamas will either be glad their daughters don't play a contact sport, or refuse to let their sons do so because of the (very real) risk of .

Explore further: Concussion treatment in rugby league may mislead public

Related Stories

Concussion treatment in rugby league may mislead public

August 15, 2012
Media representation of concussion management in rugby league could affect public understanding of appropriate medical care, according to a new study.

Research tackles attitudes to concussion

July 27, 2012
(Medical Xpress) -- Rugby players and the sports media continue to underestimate the seriousness of concussion, a School of Psychology study has concluded.

No injury spike in Bantam bodychecking

June 20, 2011
A new study published in the Canadian Medical Association Journal by University of Calgary Faculty of Kinesiology researcher Dr. Carolyn Emery and colleagues has shown that when bodychecking is introduced into Bantam ice ...

Can playing soccer lead to brain damage?

November 13, 2012
(HealthDay)—Soccer is an extremely popular team sport, and one of the few that doesn't require any protective head gear. But, a small study of professional soccer players from Germany suggests that even in players without ...

Recommended for you

Who uses phone apps to track sleep habits? Mostly the healthy and wealthy in US

January 16, 2018
The profile of most Americans who use popular mobile phone apps that track sleep habits is that they are relatively affluent, claim to eat well, and say they are in good health, even if some of them tend to smoke.

Improvements in mortality rates are slowed by rise in obesity in the United States

January 15, 2018
With countless medical advances and efforts to curb smoking, one might expect that life expectancy in the United States would improve. Yet according to recent studies, there's been a reduction in the rate of improvement in ...

Teens likely to crave junk food after watching TV ads

January 15, 2018
Teenagers who watch more than three hours of commercial TV a day are more likely to eat hundreds of extra junk food snacks, according to a report by Cancer Research UK.

Can muesli help against arthritis?

January 15, 2018
It is well known that healthy eating increases a general sense of wellbeing. Researchers at Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) have now discovered that a fibre-rich diet can have a positive influence ...

Your dishwasher is not as sterile as you think

January 13, 2018
(HealthDay)—Your dishwasher may get those plates spotless, but it is also probably teeming with bacteria and fungus, a new study suggests.

Study reveals what sleep talkers have to say

January 12, 2018
A team of researchers with members from several institutions in France has conducted a study regarding sleep talking and has found that most sleep talking is not only negative in nature, but involves a large amount of swearing. ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.