It’s early in the NRL season, and the AFL men’s opening round has barely begun, but already the biggest issue on and off the field is concussion.
More than 60 former AFL players who sustained concussions during their careers are part of a class action filed in the Victorian supreme court this week, seeking up to $2m per player for pain, suffering, financial loss and medical expenses due to their injuries. The same day the papers were lodged, the AFL released its new guidelines for the management of concussion in its elite codes and its four-year concussion strategy, including a 10-year, $25m study into the long-term effects of head injury on players.
Lawyers representing a second group of footballers affected by head injury have also vowed to file papers for a lawsuit this week, with the affected cohort including the former Melbourne player Shaun Smith, former Crows star Darren Jarman, and the wife of late Richmond player Shane Tuck. This second case has been eight years in the making, with Greg Griffin, managing partner at Griffin Lawyers, estimating hundreds of players could join it.
Meanwhile, there has been something of a tussle occurring between the NRL and its clubs when it comes to taking responsibility for concussion-affected players. Last week, the Dolphins coach, Wayne Bennett, and Canberra Raiders coach, Ricky Stuart, both took aim at the NRL’s independent concussion-spotting doctors, who have been in place since last year, saying they were a sign that the NRL didn’t trust coaches to look after their players. Canterbury-Bankstown’s general manager of football, Phil Gould, called the independent doctors “the greatest abomination perpetrated on our game in history”.
Then on Wednesday, the NRL announced its previously more club-based discretionary concussion stand-down process would be replaced by a mandatory 11 days off-field for players who have been diagnosed with what they are calling “category one” concussion. Leaving aside questions as to the clinical justification for a multitiered categorisation of concussion, the announcement is significant.
When the AFL updated its concussion guidelines in 2021 and gave players a mandatory stand-down period of 12 days, the NRL said they wouldn’t be following suit, and would instead wait for the long-delayed update to the fifth International Consensus Statement on Concussion in Sport. That statement hasn’t emerged yet, even though the much-belated sixth conference of the global Concussion In Sport Group (CISG) met in October.
But the AFL had changed their concussion stand-down rule following a series of revelations from the Australian Sports Brain Bank that high-profile former players, including Polly Farmer, Danny Frawley and Shane Tuck, had been posthumously found to have suffered from chronic traumatic encephalopathy (CTE), the neurodegenerative disease caused by repeated head trauma, which has been increasingly linked to contact sports.
The CISG statements on which all these codes rely heavily for their concussion policies are hugely controversial among the scientific community, as they have so far denied a cause-and-effect relationship between contact sports and CTE, even as the scientific evidence for precisely this keeps growing. For the NRL to tighten its rules prior to the release of the next CISG statement suggests the pressure to be more conservative is having at least some effect.
It seems to be no accident that all this is occurring in the midst of a senate committee inquiry into concussion and repeated head trauma in contact sports. The inquiry has heard harrowing stories from numerous former rugby league players and their families who have seen and felt the trauma of long-term brain damage first-hand.
The inquiry was called after the AFL apologised to players who had been part of a previous, huge and supposedly “groundbreaking” study about concussion that resulted in no published research and “confusion” about what happened to tests performed on players. The review that led to that apology was itself a consequence of pressure from Guardian Australia for the AFL to account for the work of its former concussion adviser, Dr Paul McCrory, whose academic and scientific publishing record has been blackened by numerous allegations of plagiarism.
At the centre of all of this is a question of liability, and how much the codes can or will be held to account for the ongoing health of players, particularly those whose serious conditions only become apparent after their playing careers are over.
CTE is no longer the elephant in the room, but it’s still noticeably absent in name from, for example, the AFL’s long-term concussion strategy and management guidelines. References to educating players on “potential long-term outcomes” of repeated head impacts and “concerns” about the long-term ramifications do not quite capture the potential scale of the issue.
While it’s no longer disputed by anyone who takes player health seriously that concussion is a dangerous condition that can have serious and ongoing consequences, the still-unaddressed problem is subconcussive blows: that is, all the bumps and thumps and crash-tackles that happen in the course of playing collision sport, that don’t result in concussion symptoms but can cause microscopic damage to the brain. As the scientists who study CTE have repeatedly made clear, the best evidence shows that the accumulation of smaller blows over a long period of time is the most significant contributor to developing CTE. That means it’s not just players with clinical concussions who may be at risk of developing it, but everyone who plays contact sport over a long period of time.
Under questioning by the senate committee, both the NRL and Rugby Australia acknowledged the relationship between head trauma and CTE, but were not asked whether they accept that playing their games causes the disease. It’s a nuance that’s incredibly important. The NFL’s acknowledgment of a link between American football and CTE in 2016 was seized upon by lawyers acting for players seeking compensation at the time. Proving the link between rugby union and CTE is also a critical part of the players’ case in the class action World Rugby, the Rugby Football Union and Welsh Rugby Union are now facing overseas. The AFL has yet to face the senate committee. That is expected to happen in the Melbourne hearings, which have not yet been scheduled.
When it comes to concussion and long-term brain damage, Australia’s biggest sporting bodies are trying to thread a very fine needle. How successful – and how accountable – they will be remains to be seen.
