It was as striking as a punch to the head at a Senate inquiry hearing in Melbourne this week that it is one thing to develop a will to deal with concussion and head trauma in sport, another to find a way.
The further down the grades you go, the murkier it becomes. Stars might appear larger than life beside community plodders, but brain damage does not distinguish between them.
Anita Frawley speaks during a public hearing into concussion and repeated head trauma in contact sports at Melbourne on Wednesday. Inset, her late husband Danny Frawley in 2014.Credit: AAP; Getty
Elite sport – and for now, we’re talking principally about AFL – at least is awake to what neurophysiologist and long-time concussion researcher Dr Alan Pearce called a “neurological disease that has been hiding in plain sight”.
There is a consensus that collision sport inherently cannot be made foolproof, but it can be made safer. Dr Michael Makdissi, the AFL’s chief medical officer, noted a shift away from the valorisation of survivors of the big hit. “I think we’ve seen a change in that culture,” he said. “I don’t think we’re there yet.”
Even lawyer/campaigner Greg Griffin, who is leading one of two high-profile class actions against the AFL by former players, agrees that after what he says was generations of neglect until the middle of the last decade, things have latterly improved. AFL Players Association chief Paul Marsh said concussion was now the issue that “scared” players more than any other. Fear is driving change.
But it’s a headache still. When Pearce talks to clubs and players, “what comes across to me is that they’re confused,” he said.
AFL chief medical officer Michael Makdissi and operations manager Andrew Dillon at the Senate inquiry. Credit: Jason South
He chafes at the fudging. “We use the words head knocks a lot,” he said. “I hate that. It underplays the significance of what concussion is.” It is well established that cumulative head knocks can be just as destructive as any knockout blow.
Fear does drive change, but also drives some underground. Reporting is still problematic. You’d imagine more sophisticated diagnoses would disclose greater incidence of concussion, but the reported numbers remain counter-intuitively little changed, about 4-5 per club per season.
The AFL introduced a 12-day rule last season, but Makdissi said it had led to an unhealthy public focus on time rather than soundness (and others to fear that it has also led to a counter-productive increase in players returning too soon).
Veteran crusader Peter Jess has always maintained that 12 days was risibly too few anyway. Makdissi said 12 days was only ever meant to be an absolute minimum. “I’d like to see the 12-day protocol for concussion eliminated from discussions,” he said. “I think we should be focusing on stages of recovery.”
Sydney’s Paddy McCartin receives attention from a trainer after suffering another concussion earlier this month.Credit: Getty Images
That’s the elite. In 2019-20, the Australian Institute of Health and Welfare reported 246 concussions in Australian rules. “That is probably the tip of the iceberg,” said Makdissi, acknowledging a recreational playing population of 500,000 to set against 800 full-time professionals. “I think we’re doing a reasonable job at the elite level, [but] there’s not the expertise at lower-tier competitions, so that is a little bit more of an issue for us.”
In this, big-time administrations are victims of their own self-importance. Their wont is to present themselves as governments of their sports, but at most they’re custodians. Because they do not fund subsidiaries anywhere near to the extent they make out, they have little moral and no financial clout.
Cricket Australia is even blunter about this than the AFL. It had no authority over junior clubs and competitions, said chief medical officer Dr John Orchard. All it could do was model best practices. “The elite sets the standard for the community,” he said. Mercifully for cricket, hits to the head average one per player every three seasons, and unlike for football, helmets do work.
The AFL and Latrobe University have teamed up to mine the Yarra Valley Junior Football League – the biggest junior comp – for data, but otherwise authorities depend on voluntary surveys and ad hoc anecdotes. Insight into the sub-elite concussion landscape remains dim.
Former AFL players Shaun Smith, Darren Jarman, the late Shane Tuck, John Platten and John Barnes are among those taking a class action against the league.
Redress for the afflicted is pot luck. The courts will help some, the AFLPA others. As reported here last week, one club is urging players to take out personal trauma insurance. Workcover provides only for jockeys, but that could be widened, or another no-fault accident compensation scheme instituted.
Typically, New Zealand is way ahead of us. Their government-run Accident Compensation Corporation was held up to the inquiry as an archetype. “They’ve got much better data than us and much better funding,” said Orchard. “Sports and exercise medicine, as a medical speciality, gets very poorly funded in Australia, so we struggle to provide services at the community level.”
Joey Didulica in 2019.Credit: Jason South
Preventative, or at least mitigating, measures are on the table. These include more research – and more money for it – rule changes, especially in under-age footy, and an app so that to the extent junior clubs collect data, it can be centralised in a registry.
Curtin University is developing one for all sports. Most clubs use apps anyway to report scores, and they could be adapted. Jess proposes a concussion passport along the lines of drug passports in some sports.
Education underscores and overrides all. The AFLPA’s legal eagle Megan Comerford suspects the odd hour here and there for AFL players is not enough. At lower levels, the need is even more pressing. Pearce came across a woman at a suburban club who did not realise she had been concussed.
A further, bolder step would be to remove from sports bodies altogether their presumed responsibility for the issue because goodwill always will to some extent be compromised by commercial imperatives and brand protection.
The AFLPA’s Paul Marsh.Credit: Jason South
To that end, one proposal is to make concussion the remit of Sports Integrity Australia, the amalgamated body that since 2020 has overseen drugs in sport, match-fixing and child protection. But it is doubtful that SIA in its present form it would have the resources.
Another is to look upon concussion not as an occupational sporting hazard, but a full-blown public health issue. This is the position of Bond University sports law academic Annette Greenhow and is where the discourse is trending in the UK and Canada, for instance. Don’t forget that this is a Senate inquiry, at heart to determine what role government can or should play.
“You simply cannot trust this very, very onerous and difficult obligation to the sports bodies themselves,” said Griffin, “because quite frankly they’ve shown absolutely no desire to implement anything.” Within this rhetorical flourish, there is a kernel of troublesome truth.
If nothing else, the Senate inquiry is putting a human face on a hidden pain. On Wednesday, it heard the harrowing accounts of Anita Frawley, widow of St Kilda’s Danny, Renee Tuck, sister of the late Shane, and Joey Didulica, a broken-down former international goalkeeper. But it also heard a couple of tragic stories from the suburban darkness. This epidemic does not discriminate.
Listening to them, I quietly wished that they would also reach the ears of a few other footballers, some prominent, some not, all suffering. They were stories to exercise any and every mind.
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