One of Australia’s pre-eminent concussion researchers says Super Netball needs to walk the walk on brain injury and tighten its protocols, describing several recent incidents as troubling.
Dr Alan Pearce, a Professor in the School of Allied Health at La Trobe University, this week told The Down Low that Super Netball’s approach to concussion appears similar to other elite
leagues, offering only “vanilla rhetoric around player health and wellbeing”.
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“But actions speak louder than words,” he said. “Despite the incidence of concussion being lower in netball than sports such as Australian Rules and rugby league, it is still a clear, present and future danger to Super Netball players, he said.
“And if player health and welfare is your greatest priority, is at the centre of your decision-making, you don’t have athletes being assessed for concussion in just a few minutes,”
Professor Pearce said, referring to the management of Vixens defender Emily Mannix in round one on March 18.
Mannix, who has been open about her history with post-concussion symptoms, was sent from the court in Perth by an umpire – allowed under the league’s rules – after a clash with West Coast Fever midcourter Verity Simmons, who dealt with concussion after the pre-season Team Girls Cup in February.
After being assessed and joining a Vixens time-out huddle, Mannix returned after just a few minutes to play out the match. In total, she was off the playing arena for less than five minutes.
The league has publicly backed the way Mannix’s case was handled as in line with the international rules of netball, the league rules and Netball Australia’s policy and guidelines for management of sport related concussion and she was also cleared to play the following week.
But Professor Pearce said the time taken to review Mannix “wasn’t long enough at all”. He said the league’s policy should be more prescriptive – where it currently is not – about how long an assessment should take.
“It needs to be at least 10 minutes, to let the athlete settle and then move into diagnostic questions. All the research tells us things can evolve over time.”
In addition to Mannix, the respected neurophysiologist also highlighted an incident involving Collingwood’s Molly Jovic in her side’s match against the Vixens at John Cain Arena on Sunday.
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The midcourter, who has a history of concussion, remained on the court after a clash with Vixen Liz Watson in the third quarter saw her clatter to the ground and reach for her head.
Jovic should have been taken off for review, “especially given her history with concussion which has seen her miss games in the past”, Professor Pearce said.
“Given it defers to the International Consensus Statement (from the 5th International Conference on Concussion in Sport, held in Berlin in 2016), the Super Netball policy is based on erring on the side of caution … and part of erring on the side of caution (is removing)
someone who has a history of concussion anyway, because concussion is an evolving injury.
“Molly may have got up and not shown anything straight away, she could have shown some symptoms 10 minutes later, 15 minutes later, or half an hour later, but yes there was a risk there.”
Professor Pearce said consideration of a player’s concussion history should be built into Super Netball’s policy too, as it’s believed effects can be cumulative over time.
In a statement to The Down Low, Collingwood said the club doctor “reviewed vision of the incident at the time, assessed Jovic during the game and in the subsequent days monitored her
for any symptoms of concussion, which she has not shown.”
The club said “the health and safety of all Collingwood athletes remains paramount.”
Emotive language used by the Pies’ official Twitter account to describe Jovic after she remained in the contest was also problematic, Professor Pearce added.
“Saying things like ‘tough as guts’ isn’t helpful when we’re talking about a potential brain injury, and that’s what a concussion is … a brain injury, not a head knock, not a bump, not whatever else you want to call it. When it comes to a possible brain injury, staying or coming back on is not a sign of toughness.
“One of the arguments we hear from sports is that (researchers like me) are ‘sensationalising’ the issue. Well … that kind of language is sensationalising it in the opposite direction, by almost downplaying the injury and ‘upplaying’ the players’ toughness. And that is something we’ve got to address and educate people about.”
Professor Pearce, who studies brain injury and repetitive brain trauma in sport, said every Super Netball game should have an independent, league-appointed doctor.
Current rules allow for either an independent doctor or the home team’s doctor to respond to concussions for both teams.
“Without wanting to criticise the expertise of club doctors, we know from research internationally that club doctors can be put under pressure – not necessarily by the coach, but the players themselves – to be put back into a game. It’s unfair on that doctor to try and make those decisions.”
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Team doctors can also be rightly distracted by other duties in-game, Professor Pearce added. Speaking on Fox Netball’s Centre Circle after Mannix’s head clash in round one, Australian netball great Caitlin Bassett said: “You can see the benefit of an independent doctor as it takes away any doubt over a conflict of interest happening between the club
and the player… but I think there is some benefit that the doctor is with the player’s club, for the fact that they know the athlete, they know their personality, their normal behaviours, and more importantly they understand the medical history of the athlete.”
Professor Pearce praised the league for allowing umpires to call time and send a player off for concussion review.
“It’s quite refreshing to see the umpire pick up the signs and symptoms immediately following the incident. That’s great. I would like to see more of that.”
Professor Pearce, who is a director of the Concussion Legacy Foundation Australia, said Super Netball should tighten its policy – the talk – and how it’s applied in the heat of the moment – the walk.
As well as immediate player welfare, an example needs to be set for the grassroots, where more than one million Australians, mainly women and girls, play netball, he said.
“If a young girl sees Em Mannix come back after just a few minutes, what message does that send about how seriously we should treat a possible brain injury?”
The Down Low put detailed questions about Professor Pearce’s views to Super Netball for response. The league provided the following statement: “Netball Australia takes head impacts and concussion extremely seriously. The health and well-being of all players who play our game, at all levels from grassroots through to the elite game, is our priority. Netball Australia’s concussion guidelines are best practice and constantly reviewed in line with evolving scientific evidence.”
