Firstly, an admission.
In 2007, as the playing coach of a senior Victorian country football team, I endangered one of my players.
The context: it was a grand final; there were thousands of people watching; we had not won a flag for decades; we were in front but only just.
My captain was sick from a head clash but was determined to play on.
I said to him in the changeroom at half time, “You don’t look good, mate.”
“I’ll be right,” he said.
“I don’t think you should go back on.”
“Mate, I’ll be f***ing right,” he said. “Just tell me which way we’re going.”
Understanding he was not thinking straight, I said: “Start the next quarter on the bench.”
But I did not rule him out for the entire second half.
In the third quarter, he was back out on the field tackling and chasing kicks, still a bit dazed.
An hour later, we raised the cup in celebration, but I have since regretted my failure to protect my friend’s health.
Thanks to investigations and debate over CTE (chronic traumatic encephalopathy) in America’s National Football League, I am more aware of the dangers of concussion than I was 12 years ago.
The “I’ll be right” era is over.
New Australian initiative launches
Today, Australia’s leading sports medical bodies are launching their official position statement on concussion, which details how athletes, coaches, parents, clubs and associations should handle the issue.
The government-funded “Concussion In Sport” document was an initiative of the Australian Institute of Sport, Australian Medical Association, Australasian College of Sport and Exercise Physicians and Sports Medicine Australia.
Its “partner organisations” include the AFL, NRL, Rugby Australia, Cricket Australia and Netball Australia.
Sport Australia’s position paper outlines stance on concussion
“By bringing these four peak medical and sporting organisations together we’re ensuring that Australians have access to up-to-date and reliable resources that they can trust,” AIS chief medical officer David Hughes said.
Dr Hughes said children concussed in sport should be rested for weeks, not days.
“We think anyone who’s concussed, firstly, must be removed from the field of play and must not return to play that day,” he said.
“This initiative strongly recommends that children are symptom free for 14 days before they return to contact or collision activities.”
Adults are different, according to Dr Hughes.
“They should enter a structured and graduated return to sport protocol, which starts with one or two days of deliberate rest,” he said.
“The earliest they could get back is potentially around six days but it really depends on their symptoms.
“Every concussion is different and that’s why it’s very important that all concussions and the return to sport after concussion is monitored by a medical practitioner.”
Legal threats loom
Most coaches are caring people and will appreciate the best advice.
But all team leaders — from juniors to over-age competitions — should be wary of the emotional pressure of games that might cloud decision making.
Modern sporting teams are getting better at protecting injured athletes from further harm.
However, it is common to see professional and amateur footballers removed from the field with concussion only to resume playing the next week.
“The only way that someone should be able to return to sport the following week is if they were completely asymptomatic the next day,” Dr Hughes said.
The Concussion In Australia statement was less emphatic about the long-term effects of concussion, which is still a contentious issue in Australian sport.
“There is currently no strong evidence clearly linking sport-related concussion with chronic traumatic encephalopathy (CTE),” the report states.
“The reliance on retired athletes nominating to posthumously undergo autopsy for this research generates significant bias in the samples examined.”
Dr Hughes told News Breakfast: “The frustration for me and others who have an interest in concussion is that properly controlled design studies that control for confounding variables like alcohol use, drug use etc. have not been performed.
“They are underway at the moment but the evidence is still out.”
That has not protected sporting bosses from lawyers representing former athletes in the US.
Three years later, NFL executive vice-president for health and safety Jeff Miller conceded to the House Government and Commerce Committee there was a link between football and CTE.
A legal position has not been reached in Australia but documents for a class action against the AFL, led by former player manager Peter Jess, are expected to be served within six months.