ARE we being fair to high-contact sports, like football, when it comes to potential risks of head injury?
There are major barriers to defining the true impact of concussion because there were so many factors to such a complex issue, a leading Ballarat sports injury expert says.
Federation University-based senior researcher Lauren Fortington is part of the Australian Centre for Research into Injury in Sport and its Prevention. Dr Fortington said there needed to be stronger, long-term data collection for head injuries in Australia.
Australia’s first sports brain bank launched three weeks ago. Former AFL and Newlyn footballer Shaun Smith has already pledged to donate his brain because he wants answers to uncharacteristic mood swings and depression he believes is linked to heavy knocks in a long, fearless football career.
“This will be great to learn further about the pathology of the brain but we would need to be looking at the burden of problems with other specialists, like heat-related and cardiac specialists. Only looking at one of these pieces in isolation can make things out of whack,” Dr Fortington said.
“We know head injuries are bad but we don’t know how bad. Cardiac arrest in sport is bad, heat-related illness in sport is bad, but what is most important to focus on first?”
We can start by not getting caught up in the hype and figuring out what are the key safety issues, keeping sport as safe as possible, but without overburdening clubs and volunteers with policies and procedures
Dr Fortington said football codes, like Aussie Rules, tended to get criticism for head injuries. But these high-profile, high-participation sports also tended to do more safety promotion and have more resources to monitor and treat such injury.
The data Dr Fortington can access with research centre ACRISP is accurate for those hospitalised with concussion. Where research becomes fuzzy is in the majority of people with head injuries who were not admitted to hospital, like those visiting the emergency department or failing to seek help at all.
Dr Fortington said people tended to go to hospital for more obvious physical injuries, like swollen hands or wrists, so data-wise it raised questions as to whether these injuries were a bigger issue in sport.
Hospital privacy laws and a lack of surgical registry also made it hard for researchers to track ongoing or delayed injury impact.
AFL Goldfields is implementing a mandatory reporting system for head injuries and heavy knocks in all women’s football this season.
The move comes as international research suggests female athletes are more likely to suffer concussion from less brutal blows and report more symptoms than male athletes.
Trainers must record any concussion-like symptoms in female competition, including sideline durations for players, in a bid to monitor and better understand impact in the game.
ACRISP has conducted a study into injuries sustained in Australian football drawing on records from grassroots clubs, including a sample from Ballarat, which predominantly highlighted lower-limb injuries. About five per cent of reports were for a head injury.
We need to understand how it is happening and this is challenging because head injuries are so hard to defineDr Lauren Fortington
“It’s hard to know concussion because players are self-reporting symptoms,” Dr Fortington said.
“We need to interpret injury really carefully and in how to capture the injury progression over a long period of time and not just once. This is hard to capture at community level and not feasible for most community players.”
Professional contact sports, like football, tend to do pre-testing and periodic testing in player brain activity so medical staff can monitor potential risk if normal levels for a player change.
Dr Fortington said there were evolving guidelines for concussion in sport but the big issue for researchers was how to get academic information effectively into grassroots sport.
Putting up infographics, she said, was not enough.
“We want people to be active but understand areas where we can help keep sport as safe as possible,” Dr Fortington said.