Is the AFLW reckless to hit the accelerator while concussion concerns hang over players' heads?

The 2022 AFLW season launched this weekend to a blaze of positive publicity. With club membership up by more than fifteen percent, four new teams slated to make their competition debut in December, and community leagues itching to make up time lost to COVID, there is a lot for fans to be excited about.

You don’t have to scratch too deeply however, to uncover the uneasy paradox that pits the rapid growth and increasing popularity of AFLW against the exposure of greater numbers of female players to the harmful effects of brain injury.

That any football code feels compelled to shoehorn its season into the height of an Australian summer is a story in itself. But as uncomfortable as that might be for players, there is a far darker concern lurking.

Late last year the AFL released ‘Women’s Football Vision 2021-2030’; a typically glossy, buzzword-filled document full of all that is good about AFLW. It trumpeted the goal to “become the most accessible, inclusive and visible sport in Australia, and the number one sporting choice for girls and women.”

The document also flagged challenges ahead for the sport, including lack of media coverage and investment, lack of suitable facilities in the community, and pathways for indigenous girls.

As valid as these concerns might be, why was the prevention of brain injury and management of its deleterious effects – to individual players and the reputation of the sport itself – a challenge not considered worthy of mention in such a pivotal document?

(Photo by Sarah Reed/AFL Photos via Getty Images)

Does the AFLW (and by definition, its master, the AFL), deny the existence of the problem, or do they merely fail to grasp the seriousness of it?

It is understandable that in its haste to attract girls to the sport, the AFL chooses not to amplify any concern which might mitigate against growth in participation numbers, sponsorships and value to broadcast partners.

But consider how concussion incidences in the AFLW are on the rise. According to its own statistics, the AFLW recorded 8.27 concussions per 1,000 player hours in 2021, compared to 4.76 concussions per player hours in 2020.

In a December 2021 ‘Injury Report’, AFLW CEO Nicole Livingstone, stated that this increase “reflects ongoing conservative management.” But what does this actually mean? Was concussion management in previous years sub-standard? How many or how few brain injuries are acceptable?

For the 2021 season, the AFL and AFLW required players deemed to have been concussed to stand down from play for a minimum of 12 days; a move painted as ‘best practice’.

The problem with this is that an ‘out’ exists for players to be deemed ‘unconcussed’ after the original diagnosis, meaning that the 12-day minimum is not hard and fast. Further, research by prominent neurophysiologist, Associate Professor Alan Pearce from Latrobe University, demonstrates that the brain does not ‘normalise’ until 28-30 days after a trauma event; regardless of whether symptoms are resolved or not.

In recent years, a string of AFL players have been forced into early retirement, as a result of suffering brain injury. Nobody with a passing interest in the sport can have avoided the tragic deaths of Danny Frawley and Shane Tuck; both now known to have been suffering from CTE (Chronic Traumatic Encephalopathy).

In excess of 100 past players, suffering a range of conditions, many of them debilitating, now comprise a group managed by concussion advocate Peter Jess, and they are seeking answers from the AFL.

The AFL’s own data also highlights how concussion instances for AFLW players are more than double that of male AFL players.

Further, while there is some caution from physicians around drawing definitive conclusions, a body of papers from researchers like sports scientist Tracey Covassin from Michigan State University, Doug Smith from the University of Pennsylvania’s Center for Brain Injury and Repair, and Willie Stewart, neuropathologist at the University of Glasgow, demonstrate how (for reasons including physiological, hormonal and sociological differences) the negative effects of concussion are significantly greater for girls/women than they are for boys/men.

Let that sink in for a moment. The AFL is aggressively seeking to grow female participation rates at precisely the same time they are armed with the knowledge that female AFL players are twice as likely than men to suffer a concussion, and when they do, the health implications for them are almost certainly worse.

In October 2020, Greater Western Sydney player Jacinda Barclay, took her own life. Post-mortem examination of her brain by neuropathologist, Associate Professor Michael Buckland of the Australian Sports Brain Bank, uncovered a degree of degradation of cerebral white matter in her brain, normally associated with elderly people, or much older American football players.

Jacinda Barclay. (Photo by Jack Thomas/Getty Images)

Particularly concerning was the fact that Barclay was not known to have suffered any major concussion incidences from playing AFLW or American football. This raises the spectre of accumulated sub-concussive hits, acquired in the time since Barclay first started playing Australian Rules Football at age 12.

It is here where another paradox emerges. Because of its newness, and because the AFLW has aggressively recruited athletes from other sports, many players do not have a depth of experience around how to initiate safe contact, avoid contact, and how to absorb contact.

Kicking distances are considerably shorter than in the AFL, meaning that play is often compressed, with large packs of players – not lacking in courage and hardness at the ball, but sometimes with a degree of clumsiness – crashing into each other with force.

Yet if the answer is to evolve the sport over time; to become a full-time proposition, to improve coaching, conditioning, skills, and positional and game awareness, how does this reconcile with players being at greater risk of brain damage from accumulated sub-concussive hits, by nature of them playing the game for longer?

And what does this say about the addition of four more sides, injecting tens of new, inexperienced players into the elite league? In its haste to seize the moment and grow the sport, is the expansion of the AFLW competition galloping ahead of the ability to populate that league with elite level ready players, and risking the health of young women in the process?

In last year’s AFLW preliminary final, Adelaide captain Chelsea Randall was heavily concussed. Initial reports suggested that moves would be made to circumvent the mandatory 12-day stand-down rule to allow her to play in the final, however Randall released a public statement reinforcing the need for all participants to treat concussion seriously.

This serves as an interesting illustration of how the narrative around concussion is easily manipulated. Much was made about Randall accepting the 12-day stand-down and not using the ‘get out’ clause of a ‘presumptive concussion’ diagnosis which, in some cases, can allow for players to be cleared to play within a week.

Rugby union has been forced to take issues of concussion seriously. (Photo By Ramsey Cardy/Sportsfile via Getty Images)

But should not the real story – the one that will inevitably have to be confronted by the AFL and all collision sports – have been; ‘on what basis is a 12-day stand-down considered safe in the first place, and how will sports deal with properly aligning return to play protocols with what the science is informing them about brain injury and recovery times?’

In this regard, it seems puzzling that the AFL, (and the rugby codes), has not moved to condition fans and people in the sport to accept longer stand-down periods.

What does it say about the sport when a player who pulls up with a hamstring tear is automatically understood to be facing a three-to-four-week recovery period before playing again, while a player suffering a brain injury – who is at risk of far more serious repercussions – is willed and encouraged back to play as soon as possible, on the assumption they are no longer suffering headaches?

Randall said that her stance was informed by having seen a male South Australia E-division player, who had suffered a concussion the previous week and been cleared to play, receive another head knock, and die on the field. In an eerily similar case, Angle Vale player Maggie Varcoe, died after suffering a heavy head clash in the 2018 South Australian women’s final.

Randall’s direct, clear-headedness stands in contrast to the AFL and AFLW leadership.

The Roar put the following questions to CEO Livingstone. What is the AFLW’s plan to 1) minimise concussion incidences; 2) establish a future fund to support affected players; and 3) demonstrate to girls interested in playing, and their parents, that the game is safe to play?

By way of response, we were referred back to the generic December media release on injuries.

Ahead of the current season, it was announced in December, that for both the AFLW and AFL competitions, players who make contact with the head of an opponent, will face heavier sanctions. Adjudication will now put greater emphasis on the potential to cause injury, rather than apply leniency should the receiving player not be injured.

Albeit a small step in the right direction, much deeper analysis and remedial action will be required, encompassing cultural acceptance of the need for change, further rules modification, judiciary outcomes, umpiring interpretations, coaching, contact during training, and specific considerations for community, junior and schools football.

Not the least is the challenge of ensuring that measures put in place to minimise concussion incidences at the elite level are transferrable into the lower reaches of the sport.

The Roar also asked the AFL Player’s Association (which encompasses male and female players) if they were satisfied that the AFL had sufficient measures in place to ensure the safety of female players, and if they supported the establishment of a fund to assist the care of AFLW players who may, in the future, suffer from conditions linked to concussions and brain injury?

No response was forthcoming.

In all football codes, Player’s Associations have been slow to accept responsibility for protecting the health of their players. This is partly due to a lack of education about the seriousness of the problem, where a ‘it’s all part of the game’ mantra still exists. It is also partly arisen from a conflict of interest where Players Associations are reliant on the sport’s governing bodies for funding.

Even if the AFL Players Association doesn’t yet realise it, this will have to change.

When it comes to the establishment of a fund, player advocate Jess insists that there is a ready-made situation at hand. “The AFL directly, and via clubs, generates tens of millions of dollars per annum through gaming,” Jess told The Roar.

“We have a situation where corporate bookmakers have agreed with racing authorities to contribute a percentage of revenue to a fund for the welfare of horses, via a levy on wagering. It beggars belief that the same cannot be done for the welfare of players,” he concluded.

Chelsea Randall of the Crows is challenged by Jacinda Barclay of the Giants (Photo by Matt King/Getty Images)

The AFL Player’s Association is known to be uncomfortable about the sport’s heavy reliance on gaming revenue being at odds with negative social connotations attached to gambling. In 2019, Western Bulldogs captain and Player’s Association vice-president Easton Wood, said that he would be prepared to forgo income, if it meant that gambling advertising was to be reduced in the next broadcast arrangement.

The current collective bargaining agreement (CBA) expires this year. An obvious solution would be for the players, rather than try to force the AFL to lessen their reliance on gaming revenue, to insist upon that revenue being redirected into a fund for players affected by brain injury.

For female players, working against the establishment of such a fund is its discordance with the current expansion and recruitment drive. Knowing that their daughters will, in the future, be able to draw upon a fund should they find themselves suffering early onset dementia, is hardly going to motivate parents to push them into the sport in the first place.

There is enough data on concussion in women’s football to know that, in time, the list of players attached to Jess and legal firms mounting class actions, will become increasingly populated with women. No matter the optics, the time for the AFL to implement measures to prevent this from happening, and also initiate such a fund for female players, is now.

It has come to the attention of The Roar that a prominent AFL director has, in recent months, become increasingly concerned about the growing incidence and severity of outcomes related to head injury in the AFL. It remains to be seen whether this will translate into more transparency and pro-activity from the AFL’s executive management.

There are no easy solutions, and nobody wants to shut the gate on young girls and women enjoying the physical and social benefits associated with team sport. Concussed players are invariably lauded by fans and their coaches for having displayed courage. But at what point does that virtue no longer override an acceptable level of risk?

When it comes to brain injury and the AFLW, an opportunity exists for the AFL to not repeat the inaction and mistakes made in the men’s game.

So far, administrators appear to be adopting a ‘head in the sand’ approach. By doing so they are doing the sport, and their female players, a grave disservice.