Study finds impacts of AFL players concussion last longer than previously thought

January 11, 2021

A five-year study has found AFL players are likely returning to play from concussion before their brains have has recovered, putting them at risk of long-term harm.

The newly released Monash University study of concussed AFL players found on average they showed no ill symptoms after a week.

However, analysis of their blood showed their brains had released elevated levels of the protein Neurofilament light (NfL), which is evidence of damaged brain cells.

Even more worrying was that the levels of NfL had doubled a week after the concussion and tripled after two weeks, all while players' symptoms had subsided.

Warning that players were at risk when they played again in that state, study author Dr Stuart McDonald was quoted by the ABC as explaining “if players return to play whilst these levels are still elevated, that may indicate that the brain is in a highly vulnerable state.”

The Monash study, published in the journal Biomarker Research, carried out baseline blood testing on between 100 and 200 Melbourne University Blacks players in pre-season each year from 2017 to 2019.

The researchers then followed up with further blood tests and MRI scans for the 28 that suffered a concussion.

It found on average NfL levels were double the player's baseline figures after one week. After a fortnight, they had increased three-fold. Players were not tested after that time.

Dr McDonald said Monash research into other sports showed elevated levels of NfL are still prevalent one month after a concussion, adding “some players may be returning to play before the brain has recovered and potentially is still in a vulnerable state.

"Repeated concussions can have cumulative effects and these can result in worsened and potentially long term outcomes for players who sustain repeated concussions."

The ABC reported that former Collingwood and Brisbane player Jack Frost suffered 14 concussions in his AFL career and is painfully aware of the impacts, he suffers from memory loss and has forgotten key moments in his life.

The 28-year-old told the ABC "I can't exercise or get my heart rate up at all without getting headaches and feeling like I'm in a fog or getting head spins or dizzy.

"I struggle to go to sleep, stay asleep, I wake up all the time so therefore in the mornings I wake up and feel super lethargic."

Frost welcomed the findings of the study and said he wished he had access to the information during his 56-game career.

He added “it doesn't surprise me one bit and I've sort of always thought it doesn't matter how bad your head knock is, you should at least give four weeks rest because it's just not worth it in the end.”

In the AFL, players who have suffered a concussion generally return to play one to two weeks after the incident.

The presence of NfL has raised concerns players are returning to play too quickly, but Dr McDonald believes this knowledge can provide a breakthrough, going on to say “it's very difficult to actually establish when a player has recovered from concussion and it's completely reliant on self-reporting of symptoms

"This protein in the blood (NfL) may be able to actually indicate when the brain has recovered and therefore may be used as an objective tool to guide when it is safe to return to play."

In September last year former AFL player Shaun Smith, who played for North Melbourne and Melbourne in the late 1980s and 1090s, was paid just over $1.4 million in acknowledgement of the permanent damage caused by repetitive concussions while playing.

The historic insurance payout came as a result of his insurance company finding he was "totally and permanently disabled" from the brain injuries acquired during his career.

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