Australian sport needs a complete rethink in relation to concussions and CTE, researchers warn

When parents send their kids to exercise, they make sure they wear a hat and sunscreen to protect them from long-term sun damage — but experts say we should take similar preventive measures for brain injuries.

While most people associate the devastating brain condition Chronic Traumatic Encephalopathy (CTE) with bad concussions in heavy-contact sports like the Rugby Codes and Aussie Rules, researchers at the Australian Sports Brain Bank say the problem may be minor bumps that worsen over time.

They say sport-loving Australia needs to completely rethink how it thinks about CTE and what we should be doing to protect young athletes.

“CTE is an exposure disease,” said Dr. Alan Pearce of La Trobe University.

“We have a lot of players who might have had a concussion or two, but they’ve probably had 20,000 or 30,000 minor hits.

“This applies not only to football or rugby, but also to other sports. It’s in the military, we even have domestic violence concerns.

“It’s not just a problem for elite athletes, as a lot of our research has shown similar results in athletes at club and community levels, so nobody’s really immune and the brain doesn’t differentiate what level of sport or activity you’re playing .”

“My life has changed completely

Lydia Pingel only started playing Aussie Rules five years ago but within three seasons she had to retire.

Lydia Pingel says her “life has completely changed”.ABC News: Alice Pavlovic)

A series of neurological tests led specialists to conclude that repetitive head pounding occurs influences how the otherwise healthy 30-year-old goes about her daily life.

“I can go to the stores and I would have no idea why I went to the stores,” she said.

“Just the simplest of tasks, like I don’t know how to get to work or places I’ve been to multiple times.

“I’ve had a headache every day for three years. Headache, nausea, dizziness, memory problems.

“My life has completely changed.”

While CTE can only be diagnosed after death, Ms. Pingel worries she may be affected.

“When it’s done, it’s done”

Raised as an avid sports lover, she played everything as a child before attempting to make AFLW through the Bond University program.

she was chosen for her fearlessness and courage.

Lydia Pingel is playing Aussie Rules for Bond University in late 2020.(delivered)

In the mark she took that secured her place, she suffered her first severe head blow, which she believes would ultimately trigger the onset of her brain deterioration.

“My first hits to the head were pretty bad, but they ended up being pretty harmless, just a little bump and that was enough to trigger symptoms and this disorientation,” she said.

Each time, however, she went right back onto the field.

“You can’t see it, you don’t have blood gushing from anywhere, you don’t have a limp or anything, so hiding the ability to move on again was pretty easy.

“I didn’t really notice the impact initially and kind of played it off, like you do, that there’s not a lot of education, it’s about that courage … it was just going forward, get ready for next week stuff like that.”

Spacebar to play or pause, M to mute, left and right arrows to seek, up and down arrows for volume.Former soccer player Lydia Pingel hit her head during her playing days. (included)

Eventually, their day-to-day life was affected.

“I didn’t get much help from medical professionals because it wasn’t their fault [head knocks] aren’t that well researched and finding someone who cares is pretty niche.”

That’s when she found Professor Pearce. Tests in his labs revealed that her brain had suffered serious impairments.

Neurophysiological tests by Lydia Pingel compare her brain activity to someone of the same age and sex who did not play contact sports.(Delivered: Lydia Pingel)

“If you don’t take it seriously, you don’t get a second brain,” she said.

“You can have knee reconstruction, you can’t have brain reconstruction.

“Once it’s done, it’s done. There is no reversal, there are obviously ways to deal with it.

“If you don’t take care of it [your brain]you don’t take it seriously… it can really creep up on you.”

Alan Pearce says Australian sport needs to change to protect players’ brains.Delivered: Dr. Alan Pearce)

Sporting codes must ‘find a balance’

Experts want parents to give the same care and attention to protecting their heads as they do to protecting children from the sun or ensuring a mouthguard.

“We [researchers] it’s never been about anti-sport or anti-soccer or rugby or soccer… the message we’re trying to get across is that we want a safer sport,” said Professor Pearce.

“We can still enjoy our sport as it is, but we just need to be able to think about it from a smarter perspective.

In the UK they restrict header football for children up to the age of 12.(ABC News: Michael Lloyd)

“For example in the UK they restrict header football for children up to the age of 12. In rugby, they limit the amount of physical contact training to 15 minutes per week.

“So what you’re trying to do is try to strike a balance by allowing the sports to do what they’re doing and carry on as they are, but also introducing some mechanisms that can also help protect the brain.”

He said it was time society looked into the damage caused by brain injuries in sport after rugby league coach Paul Green died by suicide in August.

The 49-year-old’s brain was donated to the Australian Sports Brain Bank, with an autopsy showing the former NRL and State of Origin player had CTE.

“We actually have to be brave enough to admit that we have to deal with this, and if we can address it, we can actually make cultural changes, we can modify the sport and keep the sport going.”

The brain bank was launched in 2018 – since then 51 brains have been donated.

Associate Professor Michael Buckland says Australia lags behind the US when it comes to CTE in sport.(ABC News: Timothy Ailwood)

Studies from the United States over the past few decades prompted Australian experts to take action, but neuropathologist Professor Michael Buckland said the notoriously sports-loving nation is about 10 to 15 years behind in tackling the problem.

“The NFL and the American Football Pro League admitted in a Senate investigation that playing football caused CTE, and they instituted one as a result [concussion] ex-gamer compensation fund, which is approaching $1 billion,” he said.

“We have yet to see sporting recognition of the problem so publicly in Australia, but we hope working with all the major sporting codes will drive recognition and get it right.”

The potential of CTE plays in the minds of former players

James Graham retired from professional rugby league in 2020 after playing 423 club games.

He officially said he suffered 20 to 30 concussions during his career, but by current standards he would put that number at more than 100.

James Graham says he is worried about the possibility of CTE.(AAP: Darren Pateman)

The former striker said he was looking for solutions in light of Green’s death.

He believes rugby league in particular needs to do more for retired athletes.

“Medically, the way you’re treated throughout the game is top-notch, but you’re not prepared for the real world when you retire,” he said.

“We’re trying to push for an annual brain, body and mind survey. And I think it could have some great results, some of the results will be invisible, but it would be a great way to honor the past.

“Just to help these former players become the best version of themselves post-career, we know the struggles they go through.”

He said the potential for CTE lies in the memory of retired athletes.

“I wouldn’t say it’s a fear … but in a way, [the possibility of having CTE] is in the minds of everyone who played the game.

“And it’s important to remember that there’s something we can do about it, it doesn’t have to become a self-fulfilling prophecy of ‘I am doomed.’

“Experts say you should monitor your alcohol consumption, take care of your mental health, stay physically active, watch your diet, stay socially engaged and challenge the brain.”