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‘This is a barbaric game, this game is not for the weak. You play football, you understand that.’ Former gridiron player Marshall Faulk is blunt in his assessment of the violence involved in American football.

This year, for the first time, AFL players are banned from returning to the field if they are diagnosed with a concussion. The rule was rushed in three days before the season opener and it didn’t impress players like Carlton captain Chris Judd who rebuffed, ‘You'll just never get anyone concussed anymore.’ He’s probably right – players may get concussed, but the new rule will be a disincentive for doctors to diagnose it. The rule isn’t accompanied by any guidelines for diagnosis or independent doctors’ rules to keep team physicians accountable. But nonetheless, it’s clear the AFL felt it had to do something.

News coming out of the US on the long-term effects of football head injuries is horrific. Former Chicago Bears player Dave Duerson shot himself in the chest last month after he suspected he was suffering long-term brain damage. He left behind clear instructions for his brain to be donated to the NFL’s brain bank for research purposes. Duerson’s death sent shockwaves through the NFL and was a wake-up call to football codes all over the world to take brain injuries more seriously.

Unfortunately Duerson was only the latest in a long line of NFL players who have suffered from the effects of a brain disease called chronic traumatic encephalopathy (CTE). The disease is caused by repetitive head trauma and displays symptoms such as depression, erratic behaviour and premature memory impairment. In 2008, Tom McHale was found dead at forty-five from a drug overdose after battling years of addiction. Before him Andre Waters and John Grimsley both died of suspected suicides. The symptoms of CTE eventually progress into full-blown dementia. It can only be diagnosed posthumously and so far, almost all NFL players examined in the NFL brain bank study at Boston University had the disease.

A separate study of retired NFL players found that 6.1% of retired players over fifty had been diagnosed with dementia, Alzheimer’s disease or other memory-related disease – five times more than the general population of men over fifty.

Such controversy has meant that the NFL leads the world in rules changes to prevent head injuries. Not only do players in the NFL have to sit out the game if they are concussed but also if they have less serious head injuries and can’t pass the NFL’s health test. The NFL also provides independent neurological consultants to examine players with suspected head injuries to prevent the issues of under-diagnosis that concern Chris Judd. Some states in the US even have laws which force coaches to refer young players to a doctor if they have suspected head injuries. Recently the NFL has introduced harsher penalties for helmet-to-helmet hits.

In Australia, the AFL, ARU and NRL have made a number of rules changes to minimize head and neck injuries. Before the concussion rule, they tried the ‘head down over the ball’ rule in AFL, the spear tackle and head-butting rules in NRL, banning gang tackles and shoulder charges in rugby and tougher penalties in all codes. The AFL is the first to try the concussion rule and reduce the number of interchanges to slow the game down. Rugby codes are already discussing the concussion rule and expected to follow suit.

Adrian Anderson, the AFL’s General Manager of Football Operations, says that rules changes are working and that head and neck injuries are at the lowest on record. But after watching the five concussions or serious head blows which occurred in Round 1 and considering that at time of writing, 116 AFL players are on the injury list, I find this very hard to believe.

The truth is that football is still as violent as ever. While the rules changes are attempting to slow down the play, players are encouraged to get bigger and hit harder. It’s these big hits that get replayed and used to advertise the game, especially in rugby league.

This article was first published at Overland

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