Concussion in AFL: Subsequent Injury & Rehabilitation

Tuesday, October 15, 2019

Concussion is a hot topic at the moment. We know that the incidence of concussion has been increasing, but this may be because we are better equipped to detect and diagnose concussion. Concussion is defined as a disturbance in brain function caused by direct and indirect forces to the head. We know that concussion can effect how we think and can impact on the movement of our muscles. And we know that these problems can linger. This is the theory behind why concussion increases a players’ risk of sustaining a subsequent injury.

In a recent study I was involved in with Daniel Lee, Phillip White and Dr Joel Fuller at Macquarie University, Sydney we looked closer at the effect of concussion in professional AFL players:

  • what kinds of injuries specifically occur following a concussion?
  • which period following a concussion are players most likely to sustain subsequent injuries?
  • how concussion actually affects player performance in AFL, such as number of tackles, marks or errors?
  • how many games are missed after a player sustains a concussion?

During the 2017-2018 AFL seasons, 149 concussions were identified in male players. We found that:

  • Players who sustained a concussion had a 1.55-2.05 higher risk of sustaining a subsequent injury. The lower limb was most commonly involved in subsequent injuries.
  • The highest percentage of subsequent injuries occurred after week 9 return to play.
  • Performance was not significantly different after concussion injury for disposals, contested disposals, disposal efficiency, errors, total marks, contested marks, tackles and AFL fantasy points.
  • The most common period rested following a concussion was 1 game. There were no consistent trends to suggest the number of games missed influences subsequent injury rates.

There are interesting practical implications of this research:

  • Concussed players are at an increased risk of subsequent injury.
  • Concussions do not lead to a decrease in a players’ performance and therefore it would be plausible to suggest that the management protocols used by the AFL are sufficient in maintaining players’ performance.
  • The lower limb region of the body was the most commonly affected region associated with subsequent injury following both a concussion and non-concussion injury. A return to play rehabilitation program needs to have a heightened focus on weeks 5 – 12 after returning to play from concussion, and be tailored to the lower body.

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