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question_id: 428
The debate over whether wearing helmets should be compulsory for AFL Footballers has opinions divided. Read the Pros and Cons views expressed in the articles below and write your thought on the issue.
There would not be an AFL player who did not take the field without a mouthguard. It is an obvious and sensible precaution against losing teeth during a game. Australian rules football is not for the faint-hearted. It is courage, aggression, skill and contact. This is not chess.
Injuries, as any weekly round-up of the clubs’ casualty lists will attest, are part of the game. This week, 150 players are on those lists. Among the listings of ankles, knees and hamstrings are three for a concussion. There are no teeth injuries. It is not a facetious observation. The mouthguard works. And if a tooth is broken there are remedies.
Yet the brain is rarely protected. The number of players who wear headgear is negligible. The Age believe we are now at a point where helmets should be considered the norm rather than the oddity. Brain damage can irreversibly and irrevocably change a person’s life. Surely, if there were a means to substantially reduce that risk it should be taken. We do not advocate – at least, not yet – that the AFL impose a mandate on the wearing of headgear. But the league is proactive in looking after players, post-concussion, and we believe it would be in the best interests of the players that a more proactive position be adopted pre-injury.
On Monday, a giant of the game, Jonathan Brown, retired. He had received medical advice following another concussion – the third in a year – that the risks of returning to the field were too great. ”The invisible injury is the head injury that nobody can really predict,” he said. Playing again, with the attendant chance of more such injuries, wasn’t a risk he was willing to take.
Yesterday, the AFL met club doctors to discuss better management of players who had been concussed. It followed an incident last weekend in which Geelong player Allen Christensen was allowed back on the field only a few minutes after receiving a knock to the head.
The AFL, and the other codes of rugby league, soccer and rugby union, have guidelines for managing concussion.
The AFL’s football operations manager, Mark Evans, says a consistency of approach is needed in dealing with such injuries. He is right. But while that is being done, the AFL should encourage players to consider headgear. It would lessen neither the spectacle of the game nor the bravado of the players. It would, however, set an example that would trickle down to all levels of the code.
The debate on concussion in Australia has not reached the pitch that it has in America, where the National Football League settled a class action for more than $800 million with 4500 former players who alleged brain injury from their sport. This month, AFL player agent Peter Jess urged that a concussion blood test – developed by Swedish researchers – for players after a match become standard practice. He believed it would remove subjectivity from a diagnosis.
The effects of a concussion can be short and long-term, and it is here there is a debate on cause and effect. Dr Shane Brun, associate professor of musculoskeletal and sports medicine at James Cook University, is cautious about what is provable in relation to a concussion. ‘In 40 years’ time, an athlete develops dementia. Do we blame the fact he had concussion three times as an athlete or was he going to get dementia anyway?”
It is a reasonable question. If a measure can be encouraged among officials and players that lessens the need to ask it, who could argue otherwise? Headgear for footballers is such a measure.
We’ve heard a lot about concussion this AFL season, with claims that too many knocks to the head can cause mental illness, calls for more research into the possible link between football concussions and long-term brain injury, the enforcement of mandatory headgear for junior players in some clubs, and calls for all AFL players to wear protective helmets.
The AFL responded to these concerns by releasing a position statement which recommends helmets not be used for the prevention of concussion. It also claims “younger players who wear a helmet may change their playing style, and receive more head impacts as a result”.
So has the AFL got its policy right
Severe head injuries in Australian football and the rugby codes are not common, with just nine cases of severe traumatic brain injury reported in Victoria in the 31 years to 1999. Therefore, any focus on helmets (or headgear) needs to be on reducing concussion, which accounts for up to 5% of all injuries in junior Australian football and up to 20% of head injuries among adult community-level players.
There are many types of padded helmets available for players of Australian football and the rugby codes. But there is currently no evidence to show that any of this headgear prevents either concussion or more serious head injury. At best, padded helmets might make head knocks feel a little less hard and could prevent some superficial head wounds.
Helmets could certainly be improved with design changes and better technology. To actually stop head impacts that will cause a concussion, one simple design solution is to have headgear that is thicker and heavier.
But the barriers to players having access to, and then wearing, new helmets are possibly greater than the technological barriers. Players are reluctant to wear this type of headgear and sports bodies don’t support it. The international rules of some sports, such as Rugby Union, even restrict the type of protective clothing players can wear.
Concerns have also been raised in general commentary by players, parents, officials and others that the nature of sport would change with widespread helmet use. They argue that players would modify their behaviour and tackle more aggressively if helmets were made compulsory or if new helmet designs were introduced.
It’s possible that individual players might tackle harder but there is little direct evidence that this actually occurs in the Australian context. Our on-field studies of helmeted and non-helmeted players in Rugby Union did not find that helmeted players were more likely to throw themselves recklessly into contact situations and injure themselves or others.
Our laboratory research also found no difference in the force of tackles between rugby players wearing and not wearing helmets.
In terms of young players, it’s natural that a parent would be concerned about the risks of their child playing a contact sport. But there is no evidence that wearing padded helmets would be either beneficial or detrimental for children.
To reduce the risk of harm, many junior sports have modified rules so children only start to tackle when they are old enough to do so safely.
What about other sports?
Last year, a group of international experts at the International Olympic Committee (IOC) World Conference on Prevention of Injury and Illness in Sport came together to agree on the science behind sports helmets.
Noting that the quality and type of evidence about what injuries could be prevented by helmets was inconsistent across sports, the experts concluded that different types of helmets were needed for different sports, and there was great potential to improve helmet design and performance.
In cycling, however, there is a strong body of evidence that clearly shows helmets prevent injury.
Australia is well known for its international leadership in mandatory helmets for cyclists. This was only achieved after medical and scientific evidence showed they were needed and they worked, following more than ten years of consultation, promotion, mass media advocacy, education of the public and purchasing incentives.
The move towards mandatory helmets coincided with new product and manufacturing design standards to make high-quality helmets that people were willing to wear. Only after this, was there a high level of general public support and levels of voluntary helmet wearing. Once helmets were mandatory, regulatory mechanisms were established to support the laws.
But such performance standards, quality control and consumer information requirements do not exist for helmets used in football, alpine sports, equestrian sports and cricket. This means that well-meaning athletes, families and clubs may be buying a helmet that does not work as expected.
A system of consumer-focused, independent product testing for sports equipment is one solution that would lead to rapid improvements in helmet safety. It would also provide consumers with much-needed information about what helmets to buy.
Until such standards exist for football helmets, mandatory helmet wearing for our football codes cannot be supported.
So the available evidence does support the AFL’s current position on helmet use, but it doesn’t support claims that helmets in junior codes may change their playing style.
Ongoing research and monitoring of head injuries in sport are needed to ensure that such statements can be based on high quality, strong evidence in the future.
Credit: ‘The Conversation’ & ‘The Age’.
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