1. What are the potential complications or consequences of concussion?
There are several potential risks and complications that may be associated with concussion. These include:
- Severe brain swelling (or “second impact syndrome”) which is a rare complication of head trauma in children or adolescent players;
- Increased risk of further concussion or other injuries on return to play;
- Prolonged symptoms (lasting longer than four weeks)
- Symptoms of depression and other psychological problems; and
- Long-term damage to brain function.
The risk of complications is thought to be increased by allowing a player to return to sport before they have fully recovered. This is why it is important to recognise concussion and keep the player out of full-contact training and matches until they have fully recovered, as outlined below.
Some of the longer-term risks or consequences (such as problems in mood e.g. depression and brain function e.g. CTE, dementia) may be related to high loads of repeated head trauma even in the absence of concussion.
2. What are the common symptoms of a concussion?
The symptoms of concussion may vary from injury to injury, but they include headache, dizziness or balance problems, nausea or vomiting, feeling dinged or dazed, feeling like in a “fog” or slowed down, having trouble concentrating or remembering, or not feeling “quite right”, seizure. Some common visible clues or signs of concussion include loss of responsiveness, lying motionless on the ground, unsteady on feet, dazed or blank look, confused or difficulty remembering, or the player is not behaving like their normal self.
3. What action should be taken in the event of a head knock?
Follow the four R’s – recognise and remove, refer, review and return. More information on each step is available in the section above.
4. What are the AFL Concussion Guidelines for Australian Football at all levels outside the AFL / AFLW competitions?
They are the guidelines that have been developed to assist community football leagues, clubs, players, parents, coaches, trainers and other stakeholders on how to assess and manage any player who has suffered concussion or is suspected of having a concussion. They include specific provisions for children and adolescents (Aged 5-17 years).
Head impacts can be associated with serious and potentially fatal brain injuries.
In the early stages of injury, it is often not clear whether you are dealing with a concussion or there is a more severe underlying structural head injury. For this reason, the most important steps in initial management include:
- Recognising a suspected concussion
- Removing the player from the game
- Referring the player to a medical doctor for assessment.
Where there is no medical doctor present to assess the player, or the diagnosis of concussion cannot be ruled out at the time of injury, the player must NOT be allowed to return to play in the same match / training session.
CLICK HERE to visit the Community Football Concussion Management hub
5. Why do we need these guidelines?
Concussion is caused by a direct knock to the head or a jolt of the head following an impact to the body with forces transmitted to the brain that, when high enough, affect the way in which the brain functions. It is important that the brain is given an appropriate period of time to recover and that a phased recovery process is followed to decrease the likelihood of any long-term impact from the concussion. The AFL’s previous concussion guidelines for community football were released in 2017 and were updated in 2021 based upon the latest research, medical advice and consultation. In 2024, the AFL announced important developments in relation to the return-to-play protocols in the concussion guidelines for AFL and AFLW and all levels of Australian Football, including community football. In AFL and AFLW, the mandatory minimum 12-day return-to-play protocol will be maintained, while under the new community football guidelines, the earliest that a player suffering a concussion can return to play is on the 21st day post the concussion incident. Click here.
6. In community football, the graded loading program in the policy means that the earliest that a player suffering a concussion can return to play is on the 21st day post the concussion incident. Does that mean any concussed player can return after 21 days out?
No. While players often want to play as soon as possible after a concussion, the AFL’s role is to balance those legitimate desires with appropriate protocols that protect the health, safety and welfare of players. It is important for players to complete each phase of the graded loading program, rather than simply tick off 21 days! Under the new community football guidelines, the earliest that a player suffering a concussion can return to play is on the 21st day post the concussion incident provided they get medical clearance. The new community football guidelines and the elite football guidelines are in-step with the recent Australian Institute of Sport’s Concussion and Brain Health Position Statement regarding return to play protocols post-concussion.
Players should not enter the graded return to activity until they have fully recovered from their concussion. If symptoms persist or return at any stage of the process, individuals must go back to a previous step in the process.
7. When was the minimum 12-day return to play period brought in at the elite level of the competition (AFL/AFLW)?
The AFL/AFLW minimum 12-day return to play protocol was implemented in 2021. The Concussion Guidelines for the elite game are reviewed on an annual basis and the current updated version is a reflection of the evolving understanding of the impact of concussion and head trauma and the AFL’s ongoing commitment to the health and safety of all present, past and future players. Under the current protocol, all players suffering a concussion will miss at least one match (assuming standard fixturing) and sometimes they will miss more than one match depending on an individual’s recovery and other factors such as concussion history, etc.
8. Are the guidelines for community football different to what they are for the AFL/AFLW?
Yes. Announced important developments in relation to the return to play protocols in the concussion guidelines for AFL and AFLW and all levels of Australian Football, including community football, it was confirmed that in AFL and AFLW, where there are advanced care settings for players suffering a concussion, the mandatory minimum 12-day return to play protocol will be maintained.
Other Australian Football competitions at all ages (i.e. adult/open competitions and all junior competitions), will adopt a mandatory minimum 21-day return-to-play protocol. This new protocol will apply for State Football competitions (including the VFL and VFLW), elite pathway competitions (including the Coates Talent Leagues for boys and girls) and all community football competitions. All other Australian Football competitions at all ages (i.e. adult/open competitions and all junior competitions), will adopt a mandatory minimum 21-day return to play protocol. This new protocol will apply for State Football competitions (including the VFL and VFLW), elite pathway competitions (including the Coates Talent Leagues for boys and girls) and all community football competitions.
CLICK HERE to visit the Community Football Concussion Management hub
9. How is the AFL taking action in regards to concussion?
The AFL employs a number of concussion experts and consultants who are maintaining the AFL, AFLW and community concussion guidelines (which can be accessed here) accordingly.
In 2021, we made two significant appointments to further strengthen our commitment to concussion research and management. Two key executives – Head of Concussion Innovation and Research – Adjunct Assoc. Professor Catherine Willmott and Head of Concussion and Healthcare Governance - Rachel Elliott – joined the AFL to lead development, research, education, innovation and governance of the game’s ongoing concussion strategy.
Dr Michael Makdissi has been the AFL’s Chief Medical Officer since November 2021 and is widely regarded as one of the world’s leading Sport and Exercise physicians with expertise in the field of sport-related concussion. Dr. Makdissi recently led the AFL delegation to attend the 6th International Consensus Conference on Concussion in Sport in Amsterdam in October, 2022, and was one of a select group of experts to present at the conference.
As research evolves, we are actively engaged in following the science and updating measures to reflect leading global practices and keep our participants safe.
Over the past two decades we’ve changed rules and the tribunal system, we’ve strengthened protocols and educated our clubs, players and the football community on the reasons why we’re treating the issue so seriously, and will continue to do so.
The priority is, and always will be, the short and long-term welfare of every player who participates in our great game at any level.
The AFL is providing key information about the league’s initiatives around sport-related concussion, and what we’re doing as part of our commitment to prioritise health and safety while maintaining the fabric of our spectacular game.
Australian Football is a contact sport and head impact and concussion events can occur, as they can in all contact sports.
Head impacts can be associated with serious and potentially fatal brain injuries, although the AFL is committed to mitigating that risk across the game.
Players need to be managed properly ensuring recovery and preventing re-injury, and on this website you will find a complete guide on how to return to the game safely.
10. Is the AFL using the most up to date evidence in dealing with concussion?
The AFL has continued to change its guidelines over the past two decades as research as evolved. Our obligation is to be informed by all of the science - past, present and emerging. We make policy and maintain guidelines based on the best judgement of the range of experts in this area growing .
11. What is the HeadCheck app?
HeadCheck is an AFL-approved concussion management app (headcheck.com.au) that should be utilised to recognise and assist in the management of any suspected concussion for both adults and children.
HeadCheck was developed in collaboration between the AFL, the Murdoch Children’s Research Institute and a panel of sport-related concussion experts led by Professor Vicki Anderson.
For more information on the HeadCheck app, visit the AFL’s Concussion Management guidelines for community football.
