REDEFINING what actions are considered tough in contact sport is an important step in minimising the risk of players suffering long-term brain trauma, according to US-based concussion advocate Chris Nowinski.
He told AFL.com.au such cultural change helped players reveal symptoms and take their long-term health into account after a hit to their head.
Nowinski also said players needed to look after teammates who suffer concussion and advocate on their behalf if they notice symptoms as players often failed to make good decisions post-concussion.
"It's like a drunk person saying they can drive," Nowinski said.
After addressing industry representatives on Tuesday about concussion and chronic traumatic encephalopathy (CTE), Nowinski told AFL.com.au that raising awareness of concussion was critical to increase the chance of recognising concussion symptoms, signs and reporting them as well as limiting the chances of players returning early after being concussed.
He said part of his work was to try to "get [athletes] to appreciate how important it is for them to rest their brain after a concussion".
Visiting Australia on his honeymoon, former wrestler and author of the book Head Games: Football's Concussion Crisis, Nowinski also addressed the AFL Players Association board on Monday night on the issue of concussion and CTE.
Nowinski said players should ensure the environment they played and trained minimised the chance of head knocks.
"You don't have to be self-destructive to play the game and if there are things that could be better then fight for them," Nowinski said.
NFL players have successfully lobbied to reduce contact at practice with just 14 full contact days now allowed in an 18-week season.
There are also posters within locker rooms detailing the risks inherent in playing such a contact sport, part of Nowinski's ambition to ensure informed consent becomes part of the culture of professional contact sports.
Currently there is no mandated time for players to return after a concussion however AFL clubs are expected to follow a protocol that ensures players pass a series of tests before returning to play.
Melbourne utility Rohan Bail missed four games in 2012 after failing his concussion test for several weeks. He was also forced to miss contact work for two months during the 2013 preseason after receiving a knock at training.
Nowinski has created significant change within the NFL and world sport around the management of concussion and his involvement in headline-grabbing research into CTE.
He is also keen for increased awareness to filter below professional sport into junior sport.
"Based on the evidence we have I think there is no reason not to aggressively take care of concussions and minimise brain trauma. The things we are asking for are not going to ruin the sport. I think you go full speed on these things and then invest more in research to get the firm numbers and [understand] the risk factors," Nowinski said.
Following developments in the NFL, the AFL has adopted stringent guidelines in relation to concussion with the latest guidelines implemented after the Consensus Statement on Concussion held in Zurich last November.
The AFL introduced a concussion substitute to allow proper assessment and included broadcast footage as a sideline assessment tool. Players also have to pass concussion tests in order to return the following week after suffering concussion.
It has also developed a concussion working party to examine the issues surrounding concussion and CTE and has changed rules to protect the head.
The AFL has also entered a partnership with the Florey Institute for scientific research into concussion and mild traumatic brain injury.
It recently announced a partnership with Florey and the AFLPA enabling an online survey of former players to increase knowledge and understanding of concussion issues, particularly the potential long-term impact of sport related concussion, to be conducted.
When the survey was announced AFL Medical Director Peter Harcourt emphasised that the management of concussion remains an issue of increasing concern for sportspeople at elite and sub-elite levels.
"It is a key health and welfare issue for Australian footballers past and present, which requires a measured, informed and scientific approach," Dr Harcourt said.
The AFLPA has advocated to its players the need to report symptoms and has been heartened with the response of players in 2013 to concussion initiatives. It is continuing to advocate for reasonable steps to be taken to ensure the welfare of past and current players remains a priority.