Concussion injuries are a frequent occurrence on the football (and rugby) field. Concerns are rising about the long term neurological damage that may follow such injuries after post-mortem studies of various American football players’ brains showed signs of chronic traumatic encephalopathy (CTE). 1

Head protection needs to be considered as a high priority for the health of football players in Australia. Concussion injuries in sport have become an increasingly significant public health burden. 2

What is CTE?

Chronic traumatic encephalopathy is a type of degenerative brain disease and it results from repeated head trauma. The symptoms of CTE are similar to that of early-onset dementia and cognitive and behavioural impairment may also set in. At present, the effects of these chronic brain injuries can only be observed in post-mortem analysis.

As the most frequently reported kind of traumatic brain injury, concussion is no stranger to the football field. Sports-related concussion may result in headaches, nausea, fatigue, visual disturbances, changes in mental status, unsteadiness, loss of balance and even loss of consciousness. 3,4

Some risk factors like multiple concussions, age and drug misuse may place certain athletes at a higher risk for developing CTE. Football players who report a history of multiple concussions appear to be more likely to suffer from neuropathological symptoms including depression and memory impairment. 1

What is the AFL doing to minimize the risks?

Football codes can take certain steps to make the sport safer for the athletes.

In general, players who are suspected of suffering a concussion injury are removed from the game for assessment by a physician and they are not permitted back onto the field while they suffer the after-effects of a concussion injury.

In 2011, the AFL implemented a return-to-play guideline according to which players who have suffered a concussion injury during a match are not allowed to continue playing in that specific match.  1

When is it safe for a player to return to the game?

The immediate effects of concussion injuries can be observed by using certain cognitive, motor and neurophysiologic tests. Seeing as different people have different recovery speeds, a multi-nodal approach is the best approach to evaluate the player who has suffered a concussion injury. By using a range of different tests, the decision of when a player can safely return to the game can be done more accurately. 3

Future studies to improve player safety

Some more studies are needed to determine how long players should “sit-out” after a concussion injury to reduce the risks of harm in the long term. 1,4

If you suspect that you or a loved one is suffering from the effects of a concussion injury, do not hesitate, get help today. Call Brain Hub on 1300 770 197 now!



  1. Gilbert F, Partridge BJ. The need to tackle concussion in Australian football codes. Med J Aust. 2012; 196 (9): 561-563.
  2. The Courier. Concussions more likely in AFL. Available from:
  3. Pearce AJ, Hoy K, Rogers MA, Corp DT, Davies CB, Maller JJ, Fitzgerald PB. Acute motor, neurocognitive and neurophysiological change following concussion injury in Australian amateur football. A prospective multimodal investigation. Journal of Science and Medicine in Sport. 2015 Sep 30; 18(5): 500-6.
  4. Bleiberg J, Cernich AN, Cameron K, Sun W, Peck K, Ecklund LP, Reeves CD, Uhorchak CJ, Sparling MB, Warden DL. Duration of cognitive impairment after sports concussion. Neurosurgery. 2004 May 1; 54(5): 1073-80.

Dr Carlo Rinaudo (Chiropractor and PhD candidate) is the clinic director of Brain Hub, a clinic in Sydney focussed on helping people with dizziness and vertigo conditions, poor balance, whiplash and concussion symptoms.

The clinic and its practitioners use a range of modalities to help assess and manage these conditions and/or symptoms. Vestibular rehabilitation therapy and other brain-based therapies are primarily utilised, along with standard Chiropractic and physical therapy techniques.

The growing evidence showing support for the management of these conditions comes primarily from the physical therapy and clinical neuroscience fields, rather than chiropractic specific. Fortunately, Dr Rinaudo with post-graduate training both in Australia and from overseas is experienced to translate this knowledge into clinical practice. Additionally, he is currently undertaking a PhD from the University of New South Wales (UNSW) and Neuroscience Research Australia (  in Vestibular Therapy, more specifically clinical trials on how to help people with dizziness and vertigo conditions. He is working alongside leading researchers and Neurologists in the field. Additionally, the benefits expected from his PhD research will be used to further validate the use of vestibular rehabilitation therapy for other related conditions like whiplash and concussions.

Dr Rinaudo is a frequent speaker at national events, as well as lecturer in the field of vestibular rehabilitation and dizziness conditions to other health practitioners.