AFL statement on updated concussion guidelines

THE AFL has on Thursday released its updated 2021 AFL/AFLW Concussion Guidelines, which will see players sidelined for at least 12 days if they suffer a concussion.

The minimum 12-day return to play protocol is a substantive increase on the previous six days required under the 2020 guidelines.  

Under the new 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 clinical symptoms.
The Concussion Guidelines are reviewed on an annual basis and the current updated version has been prepared by the AFL’s Chief Medical Officer Peter Harcourt and Deputy Chief Medical Officer Michael Makdissi.  

This is an extremely important issue and the AFL will continue to take steps to protect the health and safety of past, present and future players.
AFL General Counsel Andrew Dillon said the League takes seriously the issue of concussion and the updated guidelines reflected the AFL’s ongoing commitment to the health and safety of all present, past and future players.

"The updated concussion guidelines represent a significant step in the AFL’s existing record of ongoing improvements to its concussion management strategy that reflect medical research and other learnings over time," Mr Dillon said.

"The reality is we play a contact sport and there is always going to be risk, however over recent years we have continued to take action to strengthen match-day protocols and amend the Laws of the Game to discourage high contact.  We also have used the technology that is embedded in the AFL ARC to provide another opportunity to identify potential concussive incidents that would not have otherwise been detected.

"The updated guidelines are the most stringent concussion protocols in Australian sport and we are committed to continuing to take action to protect the safety of players at all levels of the game.
Mr Dillon said the AFL was in the final stages of interviewing for a Concussion Lead at the League and expected the successful candidate to be appointed in the coming weeks.

"We continue to listen and learn and take action and the new role will specifically focus on the work that we are doing as an industry – both at the elite and community level – to deal with the important topic of concussion."

Under the Guidelines, the earliest that an AFL or AFLW player can return to play after a concussion is on the 12th day after the day on which the concussion was suffered (noting that in some instances a longer period of recovery and rehabilitation will be needed).  

In that 12 days (or more) the player will initially rest, then undertake an individual graduated loading program and finally will make a graduated return to team training with periods of rest in between such sessions.  In some instances (e.g. where clinical symptoms persist or reoccur over time) a longer period of recovery and rehabilitation will be the appropriate response, overseen by the club doctor.

In connection with this substantive change, where a player is withheld from a game with a presumptive diagnosis of concussion but on subsequent assessment the club doctor and/or specialist supports a change in that diagnosis,  the subsequent assessment must be discussed with and can only be approved by the AFL Chief Medical Officer.

The AFL and AFLW Concussion Guidelines closely follow the Consensus Statement from the most recent Concussion in Sport International Conference (Berlin in 2016) with additional incremental improvements in the identification and management of concussion reflecting technological and other advancements since that meeting.  

The Concussion in Sport Group was due to convene in Paris in late 2020 but (due to COVID-19) that meeting has now been deferred until October 2021.

Mr Dillon said that in light of increasing global concerns as to outcomes following repeated head trauma and concussions as well as difficulties in objective assessment of recovery following concussions, the new guidelines describe the revised conservative approach adopted by the AFL to return to play decisions. The AFL will monitor and take further guidance from the Conference later in the year.