Right: Children, including girls, are now being recruited to junior AFL.
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Arguments against preventing children playing Australian Rules football
1. The link between serious health conditions and Australian Rules football has not been conclusively established
Defenders of Australian Rules football and its suitability as a game to be played by children argue that no clear connection has been established between playing football and suffering significant brain injury.
It has been noted that a number of United States studies have failed to establish a link between participating in percussive sports and showing symptoms of brain injury. A United States study of some 10,000 people found no association between participation in contact sports and later cognitive decline or increase in symptoms of depression. Adam Bohr, a researcher in integrative physiology at the University of Colorado Boulder and one of the co-authors of the study, stated, 'We don't see this being a massive epidemic across a huge swath of the population.'.
Another American study tracked Wisconsin high school football players from the 1950s. Those former players, surveyed decades later in their 60s, did not have different cognitive or depression outcomes compared to nonplayers. Likewise, another recent survey of 35 retired NFL players over the age of 50 did not find a link between the number of concussions a player incurred and his cognitive decline.
Similar doubts regarding the connection between playing contact sports and suffering brain injury have also been raised. Monash University neuropsychologist, Dr Catherine Willmott, who has worked with the AFL on multiple sports concussion studies has suggested that the finding that some ALF senior players have developed CTE does not indicate that the game is necessarily injurious for young players. Dr Willmott has stated, 'The finding of this (CTE) in Polly Farmer's brain doesn't equate to every child who plays Aussie Rules being at risk.' Dr Willmott has further stated, 'Many children make quick, full recoveries from a single concussion.'
It has further been noted that some of the claims made by researchers warning of the dangers of contact sport for young players have been disputed. Neuropathologist, Dr Bennett Omalu, has cited a Swedish study that he has claimed indicates that young people who play contact sport before the age of twelve have a dramatically increased incidence of several neurological conditions. The original authors of this study have disputed Dr Omalu's interpretation of their work. The Swedish research examined a population that included people who had suffered concussions in sports but also people who had survived much more severe injuries, such as head impacts during car crashes that resulted in lengthy hospitalisations.
The lead researcher, Seena Fazel, professor of forensic psychiatry at the University of Oxford, has stated, 'We're not just talking about someone who's had a bang on the head at a sports match. . . . We're talking about the more severe end of the spectrum...These papers don't say, "Don't play sports." . . . They support good [head safety] policies in sports.'
Furthermore, it is very difficult to establish that playing Australian Rules football (or any other high contact sport) has led to brain injury. CTE normally does not manifest symptoms until years after players have ceased playing and determining the condition cannot be done via symptomology as there are numerous conditions that cause the same set of symptoms as does CTE. Definitive diagnosis can only be achieved through brain dissection postmortem. Even in this context there have been disputes and diagnoses have been challenged because of the retrospective design of these studies with the potential for referral and recall bias, and whether or not the pathologic findings made postmortem cause the presumed clinical signs and symptoms. In addition, it remains uncertain whether the presumed risk factors such as sports activity, cerebral concussions, and subconcussive blows are solely causative of the clinical signs and symptoms.
These and other diagnosis issues have been encountered by those players seeking financial compensation for injury. They need to show that the hits they absorbed as pro players directly led to their current medical problems. Jack Anderson, who teaches sports law at the University of Melbourne, has explained that players face having to respond to questions such as, 'How much of any brain damage they suffer with was due to their career and how much is attributable to other activities or factors?'
Substantiating injury claims with medical records is also difficult. In Victoria, where most AFL teams play, doctors are required to keep records for only seven years after a patient turns 25. This makes it difficult for older players to document their injuries.
2. A 'match program' has been developed and the rules for junior football have been modified to reduce the risks for young players
Those who argue that Australian Rules football is a safe game to be played by children and adolescents note that the AFL has in recent times set out a 'match program' for children that emphasises different skills appropriate to different stages of development and has also modified the rules of the game to reduce the risks faced by young players.
In 2008, the Australian Football League in collaboration with state football bodies and the Australian Sports Commission (ASC) developed the Next Generation Australian Football Match Policy - for the conduct of the game for players aged 5-18 years. The Next Generation Australian Football Match Policy seeks to meet the needs of young players. It opens with this overall statement of belief, 'The AFL and its state affiliates have a view that any person wishing to participate in our great game should be able to do so in a manner that is appropriate to his or her skills, needs and aspirations... it is appropriate young players are introduced to the game through a sequentially modified match program that consists of modifications to the Laws of Australian Football. In other words, young players have different needs to adults.'
The AFL Youth Match Program consists of three stages covering ages 5 to 8 years, 9 to 10 years, and 11 to 12 years. There are distinct skill objectives for the different stages of development. There is a Junior Girls Match Program for girls aged 11 to 12.
The rules of the game have also been significantly altered for young players. One major change is to delay the stage at which young players can tackle each other. The new Junior Football Match Guide for players aged 5-12 years discusses the changes to the rules regarding tackling. It states,' The physiological and emotional readiness of children's bodies to withstand the pressures of tackling...needs to be recognised in assessing when to introduce tackling. The "age of readiness" will vary from child to child, but generally is recognised as being around the 11-12 years age group.'
At ages 8 and below 'There is to be absolutely no contact or spoiling whatsoever, except accidental and light 'shoulder to shoulder' contact while running to and at the ball. Players cannot:
Hold an opponent with their hands
Steal the ball or knock it out of an opponent's hands
Push, bump or barge another player (incidental contact only is permitted)
Smother an opponent's kick
Shepherd (pushing, bumping or blocking an opposing player from gaining possession of the ball or reaching the contest)
For Under 9s, players can perform a modified tackle. A player in possession of the ball may be tackled by an opponent wrapping both arms around the area below the top of the shoulders and on/above the knees. The tackle may be from either side or from behind, providing the tackle from behind does not thrust forward the player with the ball (i.e push the player in the back).
If the player in possession of the ball is taken to the ground in the act of tackling, they will receive a free kick. If the umpire feels the player drops to the ground deliberately in order to receive a free kick, they will be penalised for holding the ball. There is strictly no bumping, slinging or deliberately bringing the opposition player in possession of the ball to the ground.
For Under 11s and Under 12s full tackling rules as apply in the adult version of the game come into force. These are outlined in the Laws of Australian Football.
Regarding young players (5 to 17 years) who suffer a concussion, the same protocols and safeguards as apply to adult players are used; however, some additional elements of protection are added.
Symptom evaluation in the child often requires the addition of parent and/or teacher input. Further, the child is not to return to football, or other sport, until he/she has successfully returned to school / learning, is symptom-free, and has received medical clearance.
The AFL has a Member Protection Policy that focuses on the relevant legislation to ensure the safety, health and welfare of young people and volunteers who participate in and deliver junior football competitions. The law related to the welfare of junior participants emphasises the serious obligations for anybody taking responsibility for providing junior participants with activities and/or care.
Sports Medicine Australia has stated that recent studies have indicated that the rates of injury in junior Australian football, particularly AFL Auskick, are very low. Sports Medicine Australia has also noted that among the factors that decrease a player's likelihood of being injured in Australian Rules football is playing a modified rules version at junior level.
3. Protocols and regulations have been put in place to reduce the risks associated with head injuries in Australian Rules football for senior players
Defenders of Australian Rules football against charges that the safety risks it poses are too high argue that the administrators of the game have made significant changes to reduce the hazards involved.
AFL chief, Gillon McLachlan, has argued that the game had changed considerably over the last couple of decades with the League putting in place reforms to provide greater on-field protection for players, while educating clubs about the effects of concussion.
In September 2020, McLachlan stated, 'We have strengthened matchday protocols for the identification and management of concussion, we continue to change the Laws of the Game to discourage high contact, and also moved earlier this season to change the Tribunal rules to more strictly sanction tackles that endanger the head.'
In June 2017, the AFL released the new guideline document, 'The Management of Concussion in Australian Football'. The concussion management plan includes directions on recognising a suspected concussion, removing the player from the game and referring the player to a medical doctor for assessment. The player is not to return to the field during that game or practice session and not to return subsequently until medically judged fit to do so.
Regarding on-ground rules of play, the AFL has consistently worked to clarify those regulations that prohibit high tackles. As of 2019, the Laws of Australian Football regard as 'prohibited contact', making 'high contact to an opposition Player (including the top of the shoulders) with any part of their body.'
The League has worked consistently to act against players who strike the heads of other players or caused them to make contact with the ground. For example, in 2017 the rules were changed so that fines were imposed for blows to the head made with insufficient force to constitute a Low Impact offence. Prior to this no penalty had been applied.
.In June 2020, the AFL commission passed an urgent amendment to the tribunal guidelines to make sure anyone found guilty of a dangerous tackle will face a minimum one-week suspension. AFL football operations head Steve Hocking has explained that whether a player is concussed or gets straight up again is not the measure of impact to be considered. Hocking stated, 'It is the action, we are pulling it right back to the action here [not the outcome].'
Hocking further stated that the tribunal was also notified that the AFL's intent is for the potential to cause serious injury to be accepted as a serious consideration in levying penalties on players for acts. The AFL has indicated that it wanted to send a clear message to players across all levels of football that any dangerous tackle will be met with a heavy penalty.
The AFL has also expressed its willingness to continue to make changes to rules and protocols to increase player safety. Referring to the diagnosis that suicide victim and former AFL player Danny Frawley had had stage 2 CTE, McLachlan has stated, 'In our discussions, Anita [Danny Frawley's wife] has been really clear that she wants the learnings from Danny's death to continue to provide a benefit to sport and we will continue to work with Anita and the family and researchers to learn as much as we can and to continue to make whatever changes are necessary to keep the people who play our game safe.'
4. Sporting activity carries many health, psychological and social benefits
Those who argue that Australian youth should not be prevented from participating in Australian Rules football point to the many health, psychological and social benefits that playing sport provides.
On September 8, 2020, Better Health Victoria noted , 'Australians' physical activity levels are low. Physical inactivity can also place a burden on the health system, and lead to premature death or disability from injuries such as falls. It is estimated to cost the Australian economy around $13 billion each year. Research suggests over a third of the total burden of disease experienced by Australians may be prevented by modifying lifestyle risk factors such as increasing your level of physical activity.
If we are active, not only are we likely to reduce body fat, but reduce our risk of obesity, type 2 diabetes, cardiovascular disease (CVD) and some cancers. Our overall mental health and wellbeing is also likely to improve.'
Better Health Victoria also discussed some of those factors contributing to an unhealthy lifestyle, 'The sedentary nature of our lifestyle can also lead to poorer health outcomes. Many of us are sitting or lying down for long periods such as spending time in front of a computer at work or driving to work or school. Also, a lot of our downtime is spent on electronic devices scrolling through social media, bingeing on our favourite programs or playing games. A recent survey found around 90 percent of Australian children have 10 hours or more screen time each week.'
Better Health Victoria also stressed the importance of organised sport as a means of giving children the exercise they require. Its website states, 'According to the latest participation research, over 60 percent of Australian children (5-14 years) were involved in organised activities (such as those through an organisation or at a specific venue) at least once a week. Children in this age group are more likely to be involved in sport-related and organised activities than other age groups.'
In February 2015, LaTrobe University's Centre for Sport and Social Impact released a report which indicated the significant community and social advantages to be derived from Australian Rules football. The study found that for every dollar spent on community football generated at least a $4.40 return in social return in terms of social connectedness, wellbeing, mental health status, employment outcomes, personal development, and physical health.
Community football clubs' reach was found to extend to 10 people for every one player, and the clubs were three times more useful for developing social networks than work, education or other community group networks. The research also found that those social networks helped the club provided individuals with significantly increased chances of securing employment, particularly to 15 to 24-year-olds.
Playing Australian Rules football has also been shown to have particular advantages for Indigenous youth. A 2017 study conducted by the Bankwest Curtin Economics Centre (BCEC) found that playing football serves to bring people from all sectors of the community together, including Indigenous, refugee and migrant groups, in a safe space of mutual respect.
BCEC Principal Research Fellow and report author Associate Professor Mike Dockery stated, 'Of significance is both the high rates of young Indigenous men participating in AFL - reaching up to 65 per cent in remote areas across Australia - and the positive impact this has on mental health...'
Professor Dockery added, 'AFL has an important role to play in fostering mental health and positively engaging disaffected youth... We found playing football led to better school attendance for Indigenous boys in remote areas. Football clubs and carnivals are being used to deliver road safety and anti-domestic violence programs, to conduct health checks, and vehicle safety and seat-belt checks.'
5. Most sporting activities pose some degree of risk
Defenders of Australian Rules football and its suitability as a game to be played by children argue that its relative dangers have been exaggerated. They claim that there is some degree of risk in all sports and that the extent of the hazards represented by Australian Rules have been overstated.
There is a range of evidence to indicate that many sports are as dangerous as or more dangerous than Australian Rules football. The Australian Institute of Health and Welfare has recently released data which indicates that Australians who take part in motor sports are more likely to end up in hospital than those who participate in any other sport. In 2016/17, motor sports, rugby and roller sports - like roller skating or skateboarding - had the highest rate of injuries per 100,000 participants. Rugby was the country's riskiest football code per 100,000 participants. Cycling had the highest number of injuries in absolute terms with 4919 injured in 2016/17. Cycling was the most common cause of injuries that resulted in a hospital stay for men, while for women it was equestrian sports. Soccer caused the most injuries for Australians aged under-15, rugby and Australians rules for 15- to 24-year-olds, then soccer again for 25- to 44-year-olds. One in 10 sports injuries were life threatening, with swimming and diving, cycling, equestrian sports, motor sports and recreational walking the most likely to see life-threatening injuries.
The same findings were replicated in another Australian Institute of Health and Welfare survey published three years earlier. The 2013-2014 survey found wheeled motor sports, such as motorcycling and go-carting, were the riskiest with more than 3,500 hospitalisations per 100,000 participants. This was followed by roller sports, such as roller skating and skateboarding, with more than 2,000 hospitalisations per 100,000 participants. Roller sports had almost double the injury rate of Australian Rules and rugby, which had 1,319 and 1,292 hospitalisations per 100,000 participants respectively.
Referring specifically to concussion risk, a study published in Sports Health in May-June 2018 revealed that concussion is less common in AFL than other tackling sports.
Again, referring to the relative concussion risk, the injury profile of Australian football tends to be more contact-orientated than soccer but more noncontact-oriented than rugby union and related sports (American football and rugby league.) Despite the recent media focus on head injuries, the most prevalent injuries in the AFL are hamstring strains, ACL injuries, shoulder sprains and dislocations, leg and foot stress fractures, and ankle sprains or joint injuries. Referring to the most common type of injury found in lower level and junior Australian Rules competitions, the Sports Health study found that irrespective of the level of play, the lower limbs are the most commonly injured body region.
These same results have been replicated on a local level in some schools. Robbie Wright, a former St Kilda player who, as a physiotherapist, runs north Sydney Barker School's concussion management program, has stated that the school sees more head injuries from basketball than AFL, and more students get hurt playing rugby.
Broken bones were the most common type of injury requiring children in Australia to be hospitalised across all sports. In a longitudinal study conducted by Macquarie University, the researchers analysed data over a 10-year period on injuries suffered by children up to 16 years old. They found broken bones to be the single biggest cause of hospitalisation accounting for 41 per cent of all paediatric trauma admissions. Of 686,409 children admitted to hospital over 10 years as a result of an injury, the largest number (287,646) were hospitalised for fractures.
Looking at the danger posed by sports across the world, Rules of Sport.com listed the top five most dangerous sports as base jumping, swimming, cycling, running and sky diving. No form of football made the list. The ranking was achieved in terms of deaths per 100,000 of population.
It has been suggested that neither children nor their parents seem to have been dissuaded from junior Australian Rules football by the publicity about the threat of head injuries. An AFL spokesperson has claimed there has been a 10 per cent increase in the number of girls (18 and under) and boys (17 and under) signing up to play AFL across greater Sydney in the twelve months from 2019 to 2020.