Article Text

Download PDFPDF

Australian Football League concussion guidelines: what do community players think?
  1. Peta E White1,
  2. Alex Donaldson1,
  3. S John Sullivan2,
  4. Joshua Newton3,
  5. Caroline F Finch1
  1. 1Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia
  2. 2Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
  3. 3Faculty of Business and Law, Deakin Business School, Deakin University Melbourne Burwood Campus, Melbourne, Victoria, Australia
  1. Correspondence to Professor Caroline Finch; c.finch{at}


Background Preventing concussion in sport is a global challenge. To assess community-level adult male Australian Football players’ views on following the Australian Football League's (AFL) concussion guidelines.

Methods 3 focus groups, each comprising 6 players from 1 regional league, were conducted until saturation of issues raised. Discussions followed a semistructured script and were audio-recorded and transcribed verbatim. Thematic analysis was conducted by 2 coders independently.

Results Identified advantages of the guidelines included highlighting the seriousness of concussion; changing the culture around playing with concussion and shifting return-to-play decision responsibility from players to others. Disadvantages included players being removed from play unnecessarily; removal of players’ rights to decide if they are fit to play and players changing their behaviours to avoid being removed from play. Identified facilitators to guideline use included local league enforcement; broad information dissemination and impartial medically trained staff to assess concussion. Identified barriers to guideline use included players’ desire to play at all costs; external pressure that encouraged players to return to play prematurely; and inconvenience and cost.

Conclusions Players generally understand that the AFL concussion guidelines protect their long-term welfare. However, their desire to play at all costs and help their team win is a common barrier to reporting concussion and adhering to guidelines. Leagues should take a lead role by mandating and enforcing the use of the guidelines and educating coaches, game day medical providers and players. The return-to-play component of the guidelines is complex and needs further consideration in the context of community sport.

  • Concussion
  • Prevention
  • Australian football
  • Implementation
  • Community

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors PEW and AD conducted the focus groups. PEW and SJS undertook the qualitative analysis of the focus group data. CFF and JN contributed to the design of the larger study that this project was associated with. All authors assisted with the interpretation of the findings. PEW led the writing of the paper and all other authors contributed to its editing and gave their approval of the manuscript for submission.

  • Funding This study was funded by a Victorian Sports Injury Prevention Research Grant through the Department of Planning and Community Development, Sport and Recreation Victoria. CFF was supported by an NHMRC Principal Research Fellowship (ID: 1058737).

  • Competing interests None declared.

  • Ethics approval The project received ethical approval from the Monash University Human Research Ethics Committee (HREC CF12/1178–2012000575).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.