AFL accused of putting players at risk as 33 footballers diagnosed with CTE

Thirty-three Australian Rules players, including 19 professional and semi-professional footballers, have been diagnosed with the degenerative brain disease chronic traumatic encephalopathy (CTE), exposing the scale of the AFL's brain trauma crisis.

Four Corners can reveal the alarming findings, compiled by the Australian Sports Brain Bank, include high-profile players who died in their 20s, 30s and 40s.

Until now, there had only been five known cases of CTE diagnosed in professional AFL players.

CTE is caused by repeated hits to the head and can only be diagnosed after death.

In life, the disease has been associated with symptoms including depression, memory loss, rage, poor impulse control and suicidal thoughts.

With the disease claiming modern-day heroes like Adam Hunter and striking down young footballers like 23-year-old Nick Lowden, the AFL is facing heavy criticism from experts who say the league's culture of denial is putting its players at risk.

"CTE is a preventable environmental disease," Professor Alan Pearce said.

"The evidence that I'm seeing from these tragic deaths, talking to players in my research program and the almost lack of concern, and some of the deflection of CTE says to me that the AFL does have blood on its hands."

Nineteen of the Australian Rules brain donors to the brain bank died by suicide. Fifteen had CTE, four did not.

Associate Professor Michael Buckland, from the Australian Sports Brain Bank, said there was a "disturbing association" with CTE and suicide, but more evidence was needed to establish if there was a direct causal link between the two.

He said his latest findings of CTE in Australian Rules players were alarming, particularly with the brain disease being diagnosed in younger footballers who only played at amateur levels.

"It tells all of us that there's a problem that playing a lot of contact or collision sports leads you to have a high risk of CTE later in life," he said.

"It's a problem that needs to be urgently addressed."

'No-one walks away unscathed'

Concussion is the second most common injury in the AFL, and the league has implemented more than 30 rule changes to reduce the risk of head knocks over the past decade.

But a concussion alone does not cause CTE in players.

"What drives CTE risk is exposure to repeated head impacts," Dr Buckland said.

"Most of those won't give you any signs or symptoms; they will just be part of the rough and tumble of the game, but each one of those is doing microscopic damage."

Much of the AFL's response to player safety has been developed with concussions in mind, but Dr Pearce said the league's policy only addresses the injury itself.

"The concussion protocols do not protect against CTE," he said.

"CTE and other neurodegenerative diseases like motor neurone disease and dementia are due to what we call sub-concussive impacts. These are things like bumps, tackles, being thrown to the ground, getting back up, running on with no apparent signs or symptoms.

"These are the small impacts that come into the tens of thousands over a player's career, from when they start through to when they retire."

Former Western Bulldogs player Matty Robbins is feeling those cumulative effects of a career that spanned 11 seasons and 146 games in the AFL.

Now coaching the local under-16 team in Ocean Grove on Victoria's Bellarine Peninsula, the 49-year-old believes he has CTE.

"I'm paying the price. No-one walks away unscathed," he said.

"From the age of probably 42, I started to deal with memory loss.

"I've got all the symptoms. I've clearly got this."

Risk awareness

Dr Pearce, who has been studying players' brains, including Matty Robbins's, for almost 20 years, said the league was reluctant to discuss CTE and has not educated players or the wider AFL community about the brain disease.

"The players are being kept in the dark. I don't think they fully appreciate what CTE really is … they talk about concussions quite openly," he said.

"I've had former AFL players saying that we're not being made aware of CTE. We were never made aware of the long-term issues … because of the exposure to tens of thousands of repetitive impacts over our careers."

Lawyer Michel Margalit, who is leading a class action against the AFL involving over 100 players, agreed that most, if not all did not understand the risk.

"They weren't advised of the long-term risks of concussion and permanent brain injury. In addition to that, when you're in that type of environment, elite sport, you have very little say," she said.

"When you're in a stadium, when you've got thousands and thousands of people staring down at you, when you have adrenaline pumping through your veins, you are not able to make any kind of self-determination in that moment.

"For those people to be able to protect themselves at that moment, it's just not possible."

Dr Ann McKee, one of the world's leading experts in CTE, who has diagnosed the disease in hundreds of American football players, said the evidence demands action.

"There's a potential financial benefit of pretending that these sports don't have risks, but I think the scientific data is incontrovertible," she said.

"There is a huge danger to these contact sports that involve head impacts and that's not restricted to American football or Australian Rules football, it's also seen in rugby and ice hockey and even soccer.

"We're waiting now for Australia to catch up to what I know is very bad news, very inconvenient news, but if we want to move forward and make these games safer … we have to do something about this."

Accountability not culpability

Two Victorian coroners have recommended that the AFL establish a formal partnership with brain banks.

The coroners wanted the AFL to encourage players to donate their brains to help research and better understand the condition.

The recommendation followed inquests into the suicides of St Kilda great Danny Frawley and Richmond player Shane Tuck, both of whom were found to have CTE after their deaths.

In the five years since the recommendation was first made, the AFL has still not acted on it.

Frawley's widow, Anita Frawley, told Four Corners she could not understand why there had been no progress from the league.

"Why is the football community still without a clear, nationally recognised pathway to support vital brain research?" Ms Frawley wrote in a statement.

"This is not about blame, it's about leadership, accountability, and player welfare. The football community deserves answers. More importantly, players, past, present, and future, deserve action."

AFL executive Laura Kane, who oversees player health and concussion, said a partnership with a brain bank was still being considered.

"We're committed to a long-term study that includes brain donation and we will make sure that we deliver that research program … that's all being contemplated right now as part of our Brain Health Initiative," she said.

The AFL only formally acknowledged the link between the game and CTE in April 2023. Seven months later, the coroner inquiring into Tuck's death also recommended the AFL limit contact training to reduce players' risk of concussion, which will be introduced from the start of the 2027 pre-season.

The AFL does not have an official CTE policy, but Ms Kane said the league does inform players of the risks involved.

"Every year our chief medical officer will educate our players on everything from the reporting of symptoms, the management of concussions, the long-term risks, and there's education and training that's conducted annually," she said.

Conflicting priorities?

The AFL has long maintained that the health and safety of its players is its top priority but despite past promises of a long-term study, it has failed to complete one.

Three years ago, the AFL announced a new $25 million research study called the Brain Health Initiative.

Ms Kane said the project was on track, with two clubs having completed their pilot program and a further five soon to join.

"From a research perspective, the Brain Health Initiative is where we house both research but also innovation," she said.

"So innovation with equipment, whether it be mouth guards … brain scans and other medical overlays that we can apply through the research, all the way through to protective equipment and learning here at the AFL about what the options are to help us reduce head trauma.''

The league is already under pressure to reduce players' exposure to hits by limiting contact training, officially monitoring all impacts and reducing the length of the season.

But the AFL has been considering extending the season, which James Gallagher from the AFL Players Association says it needs more time to evaluate.

"I think one of the things to consider is, if we were to have more games, how long are those games? How long is the training that sits around it, and the preseason training that sits around it? So I think it's about the cumulative load across the course of 12 months or a player's career," he said.

"At this stage, it's something that we know is a possible topic of discussion that the AFL would like to have with us. It's not something we have a firm position on yet, and we're currently discussing it with our members."

Dr Pearce said it was critical that the AFL take proactive steps to reduce the risk facing its players at all levels of the game.

"It's hard to reconcile that this sport that I've been researching could actually be contributing to an insidious brain disease that we're not talking about enough," he said.

"We can still have our sports, we just need to implement some small things that can reduce that risk."

Watch Four Corners' full investigation into the AFL's brain trauma crisis tonight from 8:30pm on ABC TV and ABC iview.