No athlete – elite or otherwise – wants to be told that they have to stop playing sport, particularly in the prime of their career.

But that’s exactly what happened to Canberra rugby league player Matt Kelly when the first match of the 2021 football season ended up being his last-ever as a footballer at the age of just 23.

In eight years, Kelly had suffered at least 13 concussions playing football. And with such a medical history, he knew his playing days were numbered yet still wasn’t prepared for the way it happened so quickly.

Kelly’s attachment to rugby league began at the age of six when he started playing in his hometown for the Darling Point Coleambally Roosters.

He suffered a couple of head knocks and minor concussion episodes in his early playing years but nothing that he, his family and medical practitioners’ thought was of long-term significance.

Kelly moved to Canberra in 2018 to go to university but his football remained an important of his life, quickly becoming a first-grade regular with the West Belconnen Warriors.

Midway through his second season, Kelly suffered his worst concussion when his head heavily collided with an opposing player, leaving him knocked out on the ground.

It’s an incident that changed his life. To this day the event is a blur for Kelly. He’s unable to recall more than the start of the match and then the aftermath, sitting in the hospital waiting room.

Kelly and his family were so concerned with his welfare, he decided to see a sports doctor who specialised in concussions.

The 21-year-old recounted his history and severity of concussions to the doctor, who immediately advised Kelly to take a year off from any contact sport so his brain could rest and recover.

“It was the first time I did an actual concussion test of memory and balance which was surprising because of all the times I’ve had a concussion I’d never done one until then,” Kelly said.

Kelly was also advised to seriously consider retiring from contact sport if he was to suffer one more concussion.
At such a young age – often when people feel ‘invincible’ – it’s difficult to confront the prospect of giving up something they love.

Kelly returned to football in 2020 for the short pandemic-affected season and, thankfully, made it through without incident and injury.

But in round one of the 2021 competition against the Goulburn City Bulldogs, Kelly suffered one more knock that marked the end.

Chasing from marker to make a tackle, his head met with the force of an opposition player’s unintentional elbow.
Despite knowing he had suffered a bad knock, Kelly tried to cover it up by getting up off the ground and straight back into the defensive line.

“Straight away I sort-of knew in my head because – I don’t know how to describe it – but I was fuzzy when it happened. Straight away, I was trying to just prove to myself that it wasn’t a head knock,” Kelly said.

“I just ran back to the line, and I didn’t make a tackle for the rest of that set, but I knew I wasn’t right.”

Even in those moments – and afterwards when he stormed off the field into the sheds – the reality of the serious threat to his health was starting to dawn on Kelly.

“I struggled to go to games after it, and I lost motivation a little bit. I was so frustrated because I’d just want to be playing.”

Concussion events, like the one Kelly just described when a player tries to cover up a head knock, are hard for trainers and officials to identify at the local rugby league level.

Unlike the National Rugby League (NRL) competition, there is no live replay or other technology, which means concussions can only be identified by the naked eye.

Players have a significant responsibility in being honest with their sports trainers if they feel any differences after a heavy clash. It is then the responsibility of a sports trainer to attend to the player, take them from the field, and report the suspected concussion.

As a result of an increase of concussions in rugby league in Australia – in some age groups, the figure is more than 100 percent – the Canberra Region Rugby League (CRRL) implemented new rules and protocols for concussion management in 2021.

One of the protocols introduced was a concussion referral form to ensure players who suffered suspected concussions were reported and appropriately rested from the game and training.

CRRL’s Competitions and Accreditations assistant Jennifer Pilosio manages and enforces reporting of concussion throughout Canberra’s rugby league competitions.

In the 2021 season, Pilosio received about five concussion referral forms a week across the Canberra Raiders Cup (men’s first grade), George Tooke (men’s reserve grade) and Katrina Fanning (women’s) senior competitions.

Pilosio said the new forms and protocols were also implemented to ease the immense responsibility on sports trainers on game day.

“Sports trainers have so much responsibility that I try and take some from them because there’s no equipment that we have access to at the local level to help identify concussions,” Pilosio said.

Another crucial change in the CRRL’s protocols was that once a player left the field for a suspected concussion, they would not be allowed to return to play in that match.

The order protects the player, sports trainer, club and CRRL because medical research shows concussion symptoms can have a delayed onset.

A concussion protocol the CRRL adopted from the NRL is the 18th man rule, which allows another player on the reserves bench to be used.

Unlike the NRL, the substitute can come into play as soon as one player has suffered a concussion.
Pilosio says the rule allows clubs to not completely lose a player with their ‘once the player leaves, they don’t return’ policy.

Fortunately for the CRRL there is a great amount of trust between the clubs and sports trainers who undergo concussion training, and they can only hope that the players follow suit and cooperate.

“The players have a job to do, and player honesty is huge which is why we’re big on club education,” Pilosio said.
“We need to put more force on the junior clubs to do this education so then kids have grown up with it.

“Telling a four-year-old that concussion is really bad, they’ll keep that forever rather than trying to teach a 32-year-old or 27-year-old that concussion is bad when they just go ‘yeah, I’m fine, whatever’.”

One of the biggest concerns the CRRL has is that players won’t follow their ‘concussion and return-to-play protocols’.

“I can’t stop them from going out and drinking, but as soon as we receive their form of a suspected concussion, they become unavailable on our system to play,” Pilosio said.

Experienced sports trainer Grant Hogan has dealt with concussions in many forms. Hogan has been a paramedic for 34 years, was a sports trainer for the Canberra Raiders for 14 years and now is a trainer for the Belconnen United Sharks in the Canberra Raiders Cup.

Hogan says concussion should be managed in any circumstances with the ‘worst case scenario’ mindset, exactly like chest pains.

“They’re picking up on concussions a lot earlier now, because there’s more medical knowledge now and more testing that goes on for players, post their career,” Hogan said.

“You can have one concussion and it may not cause too many dramas, it might dissolve. But they’re looking at added concussions, and they’ve found that they’re much worse both short-term and long-term.

“Years ago, they didn’t really have the knowledge to back that up and explain it to players and so they kept playing and thought ‘that’s just part of the game, I feel okay, so I don’t need to come off’.”

One of the biggest challenges Hogan says he faces as a sports trainer dealing with concussions is impressing on players the importance of rest.

“The first thing you’ll notice players do is they’ll get on their phone, and that is the worst thing for the brain. So, trying to get that instilled in the players is hard as well, but they need to be aware of these things.”

Hogan admits identifying concussions as a sports trainer is harder in local league compared to the NRL. There is no doctor on the sideline to re-watch collisions to identify if a player needs to be assessed and possibly taken off.

“When you don’t have many staff, you’re doing everything. You’re doing the set-up, the strapping, the ice, the water, and other things, and so when the game starts you can be absolutely knackered.”

Hogan says his job as a sports trainer in local rugby league is almost harder than in the NRL as it requires significant concentration and awareness of players on and away from the ball.

Matt Kelly, Jennifer Pilosio and Grant Hogan are all strong advocates of education and awareness around the severity of concussion.

“I wish I knew what players in the NRL do to recover from concussions, such as Ryan Papenhuyzen or Boyd Cordner,” Kelly said.

“Even just knowing what they were doing which meant they could or couldn’t come back, pretty much their rehab.

“I think if I was 15 now and it was managed and talked about the way it is now, I possibly wouldn’t be in the position that I am.”