The AFL should consider following the lead of American football in “severely limiting full contact practices” to “dramatically reduce the risk” of players developing neurodegenerative disease, a US expert has told the first hearing of the inquest into the death of the late AFL player, Shane Tuck.
Tuck played 173 games for Richmond Football Club between 2004 and 2013, and later had a brief boxing career, from 2015 to 2017. He killed himself at the age of 38 in July 2020. After his death, he was found by the Australian Sports Brain Bank to have suffered from severe chronic traumatic encephalopathy (CTE), the debilitating degenerative brain disease caused by repeated head trauma and increasingly linked to long-term exposure to contact sports. It can only be definitively diagnosed after death.
In his opening remarks at the Victorian coroner’s court on Wednesday, coroner John Cain said that much of the inquest would focus on head trauma in Australian rules football and in boxing, and the opportunities to reduce or minimise the risk of it.
“The inquest is not about blaming individuals. It’s not about finding guilt or liability. My intention is to search for answers, to better understand the prevention opportunities,” Cain told the court.
Dr Robert Cantu gave expert evidence by video-link to the first hearing of the inquest. Cantu is an internationally renowned neurosurgeon and expert in CTE.
Cantu said that after reviewing hundreds of documents provided to the court by the AFL, the sport appeared to him to be doing “a very fine job” in managing concussion, in part due to its reference and adherence to the global consensus statements on concussion in sport.
Cantu is a member of the international Concussion in Sport Group that compiles these statements, and has been so since its first meeting in 2001.
Cantu told the court, however, that there was a “missed opportunity” for the AFL to focus on prevention of CTE and long-term damage in players from the cumulative effects of both concussion and sub-concussive trauma; that is, the jolts and blows that cause damage to the brain but don’t result in clinical symptoms.
“There was really no mention of CTE and no focus on the effects of repetitive head trauma, and that is something that is a missed opportunity. Since we know that the risk for CTE is related to cumulative head hits, every effort ought to be directed towards reducing the number of hits that one takes over the course of a career,” Cantu said.
He referred to the “dramatic reduction in total head impacts” – an estimated reduction of more than 60% – accomplished by the American NFL through only allowing less than one full contact practice per week during the season and none at all in the off-season.
Severely restricted full-contact training would also be appropriate for amateur, junior and community football codes, Cantu said.
Central to the scope of the inquest into Tuck’s death are questions about the connections that might be established between head injuries sustained by Tuck during his football career, his boxing career, and his diagnosis of CTE, and what connections there might have been between CTE and his death.
The former player’s widow, Katherine Tuck, had first reported worrying changes in her husband’s behaviour from as early as 2006, with his first neurological assessments occurring in 2008, due to him reporting dizziness and forgetfulness, the court heard. His mental health episodes escalated in severity over the last decade of his life, resulting in multiple admissions to hospital as a psychiatric inpatient.
Cain apologised to Tuck’s family for the timing of the hearing, noting that the inquest was opening the day before the three-year anniversary of Tuck’s death. However, Cain said, the timing of the hearing did “put in sharp focus” the importance of the hearing and the imperative to avoid any further delay.
The inquest has hit numerous snags over the past three years. The first appointed coroner, Simon McGregor, recused himself in March 2021 because his brother works for the AFL Players’ Association, which had referred Tuck to mental health services. Cain then took carriage of the investigation.
The inquest was delayed again in October last year to give the AFL time to finalise their report into the work of their former concussion advisor, Dr Paul McCrory.
In April, Katherine Tuck said she would no longer take any further part in the inquest, citing “grave concerns” about the scope of the inquiry and its ability to deliver “a just outcome”.
The inquest continues.