Researchers of an AIS-led study into long-term effects of concussion have discovered non-collision sporting injuries can also have a substantial effect on the brain.
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Recent findings suggest injuries like torn knee ligaments or even a sprained ankle impact brain health, a concept unknown to scientists less than two years ago.
The effects of non-collision injuries are being observed in retired sportspeople as part of a joint study between the AIS, the University of Canberra, the Hunter Medical Research Institute and the University of Newcastle, backed until 2024 by a $340,000 federal government funding injection.
Brain function of retired athletes from collision, and non-collision sports, will be observed over several years, while brain activity will be measured through a series of regular MRI scans to quantify changes over time.
And according to the UC and AIS Professor of Sports Medicine Gordon Waddington, the study has already thrown up some surprise findings.
"You'd have gone crazy if I said this a year or two ago, but if you sprain your ankle or tear a ligament in your knee, the brain now actually changes," Waddington said.
"If you've got a chronic ankle injury, a part of your brain changes, you can actually see on the scans. If you've had ACL injuries, that will also produce changes in your brain.
"This is not concussion, of course. What we've become aware of is the brain is what we call plastic, it changes constantly.
"If you're not somebody who's done much with your hands and you do a course to learn juggling ... you can actually see that part of the brain that controls your eye-hand coordination actually gets bigger.
"The change is really quick. You can actually look at the brain while somebody's doing something and see which part of the brain is lighting up and see how intense that is and how much activity is going on.
"Exactly the reverse of that happens as well, if you stop doing something. If you've got an ankle sprain or you have an ACL injury which is a common big injury in sport - we all limp when something gets sore and that limp is a reflection of changing the movement pattern.
"The brain says well I'm not using this bit of the brain for the moment for that control, I'll put something else in and change that or I'll simply reduce the size of the brain in that space.
"We know when an individual has an injury, even though they've had their rehab. . .they're two-and-a-half times more likely to get re-injured again in that following season. That's a brain change."
The effects of concussion have became a major focal point for professional sports across the world, particularly in American football where the degenerative disease Chronic Traumatic Encephalopathy (CTE) is having major ramifications on the health of retired players.
CTE sufferers undergo major changes later in life as their brains degenerate, often leading to violent behaviour towards others, and suicidal tendencies.
It's a disease which has been found in professional football players in Australia, also. AFL stalwarts Danny Frawley and Shane Tuck, who both died in recent years, were found to have been suffering from CTE.
In 2021, the NRL actively cracked down on high tackles affording referees more power to send offending players from the field.
"The CTE side is very much what this long-term study is all about, trying to see whether or not in certain individuals that's more likely to happen," Waddington said.
"It's very important that we do tackle it and things like understanding the period of time when somebody does receive a head knock to ensure they have time out before they play again.
"Nobody knows what the total number of head knocks is that you can tolerate. Nobody knows what the contribution [is] of having a lot to drink after a match
"One of the things I've become more and more aware of through the research is there's more we don't know then we do know.
"The brain is the most complex thing that we deal with as humans in the universe and we're only just starting to scratch the surface of what can go on
"This study will go a long way to starting to put some of those bricks in the wall."