A second expert has joined calls for Netball Australia to update its concussion policy, in the same week that its submission to the senate parliamentary inquiry was made public.
The sport's Super Netball guidelines – last updated in 2021 – have come under the microscope recently, after more than one athlete with a history of concussion was allowed to continue playing throughout the early stages of the 2023 season despite contact with the head.
The most high-profile example involved Emily Mannix in round one, where the Melbourne Vixens defender was allowed to return to play within four minutes of colliding with the opposition.
Mannix bent down to pick up the ball in the fourth quarter, when her face hit Verity Simmons' shoulder and she fell backwards onto the floor. The impact left Mannix clutching at her forehead and slow to get up before she was sent off by the umpire.
This approach is standard practice in netball for injury time, which requires the injured athlete to leave the court within 30 seconds of time being held for treatment.
Mannix was led out of the arena by the home team's doctor to the change rooms where a concussion assessment took place based on category c in the current policy, 'unclear but concerned'.
This assessment requires the player to confirm what happened and complete the Maddock's Questionnaire. If cleared, those in charge will continue to monitor them throughout the game and remove the player if there is any further concern.
Two and a half minutes after being knocked to the ground, Mannix was seen standing behind the coaching bench. The Vixens called a tactical timeout, and following this, the defender was back on court within a little more than four minutes.
This fast turnaround was cause for concern, considering the larger discussion happening in sport around the world at the moment, regarding the growing research that supports the seriousness and long-lasting effects of trauma to the head.
However, in the days that followed, each of the relevant parties came out and said they were happy with how the situation was handled.
Netball Australia and the Melbourne Vixens both confirmed this with the ABC, while Mannix issued her own statement to Fox Netball's Centre Circle that said she felt fine and had continued to do so in the days after the match.
So why are we still talking about this?
Well, experts are worried that this precedent, purely in the form of the sport's policy – not the medical professional who followed protocol – is simply not cautious enough.
Particularly given Mannix has previously written an Athlete's Voice article where she opened up on the severity of a concussion she sustained back in 2018, that sidelined her for two months.
In that instance, Mannix copped an elbow to the head and said the injury left her feeling angry and depressed for about six weeks, battling headaches, dizziness and fatigue.
Last Monday, Professor Alan Pearce from La Trobe University appeared on The Netty Life podcast and suggested netball should at least consider introducing a 10–15-minute compulsory window to assess a player, like the AFL, knowing that symptoms can sometimes take days to present themselves.
He added that the sport should also be updating its protocols on a yearly basis with current research, rather than relying on the 2016 Berlin Consensus Statement of Concussion from the International Conference in Sport – cited as the main point of reference in Netball Australia's guidelines.
Mannix isn't the only player that has suffered a blow to the head in 2023. Several players have dealt with concussion throughout the pre-season, while Molly Jovic was somehow allowed to stay on court throughout the Melbourne Derby in round two by the Collingwood Magpies, despite copping an arm to the face that saw her lose balance and fall over.
Jovic has a history of concussion, after sitting out a game during the 2020 season to recover from a head injury, but in this instance, there was no injury time called and she was left unchecked until the next break in play; even though the clash happened at the start of the third quarter.
Now, a second neurologist has weighed in on netball's 'lax' guidelines.
Speaking with the ABC, Rowena Mobbs from Macquarie University says she doesn't think the sport is taking a strict enough approach.
"Emily Mannix showed clear neurological signs of concussion with her slow movements and stunned or confused appearance after a heavy head impact … Common sense would dictate that she should not have been allowed to return to play," Dr Mobbs said.
"Netball, like many sports in Australia, is currently under close watch for their concussion policy, but they will be a better sport for it.
"Too often we have seen sports lag behind, and for Netball Australia to rely on a 2016 approach is lax and outdated, they need to adapt fast."
Netball Australia submits to the parliamentary inquiry
Mobbs has been involved in the 2023 parliamentary inquiry taking place in the Senate, which is investigating the way Australian sport deals with concussion from grassroots all the way to the top; and whether any legislation or a blanket set of guidelines needs to be introduced at a national level.
So far, there have been three hearings, in Bass Hill, Brisbane and Canberra, and although most of the focus has been on the footballing codes, other sports have been invited to take part too.
This includes Netball Australia, whose submission in February – before the season started – has only just been made public on the website over the past week.
At this stage, the Melbourne-based sporting body are not scheduled to attend the final hearing in their home city on April 26, but this could change as the rundown is still being finalised.
As a director of the Australian CTE Biobank, Dr Mobbs presented at the Bass Hill hearing, and says she would like to see a representative from Netball Australia attend in Melbourne.
"Concussion protocols vary across sports nationwide and interstate, causing great confusion amongst parents and athletes," Dr Mobbs said.
"This latest concern over Netball Australia's concussion policy reinforces the need to take the pressure away from the sports and to see government institute a national set of protocols led by independent scientific expertise.
"It is vital that the sporting representatives front the inquiry, but ultimately the government should intervene with tough recommendations for the professional sports come the report in June."
The details regarding Netball Australia's submission
In the submission, there are some interesting things to note.
Firstly, it lists netball as a "non-contact" sport, without clarifying that this definition is being debated with the professional rise of its athletes.
As the strength and speed of players has developed and the physicality grows, it is increasingly being referred to now as a 'controlled contact' sport or a game of 'fair contest'.
Secondly, it states that Netball Australia "conducts regular education across players, coaches, medical practitioners and other support staff across the NA Elite Programs to ensure that each can recognise common symptoms of concussion (including delayed concussion), the importance of reporting and return to play protocols".
But when the ABC checked with current players, across three different clubs, they said they've never received any type of formal concussion education session; just the usual head assessment conducted with the club doctor ahead of each season (SCAT) to find their baseline.
Instead, they say most of what they know has come from observing their peers when they've gone through a head injury or purely by experiencing it first-hand themselves, and that is something that seems consistent with retired netballer and AFLW star Sharni Norder (née Layton).
Former player shares her experience
The 46-capped Diamond, two-time World Cup champion and Commonwealth Games gold medallist had a netball career that spanned 14 years at the elite level before she moved on to footy. Now retired from both, Norder wishes she'd been more cautious and careful with her recovery.
"There definitely was no sit-down concussion session, the most I learnt was actually from being concussed and I think I had about three or four concussions during my netball career, there were head knocks in between but I can't remember all of them," Norder told the ABC.
"My first was when I was 17 when I was playing nationals, someone took my legs out and I went head-first into the ground, pretty much knocked myself out, but I think I only had a day off before playing again … That would have been 20 years ago.
"Then my worst one came when I was with the Swifts in 2016, where I head-butted Abbey McCulloch … I broke her nose, and I got concussion, but I played the rest of that game … Even then, it was like, 'Do you feel alright, do you not?' And I was like 'I think I'm okay but how would I know?'
"I remember catching up with [Sydney Swans AFL player] Kurt Tippett because he'd had a few, and he was my best source of reference about what to expect … If he wasn't there to walk me through that then it would have been a really scary experience."
Watching the footage back of that trans-Tasman championship game, the incident happens in the midst of the fourth quarter (1:39.00 in the above video), on the edge of the circle. Norder and McCulloch collide, the latter is treated while Norder not only remains on court but is swapped into a more intensive role at goal defence as the back line shifts to cover the loss of McCulloch.
Another moment Norder feels differently about these days was the infamous 'Play Like a Girl' campaign of the 2015 trans-Tasman championship season, which copped a lot of heat for featuring Norder front and centre in the promotion with a bloodied, black eye.
It was supposed to show how tough netballers were, and at the time all the criticisms were about whether it promoted violence, but looking back, Norder says the injury had come after a teammate had elbowed her at training, and maybe for that reason it wasn't the best move.
"I had copped Erin Hoare's elbow to my head and at the time I didn't care, but reflecting now, it's probably not ideal," she said.
Norder was lucky to never sustain a head injury while playing footy in the AFLW, where she says players are ripped off straight away if there is any contact with the head. But when asked if she feels the effects of those previous concussions today, she finds it hard to answer.
"I wouldn't know to be honest; I think I'm okay, but I've had depression, I am quite forgetful and things like that, it's hard to know if it's just my personality or the head knocks and that's the hardest thing with concussion, you don't know what the lasting effects are."
"I didn't go from being an organised person to an unorganised person, I've always been that way, but I would be lying if I didn't often think I wonder if I'm forgetful because of my head knocks, not even during the games, but head knocks in pre-season camps.
"It's an irresponsible mindset, but when you're playing sport as an athlete, throwing your body on the line and you don't have the education that we now should have – you just don't care."
