Australian Rules Football Confronts C.T.E.

Australian Rules Football Confronts C.T.E.

For the first time, researchers have found chronic traumatic encephalopathy, the degenerative brain disease linked to blows to the head, in a player of Australian rules football.

The disease, which can only be definitively diagnosed after death, was found in Graham Farmer, one of the game’s best players, who died at 84 in August.

The diagnosis, which was detailed in a report in the journal Acta Neuropathologica Communications, was made by doctors at the Australian Sports Brain Bank, run by Royal Prince Alfred Hospital in partnership with the University of Sydney’s Brain and Mind Centre.

The finding is significant because for years, leaders of Australian rules football have straddled an uncomfortable fence, talking down the risks of potential long-term brain damage from the sport while also focusing on eliminating head hits and trying to prevent concussions and other traumatic brain injuries.

Michael Buckland, the founder of the Australian Sports Brain Bank and a co-author of the report, had already found chronic traumatic encephalopathy, or C.T.E., in the brains of two former rugby league players. In 2013, researchers at Boston University found C.T.E. in an Australian rugby union player.

Farmer, who known as Polly, was found to have Alzheimer’s disease in 1999, when he was 64.

Australian rules football is wildly popular in Australia, where it is seen as the country’s national sport. The West Australian splashed the story of Farmer’s diagnosis across its front page, calling the news a “bombshell.”

About 1.5 million people play the game nationwide, and the Australian Football League, which formed in 1990, is the largest sports league in the country, with about 7.5 million fans attending games. The women’s professional league continues to expand. The A.F.L. Grand Final — Australia’s version of the Super Bowl — routinely draws 100,000 fans.

But in recent years, a growing number of former players have gone public about their declining health, including a rash of cognitive problems. Many former players have complained that the A.F.L. has not done enough to help them cope with their medical conditions. Lawyers supporting the players have spoken of filing lawsuits against the A.F.L. to win medical benefits for retired players.

While several prominent former players have spoken about their health issues, Farmer’s diagnosis emphasizes the seriousness of the situation, even though the disease, which can only be detected posthumously, affected Farmer at an age when many people’s brains show signs of deterioration.

Farmer, an Aboriginal from Western Australia, starred in the semiprofessional leagues in Western Australia and Victoria from 1952 to 1971, before the formation of the A.F.L.

Farmer was considered one of the innovators of the modern game for his skill at punching the ball forward. In 1996, the Australian Football Hall of Fame named him a Legend of Australian rules football, the sport’s highest award. He was also named to the Team of the Century.

Australian rules football is one of the most violent games in the world, but by today’s standards, the games in Farmer’s era were all-out brawls. Players used their fists, forearms and shoulders to knock out their opponents. There were no established rules for diagnosing or treating concussions. Players, who had to work second jobs to make ends meet, endured brutal practices between games.

After he retired as a player, Farmer coached for several years, and later owned a motel with his wife in Western Australia.

Buckland and the other authors of the report said that the severity of Farmer’s C.T.E. was consistent with what had been found in players from other contact sports.

“A head knock is a head knock, regardless of the circumstances in which you get it,” Buckland wrote. “C.T.E. is real, and it is here in Australia.”

Researchers affiliated with the A.F.L. have tried to cast doubt on the seriousness of C.T.E. by suggesting that there is no definitive link between the sport and the disease. Still, in recent years, the A.F.L. has taken steps to reduce the game’s most dangerous plays, penalizing players who target the heads of opponents, and forcing players with concussions to sit out days and even weeks.

Alan Pearce, the report’s lead author and an associate professor at La Trobe University in Melbourne, said those efforts were positive but more needed to be done.

“This is an important occupational and public health issue,” he wrote.

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