Beyond the Head Knock: The Real Impact of Concussion

Despite occurring more than 180, 000 times in Australia each year, concussion remains one of the
country’s most misunderstood injuries.

Concussions have commonly been viewed as simple bumps to the head. A 2017 study published in
Physical Therapy in Sport analysed 200 Australian news articles and found that the most frequent
terms to describe concussions were ‘head injury’ and ‘brain injury’.
While these labels are by no means inaccurate, they do not capture the severity of concussions.
Concussions are more than a simple head clash or an isolated brain injury. They can result in serious
trauma to the nervous system, producing symptoms like drowsiness, confusion, disrupted sleep,
mood swings, and emotional instability.

Lauren Beriman has lived with concussion symptoms since childhood and has found that they have
affected her memory of how to perform daily tasks which are meant to be “quite automatic for us”.
“After my last concussion there were times where I forgot to cook basic things like steak,” she says.
“I remember being in tears because I couldn’t remember how to make pumpkin soup.”
Beriman’s memory struggles have caused her to freeze when trying to remember who certain
people are.
“It’s really tough because I’m good at remembering people, their names and faces, but then I was
finding myself being stuck,” she says.
Beriman’s most serious concussion happened in May 2024, when she was struck by a vehicle while
walking. This incident has made a “significant difference” in her life, stopping her from participating
in activities she used to enjoy.
“I wasn’t able to travel and I used to travel overseas or even interstate three to four times a year,”
Beriman says.
Given that concussions are known to increase sensitivity to noise, Beriman has struggled attending
large social gatherings.
“It’s still very difficult attending restaurants because you’re noise sensitive and it’s hard
concentrating on multiple conversations happening at once because of the background noise and
being in a big group of people,” she says.
The effects of Beriman’s last concussion escalated so rapidly to the point where her career as a
school teacher ended.
“At any point I would be triggered by symptoms as that environment would have lots of significant
triggers for me, especially the loud noises, unpredictable behaviour and light sensitivity.”
So Beriman was ultimately unable to provide children with “that duty of care they need”.

The Hidden Struggles

Beriman’s story illustrates that concussion has the capacity to disrupt any aspect of one’s daily life.
But there is one factor which continues to obscure its seriousness- the invisibility of the injury. There
are rarely any clear signs to show that a concussed person has been injured.
Beriman felt that the lack of visibility of her injuries made her recovery process more challenging as
her peers were oblivious to her pain.
“I was in hospital multiple times and during my biggest stint people would come visit me and tell me
how great I looked,” she says.
“They just really couldn’t understand what was going on or why I couldn’t participate in things.”
This lack of understanding did not just apply to Beriman’s friends. She found that even medical
professionals would fail to grasp the weight of her situation.
“You’d go to emergency not understanding anything that’s happening to yourself and the doctors
would tell you that you looked fine,” she says.
Beriman found herself to be in a “Catch-22” where she could “articulate very well” to her medical
staff and then be told by them that she was not sick.
Due to the doctors’ constant downplaying of her symptoms, Beriman became “so drained and upset
from coming in”.
“You’d be physically and visibly upset and then they’d say you have anxiety,” Beriman says. “This
isn’t anxiety, I had a car accident and I couldn’t remember my name or where I lived.”

A Widespread Lack of Knowledge

The obliviousness to Beriman’s struggles is reflective of the limited knowledge of concussions among
many different groups of people in Australia.
According to a 2025 article published in the Medical Journal of Australia, 50 per cent of people with
concussions do not receive appropriate care and concussion management is “highly variable across
health professionals and community and health care settings”.
The article attributed these findings to “limited appreciation of the associated morbidity and impact
on quality of life” and “low levels of knowledge about best practice care”.
A separate study published in 2023 by the Royal Children’s Hospital Melbourne scrutinised the role
of parents in managing their children’s concussions.
According to this study, 34 per cent of parents have little to no knowledge about concussions, 29 per
cent falsely believe they only happen if someone loses consciousness, and 54 per cent are not aware
of the treatments.
These findings are problematic as more than 20 per cent of Australian children experience a
concussion by the age of 16 and parents are expected to be children’s primary caregivers after
serious injuries occur.
As someone who experienced head injuries as a child, Beriman calls for families to help children find
ways to “regulate their nervous system”.

“It’s happening to busy children and you’re going to be able to nail a few points here with what’s
happening in today’s society,” she says.
“You’re seeing a lot of children being diagnosed with ADHD and it’s about that dysregulated nervous
system.”
Beriman believes a crucial way of helping children settle their bodies is “making sure they’ve had
that downtime” after an “intense day at school where they’ve been running around and doing
sport”.
“If children have had a concussion and a fall they’re going to be emotional and fatigued.”
So parents need to be able to “assist” their child to “articulate what has happened”, according to
Beriman.
Beriman has used her experience to raise awareness of concussions by joining the Advisory Board
for the Concussion Legacy Foundation Australia, a non-profit organisation that provides services to
individuals and families who have suffered from the injury.
Her engagement with the foundation has given her the opportunity to guide people through their
recovery.
“I know what it feels like to have those really depressive times, but I could understand it was purely
linked to the concussions,” she says. “I wanted to be able to validate people that feel that way.”
Beriman has also been working with researchers to see the link between concussions and other
issues such as addiction.
“Each time you have a concussion it increases your chances of having an addiction, so I was able to
help people with that and validate them,” she says.
Beriman has found that another benefit of her role in the foundation is her ability to provide
practical guidance.
“I think the most important thing is seeing your GP and your neuropsychologist and
neuropsychiatrist, and it’s really well worth seeing specialists in those teams,” according to Beriman.
“At Concussion Legacy Australia we have a helpline that helps you find specialists in your area, and
that’s how you take that stigma away because you’re going to have people that really care.”
Beriman feels the foundation has been highly proactive in creating positive change for people who
are finding new pathways after experiencing concussions.
“You feel as if your world has crumbled, your world has been flipped upside down, and the person
you once were you don’t feel like you can be anymore,” she says. “But the Concussion Legacy helps
you find new things to look forward to, but also being like what’s happened to you is horrible but
we’re here to support.”

Concussions in a Sporting Context

Beriman is not a solitary case of how concussion can dismantle everyday life. Former domestic
cricketer Trent Keep has faced similar consequences in a very different setting.

During a long and decorated cricket career which took place in Tasmania and then Queensland, Keep
experienced repeated head trauma from the sport.
The final straw occurred in Gold Coast in January 2023, when he was struck on the helmet by a
cricket ball while batting in the nets. This incident marked his medical retirement from all sports.
He felt that concerns over his safety were impacting his enjoyment for cricket.
“I always loved cricket but it became a point after the last concussion where the joy and satisfaction
of the game were becoming outweighed by the potential implications of being hit in the head
again,” Keep says.
For Keep, a challenging part of battling concussions during his cricket career was the fluctuation
between feeling “great” and “miserable”.
“On a Friday you feel great and everything gets ticked off and then 12 hours later you feel a bit more
miserable,” he says.
He found that this dilemma came with “an air of worrying about what other people are going to
think”.
Keep’s challenges have not always been limited to the cricket field. He experiences “real fatigue”
from computer screens if he is “staring at those for too long”.
“I was never excellent with computers but I’ve noticed that they’re really draining me,” he says.
Like Beriman, Keep recently joined the Advisory Board for the Concussion Legacy Foundation. His
experience with the organisation has allowed him to “accept the cards that had been dealt” and
“move towards healthier habits in life”.
“There was some resentment at the start in terms of feeling like I didn’t deserve it, but it became
one foot in front of the next in terms of recovery,” Keep says.
Keep feels the foundation has given him the “avenue to speak on boards” and a “real proudness”
that his story “carries weight”.
“My journey and speaking about it allowed me to heal from it a bit better,” he says. “It’s created a
real air of interest in concussion in my particular networks.”
Keep believes his decision to speak out has played a role in helping “one person feel as though they
are not alone in this journey”.
“I’m quite proud of the fact that a number of people have reached out to speak about how maybe it
has helped them,” he says.
Since joining the Foundation, Keep has noticed that he has developed a more “caring front” towards
other athletes who have faced similar adversity.
“It’s allowed me to step back from certain athletes and show some real interest and care,” he says.
“It’s given me a broader lens on why people are the way they are and what is the best learning
method for them moving forward.”

Along the way, Keep was fortunate to still have close friends within the cricket community to whom
he was “open and transparent with the difficulties of not just concussion but with life”.
“If you’re willing to give a little you get a lot back,” he says. “But we’ve got to continue to provide
the environment for people to feel as though they can understand more about concussion and that
it’s not something that’s always going to be visible.”

The Culture of Playing On

Despite his personal progress, Keep’s experience has not come without any regrets. He believes he
could have tried harder to avoid the temptation to return to the field after experiencing an injury.
“I’ve been one who’s been guilty of applying pressure in the past and wanting to get back to the
ground as quickly as possible,” he says.
“If I could change one thing it would be to sit out when in doubt and think about the long term
effects, particularly the residual stance that you are going to get concussed again.”
Keep’s desire to keep playing after a concussion is just an isolated example of an extremely common
issue among professional athletes. The Australian sporting industry has adopted a culture where
playing on is socially acceptable.
According to a 2020 survey published by the Australian Sports Commission, 17 per cent of National
Rugby League players had declined to report a likely concussion in 2018 and 2019, even though 85
per cent had received concussion education.
The survey cited the most common reasons to be ‘not wanting to be ruled out of the game or
training session’ and ‘not wanting to let down the coaches or teammates’.
This mentality is also common is less commercialised sports. A 2025 study conducted by Southern
Cross University found that 21 per cent of surveyed Australian Taekwondo athletes reported
returning to play on the same day as a suspected concussion.
These athletes most often cited internal motivations for returning early, with 56 per cent being
driven by a love of sport, 39 per cent by a desire to win, and 31 per cent by personal pressure to
push themselves.
While athletes are responsible for their own choices, we must not overlook the role of the sporting
media in the normalisation of the play on culture. Commentators and journalists have continually
celebrated sportsmen who have played through severe pain.
During the 2019 Ashes series, the Sky Sports’ commentary team labelled Australian batsmen Steven
Smith as “courageous and brave” for returning to the cricket pitch after being felled by English fast
bowler Jofra Archer.
Sites such as ABC News and NRL.com have showered compliments to former Sydney South player
Sam Burgess for playing through the 2014 NRL grand final with a broken cheekbone, describing his
performance as “inspirational” and worthy of “rugby league folklore”.

Making the Long Terms Risks a Top Concern

Annita Siliato, CEO of the Concussion Legacy Foundation Australia, believes there needs to be a shift
in the media narratives of concussions.
“It’s a brain injury, that’s how it should be treated and people should not be seen as heroes or
tough,” she says. “The narrative needs to be that they’re heroes if they come off the ground rather
than stay on.”
The media should treat concussions as “any other injury”, according to Siliato.
“If you have dislocated your shoulder it’s accepted you don’t go back and play, so it shouldn’t be
accepted that if you have a suspected brain injury you’ll be going on,” she says.
The need to change public narratives largely stems from CTE, or Chronic Traumatic Encephalopathy.
A neurodegenerative disease linked to repeated head trauma, CTE has been identified in Australian
athletes from contact sports. Data released in 2022 from the Australian Brain Bank showed over half
of brains donated by former athletes had signs of CTE.
Siliato says CTE is an area where “there could be more done in terms of education and support”.
“CTE or repetitive head knocks over a long period of time are ignored because the only way you can
get CTE is through being hit,” according to Siliato.
“It could be a way to have that right balance where you could continue to play sports but also have
CTE in the back of your mind.”
Siliato says the foundation has worked to create a space where the long term consequences of
concussions and CTE can be addressed.
“With people in their fifties there’s dementia symptoms, aggressive behaviour and sometimes
epilepsy, and I feel like that links more to mental health,” she says.
So the foundation offers a large portion of its support to middle aged or elderly people who “really
struggle with their mental health”, fail to “remember things”, and “notice their behaviour is
different”, according to Siliato.
Siliato says the foundation has sessions aimed at widening concussion conversations by amplifying
the voices of people with lived experiences and expert knowledge of the injury.
“We have younger people with post-concussion syndrome, carers who are caring for people who’ve
had brain injury, or even people who’ve lost partners due to brain injury,” according to Siliato.
“We also have a lot of older people who feel they have suspected CTE and we even have people
from the NDIS come along because they have patients in that category.”
Siliato says the foundation has been making sure that a medical clinician has been attending each
session.
“We had an audiologist come along because with brain injuries come balance issues or tinnitus,” she
says.
“We also had a naturopath as a lot of people are looking for non-medication type of methods
because medication can have worse impacts for them overall.”

Most notably, Shaun Smith- a former Melbourne Football club player who suffered from a series of
concussions during his career- recently shared his journey with the foundation.
“He was admitted to a mental health facility and that facility helped him,” Siliato says. “Now he’s
managing it more naturally and giving hope.”
We must “give hope to people with long term brain injuries” by spreading the message that “you can
still manage them and enjoy life”, according to Siliato.

Changing the Rules

While organisations such as the Concussion Legacy Foundation have been raising awareness of the
long term risks of concussions, the next step is ensuring that this knowledge translates into
consistent practice.
At an institutional level, there have been efforts to improve the safety and health outcomes for
Australian athletes with concussions. In 2024, the Australian Institute of Sport released guidelines
which recommend that athletes rest for 14 days before returning to contact training and 21 days
before returning to competitive contact sport.
David Hughes, Australian Institute of Sports Chief Medical Officer, says these guidelines are intended
to give a “generous amount of time for the neuroinflammation to settle and for the brain to return
to its normal state”.
“We need to be conservative because if you follow these guidelines, we’re hoping this will be a one-
off,” Hughes says. “If we let you get go back prematurely we’re risking you getting another
concussion.”
Medical practitioners must communicate the concussion guidelines effectively to injured athletes so
that they are not prematurely cleared to return to participation, according to Hughes.
“The person advising the athlete- the medical practitioner- needs to be sympathetic to the player,
but otherwise emotionally removed,” he says.
“You’ve got to make logical decisions and explain to the patient that I’m here to ensure that you get
to play as much of your sport as possible.”
Even though some sportsmen who have been concussed “want to get back sooner”, Hughes stresses
the need for their doctors to be “the adults in the room”.
“They need to make decisions purely based on what is best for the short and long term health of the
athlete, not about the athlete’s motivation to get back to the sport,” he says.
Hughes emphasises the importance of an “education piece” which requires “spending time talking to
the athlete”, explaining “why we are conservative”, and describing the long term effects.
“Maybe we need to explain about the neuroinflammation,” he says. “Even though the athlete is
feeling good at the moment, they could still have neuroinflammation and we need to get them
gradually increasing their activities and making sure they’re symptom free before returning to
participation.”

According to Hughes, the “education piece” must be understood by multiple groups of people,
including sport officials, parents and school teachers.
“Everyone needs to be aware of what the concussion policy is and it needs to be well-socialised so
everybody understands we’ve got a concussion, here’s our protocol, and we have that protocol
followed,” he says.