Dr Kerryn Phelps, AMA President, 'Today', Channel Nine - Risks of head injuries in sport

GHIDELLA: The AMA has long been very vocal about the need to ban boxing. What exactly happens to the brain when it's hit with such force?

PHELPS: The brain's a very delicate organ and, unlike most of the other organs in the body, if the brain is damaged, it's permanent damage. It cannot repair itself. But if you can see the model of the brain we have here, you can see that there are a lot of blood vessels, not just over the surface of the brain, but supplying the inner parts of the brain. Now, if the brain gets knocked about in the skull, then you can get shearing and tearing of those tiny blood vessels. And when you get tearing of the blood vessels, you will get damage to the brain to that area that the blood vessels supplies, and you will find that there will be damage which will be permanent. Now, even if it's just a tiny bit of the brain, if that happens repeatedly and repeatedly, then you're going to find that there will be permanent longer term damage to the brain. And certainly, in the case with boxers, where there's an intention to hit the head and to cause brain damage - because loss of consciousness is a measure of brain damage - the intension is to cause head injury/brain injury and that is irreversible.

GHIDELLA: Well, we saw another example of a very severe punch the other day in the Anthony Mundine fight. Now, his opponent basically looked like he was out cold before he even hit the canvas. If you sustain brain injury, what happens? How does it manifest itself?

PHELPS: Well, I think a lot of people would be quite sickened by seeing that sight. Even though you hear the cheer go up, I think it, sort of, appeals to a very primitive urge in a lot of the people who are watching it. But when you come from a medical perspective or, if you come from the point of view of someone who actually cares about the person who is that boxer hitting the canvas, then you're thinking about what's actually happening in the brain. Now, the brain, when it sustains a very large single injury, will go into a concussion or even a coma, and that's an indication of the acute level of the brain injury - that the brain simply shuts down and they're out for a specific length of time. It might be for a few seconds, a few minutes. In some cases, it can be weeks and, in the case of that tragic case last week, it can result in death.

GHIDELLA: And, as a result, you can also get slurred vocal range, you have trouble seeing, all those sorts of things. Just explain what happens there.

PHELPS: Well, rather than just the acute brain injury and sudden death for a boxer, or death soon after the bout, there is, as I said, the multiple smaller traumas when these blood vessels have been broken. And where there's bruising, damage in the brain, that is, over many years, then you will get a syndrome called DDP Syndrome - which is dementia, deafness, and Parkinson's disease. And so boxers will, over a period of time, when they get older, they will get dementia, which is loss of ability to think to concentrate, to develop abstract thought, and personality changes. They'll get deafness because there is damage to the hearing centre in the brain, and Parkinson's. And we, of course, have seen, as an example of that with Mohammad Ali, and that involves shaking and problems with motor coordination, and trouble walking, and those sorts of things.

GHIDELLA: Well, head injuries are not only restricted to boxing. Other sports are just as guilty. Rugby league - we've seen Brad Fittler and Trent Barrett both charged with head slamming. How do you minimise these injuries? I mean, you can't stop the sports, at this stage, so how do you minimise the risks?

PHELPS: Well, I think that there's such a vocal call for banning of boxing around the world that, I believe that will eventually happen and certainly to see the money side out of it, then I think that will help a great deal. Now, headgear is important because, now, as you can see there, once again, a really bad way to treat a head is to slam it into the ground with two people behind the force of it. And I think that the rugby league and rugby union officials have really made tremendous advances. I mean, I remember, as a child, going to the rugby and they used to have the spearhead tackles where one would be on the feet, they'd lift them up and drive their head into the ground and of course, not good for necks and not good for brains. So headgear will help, a little bit. But, the main thing is for the officials to continue to say, 'this is not acceptable'. To drive the safety issues into the kids as soon as they start up the sport, when they're very young and to make sure that they stay within the rules and that they stay very heavy on people who break those rules. Headgear in boxing won't protect the brain; it'll only protect the face, the cheekbones, perhaps. But, ultimately it won't protect from that long-term brain damage because the brain is still being knocked around.

GHIDELLA: Alright, Kerryn. Well, that's all we've got time for. Thank you very much.

PHELPS: Thanks, Sharyn.

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