You can’t see the injury, but you know the symptoms are there.
That’s the scary thing about concussion, says Football Fern Indiah-Paige Riley.
It’s your brain and it takes time to recover.
The striker has had five concussions in the past six years; the most recent one happened atthe end of last year and it took Riley two months to recover from it.
“It’s not like an ankle injury where you can kind of push your recovery along,” said Riley, who is 23.
“It’s your brain and you can’t muck around with your brain.
“You need that to live, to function daily.”
When people think of concussion in sport, they often think of close-contact sports such as rugby union or rugby league, but it is an issue in football as well.
ACC accepted 1221 football-related concussions in 2024, which cost it $3.4 million to help people recover.
It also paid out 11,386 days of weekly compensation to people for football-related concussions, which cost $1.4m.
One of the main causes of concussion in football is heading the ball, said Riley.
“This is scary because it happens so often in football, and you have to do it so often.”
Riley said her concussion symptoms were difficult to recognise at first.
“I was just not feeling right and like a fog, like I just wasn’t very fresh in my mind.
“It’s just not a nice feeling at all, to be honest – you just don’t really feel like yourself.”
Riley also experienced extra sensitivity to light and noise.
“When I was recovering from my most recent concussion I really started to worry because it was just taking so long.
“I remember when I was finally cleared to play again, I got a ball to the head, and I just started crying. I was so scared and thought, ‘oh no, not again’.
“Luckily, I was fine, but you just have to be so careful.”
Riley has a big career ahead of her for club and country. She has played 29 internationals for the Ferns and scored seven goals. It was a scary feeling to have ongoing concussion symptoms.
“I have a lot I still want to achieve so it has freaked me out a bit. I try not to worry about it and anytime I have symptoms I manage them well and put my wellbeing first.”
The Ferns have performed well of late – defeating Costa Rica in a two-match series and beating Venezuela in their latest game in June. Riley is excited about what the team can achieve under new coach Michael Mayne.
“The main thing he is stressing is buy-in from the players,” she said. “It’s a long road to the World Cup [in 2027] and he has been talking about being all-in so we can understand each other and the style of play he wants to implement.”
Football-related concussions cost ACC $3.4 million in recovery support last year. Photo / Lynne Cameron, Photosport
Last year, ACC launched the National Concussion Guidelines for community sport and Riley said they are a great initiative for football.
The guidelines provide principles and advice for the sports community and health professionals to recognise concussion and manage return to play in a consistent way.
ACC injury prevention leader Nat Hardaker said the growth in the women’s game is exciting.
“We do see that female players have a higher rate of concussion than male players,” she said.
“Although that difference is not yet fully understood, there are some data that show females close their eyes earlier before the header and use less protective body positioning, potentially leaving them more vulnerable to injury.
“This is actionable; good skill and technique can reduce the risk of injury.”
Hardaker said if a player does suffer a concussion, research shows good early management can improve long-term outcomes.
Over the next two years, ACC will invest $2.5m into the NZ Football Prevention and Performance programme. The partnership has a focus on improving concussion management.
“The investment into this partnership will deliver important resources. It will help ensure there is clarity on how to manage concussion in football and put player welfare first.
“We are trying to change the culture around concussion in sport.”
Riley said it’s important for young players to install good habits early when it comes to recognising and reporting concussion.
“The younger that people get that support the more beneficial it will be,” said Riley. “I never really understood how serious they were, and I’ve had so many now.”
Riley’s advice to anyone experiencing concussion symptoms is to trust their body and seek professional medical care.
“Listen to how you feel. It’s not something to rush, or to push, because they are so serious and they can be really dangerous if you don’t treat them right.
“Be honest and report your symptoms if you feel like anything is not quite right.”
National Concussion Guidelines – Fact box
The guidelines present an opportunity to improve the health outcomes and wellbeing for people who play community sport by introducing a standardised approach to managing concussion.
The key changes are: (1) When a player suffers a concussion, they must be symptom-free for 14 days post-injury before a graduated return to play. (2) They must complete a minimum period of 21 days away from full competition before clearance to return. (3) Medical clearance must be obtained before return to play.
The four Rs of concussion management
Recognise (the signs and symptoms of concussion)
Remove (the person from play)
Refer (to a medical doctor to confirm diagnosis and provide treatment)
Recover (before returning to school/work and sport)