Lance Picioane is the Founder & CEO Love Me Love You foundation, a leading mental health and suicide prevention advocate, and a Former AFL player for Adelaide FC, Hawthorn FC, and North Melbourne FC. He is a husband and a father of two boys.

Where does my story begin and where does my story end… There is darkness and there is light in my story and a lot in between. Like everyone else, I have a story to tell and mine has a lot of unanswered questions as to the effects and consequences from my past.

I was recently asked to write my own birthday speech and my own eulogy, which is an extremely confronting and daunting task. “His desire to make the world a better place what people don’t really acknowledge, and this comes from him growing up with internal warfare, placing such trust in people has bitten him on the ass but like a dog with a bone he will not give up”

As part of my past as a professional sportsperson in a brutal contact sport, in a generation that was harder than it was smarter, I used to interpret head knocks and concussions as a badge of honor. I used to believe that if I didn’t receive some sort of head impact in a game then I didn’t play hard enough. This mentality was not only present in my professional career, but throughout my junior days as well. A little competition I had with myself was to see how hard I could go and come out unscathed… How wrong I was!

Only the bad ones I would report… bad ones where I would end up in the hands of paramedics or doctors and then fudge the protocols so that I could play the next week. My history with concussion has led to a range of brain functioning challenges, my mental health has been severely impacted, my self worth and identity had lost its path, my ability to concentrate and finish the simplest of tasks diminished, headaches/dizzy spells and vision noise were so common I didn’t know what normal was.

The challenge is: ‘Would I have changed how I played knowing what I know now?” The answer is no! What I would change is the protocols I should have followed, the recovery that I should have followed, the questions I should have asked.

I live with fear. Fear as to what damage I have done and around what repercussions I will have to face up to as we move forward. What has this done for me now? It has helped me understand the health management I need to have in play every day to make sure I am looking after my mental health. This includes taking a holistic approach to my health through the three domains of mental, physical and social wellbeing. Keeping myself more accountable to my outcomes of my mental and physical responses will hopefully keep me in a more positive position for the future.

What does the future look like? Nobody knows. Instead, the question should be, “what do I want the future to look like?” I would like to live in a world of greater understanding of the impacts our choices have on our future. Greater awareness and education on topics that I am extremely passionate about, including mental health, concussion, connectedness and community.

I am donating my brain to research when my time is up in the hope that it will give future generations a greater understanding of what we can do to decrease the negative health impacts of concussion and repeat head trauma from sport. I want to empower others through research and promote education from a young age to better facilitate a future where Australians can keep playing the sports that we love without sacrificing their long-term health. Sports participation is such a powerful vehicle for connection and community, but we need to provide is a safer sports environment for our youth so we can continue to do this!

My name is Jason Madden, I grew up in a small country town called Muswellbrook in NSW. Growing up I had different obstacles then most other people my age, I was born with Spastic Quadriplegic Cerebral Palsy. Rugby League was the biggest sport in my town, as with a lot of country towns. Even though I couldn’t run on the field, watching the boys play was my escape.

My own health and fitness journey began with attending my local gym, this then progressed to hand cycling which I quickly fell in love with. My first charity ride was for the starlight foundation in September 2022. I rode 6km a day for 30 days, proving I could achieve anything I put my mind to.

The Concussion Legacy Foundation has always reached a spot for me that I feel close to. I have two friends that play professional football and couldn’t think of a better way to raise awareness by providing information to the public around how a concussion has effects on the brain. I will be forever thankful to the Concussion Legacy Foundation Australia in supporting me along my next big ride of completing 250kms in 30 days.

-Jason

People don’t understand how at the age of 30 I have concussed myself into having a neurodegenerative disease. Trust me, if it wasn’t happening to me, I wouldn’t believe it either, but at an unknown rate my brain is declining and dying.

I was 26 when I was selected to play in Bond University’s elite women’s AFL program – QAFLW (Queensland’s top league under ALFW).

After suffering seven concussions in three years – I was forced to medically retire. My life has completely changed as a result of the head injuries I sustained playing sport and I now want to raise awareness of the ‘invisible disease’ I live with.

There was 10 minutes left on the clock, it was my first preseason game with QAFLW, I was wanting to make an impression, so I took a diving mark. In that moment I copped a knee to the head and was out cold for a minute or so.

The game wasn’t on the line (we were 50 points up) and in the words of my coach, ‘I had no reason or right to take that mark’. Some people may call it stupid but that’s how I played and to him what I displayed in that moment were qualities you cannot teach an athlete, so I was invaluable. Later, I found out that mark was the sole reason I was selected in the program. In hindsight, it was the beginning of the end.

I played our opening round the very next week after surprisingly only suffering symptoms for about 48 hours. Throughout that season I received another 3 concussions. One quite sickening to the point some of my teammates still say, ‘we thought you were dead that day’. After each I trained and played within a week or two. There were no strictly imposed protocols or rehab programs for me to follow or for concussions in general. It’s a self-reported injury and I was able to get away with not being completely honest about how I was feeling as the symptoms didn’t concern me. Seemingly I was able to bounce back to ‘normal’ quickly.

My fifth concussion came early in my second year from a sling tackle. It was overlooked by a serious neck injury that nearly left me a quadriplegic. I sat out the rest of the season and during this time, I started to notice changes in my memory. I had brain fog, dizziness, nausea, migraines, headaches and was constantly fatigued. I felt horrible all day every day, nothing helped alleviate the pain and symptoms. I saw physiotherapists, doctors, specialists in different fields and they believed my symptoms were due to the neck injury, the spinal cord swelling and the vestibular dysfunction and in time I’d feel better if I continued with the neck rehab.

I wanted to believe their advice and that it was just my neck but part of me knew there was a much bigger problem as I started to feel less like myself. But like most athletes, I blocked it out, buried the feeling and the day I got cleared to train again I started.

In preseason, I really began to struggle – I was making uncharacteristic errors, I was slower with my fundamental skills and reactions, I was fatiguing quicker and struggling to understand the drills and the game. I suffered my sixth concussion from a heavy tackle in training, which drove my forehead straight into the ground. I laid face down for a minute or so, dazed, and unable to communicate but I stumbled up, kicked a goal, and played it off. As I walked to our treatment room, I was dizzy, nauseous, my legs were like jelly and my vision was blurred. The pressure in my head and the instant headache was intense. I knew I was concussed but I also knew I could ‘act’ and ‘convince’ the right people that I was fine as I did not want to want to miss another training session or game and be seen as a liability to the team because I was always ‘injured’.

I played four days later, and I struggled significantly to comprehend the game and my overall performance was poor. I couldn’t follow the flight of the ball and keep up with the game – it was like I was in slow motion and the game was being played at 10 times the speed. Whack! A shoulder to the side of my head. My seventh concussion in 3 years.

In the months that followed all my symptoms – headaches, migraines, pressure in my head, brain fog, nausea, dizziness, blurred vision, lack of memory, mood, fatigue, light and noise sensitivity – seemed to accelerate and intensify. Noise would irritate me, I couldn’t focus, make a decision, process new information, read properly, have the lights on in the house and remember simple things. I would have to rest after only being awake for a few hours as I was completely exhausted.

As much as I tried to hide it and act fine, I was becoming a completely different person quickly. My personality started to change, my cognitive functions were slower, my concentration, my speech and my brain’s ability to process most things became affected. I battled extreme mood swings, impulsive behaviours where I’d suddenly snap and destroy whatever was in front of me. Anxiety, depression, and constant suicidal thoughts became nearly impossible to drown out. I felt I was living in a body and mind that was hijacked. It was a living hell.

As there is no specific rehab, treatment, or cure – two years after retiring from AFL I am still suffering daily a constellation of these symptoms. Because of my experience, I want to contribute to the concussion conversation. It’s the reason I’m sharing my story and have become an Advisory Committee Member for the Concussion Legacy Foundation Australia.

I want sport to be safer for everyone – I want to help create strict protocols for all levels, age groups and genders and see some of the decisions taken out of the players hands. There is no room for grey area in concussion, it needs to be black and white.

I want to drive change in awareness and education. I want to help players of all ages, genders and levels feel empowered to speak up (without judgement or punishment) and say ‘I’m not ok’ if they feel as if they have a concussion. I want to help change the perception that concussion isn’t a serious injury and instead, ensure it is treated like one.

I have been diagnosed with a brain injury caused by repeated head trauma. What can result from this brain damage is memory loss, poor impulse control, impaired judgement, aggression, anxiety, depression, suicidality and eventually progressive dementia. More people are becoming aware of the lasting effects of concussions through media reports and the tragic stories of those who have lost their battle with Chronic Traumatic Encephalopathy (CTE). However, I want my story to be one of hope rather than despair. None of us can know the future and I prefer to focus on what I can do in the moment I am living right now rather than on what might happen to me in the future. I want to convey how passionate I am about supporting brain injury sufferers and their families. This story does mention challenges, not to seek pity, but to raise awareness; that there is help out there, that you can live a normal life, that there is hope and above all that you are not alone. I want us all to work together, those who are affected by CTE, their families, friends, coaches, sports administrators and an aware community so that we no longer read yet another caption in the paper of a person who has taken their life and see pictures of their loved ones mourning their death.

PERSONAL JOURNEY

I played 194 games for the North Adelaide Football Club in the SANFL between 2000 and 2013. Being a boy from the country who lived for sport, it was an honour to play just 1 game for the red and white. I broke 1 ankle, dislocated my finger and tore a few hamstrings – I was pretty lucky with injuries. But little did I know, it would be the head knocks that would haunt me in the end.

I suffered multiple concussions in my career including five in a season at the age of 21. At the season’s end I was given two choices by the medical staff; wear a helmet or retire. The latter wasn’t an option for me, so the helmet became part of my uniform for the remainder of my career. I certainly wasn’t the most skilful football player but early on in my career my coaches would celebrate my ‘hard ball gets’. I would take pride in being courageous at the contest and not taking a backward step. One of the most severe concussions I suffered came at the age of 23. My teammate took a mark at half back and I exploded into space on the wing. Unfortunately, the kick was ill-directed and I collided with the centre half forward. The vision showed us running at full speed, with his elbow connecting with my chin. I woke up in the medical room and required sixteen stitches to my chin. At the time, I thought it was a pretty cool battle scar. Knowing what I know now, I wouldn’t change the way I played, but it’s come at a cost.

I want to stress that I certainly don’t hold any resentment towards North Adelaide or the SANFL as there was no understanding of the potential risks or protocols in place. Yes, I am faced with some challenges that I need to manage throughout my life, but would I take it back? Definitely not! The game gave me so much joy and lifelong friendships. It also played a big role in shaping the person I am today.

In 2019 I noticed subtle changes as I was winding up my footy career in country SA. There were the obvious changes of getting slower on the field, but I was also becoming increasingly anxious, particularly in social settings. Over the next three years, other symptoms crept in, including headaches and short-term memory loss. Becoming frustrated and going down a rabbit hole in search of answers, my self-worth declined. At the lowest points, I would need to self-medicate with half a dozen drinks before going to any social event. Rocking up sober was my worst nightmare and the alcohol gave me some ‘Dutch courage’. This became a pattern for me and I would think that no-one would want to talk to me or I’d look silly if I wasn’t drinking. What I’ve come to realise now is that it was the complete opposite – no one wanted to be around me when I was drinking as my behaviour could become erratic and unpredictable. I had countless mornings waking up filled with guilt and remorse and having that dreaded feeling of ‘what did I do this time.’

At the end of 2021, a visit to Adelaide based neurologist, Dr Yizhong Zhuang, saw me immediately referred to Dr Rowena Mobbs (Sydney neurologist and CTE specialist). From their observations of numerous scans and hearing my symptoms, both neurologists diagnosed me with a significant brain injury as a result of my multiple head knocks. Dr Zhuang likened the damage I have suffered to that of a car crash victim.

From 2019-2022 my mental health fluctuated, as did my alcoholism which was my coping mechanism, a way to ‘escape’. With a young family, a wife at the end of her tether and my workplace realising that things weren’t right, I was in a dark place. After my diagnosis from Dr Mobbs, I chose the self-pity, self-sabotage route. After hitting rock bottom, I knew I had to make some changes. I used the Summer of 2022 to focus on positive strategies and put the necessary steps in place to combat my symptoms. I began exercising most days, kept up a healthy diet including abstinence from alcohol and practiced mindfulness activities. I discovered the enormous benefits in all facets of my life and I’m determined to never look back. With my friends and family by my side and the support of health professionals including psychologists, psychiatrists and neurologists, I was guided in the right direction to live a ‘normal’, healthy life. I know this is daily work and there is an element of unknown to my disease but I consider myself lucky that I got the help I needed to break the vicious cycle before it was too late.

RAISING AWARENESS

As an Adelaide based ambassador for the Concussion Legacy Foundation my main goal is to spread awareness and be an advocate to support individuals and their families who suffer from similar effects. In 2023 I visited over 30 sporting clubs and schools across the State to spread the word of the importance of correct concussion protocols and the risks involved if they are not followed. In the near future, I would love to set up a past players support system for brain injury sufferers. As mentioned, I found that it is very easy to go down a rabbit hole if you don’t know where to look for help so I would like to help work on the provision of a series of treatment options and specialist resources that can be triaged to suit individual needs. It is important that this information is readily accessible and clearly understood by the individual needing help. An insurance policy could also be triggered, so sufferers wouldn’t be deterred by the financial costs of gaining help. I’m not going to rest while others are suffering, rather I would like to be proactive and add strength and support to this vital foundation.

Recently I coordinated the CLF Australia – Adelaide Team Up Triathlon on the Semaphore Foreshore with around 1500 people in attendance. I was responsible for the design and delivery of this event liaising with elite sportspersons, government members and council groups, industry sponsors, allied medical professionals and the sporting community. A large part of the role was to involve our youth and school communities. This enabled us to share important education with our junior sports groups whilst also raising awareness across Adelaide to encourage safer protocols and better supports for both concussion and CTE prevention.

I have 3 sons and people regularly ask ‘would you let them play football’? My answer… Absolutely! However that ‘absolutely’ comes with the proviso that very strong protocols are put in place and constantly reviewed in light of ongoing research in order to make the game as safe as possible. The key issues here are raising awareness at all levels of the game and keeping players safe.

“Medically retired from all sport at age 29.” Pretty upsetting to read, but I promised myself when I was contacted by CLF Australia that my story wasn’t going to be one of self-pity, as so many people have it worse than me. What do I fear the most about repeated brain injuries? It isn’t the constant daze, headaches or mood swings, but instead I fear that when life is at its most enjoyable, I won’t be able to control my symptoms. I fear that when I have a family I won’t function to the best of my ability or be able to run, kick, or maybe, I’ll forget things completely. My name is Trent Robert Keep, a 29-year-old male born in Latrobe on the North West coast of Tasmania and I have experienced repeated head trauma from sport and during my rehab processes.

The first hospitalisation took place when I was batting in the nets at Blundstone Arena in Hobart with the Tasmania Tigers Emerging Talent program. This concussion resulted in three months of rehabilitation. I remember feeling guilt, judgement, anxiety, and depression. My mates continued with preseason while I slept, tried to do exercise, slept again, had panic attacks, and slept some more. I never felt like me. With the help of a specialist, I managed to get back to full fitness and continued playing cricket that summer, although I struggled for results. Honestly, I wish I could blame the concussion completely, but I really did just perform poorly. Was there a correlation? I couldn’t be sure. What I am sure about is that my life would never be the same again.

In 2019 I won the Emerson Rodwell Medal as Tasmania’s best and fairest of the Cricket Tas Premier League. Invited back to the Emerging Talent program, I would train from 6am to 9am with the program and play AFL football from midday on.

On a Saturday afternoon I decided to go back with the flight of the ball and was caught across the face with an elbow, resulting in my head falling to the hard surface and bouncing off the ground. There is footage of this incident, but I’ve only watched it once. After a brief loss of consciousness, I remember being in and out of a state in the hands of trainers and then in an ambulance. Did I realise the severity of the incident when I was admitted to the Royal Hobart hospital? No, not at the time.

Following various MRI’s and CT scans a small lesion was found on my brain. It was after this second severe incident that doctors had decided whilst my brain was in recovery mode, sport was no longer an option for me. I lived with my brother and couldn’t do a great deal on my own. I had heart complications and a constant fog followed me step by step. Then, one day my world turned black whilst standing over the sink. I stumbled and hit my head again… concussion #3.

Fast forward 3 years and there have been so many small instances where I have hit my head and felts symptoms, including walking into stairs, hitting my head on door frames, small incidental knocks to my head at the gym. These additional concussions caused me grief.

I now live on the Gold Coast, and until recently life was rosy. I had even returned to playing cricket (it may be mad, but it meant something to me, this game had been my life). Unfortunately, on Wednesday January 18, 2023, whilst batting in the nets at the Broadbeach cricket club a ball came through the net from another player’s bat and hit me in the helmet. Luckily not at an alarming pace, but for me enough to send my brain into a spin. I was admitted to hospital again that evening and didn’t leave until the following Monday. I remember Thursday and Friday being two of the longest days of my life. My balance was shot, and I was medicated to ease the drumming between my skull, a headache like no other.

So, why do I feel like my story is worth sharing? Because like everything in life, you don’t know how it will affect someone else. Concussion is an invisible injury and, in some cases, a permanent impairment. The more people who have suffered and can share their stories the more knowledge we will gain about concussions and their impacts. My brain will be donated to science, I just wish there was more I could do now. CLF Australia is now a huge part of my life and being a mentor/support for people dealing with concussion symptoms is something that means a lot to me.

Throughout my recovery (which is still ongoing), I have been able to connect with people whose stories you may have already read. Personally, I would love to see greater education on concussion, particularly in early adolescent sport. Giving players the confidence and safe space to share how they feel without fear of weakness or judgment is a place we need to get too.

I’m grateful that I am here and able to help in any way I can. I am proud that my story may reach one person struggling with a concussion who finds comfort that they aren’t alone, and that people have walked and rehabbed the path before, and that someone understanding is just a phone call away. Assistance on many levels and a shoulder (or brain) to cry on is right here.

I hope you enjoyed my story and please don’t feel sorry for me, but instead, channel your energy towards helping with concussion awareness and research to gain a greater understanding.

Trent Keep

CLFA Ambassador, Wendy Smith, the mother of Antonio Lo Iacono advocates the seriousness of concussions and secondary impacts in contact sport after watching her son take his last breath whilst playing the first game of the 2023 footy season. Antonio, a 20-year-old talent suffered a life-threatening injury from an on-field head collision in an A grade community football game. He was airlifted to the Royal Adelaide Hospital in a critical condition of where he was later declared brain dead.

In his teenage years, Antonio was a junior footy player at Norwood Football Club, but his South Australian National Football League (SANFL) career was cut short after he suffered three heavy head knocks. Antonio was diagnosed with benign intercranial hypertension. He left the Norwood club and endured a series of lumbar punctures due to pressure on his brain. He would experience severe headaches, spending days in bed and sometimes blurred vision. After two years and having 10 lumbar punctures, he was cleared by his Neurosurgeon and could return to normal activities, including participating in contact sport. Antonio moved to our beloved South Australian Riverland of which he eventually joined the local Football Club and played in their A & B grade teams. In August 2022, Antonio played the first quarter receiving a head knock. He sat out for the second quarter and then he returned to play in the third quarter.

Later that year Antonio moved back to the city and soon joined the Birdwood Footy club of which he received another head knock in a trial game leading up to 2023 season . During Round 1 in 2023, 4 weeks after the trial game, Antonio received a high impact hit to the head in quarter one. It was so forceful he fell immediately to the ground. Unfortunately, Antonio was not removed from play and continued to play on. He received several minor impacts during the game and then the fatal hit in the third quarter. A catastrophic hit resulting in Antonio losing consciousness.

“Accidents happen in contact sport all the time but no one expects it to result in a loss of life.”

Premier of South Australia, Peter Malinauskas MP

Antonio not only donated his organs for transplant and saved 6 lives from his generous gift, but he donated his brain for research to the Australian Sports Brain Bank. Antonio will be the youngest amateur Aussie rules player to have donated his brain to assist with further research. This will give us valuable insights into the very early pathology of concussion and assist with effective treatments to help prevent future head trauma in Australian contact sports.