When a Socceroos captain talks about his brain, should we listen?

Paul Wade captained the Socceroos through the 1990s. Eighty four games for Australia. This week, at 64, he shared some hard news publicly: a diagnosis of probable chronic traumatic encephalopathy, or CTE. He said he chose to speak up because other players and families may be facing the same questions.

That word "probable" matters, so let me explain it. CTE is a degenerative brain disease linked to repeated head impacts over many years. It can only be confirmed by examining the brain after death. While a person is living, doctors can diagnose probable CTE based on their history and symptoms, which can include changes in memory, thinking, mood and behaviour. Wade had been living with symptoms for more than a year before his diagnosis.

Here is what I want you to take from his story, and what I don't.

What I don't want you to take: panic. Most people who play sport, including most who head a football, will never develop CTE. The risk sits with repeated impacts over long careers, and researchers are still working out who is most vulnerable and why. If your child plays soccer, this is not a reason to pull them off the pitch. All four of my children play soccer and have done for years!

What I do want you to take: respect for head knocks. Every single one. Wade's own neurologist has called for less heading in the game, including a ban for under 12s, and junior sport across Australia is slowly moving that way. The thinking is simple. Young brains are still under construction, and there is no version of childhood sport where repeated head impacts are the price of entry.

So what does respecting a head knock actually look like? Australia and New Zealand now have national concussion guidelines, the first we have ever had, and the advice is clear. If a knock happens, the player comes off and stays off that day. No exceptions for finals, and no exceptions for tough kids. Recovery starts with a day or two of relative rest, then a gradual return to normal life. School and work come back before sport does. If symptoms return at any step, you go back a step. And if things still are not right after a few weeks, that deserves proper assessment, not a pat on the shoulder. Lingering symptoms are real, common and treatable. I'll be writing a full plain English guide to the new guidelines here on the blog soon, because families deserve to know what good concussion care looks like.

There is one more piece of this that sits close to my work. The changes that follow repeated head injury often show up first in communication. Losing the thread of conversations. Hunting for words that used to come easily. A shorter fuse in discussions. Saying less at dinner. Families usually notice these changes long before any scan or test does, and they are exactly the changes speech pathologists assess and treat. If you have noticed them in someone you love, whatever the cause, start with your GP and ask about a referral.

And a note for my colleagues. If you are a speech pathologist seeing adults after brain injury and you want a structured, functional way to assess these changes, my ABI Communication Assessment Kit is free. It walks you from the first conversation through to measurable goals, and it was built for exactly the clients this story is about. Email me or message me and I will send it to you.

Paul Wade spent his career putting his body on the line for Australian football. Speaking publicly about his brain might turn out to be his most important contribution to the game.

For anything medical, always start with your GP.

Dr Anna Copley is a Brisbane speech pathologist with a PhD in brain injury.