For the first time since 2015 AFL teams will be afforded a "substitute", now to be called upon if necessary as a medical replacement.

AROUND every pint at the pub for the next few days there will be some clever concepts on how to take advantage of the AFL's new medical substitute.

Most, if not all, will focus on how an AFL grand final could be decided by bringing on the medical substitute to change the game - as Ted Hopkins, one of Carlton's two reserves in the era of 19th and 20th men, did with his three goals after half-time in the epic 1970 VFL grand final comeback against Collingwood.

The most-hated seat in Australian football is back - the one that from 2011-2015 was reserved for the substitute. In those five seasons, teams had the bench changed from four to three interchange players - and one substitute in a much-derided green vest.

This season, the four interchange players remain but work to reduced rotations (75 rather than 90). And for the first time in Australian football history the team sheets will have a 23rd man, to be nominated from the three emergencies.

The substitute can be activated once the team doctor rules a player out for injury - not just concussion, as was first proposed when the AFL coaches gathered last week for their annual start-of-season chat.

Those pint-fuelled debates among the fans will inevitably take issue with even more changes to the AFL rules, particularly on the eve of the premiership-season opener between AFL premier Richmond and Carlton at the MCG.

And many of these fans will be more creative than coaches on how the medical substitute can be manipulated, particularly if a player's serious injury is "poor form".

Former Port Adelaide utility Aaron Young has the unenviable honour of starting the game an AFL record 21 times as the substitute.

No-one can argue with any debate built around player health and safety, not just with concussion but also the risk of players being compelled to stay on the field while carrying injury. This brings an end to the "uneasy look" of Port Adelaide half-back Ryan Burton hobbling to the goalsquare at Adelaide Oval during last year's preliminary final against Richmond so that coach Ken Hinkley could keep working the rotations from the bench.

By extension, there is no more legendary moment such as Port Adelaide defender Ivan Eckermann hobbling off with a hamstring strain during the first quarter of the 1977 SANFL grand final to return to the field at Football Park at half-forward with a heavily bandaged upper leg to kick three crucial goals against Glenelg. And this was at the start of the interchange era when coaches could call on the 19th or 20th men to cover the (hopefully) temporary loss of any player being checked out in the medical room.

These are different times, particularly with the need to be conscious of the long-term repercussions to players suffering head knocks and concussion.

So the AFL Commission's preference to protect the game - rather than be overly concerned with all the conspiracy theories that will come from the "pub test" - of the medical substitute rule is understandable.

What pressure is there on the doctors now?

How much will players despise (again) the substitute vest?

What follows in the AFL debates at headquarters if the medical substitute is used in the second term for an injured player and then a team-mate is concussed in the third quarter?

Is this just the first move to an extended interchange bench of six, as endorsed by new North Melbourne coach David Noble? Of the six, only four can be active in each quarter.

Rule changes in the AFL often create "unintended consequences" and more rule changes ... and more debates around a pint or two.