Rugby players and brain injuries
Research done by the University of Glasgow into brain injuries in rugby recently showed that men who played professional rugby had more than twice the risk of neurodegenerative disease.
We take a look to see if World Rugby should act quicker than it has been – after “pretty slow” progress – to reduce the risks of playing the sport.
It is clear that the priority in rugby, with greater high-impact contact, should be reducing the risk of repetitive head injuries and commissioning further studies.
Consultant neuropathologist Professor Willie Stewart said the findings, which included the study of 412 Scottish men who played international rugby compared to 1,200 people from the general population, should indicate that there should more restrictions as much as possible, cutting back on the amount of rugby we’re seeing and getting rid of as much training as possible.
The study points to a 15-times higher risk of a motor neurone disease diagnosis among the retired players.
The spark that made the concussion issue catch fire in the rugby world happened in July 2013. An Australian rugby player collided violently with another player and stumbled off the field, visibly groggy and disoriented. To everyone’s surprise, however, he returned to the game only a few minutes later.
Within those few minutes, the Australian player would have been administered an “off-field cognitive test.” This is basically an audit of his symptoms and a brief test of his balance, memory, and other functions. The International Rugby Board’s (now World Rugby) Procedures and Definitions require this test to be administered to players who get severely injured during a game. The Procedures were drafted in 2011 in response to the growing number of brain injuries sustained by players.
However, players are commonly sent back to the field within a few minutes after the cognitive test, in spite of the recommendations in the 2011 rules. These note that concussion signs and symptoms can worsen over time and that there isn’t a definite time limit for determining the seriousness of a rugby concussion
Scottish rugby player Rory Lamont, who recently retired from the game directly because of this issue, has become the issue’s most outspoken critic.
Rory Lamont
New Zealand journalist Ben Heather wrote a thorough exposé of the issue. He spoke with current and retired rugby players about their experiences with injuries and treatment. He cited the following sobering statistics:
About 1,200 people suffer head injuries while playing rugby each year.
About two-thirds of these injuries are either concussions or brain injuries.
Rugby players are believed to play more aggressively when using scrum caps; however, studies have shown these make no difference for protecting against head injuries.
The figures do not account for ongoing health problems, which cannot be directly linked to rugby injuries.
In total, more than 50,000 people seek medical attention for rugby injuries each year, costing about $60 million.
In 2011, the Auckland University of Technology compared the number of catastrophic incidents (i.e., resulting in paralysis or death) in rugby with other sports between 1975 and 2005. It found that except for England, rugby incidents worldwide showed 4.6 catastrophic injuries for every 100,000 players annually.
Our research has revealed that more than 100 former rugby players are taking legal action against World Rugby and the national governing bodies of England and Wales over what they say was a failure to protect them from permanent injury caused by repeated concussions during their careers.
Many players in the group, which include former internationals Steve Thompson (England), Carl Hayman (New Zealand) and Alix Popham (Wales), suffer from neurological impairments such as early onset dementia, CTE (chronic traumatic encephalopathy), epilepsy, Parkinson’s disease and motor neurone disease.
Carl Hayman
The group is represented by Rylands Legal, which says it is in contact with more than 185 former rugby union players. The firm says the class action is being issued on behalf of the majority of those 185, with the rest taking legal action soon.
“This claim isn’t just about financial compensation,” Rylands Legal said in a statement, “it is also about making the game safer and ensuring current and former players get tested so that if they are suffering a brain injury they can get the clinical help they need.”
The allegations raised by the players include the failure of the governing bodies to “take proper steps as the game turned professional to respond to a disregard for player safety and brain health at the club and international level.”
It is claimed the rugby bodies did not educate the players about the risks of permanent brain damage or subject them to regular monitoring, and did not seek expert medical advice about the issue.
A pre-action letter of claim was issued to World Rugby, England’s Rugby Football Union and the Welsh Rugby Union on behalf of a group of nine players in December 2020.
“The players we represent love the game,” Rylands Legal said. “We aim to challenge the current perceptions of the governing bodies, to reach a point where they accept the connection between repetitive blows to the head and permanent neurological injury and to take steps to protect players and support those who are injured.”
Players showing signs of serious brain injury should be forced to retire, former Wales forward Alix Popham says.
Popham, who retired in 2011, was diagnosed with early onset dementia and probable chronic traumatic encephalopathy in 2019.
He says he regularly speaks to current players about their own conditions.
World Rugby defended its record on concussion and pointed to new protocols reacting to ongoing research, including this season’s roll-out of smart mouthguards that can measure the frequency and nature of head contact and accelerations, in matches and training.
Players do not regularly have brain scans, but World Rugby’s chief medical officer Dr Eanna Falvey said if a player had “decreasing neurological function” doctors would be “obliged to investigate”.
He added: “If you have somebody who has defined evidence of decreasing neurological function they would not be continuing to play. Absolutely not.”
The governing body’s current protocols in place to try to limit head injuries include:
head injury assessments used during matches to see if a player is fit to continue
rest weeks introduced for internationals to limit their game time
concussed players have a minimum period of 12 days out of action after new rules were brought in this summer.
The new protocols follow the latest rugby-specific research by World Rugby’s independent concussion working group.
