Dementia crisis: how rugby’s ‘win-at-all-costs’ mentality is damaging its own players


“Some people think football is a matter of life and death. I assure you, it’s much more serious than that,” so goes the old aphorism. Replace football with rugby and the sentiment remains the same for many in the sport, particularly the likes of Eddie Jones, who see it as a life mantra. Yet, for former players such as Steve Thompson and Alix Popham, the sport has had a truly fatal impact on their lives.

On 8th December, eight rugby ex-professionals stepped forward claiming the sport has left them with permanent brain damage. Each of the eight has been diagnosed with early-onset dementia and probable CTE (Chronic Traumatic Encephalopathy), a consequence of suffering countless blows to the head across their careers. Though the dangers of head injuries have been explored and addressed significantly within the sport over the last ten years, this is the first time a link to long-term ramifications has been made.

An incurable neurodegenerative disease, dementia is cruel and devastating for both sufferers and their families. In a heart-breaking interview, Alix Popham, ex-Wales international aged just 41, weeps as he acknowledges that he probably won’t see his daughters grow up. Steve Thompson, England hooker during the 2003 World Cup triumph, says he would never have played the game had he known what it would do to him. Only 42, he has no recollection of large parts of his playing career.

Rugby is over 150 years old, but the sport only turned professional in the 1990s. This change resulted in games of higher intensity as well as 9-5 training Monday to Friday. Simply put, the men who have come forward represent the first generation of pro rugby players, the first generation subjected to increased ferocity and playing time. Thus explains the new emergence. For this reason, some fear that the pros playing now may also be unknowingly damaging their brains, only to discover the ruinous repercussions in a decade’s time.

Player welfare remains secondary to results.

It is true, however, that the safety procedures of the sport have progressed immensely since the dark days of the early professional era. Greater awareness of concussion – particularly after the tragic death of a fourteen-year-old schoolboy-rugby player in 2011 – has ensured greater player protection. World Rugby have amplified the sanctions for dangerous contact, to the point that this year, any tackle above the armpits may result in a red card. If a player does suffer a head collision mid-game, then they are now obliged to undertake an HIA (Head Injury Assessment), which requires at least twelve minutes off the pitch for concussion evaluation. The player then has a secondary assessment two days after the match.

Crucially, though, these developments still aren’t adequate. The key problem is that as safety measures increase, so too does the physicality of the game, as players become bigger and stronger than ever. No longer a sport based on space and pace, elite rugby matches now are wars of attrition. At the first ever World Cup, in 1987, games averaged 94 tackles per 80 minutes. At last year’s World Cup, we saw 257 tackles per game. That is a near three-fold escalation in contact.

England’s side under Eddie Jones prides itself on its brutality; the coach instils an aggressive, adrenaline-fuelled atmosphere. And perhaps justifiably: his win ratio with England is 80%, far and away the nation’s highest of all time. Yet, it is this insatiable hunger for success that puts the players themselves at such risk. Steve Thompson describes rugby professionals as “bits of meat on a conveyor belt”, exploited then tossed aside when deemed surplus. Player welfare remains secondary to results.

More concerning still is the revelation that what harms the players’ brains long-term is not simply concussion, but a concept labelled ‘micro-concussions’: undetectable damages to the brain caused by physical contact with the head. It is these micro-concussions that allegedly provoke CTE. Alix Popham compares each micro-concussion to drip from a tap, and explains that 12 years (a career’s-worth) of drips inevitably cause a significant rot. His brain is starting to suffer the consequences of this rot.

Admittedly, the science remains hazy. The links between CTE and sport are unproven. But, this uncertainty is no excuse for negligence. The game becomes more ever more physical, yet the RFU and World Rugby are doing nothing to address this new concern. So are rugby’s days numbered?

What seems baffling is that rugby hadn’t previously woken up to this reality. In the last couple of years, football has been under the spotlight after links between heading the ball and dementia emerged. Similarly, seven years ago, the NFL was forced to pay out more than 700 million pounds to former players who sued over head injuries sustained while playing. That lawsuit almost perfectly parallels the current legal action spearheaded by Thompson and Popham against the RFU and World Rugby. When the warning signs were there, why were they ignored?

World Rugby must be willing to adapt to help their game survive, and this starts with player welfare.

RFU chief Bill Sweeney acknowledged the ‘concerning’ developments but chose to play down the significance of the situation: “I don’t think it is an existential moment; I don’t think it is a tipping point.” Though Sweeney calls simply for clarity, transparency and calm, subsequent inaction could leave the sport in turmoil, as the dementia-links become more concrete.

Finding a solution will now be of paramount importance. The eight dementia sufferers do not want rugby axed, far from it. Their legal action is no bitter vendetta against the sport itself. Instead, they are seeking to protect the current and future generations of players from suffering their affliction. As such, they have published the ‘15 commandments’, a document of proposed changes to the sport, which would improve player safety without diminishing the integrity of rugby. Changes would include a significant reduction in the yearly number of contact training sessions, and a limiting of the number of substitutes used per game (as greater fatigue reduces the intensity of the match).

The most important proposed change commits professionals to regular DTI scans, which detect microscopic changes in the brain. Like a ‘human MOT’, the scans determine whether or not the pro is fit to continue playing. This would inevitably cut short the careers of many talented players, but to me it seems a small price to pay to protect the players’ lives and to protect the sport itself.

Rugby is a sport with so many positive aspects, fostering leadership, camaraderie and fitness. It is a sport intrinsically linked the history and culture of Britain. The RFU and World Rugby must be willing to adapt to help their game survive, and this starts with player welfare.

Image: infomatique via Creative Commons

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