Tuesday, October 24, 2023

HEALTH & SAFETY IN SPORTS
Every year of playing rugby increases risk of degenerative brain disease CTE by 14 per cent


Ben Rumsby
Tue, 24 October 2023

Former England hooker Steve Thompson has early onset dementia and cannot remember 2003 World Cup final - Guzelian/Mark Pinder

Every year playing rugby union significantly increases the risk of serious brain damage, a landmark study has found.

Ahead of Saturday’s World Cup final, alarming research has been published identifying a link between the length of time participating in the sport and the danger of developing the degenerative condition chronic traumatic encephalopathy (CTE).

Based on post-mortems of the brains of former players, the study led by consultant neuropathologist Professor Willie Stewart found each additional year in rugby added to their risk of CTE – long linked with repeated head impacts and injuries – by as much as 14 per cent.


CTE was also found in more than two thirds of the 31 brains examined of players with an average rugby-playing experience of 18 years.

Even more worryingly, the mean age of those whose brains were examined died over the age of 60.

That meant many of them were likely to have played the game prior to it turning professional in 1995, before which it is widely regarded to have been significantly less physical.

The study was conducted against the backdrop of a multi-million-pound lawsuit brought by former players, including England’s World Cup-winning hooker Steve Thompson, against World Rugby, the Rugby Football Union and the Welsh Rugby Union.

Thompson and others diagnosed with early onset dementia have accused the governing bodies of an “abject failure” in their management of concussion protocols, something the organisations deny.

The new research, published in Acta Neuropathologica, was the result of a world-first collaboration between leading laboratories at Stewart’s University of Glasgow, the University of Sydney and Boston University.

It follows major findings last year which reported neurodegenerative disease risk among former Scotland players approximately two-and-a-half-times higher than expected.

Stewart, an honorary professor at the University of Glasgow, said: “In this study, we have combined the experience and expertise of three leading international brain banks to look at CTE in former rugby players.

“These results provide new evidence regarding the association between rugby union participation and CTE. Specifically, our data show risk is linked to length of rugby career, with every extra year of play increasing risk.

“Based on this it is imperative that the sport’s regulators reduce exposure to repeated head impacts in match play and in training to reduce risk of this otherwise preventable contact sport related neurodegenerative disease.”

A World Rugby spokesperson said: “World Rugby is aware of the findings from the University of Glasgow study and we are committed to always being informed by the latest science. Our Independent Concussion Working Group recently met with Boston University representatives, including Professor Ann McKee, alongside other world leading brain health experts, to continue our dialogue on how we can make the game safer for the whole rugby family.

“What all the experts told our Independent Concussion Working Group was, that we should continue to reduce the number of head impacts, and that is exactly what we will do. World Rugby will never stand still when it comes to protecting players’ brain health which is why community players around the globe are taking part in trials of a lower tackle height this season. It is also why we have rolled out the use of world leading smart mouthguard technology in WXV, our new elite women’s competition, and from 2024 all elite competitions using the Head Injury Assessment will use smart mouthguards, in addition to the current independent doctors and in-game video footage to ensure that players are receiving the best possible care.”

The RFU was approached for comment.

Richard Boardman of Rylands Garth solicitors, which represents Thompson and around 450 other players, said: “As great a spectacle as the World Cup has been, the brutal, chilling current reality for the sport is that many more rugby players will die prematurely or lead significantly impacted lives as a result of neurological impairment, including CTE, caused by playing the sport.

“Immediate, substantive changes are required to be made to the sport. Otherwise, many more players, both current and future, will be condemned to the same fate as earlier generations. This is not just about reducing concussions, but the accumulation of sub-concussive blows, too. Elite players, in particular, play far too much rugby.”


Risk of degenerative brain disease increases with longer rugby careers – study

Jamie Gardner, PA Chief Sports Reporter
Tue, 24 October 2023 



A rugby player’s risk of developing an incurable brain disease uniquely associated with repeated head impacts is relative to the length of their career, a new study indicates.

Each additional year of playing was found to increase the risk of chronic traumatic encephalopathy (CTE) by 14%, in a study of the brains of 31 former players whose average career length was 18 years.

CTE can only be diagnosed post-mortem, and to date the only recognised risk factor for CTE is traumatic brain injury and repeated head impact exposure.


The study, published in Acta Neuropathologica in the week of the Rugby World Cup final, found CTE present in 21 of the 31 brains (68%) donated to research institutes in the United States, the United Kingdom and Australia.

Cases with CTE averaged a career length of 21.5 years, while in those without CTE the average was 12.1 years.

The study’s lead author Professor Willie Stewart, of the University of Glasgow, said: “In this study, we have combined the experience and expertise of three leading international brain banks to look at CTE in former rugby players.

“These results provide new evidence regarding the association between rugby union participation and CTE.

“Specifically, our data shows risk is linked to length of rugby career, with every extra year of play increasing risk.

“Based on this it is imperative that the sport’s regulators reduce exposure to repeated head impacts in match play and in training to reduce risk of this otherwise preventable contact sport related neurodegenerative disease.”

Twenty-three of the players played at amateur level only, while eight also played at the elite level. The study found no correlation between the level the individual had played at and an increased risk of CTE, nor between whether they played as a forward or a back.

World Rugby is exploring ways to mitigate the risk of concussion and improve how diagnosed or suspected concussions are managed.

The governing body’s executive board has recommended that unions participate in an opt-in global trial of lowering the tackle height in the community game to below the sternum – also known as a “belly tackle”.

World Rugby also promotes a “recognise and remove” approach to dealing with concussion in the amateur game, while it has detailed return-to-play protocols at that level and in the elite game.

A group of former professional and amateur players diagnosed with early-onset dementia are involved in legal action against World Rugby, the Rugby Football Union and the Welsh Rugby Union.

The players claim the governing bodies were negligent in that they failed to take reasonable action to protect them from permanent injury caused by repetitive concussive and sub-concussive blows.

A World Rugby spokesperson said: “World Rugby is aware of the findings from the University of Glasgow study and we are committed to always being informed by the latest science.

“Our Independent Concussion Working Group recently met with Boston University representatives, including Professor Ann McKee, alongside other world leading brain health experts, to continue our dialogue on how we can make the game safer for the whole rugby family.

“What all the experts told our Independent Concussion Working Group was that we should continue to reduce the number of head impacts, and that is exactly what we will do.

“World Rugby will never stand still when it comes to protecting players’ brain health, which is why community players around the globe are taking part in trials of a lower tackle height this season.

“It is also why we have rolled out the use of world leading smart mouthguard technology in WXV, our new elite women’s competition, and from 2024 all elite competitions using the Head Injury Assessment will use smart mouthguards, in addition to the current independent doctors and in-game video footage to ensure that players are receiving the best possible care.”

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