The Irish Times view on brain injury in sport: the biggest challenge

Research increasingly shows that it is not just the obvious collisions and on-pitch concussions that are causing the damage

The revelation this week that 41-year-old former All Black prop Carl Hayman has shown symptoms of early onset dementia and probable chronic traumatic encephalopathy (CTE) is a chilling reminder in rugby and other contact sports that the research and understanding of the debilitating condition continues to be a work in progress.

Hayman played in 45 Test matches for New Zealand between 2001-07, during which time he was considered the best tighthead prop in the game. When he retired in 2015, he had played in close to 450 professional games. In every one of those matches Hayman would have had numerous collisions with other players. The more studies that are conducted and information becomes available, the more researchers understand that it is not just the obvious collisions and on pitch concussions that are causing the damage.

The available evidence points to sub-concussive blows also coming into play. Those are impacts that do not meet the criteria for clinical diagnosis of concussion or mild traumatic brain injury (TBI), yet are hypothesised to have an adverse long-term effect in some individuals, particularly after repetitive occurrences.

Hayman rarely got injured, trained hard and felt indestructible. He was 6ft 4in and weighed over 250lbs. That size and power was unable to protect him from what is now a life of alcohol abuse, suicidal thoughts and erratic behaviour.


Before Hayman, a Drake Rugby Biomarker study of 44 elite players between July 2017 and September 2019 revealed 23 per cent of the players’ MRI scans showed abnormalities to their brain cells. They are concerning numbers. Sport does not yet have an answer.

The gears are grinding on the legal side with a class action involving multiple players in the UK. Strides have been made in drastically limiting contact in training. But there are few certainties for competitive players as the only way to prevent CTE is to avoid repetitive head injuries. That is the biggest challenge facing sport and rugby in particular. It is a challenge that has yet to be met.