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Gerry Thornley: Rugby’s existential crisis worsens amid new dementia and MND findings

Advances in treatment of concussion are positive, according to one expert

A landmark study into the greatly increased risk of former rugby union players developing neuro degenerative disease than the general public is the latest alarm bell for the sport and compounds the existential crisis facing the game.

The study analysed medical records of 412 former Scottish players, of whom 121 have died, and compared those with 1,236 members of the general population of similar age and background.

It concluded that former players are 15 times more at risk of developing MND (motor neuron disease) than people of the same age in the general population, three times more likely to develop Parkinsons disease and twice as likely to be diagnosed with dementia.

Professor Willie Stewart, a consultant neuropathologist at the University of Glasgow who led the study, said that the MND figure was “alarming” and warned that the issue of brain damage in rugby could be even worse in 20 years’ time.

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Previous research by Stewart found that professional footballers were 3½ times more likely to develop neurodegenerative diseases than the general population, compared with the 2.5 figure for rugby players, although he maintained he was “not convinced” that there was much of a difference between the sports.

He accepted more research was required to see if these findings were reflected internationally. It would also be interesting to see further studies into sports such as boxing, rugby league and horse racing.

Even so, the headlines will again make more parents question the wisdom of allowing their children to play rugby.

More pressingly, in improving the safety of the sport, rugby needs to intensify its efforts to reduce the amount of head injuries and improve treatment of concussion.

Dr Stewart has implored the sport to minimise contact training. and reduce the global calendar. Leinster have been leading the way in virtually ceasing contact training and while World Rugby has issued guidelines which restrict contact training, they are not statutes.

This latest study comes amid the impending lawsuit by over 200 former rugby union players who have been diagnosed with early onset dementia and probable chronic traumatic encephalopathy (CTE) against World Rugby and various unions, not to mention their harrowing personal accounts.

World Rugby has sought to make the game safer with its campaign to outlaw high tackles. The study conducted by World Rugby’s Ross Tucker and others into a video library of 611 events which led to HIAs between 2013 and 2015 concluded that 72% of the head injuries in tackles were sustained by the tackler.

Furthermore, the risk of injury to both players from a high-contact tackle when the tackler is upright is 4.3 times greater and head-on-head contact is 6.5 times more likely to result in a head injury.

Cue the increased sanctions for high hits, yet the game, as well as coaches and players, clearly needs more educating. Take the red cards received by Charlie Ewels and Angus Ta’avao for high hits on James Ryan and Garry Ringrose in the Six Nations at Twickenham and Second Test in Dunedin and complaints that they were accidental or ‘rugby incidents’.

Ryan didn’t play again for eight weeks and Ringrose’s tour was ended. Yet the debate in New Zealand, among such luminaries as John Kirwan and Jeff Wilson, was depressing.

There was a chink of optimism yesterday from Michael ‘Micky’ Collins, PhD, who has treated dozens of elite sports athletes and whose clinic sees approximately 20,000 patients a year at the UPMC Concussion programme at the University of Pittsburgh.

Speaking on Newstalk’s Pat Kenny Show, Collins welcomed the latest study by Dr Stewart.

“We need more longitudinal data examining this issue. Obviously, those numbers are concerning when you see the data.”

Collins is in the second year of a study which is looking at the prevalence of potential neuro degenerative problems in former NFL players, and said there had been “great advances” in the management and treatment of concussions.

Collins recently visited Ireland to speak at a seminar in UCD and said: “We met with many universities and sporting organisations, and the advances are being shared and the access to treatment is occurring in Ireland, and I’m very excited to see those advances happen. I think your country is well prepared and is in a good spot in terms of helping to treat this injury. More needs to be done but advances are occurring for sure.”

Collins said there are factors which can lead to more protracted recoveries, be it a history of car sickness, anxiety, a lazy eye, or if they are female. Neck strength might be factor, but another is that girls are six times more at risk from migraine.

Sky Sports News also interviewed the 42-year-old former Bath and England flanker Michael Lipman, one of the initial group of former players to take a concussion lawsuit against World Rugby after being diagnosed with early onset dementia.

Now living through what he calls a regimented, day-to-day battle overseen by his wife Frances, Lipman described the findings of Stewart’s report as “shell-shocking” and repeated that if he’d known then what he knows now he would never have played rugby.

“I would have done something else, because who wants to leave with this disease? It’s horrendous.”

Lipman demanded more changes to World Rugby’s post-concussion protocols and specifically the automatic 12-day standdown for players diagnosed with severe concussions, which he described as “ludicrous”.

Lipman welcomed the increasing debate, but added that action was now needed.

“We need people to actually change the way these post-concussion protocols are handled because we never want to stop people playing rugby, we never want to stop the contacts, because you can’t. And people are going to get injured and people are going to get concussed. However, the way that they are treated afterwards, that’s what we can control and that’s what I want to see with World Rugby. I would love that.”