Concussion, early onset dementia and CTE

king_carlos wrote:Amateur men's numbers are declining but that is common across many sports. There's just more to do now. More sports, more leisure activities, more access to technology, often more work (sadly in many cases).

Climbing is a great example. I climbed growing up and as I lived in Sheffield had access to a couple of decent climbing gyms. I met a lot of kids trying to go into climbing professionally who's families moved to Sheffield to get them access to facilities. I'm currently living in a town with a population under 1,500 and there's a decent climbing gym a 10 minute walk up the road. That's absolutely brilliant in general but that improved access to other options means the traditional sports will naturally see a drop off in amateur numbers.

In other areas such as the women's game there is obvious and rapid growth though.

The key indicator longer term will be juniors numbers and as far as I know they are fairly steady?

Rugby can continue to grow but it will need to adapt to protect its players and the boards currently hoarding wealth will need to think about the future as well as themselves.

king_carlos wrote:Not in these numbers in their 30s and 40s though, GF.

The link between contact sport, head trauma, CTE and early onset dementia is utterly undeniable at this stage.

Rugby will need to change or die, simple as that. When you look at the numbers in NFL with fewer games and restricted contact training then think about the number of games and amount of contact training rugby players go through it is very scary to think just how many we may former players we may hear of in the next 10 years.

The key questions will surely be:

1. Did any of the governing bodies have research pointing to this that they slept on?
This is what happened in the NFL and if so it would be tantamount to corporate manslaughter given that players will die young due to these conditions. We can only hope this isn't the case in rugby.

2. If they didn't perform any research was it clearly their duty to do so?
I'd argue yes. Employers have a duty of care to look after their employees. Professional rugby might not be a conventional work place but the players are still employees and their work allows their employers to profit.

The Oracle wrote:Maybe I’m not thinking this through enough, but if the players win a litigation case against the union (and I don’t begrudge them at all if they do), surely that must mean the end of contact in rugby? My thinking being that if they win then the ruling must be that rugby head knocks do contribute to CTE and does lead to dementia (and other things), and that the union did not do all they could to mitigate. And so if they don’t stop the contact that causes it then they’ll be liable for all other cases going forward. The union/world rugby (or whoever) will not be able to get insurance to cover that going forward, surely? And pros would be ridiculously stupid to sign a waiver. So how can they go on sanctioning a game where contact is part and parcel of the whole game?

I just can’t see a way that, if the unions lose a case, they will be able to carry on with the game in the current format and leave themselves open to case after case. They’d be ruined.

Thinking out loud, but could world rugby enforce a certain type of tackle (one deemed safer somehow) and then if players get their technique wrong then the blame lies with the player and not the union? Similar to a waiver I suppose so not sure that would work. But how else can we keep contact?

No 7&1/2 wrote:Slightly connected to the topic. 20 min reds have been brought in for this year's Rugby Championship.

king_carlos wrote:I was discussing these court cases with a friend and an area where he suggested these cases could get ugly that I hadn't thought of was drug use - both PED and recreational.

The family of a Scotland Women’s rugby player who died aged 26 have joined the brain injury lawsuit against the game’s authorities.

Siobhan Cattigan tragically passed away in November but the cause of death was revealed for the first time during an interview which was published in the Sunday Times.

The article chronicled Cattigan’s devastating decline after suffering head injuries in February 2020 and April 2021 and serious concerns raised by her mother, Morven, and father, Neil, about how she was allowed to continue to play, the conduct of those within the Scotland camp, and the amount of support she received both internally and from external healthcare professionals.

The Sunday Times reported “it had got to the point where she could no longer live with the pain in her head and Siobhan succumbed to an irrational thought and impulsive action”.

Proclaiming “something catastrophic had happened to Siobhan’s brain”, her mother said: “As time went by, I likened it to dementia, because I couldn’t think of anything that would change a personality so massively, something that completely alters you as a person.”

Her father said: “They fixed her broken bones but turned their backs on Siobhan’s broken brain. Believing it was avoidable, knowing that you trusted people you shouldn’t have trusted, it just compounds my guilt.

“I was the one who brought rugby into this family, and the reason why she started playing was because she was with me. Rugby gave her the happiest days and memories — and ultimately rugby is why she’s not here.”

Scottish Rugby said in a statement: “Our condolences and thoughts continue to be with the Cattigan family and from the outset we offered Neil & Morven our full support.

“The mental and physical welfare of all our players and people is central to Scottish Rugby. We have excellent and dedicated colleagues throughout the organisation who are committed to delivering high standards of medical care and welfare support, whenever it is needed.

“Scottish Rugby has developed multiple ways in which mental health support can be provided and accessed, including through independent third party providers. However due to medical confidentiality we cannot provide details or comment on individuals.

“The rugby community in Scotland is close-knit — many people in Scottish Rugby and across the wider game were deeply saddened by Siobhan’s passing and continue to be affected by it, having known and spent time with her during her rugby career. We continue to make support available to them, if required.”

World Rugby has hit back in its first public response to the concussion lawsuit brought by former players, casting doubt on the numbers involved and criticising their tactical recruitment.

The sport’s global governing body has until now remained silent on the growing number of past players who have taken legal action over an apparent failure to protect them during their careers from the risks of early on-set dementia, with legal documentation submitted last month to World Rugby, the Rugby Football Union and Welsh Rugby Union.

But speaking exclusively to Telegraph Sport, World Rugby chief executive Alan Gilpin:

-   Said the governing body believes the number of players involved is smaller than the near-200 reported
-   Hit out at the apparent targeted use of the media to recruit new complainants
-   Claimed those affected should engage with World Rugby rather than take legal action
-   Confirmed talks had ended with lobby group Progressive Rugby due to members’ involvement in legal proceedings.

Gilpin stressed World Rugby’s ongoing determination to make the game as safe as possible when it comes to head impacts, and after receiving legal documentation from Rylands, the sports law team responsible for those taking action, he questioned how reports of the involvement of an estimated 200 former players emerged and whether information was being given to the media in order to attract new members to legal proceedings.

"When the original action was issued to us some time ago it was involving nine players, more recently they have started to claim that number has grown significantly," Gilpin said. "It’s not, as far as we can see, in the documentation provided to us quite at the number which is being suggested in some parts of the media.

"One concern is the approach being taken by some parties in that claim to apparently use the media effectively to recruit more players into that action.

"What we would say to those players who aren’t currently part of the action is; can we have a dialogue about how we can all provide better support. It’s important that we find a way for players to have that dialogue without feeling the need to resort to legal action."

Gilpin stressed that World Rugby was already reviewing its support structures to help players post-retirement, which could avoid a potentially devastating financial battle that may alter the future of the sport.

He also took aim at Progressive Rugby - which recently issued a series of recommendations to World Rugby - and said that the involvement of some of its members in the legal case has halted talks about how a resolution could be sought.

"We’re concerned when any kind of group in the media of people involved in legal claims are making sweeping statements which are going unchallenged, and often aren’t true," Gilpin said. "We’ve had a lot of debate with Progressive Rugby over the last 12 months.

"To be honest that dialogue has now stopped, because there are a number of people we are now aware of involved in Progressive Rugby who are involved in the lawsuit, and therefore we can’t enter into the same direct dialogue with Progessive Rugby and some of those individuals as we could previously, and that in itself is a shame. But Progressive Rugby would hopefully agree that we’ve had a positive engagement with them."

Gilpin defended World Rugby’s position, arguing that it has already taken actions that will help players to understand the full risks posed in rugby and what they can do to minimise them.

"A huge part of this is education, making sure we are pointing players to where that support does exist, or providing a structure where we can listen to them. That’s why in some respects the litigation is challenging because we can’t have that conversation with the players directly because there’s a live legal case against us.

"Our message to [those players involved in the case] is very much: we absolutely care, we are listening, we are part of the debate and we want to make the right type of progress.

"We can understand why players who maybe feel like they haven’t had another avenue to pursue are pursuing that, and maybe that suggests as a sport that we need to do more to provide a network of support for former players, particularly professionals, who come to the end of their careers and have real concerns.

"That’s definitely a big call-out for us that we’re now discussing with International Rugby Players Associations, nationals RPAs and other groups how we can provide better care for players who are coming to the end of their careers or have retired, and have concerns about mental health issues or related to dementia."

In response to Gilpin, Richard Boardman, of Rylands Law, said: "We have notified the defendants a number of times as part of pre-action correspondence of the number of clients we represent. That number is, inevitably, increasing all the time as the issue of traumatic brain injuries in rugby union is given more exposure as more and more players speak out about their brain damage.

"Aside from the legal action, there are also those with an interest in the safety of those currently playing, such as the player welfare group Progressive Rugby, who raise talking points about incidents in certain recent games that further highlight the issue. One concern is that the approach being taken by some parties in the claim is to use the media exposure effectively to downplay the scale of this issue in the sport."

As a former player himself and now father to a 14-year-old rugby-playing son, Gilpin has found the recent testimonies of Ryan Jones, Steve Thompson, Alix Popham and Carl Hayman among many more just as "incredibly challenging to read" as the rest of the rugby world.

All of those players are currently part of the legal proceedings against World Rugby claiming governing bodies failed to protect players during their careers from the risks of early on-set dementia.

Gilpin and World Rugby have made extensive efforts in recent years to attempt to reduce the number and severity of head impacts within the sport, so that future players do not suffer the same fate as their predecessors.

Speaking to Telegraph Sport, Gilpin has now revealed that World Rugby hopes to convince those players who are part of the legal action, or weighing up joining, that the governing body will do more to ensure the best possible systems are in place to support retiring players concerned by the risk of degenerative brain disease.

"We always say that anyone who has been in a rugby family never leaves it, and we have to demonstrate that to the players who feel that’s not the case. I can definitely say personally not a day or hour goes by in the job that I do where we are not thinking about these issues. It’s our number one priority for a good reason," Gilpin explains.

"We’re focused on head contact, to make the game safe and make sure we do the right thing by players. We know that high contact in the tackle leads to the most concussions in the game, so we’ve had a big drive through law change, officiating and the way we teach tackle technique."

Risks to elite pros not the same at grass-roots

Discussions around concussion and reducing head impacts remain a "very detailed, complex area", Gilpin points out, but the governing body is eager to stress that head impacts in the community game "are not comparable" to professional players.

Findings from an extensive study undertaken by the University of Otago and New Zealand Rugby, set to be published by the end of the year, are expected to reinforce that head impacts in community and age-grade rugby are "very dissimilar to the elite level of the game".

Gilpin adds: "Those important experiences of former elite international rugby players are being conflated into the question of whether it’s safe for my son or daughter to play mini rugby, and they are two different debates.

"Ninety-nine per cent of our global playing population in the sport are not playing at the elite, professional level. We’re confident that the type of head impacts that are occurring in the community game are not comparable to what’s happening in the elite game."
Why mandatory stand-down periods won’t work

Gilpin, who succeeded Brett Gosper as chief executive officer in January last year, has a lot on his plate when it comes to player safety, even though dialogue with the lobby group Progressive Rugby has come to a close in the midst of the legal proceedings. While the two parties have met for discussions in the past, there remain issues where both sides are wide apart.

"[Progressive Rugby] would like to see a different approach to the return-to-play protocols," Gilpin explains. "Mandatory stand-downs... they understand why we don’t believe that’s right for the sport and we do believe the individualised return-to-play protocols are the correct way, because history will show that mandatory stand downs drive under-reporting of concussions, and we absolutely don’t want players not to come forward and report concussion symptoms because they’re worried about missing the next two or three games.

"We want concussions to be recognised and reported properly and players to be cared for based on their own factors, which is why there’s been this further evolution of the return-to-play protocols which take into account players’ concussion history, both immediate and longer term and periods of return to play are adjusted accordingly.

"That’s not driven by World Rugby making those decisions in a dark room, it’s the independent concussion expert group that we have driving those decisions based on the latest science."

Harsh punishments must remain part of clampdown

The 20-minute red card - currently being trialled in the Rugby Championship, given a lack of data from previous Covid-impacted seasons - remains unlikely to be trialled globally and therefore to come into law.

"Given all the issues and emphasis around concussion, particularly in the northern hemisphere, there isn’t the kind of support needed for that to move forward," Gilpin says.

"I know it’s a divisive issue, and maybe it’s been driven by a coach-led debate in the south around maintaining the spectacle of the game and not having what’s perceived as red cards ruining matches, versus a slightly different debate in the north where there’s a lot more debate around head injury and concussion."

World Rugby will also "stay vigilant" when it comes to administering red cards for dangerous contacts to the head, citing how previous drives to reduce tackles in the air and spear tackles had been successful using stricter punishments and the importance of teaching the right technique at the junior level of the game with future generations, while at the same time sympathising with players.

"We genuinely understand that very often we are talking about players making decisions in a fraction of a second around changing heights, coming into contact. It’s an incredibly challenging area."

Gilpin adds that the game's top match officials are "incredibly self-critical" when it comes towards driving consistency with red cards for contact to the head, a recent bugbear for fans during the July Tests.

"No one wants to see a World Cup determined by an officiating decision, but those decisions are crucial to the behavioural change which is needed," Gilpin concludes.

Q: In the wider picture, is there a fear that (with all this potential litigation around brain injury) rugby will be legislated out of existence financially or otherwise?

MD: That's not for me to say and that's why we are waiting for medical opinion. There is a tragedy when you see any human being going through what's been alleged in the wider case, the Siobhan Cattigan case and with Kieran and John as well. What we're trying to do is not pre-judge anything, look at the facts. Whether that is damaging or deleterious to rugby in the longer-term, I don't know and can't say yet. All we can say is that we have to deal with what we know and what we knew at the time.

The legal implication of this makes it very difficult. We don't know what we are facing yet in terms of class action or individual action and we are taking advice from our lawyers, who advise us to approach this in a certain way, because we are trying to protect the people involved in this as litigants and our own people where we have a duty of care to as well. Then we've got to look at the alleged incidents, what happened to these people when they were in the care of Scottish Rugby. I'd love to be able to explain to you how complex this is and I'm not trying to put any fog out there, but if you were in our shoes, looking at the delicacy that surrounds this, and what we feel already for the Cattigan family and anyone who has been involved in this, it's not something we will take lightly. We're taking our time and doing this in the most thorough way possible so we can give the most complete picture.

Q: The allegation from the Cattigans, the impression of a lack of basic decency from the SRU around this. Why is that?

MD: That's part of the issue we have - we don't recognise parts of that [Sunday Times article]. We don't agree and we don't recognise. We are not going to comment on these things piecemeal, we are going to comment holistically on it.

Q: Bryan Easson (Scotland women's team coach) has denied that he did anything wrong in his duty of care to Siobhan. Do you have confidence in him?

MD: I have confidence in Bryan as a coach. As far as allegations are made against Bryan, we will look into those and establish facts as time goes past. Bryan is leading the team to the World Cup finals and has two international matches to concentrate on in the near future.

Q: There are an awful lot of allegations about the care - or lack of care - Siobhan may have received. The family have said they feel let down and that, had their daughter been referred to a neurologist, she'd be alive today. What's your response to that? They also say that there has been an absence of empathy from the SRU.

JJ: We are not going to come back piecemeal to say this is right and that was wrong. Hopefully, in time, the full story will come out.

MD: We've got a grieving family, totally traumatised by what has happened. There have been allegations made about the behaviour of the union and individuals. We responded immediately to the Cattigan family with our commiserations and gave them the opportunity to contact us. That wasn't taken up.

Q: Why not pick up the phone and talk to them after they spoke a few weeks back?

JJ: That support was offered to them at the time, when Siobhan died, and they didn't take that up. We were dealing through the uncle. Since then, they have written the article and have asked for their privacy to be protected.

WELL-PAST-IT wrote:This is an aside as it is not rugby related but sport and health related. I was watching the Commonwealth Games diving, the rotation speed these people achieve carrying out triple summersaults and the  like must be smashing the brain around inside the skull just as much as a collision, and they are doing this day in day out in training as well as competition. Does anyone know if there have been ill effects amongst the participants in this particular sport

Brenton Helleur, a former Manu Samoa international and University club stalwart, is quitting rugby because he fears for his safety. The 36-year-old halfback lacks confidence in the Auckland Rugby Union's (ARU) willingness to protect players after being knocked unconscious in a recent match by what he alleges was a deliberate knee to his head.

The incident, which upset his three children watching on the sideline and left his nine-year-old son Kobe left in tears, occurred in the Gallaher Shield semifinal between University and Manukau Rovers in South Auckland on July 30.

...Bayfield, who won 31 caps for England and played in three Tests for the Lions against New Zealand on the 1993 tour, insists the sport has no option but to embrace significant change, starting by reducing the height of the tackle to below the chest to reduce the number of head injuries.

“We are playing essentially a Victorian game with Victorian rules, but with 21st century athletes, that doesn't work, how can that work?” says Bayfield, who played most of his career during the amateur era, with a neck injury bringing it to a premature end just two years after the game turned professional at the age of 31.

“It's impossible. And even in my era, and before, guys were getting concussion, but no one lost their job because they didn't have a job to lose. I'm sure that there are players from my era before who suffered catastrophic brain injuries as a result of that, but no one really reads about it because who knew?

“When I look at the current crop of players, they are fitter, stronger, more powerful. The tackle has become a ‘hit’, just that subtle change in terminology says a lot. In my day, we would say ‘good tackle’ now it is ‘good hit.’

“I hate to see Steve Thompson the way he is and I mention him because I know him. I don't want to see anyone like that.

“The game is going to have to change, otherwise someone will just say it is too dangerous now and the people who will say that are the parents, and the players at the bottom of the pyramid in the game will disappear.

"I just hate the idea that the sport I love is damaging people's brains. And in this day and age, you can't justify that."
...

“We have to increase the margin for error because at the moment it is zero,” he adds. “If you hit an opponent chest high, it is a great tackle but a couple of inches higher and it is a red card and you are off. The rugby league influence has been massive, not only have you got to stop the guy, you have got to stop him from playing the ball.

“But if you're going to try and eliminate head injuries and concussion, you have to take the head out of the game as much as you can by reducing the height of the tackle to below the chest. That will change the game enormously because then players would be able to lift the ball out of the tackle area. But is that such a bad thing? I don’t think so.

“Suddenly players will be able to play the ball out of contact. That's the holy grail of rugby, you're going to see a very, very different sport.”

Three former Irish players have begun legal action against the Irish Rugby Football Union and World Rugby after suffering concussions throughout their playing careers.

Former Ireland internationals David Corkery and Declan Fitzpatrick, along with Ben Marshall, initiated legal proceedings in the High Court in Dublin on Wednesday. The three players are being represented by Maguire McLafferty LLP, a Dublin law firm.

Corkery, 49, made 27 appearances for Ireland between 1994 and 1999 and played at the 1995 Rugby World Cup. His legal case is against Munster Rugby, the IRFU and World Rugby.

In an interview with RugbyPass earlier this year, Corkery said: “Sleep is a struggle... some of the results that have come back have not been great. I really worry about it, the head. When I played, I had no respect for my body. I got knocked out. I woke up and a few seconds later I was playing again. That’s not right. That shouldn’t have been the case.

“We are obliged to be careful because the brain is so delicate. It gives me shivers when I see the hits in the modern game. I got so many concussions, I lost count. I’ve suffered from depression for years. The black dog is always in the corner, ready to bark. It is a question nagging away at me all the time. Anxiety, you read about what has happened to the NFL players. My depression, is it related to those head injuries? I don’t know.”

Fitzpatrick, 39, retired after a series of concussions in 2015 and won seven caps for Ireland between 2012 and 2013. His case is against Ulster Rugby, the IRFU and World Rugby.

Marshall, 32, played for Connacht and Leinster between 2010 and 2017 before being forced to retire. His case is against Connacht Rugby, Leinster Rugby, the IRFU and World Rugby.
'I got knocked out. I woke up and a few seconds later I was playing again'

An IRFU statement read: "People in rugby have been moved by the personal accounts of former players as reported in the media. Player welfare is of paramount importance to the IRFU and we are constantly reviewing safety protocols for all players.

"Our approach, based on scientific evidence, involves a commitment to ongoing education, monitoring and application of safety protocols across the game, including proactively managing elite player game time with a focus on injury prevention and oversight.

"As this is a legal matter it would be inappropriate to comment on these cases directly, which will now be handled by our insurers."

The trio become the first players in Ireland to launch legal action against the governing body, following a precedent set in England and Wales earlier this year when a class action was brought by law firm Rylands against World Rugby, the Rugby Football Union in England and the Welsh Rugby Union by a number of former players who are now suffering from early on-set dementia.

Former England hooker Steve Thompson and former Wales captain Ryan Jones among the claimants, in what has been billed as the largest class action case outside of the United States.

CINCINNATI -- Miami Dolphins quarterback Tua Tagovailoa was taken to a local hospital with head and neck injuries suffered on a second-quarter sack in Thursday night's game against the Cincinnati Bengals.

Tagovailoa hit the back of his head on the ground when he was sacked by Bengals nose tackle Josh Tupou, and his arms appeared to seize up almost immediately. He remained on the field for roughly 10 minutes before he was loaded onto a stretcher and taken away.

The Dolphins said shortly before halftime that he was conscious and had movement in all his extremities at the hospital, the University of Cincinnati Medical Center.

The entire Dolphins team gathered at midfield as he was taken off, and the crowd chanted, "Tua! Tua!"

In Sunday's win over the Buffalo Bills, Tagovailoa underwent concussion evaluations at halftime after he hit his head on the ground and then stumbled while trying to return to the huddle. The team initially listed him as questionable to return with a head injury but later said it was a back injury that caused him to stumble. Tagovailoa said later in the week that he passed every evaluation he took before ultimately returning to the game.

The NFL Players Association requested a review of the NFL's concussion protocols following Tagovailoa's quick return to the game. Dolphins coach Mike McDaniel said Monday that his players' health is something he doesn't take lightly, that the team would comply with any review or investigation and that he felt "fine" with whole process.

"The one thing I think our players know more than anybody, there's certain things that I'm very sensitive to. I've been called emotional from time to time, and one of those things is player health," McDaniel said. "So I don't mess around with that at all. ... They went through the protocols and in that process during the game, and it was something that we wouldn't have moved forward in the direction we did, had there been any sort of red flags because that's -- you can't keep quarterbacks out of harm's way so you wouldn't -- if he had a head issue, he wouldn't have been back out there."

Tagovailoa, 24, was listed as questionable with a back injury for most of the week ahead of Thursday night's game.

Rugby Fan wrote:Doctor responsible for evaluating the quarterback has been sacked

https://touchdownwire.usatoday.com/2022/10/01/tua-tagovailoa-doctir-fired-following-multiple-mistakes/

Former international rugby union players are 15 times more likely to suffer the devastating impact of motor neurone disease, according to landmark new research which has sparked calls for drastic changes to the sport.

The study, which was conducted by the University of Glasgow, compared the health outcomes of more than 400 former Scottish internationals, largely from the amateur era, and also found that they were twice as likely to develop dementia and three times more likely to suffer Parkinson’s Disease than the wider population.

It was the findings in relation to motor neurone disease (MND), however, which were described by researchers as the “standout high risk”.

A series of rugby heroes, notably Scotland’s Doddie Weir, South Africa’s World Cup winner Joost van der Westhuizen and former Gloucester forward Ed Slater, have been diagnosed with motor neurone disease but this is the first peer-reviewed study which makes a direct link to the heightened risk of playing rugby.

It also reinforces the findings of similar studies in other sports where there are repeated head impacts, notably professional football and the NFL. Former players were found to be around four times more likely to suffer MND in these two sports.

The study, which has been published in the Journal of Neurology, Neurosurgery and Psychiatry, was led by Professor Willie Stewart, the neuropathologist who also proved football’s link to neurodegenerative disease.

Stewart stressed that the former players who had been studied had predominantly played in the era before professionalisation in 1995 and, with head impacts and injuries having further increased in the past 27 years, urged immediate measures to mitigate the risks.

“Contact training during the week, during the competition season, should be pretty much a thing of the past,” said Stewart. “At the same time look at the number of matches that are being played – is it credible that young men and young women are playing week-in, week-out for the majority of the year just for entertainment? Is there a way we can trim back?

“I am genuinely really concerned about what's happening in the modern game [and] whether in 20 years’ time, if we repeat the study, we may see something which is even more concerning.

“Those conversations have been going on a while and the pace of progress is pretty slow. I think this stimulus to them [is] to really pick up their heels and start making pretty dramatic changes as quickly as possible to try and reduce risk.

“Instead of talking about extending seasons, and introducing new competitions and global seasons, they should maybe talk about restricting it. Getting rid of as much training as possible. I know it is tough to think about less rugby than more but maybe less is more. You can’t continue to put young men and women through what they are being put through now we know that, from the amatuer era, there is this risk of degenerative brain disease.”

Stewart, who was an amateur rugby player, did also outline the benefits of sport and suggested that non-contact forms of the game may become increasingly commonplace.

Following a similar method as their football study, researchers examined the medical records of former international rugby players in Scotland and matched them with people of the same age, gender and socioeconomic background in the wider population.

They then compared their health outcomes over an average of 30 years, with people from the study all born between 1900 and 1990.

Although the former rugby players did on average live slightly longer (79 years compared to 76.5 years), the overall neurodegenerative disease risk increase was 267 per cent, a figure described by Stewart as “much higher than we would expect to see from the general population”.

He also stressed that the data was set in the context of their wider work in sport, which includes brain autopsies that have shown chronic traumatic encephalopathy (CTE), a type of dementia associated with head impacts, in 80 per cent of the former rugby players they have examined.

“The story we are getting from all of our evidence is that exposure to head impacts is a risk and it is a risk we need to do something about,” he added.

The precise cause of the heightened risk could not be definitively identified and, in acknowledging the particular rarity of MND and the limited size of the sample, researchers are now calling for urgent similar studies across the world.

MND does not currently have a cure and affects around one in 400 people over the course of their lives, with around two in 10,000 people diagnosed each year.

Dr Eanna Falvery, who is World Rugby’s chief medical officer, said that they welcomed the call for more research and stressed that they had established an independent concussion working group to consider the latest evidence.

“This enables us to have a constant and open conversation about what changes to the game may be appropriate,” said Falvery, who added that the governing body had invested more than €10 million in welfare studies. “We will continue to build on this work in our quest to make our game as safe as it can possibly be for players at all levels within the rugby family.”

Scottish Rugby’s chief medical officer Dr James Robson said that the study would inform continued “proactive” improvement in player welfare. “Rugby continues to have many health and social benefits. Important research like this can help us continue to improve safety and mitigate risks associated with contact sport,” he said.

Head for Change, the brain injury charity whose founders include Alix Popham, the former Wales international who is part of a legal action against World Rugby, said that the connection between repetitive head impacts and neurodegenerative disease was “increasingly irrefutable”.

The charity also called for “a precautionary approach to reduce and manage this risk exposure from head impacts,” adding: “Now is the time for action. Stop talking about protecting the players. Instead prevent them from becoming victims of the future.”

Doddie Weir: 'Playing rugby did not cause my disease'

Scotland’s legendary former lock forward, Doddie Weir, has stressed that he has no worries about his children playing rugby union and does not believe that the sport caused his motor neurone disease.

MND is a relatively rare disease, with various genetic, lifestyle and environmental risk factors and Weir, who as diagnosed with the disease in 2017, has no regrets about a career that included 61 Scotland caps and a British and Irish Lions rugby tour.

“I personally wouldn’t change anything about the game and I enjoyed the game,” the 52-year-old said. “I also feel that playing rugby was not the cause for my disease. I’m delighted for my sons to play the game and have no concerns for them getting MND.

“I was very surprised with their findings. It would be very interesting to see how they came to that conclusion. I find it hard to believe. It would be good to see the bio markers and evidence before I comment more.”

Weir did echo the call for urgent new research into the causes of the disease as well as potential treatments and cures. His charity, My Name’5 Doddie Foundation, is funding a study investigating the potential link between strenuous activity and the development of MND. As well as head impacts, previous studies have suggested a possible link to agricultural chemicals.

Weir remains convinced that a cure can be found. “MND is not incurable, it is only underfunded,” he said. “The more money we can generate, the more answers to unknown questions we can gather.”

Although his movement and speech is now significantly impacted, Weir said that he was “very well” and recovering from a “fabulous” weekend away. “Twelve of us went to the Isle of Coll to see Rob Wainwright for lunch, and visit a distillery when we where there,” he said. “I’m still managing to annoy the wife and kids. I’m still enjoying the odd Guinness and red wine.”

Jessica Lee, who is the director of research at My Name’5 Doddie Foundation, described the Glasgow research as “concerning” but said that the findings should be viewed with caution and did not prove a causal link.

“The sample size included in the study is relatively small, especially when studying an uncommon condition like MND,” she said. “These findings therefore warrant further investigation in larger scale studies.”

Prof David Sharp, a neurologist at Imperial College London’s UK Dementia Research Institute, said that the Glasgow research “aligns with previous work showing increased risk in other sports” and called for initiatives to monitor the brain health of active and former sportspeople who have been exposed to repetitive head injuries.

As well as the MND findings, the former Scottish international rugby players were found to be twice as likely to develop dementia and three times more likely to suffer Parkinson’s Disease.

His colleague, Dr Neil Graham, said that dementia research required significantly more investment, including from sports governing bodies. The Glasgow study was a continuation of its work in former footballers and was part funded by the Football Association and the Professional Footballers’ Association.

doctor_grey wrote:

Rugby Fan wrote:Doctor responsible for evaluating the quarterback has been sacked

https://touchdownwire.usatoday.com/2022/10/01/tua-tagovailoa-doctir-fired-following-multiple-mistakes/

As he should be.

In Tua's game v. Buffalo on 25/09 he was sacked, then stumbled, looking briefly disoriented, as he got up.  Then on Thursday, 29/09, he was whip-sacked to the ground and was finally diagnosed with a concussion.  Supposedly he was tested for concussion each day between the two games.  

He should not have been allowed to play just 4 days later.  In Rugby, well now, any player who looks disoriented trying to get off the ground will have an automatic minimum one week off.  

dummy_half wrote:

doctor_grey wrote:

Rugby Fan wrote:Doctor responsible for evaluating the quarterback has been sacked

https://touchdownwire.usatoday.com/2022/10/01/tua-tagovailoa-doctir-fired-following-multiple-mistakes/

As he should be.

In Tua's game v. Buffalo on 25/09 he was sacked, then stumbled, looking briefly disoriented, as he got up.  Then on Thursday, 29/09, he was whip-sacked to the ground and was finally diagnosed with a concussion.  Supposedly he was tested for concussion each day between the two games.  

He should not have been allowed to play just 4 days later.  In Rugby, well now, any player who looks disoriented trying to get off the ground will have an automatic minimum one week off.  

Never mind 4 days later, Tua returned to the field on the Dolphins second drive after half time in the Bills game - basically sat for an hour (of actual time) between the head impact and clear evidence of loss of balance and coordination, and being back amongst a load of 320 lb linemen trying to hit him. It should also be noted that in neither of the instances in the Bills or Bengals games was there any impact of the tackler with Tua's head, both times the damage was done when his head struck the turf.

'Instead, I sat down with my wife and said, 'What can we do to get ahead of what's around the corner?' Research says eat well, drink less, train more, enjoy time with the kids, get more oxygen to the brain. Get your financial house in order so you can sleep well at night and have a daily purpose. I'd rather do that and approach things positively than sit around waiting and worrying. As soon as I put it out of sight and out of mind, the world opened up again. I gave myself a schedule, even if it was getting out the house one day a week to play golf. I removed the negativity of worrying about dementia and I feel better for it.

'Those guys have got to do their thing. Good on them. I support what they're doing from afar but I need to find my own way. A way that provides solutions and hope. I love the game and everything it's given me. I love coaching on a Tuesday and Thursday night. I don't want to put the boot into my sport. I don't need to chase compensation. All I want is to see change and solutions so rugby can thrive.'

For Hartley, the out-of-sight, out-of-mind approach has worked until this point. However, the subject has been impossible to ignore. Together with Dubai-based Aviv Clinics, who treat traumatic brain injuries, he booked himself in for an assessment which included multiple scans and tests. Now he is ready to embark on three months of hyperbaric oxygen therapy, spending hours in a pressurised chamber, to see if it will combat the impacts of his rugby career.

'These guys pursuing the group action have made me have a look at myself and realise that I need to be proactive about my brain and my health,' he says. 'I know I've had some knocks on my head and now I'm doing my rehab so I'm in the best possible place in 10 years' time. I wouldn't call it fear, I'd call it awareness. The reason I refused to have my brain scanned until this month is because, deep down, I didn't want to know. If I'm told my brain's damaged — and I've had brain injuries so there probably is some damage — then all I can do is be proactive and focus on all those good things that I've talked about.

'I've been working with Aviv Clinics, eight minutes from my doorstep here in Dubai. They scanned my brain with an MRI and a SPECT, where you go into the hospital and they inject low-level radiation. I've had two comprehensive scans of my brain. It's the MOT that I needed. It would be nice to have something to compare it to, like a scan from when I was 18 years old to provide a base level.

'I'm committed to this hyperbaric therapy program to see if we can show positive results in terms of brain health. I'd love to provide hope and a solution for people.

'Can I be a trailblazer in terms of brain recovery? I hope so because we can't ignore what guys like Steve and Alix are going through. I need to see my scan in a few months' time and you guys can come back to Dubai and do a follow-up article that hopefully shows some positive results.'

Pulling at his cauliflower ears that resemble chewed-up dog toys, he adds: 'In 2011, I smashed into Cian Healy's knee in the Heineken Cup final and I had a massive lump on my head. We went in at half-time with one hand on the trophy. Then I went into the toilets and this weird thing came over me. I just started crying, breaking down. That, along with the massive lump on my forehead was a clear sign of a head knock. I played the second half and I can't remember it.

'That wouldn't happen now. It would be identified and you'd be off. Things have changed for the better. In 2011 we didn't even have HIAs. You've just got to keep moving. Education, education, education. Everyone's aware of the risks now. I signed up knowing that I'd break some bones, but I didn't know getting knocked out could lead to dementia.

'We were almost like guinea pigs. If you're concussed now you don't come in to the club. When I was club captain, I had to be seen and be present. Leading things. I couldn't be at home having a week off. That was frowned upon.

'The next step should be mandatory scans for brains. If you injure your knee and you're a marquee player, or an international, they'll send you for an MRI straight away. Cost is the only reason why every player isn't getting a head scan. That is an easy first step.'

No 7&1/2 wrote:https://twitter.com/PlanetRugby/status/1594420940301275136?t=6kC_Bg9y1QfuMmdQ3tOvSA&s=19

Have to admit I was watching this game in about 10 minute bursts over 5 hours while cooking Sunday lunch. Saw White losing his balance and going off, never realised he had come back on....what on earth was the ref doing. Worst reffing mistake of the year as you can hear him say he saw White stumble.

No 7&1/2 wrote:O'Keefe is clearly at fault here, as much as, if not more so than any medic. It's not good enough in this instance that he appeared happy to be overruled by the dr. The other way round absolutely medical guidance above all else, but here when he himself is going against guidance he should simply have said sorry no, explained his decision and that would have been done and dusted.

TJ wrote:While the ref should have overruled the medic that is very difficult to do.  How the medics could say he was OK is beyond me.  Thats gross professional misconduct IMO