Two more named in Players' dementia action

The legal action against rugby union’s authorities took a decisive step forward on Thursday when the firm representing nine players diagnosed with long-term brain injuries sent pre-action letters of claim to World Rugby, the Rugby Football Union and the Welsh Rugby Union. Rylands Law also revealed the identities of two more of the nine players involved in the test cases alongside Steve ThompsonAlix Popham and Michael Lipman. They are the former Wales under-20 centre Adam Hughes and the former England under-21 back-row Neil Spence.

The development comes as the former England captain Dylan Hartley spoke out about the lack of teaching in rugby around the risk of dementia. “From when I started until last week, I didn’t know dementia was a potential outcome for any rugby player,” Hartley said on RugbyPass’ Offload podcast. “That wasn’t educated or taught to us.” Hartley admitted he is having his “own problems” with concussion in retirement, but said he does not want to reveal more about them.

Neil Spence during his playing career at Rotherham.
‘A side of me is lost for ever’: two more rugby players on their brain injuries

Hughes, 30, is the youngest player involved in the action so far. He has been diagnosed with “having brain injuries and post-concussion symptoms”, and has been told he is on a “similar medical trajectory” to Popham, Lipman, Thompson and Spence, who have all been diagnosed with early-onset dementia and probable chronic traumatic encephalopathy. Hughes played for the Dragons, Bristol and Exeter between 2010-18, and his experience throws doubt on the argument that the game has become significantly safer in the past decade.

Hughes was forced to retire at the age of 28 after a particularly severe concussion and is now working as a financial adviser. “It was just one head knock too many. I was finding it more and more difficult to recover from each and every bang to the head,” he said. He reports being knocked out eight times in his career. “At first it was the bigger concussions where I was completely knocked out that took me ages to recover from then over the time even the smaller ones started to have an impact. For the sake of my health, I had to bring it to a halt.”

One of Hughes’s former coaches, Rob Baxter at Exeter, said last week the game’s approach to head injuries has improved so much in the years since Thompson, Lipman and Popham retired that “there’s almost very little value in trying to compare the two”. Hughes, who played for the Chiefs in 2014-15, told a different story. “For me, I think the biggest issue around concussions was attitude. It was often treated like a weakness if you don’t dust yourself down and carry on.”

He added that “the game still has a very long way to go in terms of education about concussion”.

Adam Hughes (left), pictured in action for Dragons in 2016, retired age 28 after a severe concussion.
Adam Hughes (left), pictured in action for Dragons in 2016, retired age 28 after a severe concussion. Photograph: Huw Evans/Shutterstock

Four more players involved in the test cases have decided to remain anonymous. Rylands Law is already representing around 100 former rugby players and said 30 more have been in contact since the involvement of Thompson, Popham and Lipman was revealed by the Guardian last week.

In a statement World Rugby, the RFU and the WRU said: “We have been deeply saddened to hear the brave personal accounts from former players. Rugby is a contact sport and while there is an element of risk to playing any sport, rugby takes player welfare extremely seriously and it continues to be our number one priority. As a result of scientific knowledge improving, rugby has developed its approach to concussion surveillance, education, management and prevention across the whole game.

“We have implemented coach, referee and player education and best-practice protocols across the game and rugby’s approach to head injury assessments and concussion protocols has been recognised and led to many other team sports accepting our guidance. We will continue to use medical evidence and research to keep evolving our approach.”

Sir Bill Beaumont, the chairman of World Rugby, added: “As a player who retired on medical advice in the early 1980s, I care deeply about the welfare of all players. As an administrator, I will do all I can to maintain the confidence and wellbeing of those who play the game.”

The pre-action letters of claim set out the broad allegations upon which the cases are based. They state the governing bodies had a duty “to take such steps and to devise and implement such rules and regulations as were required in order to remove, reduce or minimise the risks of permanent brain damage as a consequence of the known and foreseeable risk of concussive and sub-concussive injuries”.

They also allege the risks of concussions and sub-concussive injuries were “known and foreseeable”, listing 24 failures on the part of World Rugby, RFU and WRU. The governing bodies have a maximum of three months from the date of acknowledgment of the letters of claim to provide their initial responses.

Alix and Mel Popham: ‘We turned a tragic situation in our life into something positive

Having set up Head For Change the former Wales flanker, who is living with early onset dementia, is helping others using group exercise.

 It has been about 18 months since Alix Popham got his diagnosis, and a year since he spoke about it in public. He’s doing well. Popham, who played 33 Tests for Wales, takes life the same way he played rugby: head on. In that time he has helped to launch a lobby group, Progressive Rugby, who have pulled together experts from across the sport to find ways to make it safer, and he has also set up a foundation, Head For Change, to provide support to athletes, and families of athletes, who are, like him and his, living with early onset dementia, chronic traumatic encephalopathy, or other degenerative brain diseases caused by sport.

It helps to keep busy. He has started competing in triathlons, and plans to do an Iron Man next year, even though the shoulder injuries he sustained in his career mean he can only swim breaststroke “so I’m at the back with all the older people”. And it helps to stay positive. When our talk becomes maudlin he and his wife, Mel, catch themselves and turn the conversation on to something more optimistic. “Both of us are glass half-full people.” Hope copes. They have faith that there are things they can do to mitigate the worst effects, and faith, too, that they can force the sport to do more to help other players suffering from them.

There are times when that faith is tested. Popham is one of a handful of former players who have spoken out about what they are going through along with Michael LipmanSteve ThompsonCarl HaymanDan Scarbrough, Neil Clarke, Tim Cowley, Jason Hobson, Neil Spence and Adam Hughes. There are dozens more out there who are struggling in silence. The law firm they are working with now represents 150 former union players, and 75 former league players, who are all showing symptoms of brain damage. The game rolls on, through endless rounds of international and domestic matches, but this problem is there in the background, growing bigger.

“Another 10 players got diagnosed just last week,” Popham says, “some big names among them, British Lions, England internationals, this number is just going to keep on growing.”

Many of them have reached out to him to ask for help, and advice. Recent research by the UK Rugby Health Project at Durham University provided evidence of the association between brain trauma and depression and anxiety among elite rugby players in later life. It was no surprise to Popham. He knows about this problem as well as anyone. He has been living with it every day for the past year, the evidence is there on his phone, among his WhatsApp chats and text messages.

There are former players in that group who are on suicide watch. There have been cases where he, personally, has had to arrange an emergency clinical intervention for a player after they reached out to him in desperation because they didn’t feel they were able to talk to anyone else. “I haven’t said this before, I’ve spoken to about 20 players who are still involved in rugby who are scared to talk because they’re worried they’re going to lose their jobs,” Popham says, “players, coaches, agents, people who need to be able to go and get tested, because their symptoms need diagnosing, but who are worried they will lose work if they do.”

“There are a hell of a lot of people who are suffering but are nervous to speak out,” says Mel, “people we are supporting through Head For Change who aren’t ready to go public, so this is for them, and others like them.”

She understands. It took a long time, and a lot of persuading, for her to talk about it herself. “I didn’t want to speak out because it felt so exposing, it took Alix months to convince me. But I don’t regret it one bit. It was only because Alix spoke out in your article that these players felt able to reach out to Al and talk about what they were going through. I’m really proud of what we’ve achieved since, I know we’ve helped quite a few people already, and we’re going to be able to help even more. We’ve taken what was a tragic situation in our life, and we’ve turned it into something positive.”

Midway through this interview, Mel mentions an ex-player they knew who killed himself. Alix steps away, overcome for a moment. “Speaking selfishly I’m very conscious of the emotional burden that comes with this,” says Mel. “The frustration for Al is that he wanted to be able to do more for these people, so this is about delivering that.”

Popham talks about former players, men he played with and against “who are struggling to get off the sofa” because they are so depressed, and how he wants “to be able to go over with a bike and say ‘let’s go out for a half-hour ride, nothing too crazy’, because once you’ve made that first step you can build it up”. He is evangelical about the power of group exercise.

“That part of him was conditioned by rugby,” says Mel. “I’ve definitely noticed the amount of physical training he’s been doing has hugely helped his wellbeing. I’m not saying he still doesn’t have bad days, and low points, but living with him there’s a visible difference in his symptoms, because of his focus on his exercise.”

Head For Change runs regular online bike races on Zwift. “We’re hoping we can get people to break through that first barrier and start building a life, with a community around them, bringing them back to that sense of being part of a team that they had in rugby.”

Alix Popham training at his home in Newport before a Head For Change Rugby Ride Challenge.
Alix Popham training at his home in Newport before a Head For Change Rugby Ride Challenge. Photograph: Jacob King/PA

In the main, though, the support has been overwhelming. It has come from all over, from people they know, and people they don’t, such as the group of schoolmates who got in touch because they wanted to raise money to honour a friend who died in a farming accident when he was 18. “Alix was his favourite player. Apparently he used to shout ‘Release the Popham!’ when he went in for a big tackle.” Popham is doing a 500‑mile bike ride for the Doddie Weir Foundation, “in bloody February”, and he has been in touch with Kevin Sinfield, who has just run 101 miles in 24 hours to raise money to fight motor neurone disease. “This is the positive side of rugby, people coming together and supporting what we’re all trying to do.”

It is hard to hear all this without feeling angry that cash-strapped charities are having to provide support that should really be coming from the clubs and governing bodies. Popham says they are still moving too slowly. “Most of the changes we want to see are about what happens in training, Monday to Friday.” World Rugby has said it is going to introduce guidelines to limit contact training to 15 minutes a week. “OK, but why not make it mandatory? And why not do it immediately?” Recent research by the Drake Foundation has shown evidence of brain damage in current players. He says it is proof the current protocols are not safe enough, especially the six-day return-to-play protocol, which means a player can be back playing within a week of a brain injury.

He says Harlequins are the shining example. “Last season they reduced contact training by 70%, they had more players available because they had fewer injuries, and more success because they won the league. It’s not rocket science. These are simple things that need to happen ASAP because every day, every week, every month that goes by there’s more impacts happening, and more people suffering.”

A year later, people seem to understand the sport has a problem. Talking to Alix and Mel, I’m less convinced that everyone understands how big it is.

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