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.

Red erring: players the losers in rugby’s card-happy campaign for a safer game

Much-vaunted policy of sending players off for head contact has resulted in plenty of bans but little meaningful change

 

Skinner misses the climax of the season because of the mandatory ban. And he can forget about any call-ups to play for the Lions or Scotland this summer, too. It is a rank injustice, at which far too many are prepared to shrug their shoulders while repeating some mantra, handed down from on high, about these red cards being for the players’ own good. There is no evidence so far to suggest this.

 

In the last week of the 2019 World Cup the game’s governing body, World Rugby, announced “best-ever player welfare outcomes”. The subsequent headlines around the world joined in the refrain: the campaign for a safer game was being won. And yet in the official injury audit of the World Cup, published in the South African Journal of Medical Science in February 2020, the numbers tell a different story.

The headline figure in the 2019 press release declared the number of replacements for injury in a match had fallen from 2.08 at the 2015 World Cup to 1.13 in 2019. But World Rugby has explained to us that the 2019 figure left out all injuries owing to concussion, because they were being dealt with elsewhere in the release. The figure for 2015, however, did include concussions, the game’s most common injury. This detail was omitted.

The press release also declared that concussions had fallen from 2015’s figure of 12.5 per 1,000 player hours to 10.5 in 2019, a fall of 16%. This was presented as fact before the tournament had finished, in effect declaring victory before the final whistle. In the end, World Rugby explains, two further cases came to light from preceding matches, with two more in the final, bringing the real figure up to 12.2 per 1,000 player hours, a rather less dramatic fall of 2.2%, partially explained by a 1% drop in 2019’s collision rate. No public correction was issued.

A spokesperson for World Rugby told us: “We can and should encourage a healthy, open and transparent debate about the science and the statistics at all levels of the game,” and that “it is only through honest, transparent and engaged dialogue that we can better understand the impacts on player welfare”.

The data supplied is rich, but the key set is the one relating to the number of HIAs when the tackler is upright. The chances of an HIA then are 44% higher, which is why the stated aim of the red-card policy is for tacklers to bend at the waist. But of those 611 HIAs only 164 occurred when the tackler was upright. It is thus possible to calculate the very best hypothetical reduction we could expect if we were never to see another upright tackler again. The answer is 50 out of the 611, or 8%. Incidentally, the number of HIAs resulting from a high tackle was 18, or 3%.

We should never expect this red-card wild west to shift the dial more than fractionally on the concussion front. As for the wider question of neurodegenerative conditions in later life, we should not expect even that, because the issue there is constant pummelling over a long career.

The key problem for tacklers is that they are always one step behind. The proactive party is the player with the ball, across whom is drawn the line of legality, which is constantly shifting at high speeds. Four years in, the tackle height has come down. Big hits to the upper body are no longer practised or celebrated as they were. The tacklers are doing their best.

If the deterrent were working, there would be no more red cards by now, but still they keep coming. That is because these offences are not deliberate. Players are being sent off for – at worst – technical shortcomings, in almost every case for incidents they cannot avoid.

The Premiership in England is subject to the longest-running study of injuries in elite rugby. In the latest report, concussion rates were as high as ever. Another trial with a reduced tackle height among the Championship clubs in England, too small to be conclusive, saw concussion rates actually increase by 31%.

A lower tackle height may not lead to lower counts of brain injury, but that is not to say it is undesirable, even if it should be achieved through education, coaching and law change. Which brings us back to World Rugby’s treatment of the data in 2019.

This is at heart a PR battle, and it is real. Rugby will never face a winding-up order on health-and-safety grounds, but it could wither from the ground up as parents and their children turn away. In such a context, a blow to the head in a high-profile game is just a bad look. Waving red cards is the easiest way for rugby to look as if it is doing all it can. The blame for the game’s crisis is thus shifted on to the scapegoated players, those same poor souls taking the pummelling in the first place for our entertainment.

If rugby can live with that as a necessary evil in the battle to win hearts and minds, so be it, but this purge by red card is of next to no health benefit to the players. Its only merit on that front is to give them a break from the pummelling while they serve their bans.

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