Rugby union has been urged to cut back on competitive matches and stop contact training sessions altogether during the season following a landmark study which found the risk of motor neurone disease among Scottish international players was 15 times higher than the general population.
The research, which compared 412 former Scotland internationals born between 1900 and 1990 to over 1,200 non-players with the same age, area and socioeconomic status, also found that the rugby players – all male – were twice as likely to get dementia and more than three times likely to get Parkinson’s disease.
Dr 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.
“I think that we’re seeing these observations from largely an amateur era,” he said. “The way the game has changed professionally, with much more training and game exposure, has meant head injury rates and head impact rates have gone up. I am genuinely really concerned about what’s happening in the modern game. In 20 years time, if we repeat the study, we may see something which is even more concerning.”
While the numbers of former Scotland internationals believed to have had MND is still small overall, Stewart said the results were “statistically significant”. It also follows a number of high-profile cases of rugby players being diagnosed with the degenerative condition, the latest being Gloucester lock Ed Slater who announced this year that he would be retiring at the age of 34.
The former Scotland international Doddie Weir and the late South African scrum half Joost van der Westhuizen are other high-profile rugby players to have contracted MND, which affects nerves in the brain and spinal cord.
Stewart said that while rugby had talked a lot about head injury management, the pace of progress had been “pretty slow”. He said: “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 as much as possible.
“Contact training during the week, during the competition season, should be pretty much a thing of the past. 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 and is there a way we can trim back on that? Things like that have to be addressed pretty rapidly.”
Stewart also called for more research into the link between rugby and MND, but suggested that genetics, high-intensity exercise, hits to the brain and possibly someone’s environment could all be factors.
World Rugby’s chief medical officer, Dr Éanna Falvey, said he welcomed the findings and insisted the game’s governing body was having a “constant and open conversation about what changes to the game may be appropriate” .
Falvey said: “World Rugby will never stand still on player welfare. To date, we have invested over €10m [£8.7m] in welfare studies including the largest study into head impacts in community sport anywhere in the world and a study of health outcomes for over 3,000 retired rugby players, both delivered in partnership with New Zealand Rugby.”
The results, which have been published in the Journal of Neurology, Neurosurgery and Psychiatry, were also welcomed by Dr Virginia Newcombe, of the Academy of Medical Sciences at the University of Cambridge.
“This is an important study which adds to the growing evidence that repetitive head impacts in the sporting arena may lead to an increased risk of neurodegenerative disease,” Newcombe said.
“While it is likely the increased risk of dementia and Parkinson’s disease is secondary to repetitive head impacts, the reason for higher risk of MND is unclear and understanding the mechanism will be important to facilitate future preventive strategies.”
A similar study published by the same researchers three years ago found that former professional footballers were three and a half times more likely to die of dementia than the general population – slightly higher than rugby. However Stewart said he was not convinced there was a big difference between the two sports, and that further research was likely to show it.
