I have been railing about the serious dangers to participants in American football, especially with the rise in evidence of CTE, the long-term brain injury that results from repeated collisions that can cause concussions. It is thought that the repeated accumulation of concussions, even small ones during practices, is what leads to later serious cognitive decline in players. I feel the evidence is already compelling enough that I no longer watch games and also think that schools and colleges should no longer offer this as a sports option to their students. It is an activity that should be left for adults to choose to participate in, though they should be made aware of the risks.
Americans tend to view rugby as pretty much the same as American football, except without the protective helmets and body padding and hence think that it must be much more dangerous. I used to tell them that it was not so, that there were differences that made rugby safer. One is that there is evidence that the protective gear actually gives players a false sense of safety and encourages them to do dangerous things that they would not do without it. Another is that in rugby, it is only the player who has the ball that can be tackled, thus any given player faces far fewer collisions per game. A third is that any collision that results in contact with a player’s head results in an immediate yellow card that requires the offender to be off the field for ten minutes, to sit in a chair that is quaintly called a ‘sin bin’. If, during that time, an off-field review shows no mitigating factors, it is upgraded to a red card and the player cannot return to the game.
But in following the recent rugby World Cup, I have come to realize that I have been viewing rugby through rose-tinted glasses based on the fact that, before this tournament, I had not seen a full rugby game for about five decades, with the last ones in Sri Lanka and mostly featuring school teams. In the World Cup, I was shocked at how many players were seriously injured, bleeding extensively from the ears, nose, mouth and other parts of the head and requiring medical attention and bandaging. There were also many bodily injuries arising from tackles and the piling on top of players. When one watches the highlights, as I had been doing up to now, these are almost never shown, the focus instead being on the fast-moving action.
I noticed that there were many differences in the game from what I remembered. One is that there far fewer of the classical tackles, where the defender stops the ball carrier by wrapping their arms around the players legs below the knees. This causes the ball carrier to fall forward to the ground. Now there seem to be more of the kind of ‘hits’ on sees in American football, where the defender throws their full body at the ball carrier. This kind of hit causes the ball carrier to be thrown backward, creating a greater risk of whiplash and brain concussion.
One big threat of injury occurs when a player holding the ball is brought to the ground and the other players crowd around and pile on top in what are called ‘rucks’. In such situations, the ball carrier must release the ball but the other players are not allowed to pick up the ball with their hands but must use their feet to get the ball out of the pile before it can be picked up. So one can imagine the beating that the poor players at the bottom receive as the cleated boots of players hack away at them, trying to get the ball out.
There is a new book Concussed: Sport’s Uncomfortable Truth by Sam Peters that argues that concussions and other injuries in rugby are a much greater problem than the authorities are letting on, and that this is a consequence of professionalism and the drive for more money, and that they are manipulating and fudging the data to hide the scale of the problem.
As a reporter, Peters interviewed former players whose lives had been irrevocably altered by concussions and other injuries, which were aggravated or outright caused by lax rules, regulations and attitudes encouraged from the top down. The RFU and other prominent organisations in the sport shot down any attempt to question the status quo – rather bullishly, it seems.
Peters makes the case for how professional rugby has become more dangerous and explains how the risk to players’ health has increased dramatically since turning professional in 1995.
He believes the need to appeal to a wider audience became an “unhealthy obsession” in the years after the sport became professional. Rules were rewritten in order to attract more viewers, in pursuit of more sponsorship and advertising. “Laws were constantly tweaked to speed up the game and improve the spectacle,” he says. “Collisions replaced contacts, hits replaced tackles. Passes became offloads. Tackles were more frequent, scrums reduced, hits got bigger. Money rolled in. Audiences grew.”
By 2022, however, organisations began to change their stance. The RFU conceded a potential connection between repeated head trauma and CTE. Paul McCrory, “this century’s most influential sports doctor” and a key critic of the link, was exposed as a serial plagiarist, misrepresenting data and using other researchers’ work as his own. McCrory was the lead on the Concussion in Sport Group, from which the RFU took its advice about concussions. Among other changes, independent matchday doctors were employed at international games.
Today there is a legal case against World Rugby, the RFU and the Welsh Rugby Union, with more than 300 ex-players involved, alleging that they suffered brain injuries sustained during their careers.
One other factor that Peters points out is that rugby players are now bulking up (like American football players) which means that the hits have become more concussion-causing.
The physicality of the players changed too. Peters notes that in 1987 at the first Rugby World Cup, the average weight of the South African national team was [203 lb], while at the 2019 final, 24 years into professionalism, the average weight was [236 lb]. While previously players were taught to tackle passively, the tackle was now seen as a weapon with which to hit an opponent. “Everyone knew the sport was far more dangerous than ever before,” says Peters.
I only heard about this book after the tournament ended and it resonated with me and the above fact may well explain why my experience with the recent World Cup was so jarring. It had struck me while watching that the players were bigger and faster and the collisions were more brutal. My previous experience of seeing a full rugby game consisted of it being played by players roughly half the size of the current professional players.
There is some effort to use technology try and reduce head injuries in rugby.
World Rugby is expected to confirm within the next 48 hours that it will adopt smart mouthguard technology, which measures the G-force of every head impact in real time, in all its elite matches to help make the game safer.
The technology, which works by using bluetooth to immediately alert an independent doctor whenever a player has a big collision in a tackle or ruck, will be debuted in the WXV women’s match between Italy and Japan on 13 October. It will then be rolled out into the men’s professional game in January, in time for the Six Nations.
The new approach will ensure that anyone who experiences a crunching hit that is not spotted by TV cameras – or who does not show concussion signs and symptoms straight away – will no longer remain on the pitch.
Instead, when the mouthguard registers an acceleration above 70g and 4,000 radians per second squared for men – and 55gs and 4,000 rad/s2 for women – it will immediately ping an alert to an app that is being watched by an independent doctor.
As soon as that happens the player will be taken off and will have to undergo a head impact assessment. Even if they are cleared to play, they will be checked again after the match and two days later.
This may help. But I think that I will not watch professional rugby again. It has become too much like American professional football in terms of seeming to want to appeal to fans who like to see bone-jarring hits despite the potential harm to players. I find it hard to watch people seriously risking their health for the purposes of entertainment.