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Is Rugby sitting on a concussion time bomb?

By Prof Dr Steve Cornelius, Sports Law Centre University of Pretoria South Africa

A recent study at the University of Durham, United Kingdom, has compared 83 retired professional rugby players from both rugby union and rugby league with 106 amateur rugby players and 65 non-contact athletes of the same age.

To begin with, the research revealed that the professional rugby players suffered more concussion during their careers, than the other groups. It is not surprising, then, that they are more likely to develop mental health issues later in life, when compared to amateur players or  athletes in non-contact sports (Rugby, concussions and mental health - Durham University).

There was a strong association between head injuries and the onset of mental health issues later in life.

The study also concluded that players, who suffered multiple head injuries during their careers, are more at risk of developing depression, anxiety and sleep disruption. Players, who suffered five or more head injuries during their careers, have a 50% chance of developing depression and an almost 66% chance of developing irritability and anger management issues.

A major concern was that a significant number of professional players indicated that they would not seek help if they experienced these kinds of health problems. Interestingly, the various groups showed no difference in alcohol consumption.

The results of the study are hardly surprising. Over the past 40 years, there has been a concerted effort on the part of rugby authorities to speed up the game and make it more attractive for spectators. The impact of this effort can be clearly seen when one compares statistics from the various rugby union world cup tournaments. (Revolutionising Rugby – A Statistical Analysis On How the Game Has Evolved (

In 1987, there were an average of 32 scrums and 45 lineouts per match. As a result, the ball was in play for an average of 28 minutes per match. In 1995, the ball was in play for an average of 25 minutes per match. At the 2019 event, the average number of scrums per match was only 14 and there were on average only 25 lineouts per match. The ball was in play for an average of 34 minutes per match. This is a 33% increase in active play time. At the same time, the average number of penalties at scrum time, increased from 2.9 per match in 1987, to 3.7 in 2019. Whilst this could be attributable to stricter refereeing at scrum time and other laws of the game changes, it is still concerning that the number of scrums decreased by half, whilst the number of penalties increased by almost one third.

The increase in the average time that the ball was in play, meant that the physical demands on players have also increased significantly. In 1987, a team on average carried the ball 86 times, made 48 tackles and there were 25 rucks. By 2019, the average number of ball carries had increased to 115, 129 tackles were made and there were 82 rucks. The average tackle success rate also increased from 70% to 84%. This suggests that the intensity of tackles also significantly increased between 1987 and 2019. Furthermore, the average number of times players offloaded the ball decreased from 30 in 1987, to 15 in 2019. This means that players were more inclined to carry the ball into contact, than to pass it to a teammate.

Whilst rugby authorities would consider that all these as positive developments to make the game more spectacular as a spectator and television sport, the statistics should send alarm bells ringing. The way in which the game has evolved places far higher demands on individual players and it is not strange these days for a single player to exceed the work rate in respect of ball carries, tackles made or rucks joined, that entire teams would have produced during the 1980s. Whilst the individual work rate has, in some ways, been relieved with the introduction of substitutions during the 1990s, this is a double-edged sword as "fresh" players come onto the field later in a match when other players are exhausted.

In addition, the proliferation of professional tournaments also means that rugby players today are engaged in matches throughout the year. Up to the 1990s, there were clear rugby seasons, when players were active, and off seasons when players could recover from injuries and the stress that elite competition placed on the body. Arguably, players today are in much better physical shape than in the 1980s, as training regimens have taken an almost scientific look. But this is another double-edged sword, as stronger players also tend to hit much harder in the tackles and rucks.

If one takes all of this into account, it is hardly surprising that professional players have significantly higher injury rates and are at higher risk of long term physical and mental health issues. The efforts to make the game more attractive, comes at a cost, which is ultimately borne by the professional players who sacrifice their bodies and wellbeing for our entertainment.

World Rugby has taken a number of commendable steps to try and improve the safety of the sport. But much more needs to be done and I fear that it is just a matter of time before one sees a class action against rugby authorities in the same vein as the concussion claims made against the National Football League in the United States. That ended in a billion US dollar settlement. So, I wonder if World Rugby can survive such a claim?

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