It has been just over two decades since Steve Thompson threw the ball to his teammate Lewis Moody in a line-out, setting up the play that led to England’s 2003 World Cup victory. In the dying moments of extra time in a slightly damp Sydney both players were form-perfect – allowing Jonny Wilkinson to drop the most famous of all goals. Australia 17, England 20.
Thompson doesn’t remember any of this happening. “I was watching a game where England are playing, and I can see that I’m there, but I can’t remember any of it. I can’t remember being there whatsoever or being in Australia,” Thompson has said. He has spoken of routinely scrummaging more than 100 times in training, causing him to black out and the blood vessels in his eyes to burst. In 2020 he was diagnosed with early onset dementia and probable chronic traumatic encephalopathy (CTE).
CTE is a neurodegenerative disease caused by traumatic brain injury – be it from one catastrophic incident such as a car crash or through repeated blows to the brain over several years, as in collision sport. The Wales international rugby player Alix Popham and the New Zealander Carl Hayman have also been diagnosed with suspected CTE. With Thompson they are among more than 550 former rugby union and league players advancing a legal case against the sport’s governing bodies for alleged negligence in the handling of brain trauma.
Plenty are calling for a significant change in rugby’s attitude to safety. Four players alone died in the 2018-19 French season. There have been plenty of fatalities before – the Oxford University player Ian Tucker in 1996 and 14-year-old Benjamin Robinson in 2011 are among the most high profile. But unlike other sports such as Formula One, which acted decisively following the deaths of Ayrton Senna and Roland Ratzenberger in 1994, rugby has largely resisted introducing more stringent safety measures. In 2007, for example, in the World Cup pool stages, England captain Lewis Moody played on after losing consciousness twice in one game against Tonga. Had he been a boxer, Moody would have been stood down for a minimum of 28 days. He played the following week.
As the Six Nations winds down today – England against Wales in Cardiff, Ireland in Rome to take on Italy, and France hosting Scotland in Paris – many figures at the top of the sport remain firmly in denial.
Ten days ago, the former Wales and British Lions captain turned BBC television pundit Sam Warburton blamed rugby’s dwindling playing numbers on media “scaremongering” and “clickbait” journalism. “The media don’t do a good enough role in promoting the safety of rugby because obviously the clickbait that you want from head injuries is an obvious one,” he said. Warburton went on to describe rugby as “very, very safe”, while reiterating his belief that those calling for improved safety were the cause of what the Rugby Football Union (RFU)’s own report last year described as “an existential threat to the sport”.
This is some change for the 36-year-old, who had previously spoken of the extreme risks he took as a professional and the regret he had over the cavalier approach he took to concussion during his playing career. As recently as 2019 Warburton wrote in his autobiography Open Side: “I’ve lost count of the number of times I’ve taken a knock to the head, got up and not been sure which way I’m playing. Never go off unless you’re injured. And a blow to the head, unless you’re actually unconscious, doesn’t count.” He continues: “I’ll look back and think how frightening it was we knew so little (about concussion),” while in the same breath praising the media for “highlighting the dangers”.
Peter Robinson is the father of 14-year-old Benjamin who died in 2011. The cause of death was second impact syndrome. But, as the Guardian sportswriter Andy Bull put it: “Behind those words is a simpler one, a word [Benjamin’s mother] describes as ‘rugby’s dirty secret’. Ben Robinson died because of concussion.” Peter called me in disbelief after Warburton’s strange intervention about rugby’s safety. “What on Earth was he thinking?” he asked. “Why would he say that?”
For almost two decades following the chaotic onset of professionalism in 1995, when the end of RFU’s self-imposed moratorium allowed England’s clubs to sign up the top stars, creating a tension whereby player welfare was sacrificed on the altar of growth, the sport which once sold itself as being “for all shapes and sizes” changed beyond recognition. And became more dangerous.
Commercial pressures led to extreme practices, and injuries skyrocketed accordingly. As players got bigger, faster and stronger, collisions became more ferocious, frequent and consequential. In 1987, for example, the average number of tackles in a game per team during the first ever World Cup was 48, while the average number of carries was 86. By the 2023 edition, that had risen to 169 tackles and 114 carries. Between 2002-03, when the RFU began recording injury data, recorded concussions in the Premiership rose from around 40 per season to above 160 by 2019-20. Concussion is the most common injury suffered by professionals over the past decade. Many of these concussions occur in training, which remains dangerously unregulated to this day.
(Some of this dramatic increase in concussion numbers can be attributed to better record keeping, but the overriding trend for injuries has tracked upward for more than two decades.)
Only now are we beginning to see first-hand the toll an entire career playing professional rugby can take on players’ health. “I knew that I had issues with memory and brain,” explains Thompson’s fellow World Cup winner Phil Vickery. “When I went for the scan, it came back and showed probably CTE, which I kind of knew before I’d even had it done. I said that to the guy: ‘I know something’s wrong with me.’ But I didn’t want to do anything about it. There are lots of people out there now who are in denial but have got issues and problems. I know it. But that’s another story.”
What will it take for things to change? Some fear only a televised death, God forbid, will force the sport to change when it comes to safety and player welfare. Hopefully it will be the law courts. In the US, a case taken against the National Football League led to almost $1bn being paid to former American footballers. Today, as 550 former players take legal action against various national and international rugby authorities, lawyers for the claimants argue that simple measures could have been introduced to prevent the sweeping increase in traumatic head injuries: a radical reduction in contact training, stricter limits on match exposure, and longer stand-down periods following a diagnosed concussion. Last month, the presiding judge indicated the trial could start within two years.
And yet, rugby has a history of denial. Following an anomalous drop in injury severity reported in 2009-10, Rugby World magazine ran an article headlined “Rugby is getting safer in England’s top flight”, accompanied by supportive quotes from Dr Simon Kemp, the RFU’s head of medicine. It created a false sense of security. And lawmakers struggled to keep up with the demands to grow the game and exploit numbers driven by television. Players were routinely allowed to play with concussion, even after they had lost consciousness. And then in 2011, rugby lurched even further in the wrong direction.
Encouraged by the Australian sports physician Paul McCrory, who had established himself as sport’s leading brain injury authority but steadfastly denied the link between concussions and CTE, professional rugby shelved a minimum three-week concussion stand-down in favour of a six-day graduated return to play. Amid all this, the RFU insisted it was merely following the guidance set out by the Concussion in Sport Group, led by McCrory.
Meanwhile, in the same year as the six-day-return-to-play policy was announced, Peter Robinson sat by Benjamin’s bedside as his son’s life support machine was turned off. Rugby is still not honest about the scale of the problem it faces.
[See more: In defence of the Premier League – and the new Man Utd stadium]
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