Scientists researching the effect of concussion on the brain claim that rugby’s authorities are in a state of denial about the ‘almost incontrovertible’ evidence of a link between repeated concussion and the development of degenerative conditions.
In a pioneering study, Dr Michael J Grey, reader in Motor Neuroscience at the University of Birmingham’s School of Sport, Exercise and Rehabilitation Sciences, and Tony Belli, a consultant neurosurgeon at the city’s Queen Elizabeth Hospital, are investigating the state of the brain after a concussion using cutting-edge technology funded by the British Medical Association and the National Institute for Health Research.
Having already undertaken research into the effects of traumatic brain injuries in sportsmen and women, they are alarmed by rugby’s refusal to admit that repeated concussion can lead to long-term brain damage.
In last week’s Mail on Sunday, the RFU’s head of medicine, Dr Simon Kemp, said: ‘It is going to take some time to definitively answer this question.’
But Kemp’s view is not shared by Belli. ‘There is clear evidence of a link between concussion and dementia, but rugby is in denial about that,’ said Belli. ‘It was the same argument used by the cigarette companies many years ago to deny that smoking caused cancer.
‘We already know that people who have developed a large number of concussions over time are at risk of developing neurodegenerative conditions and that evidence is now pretty clear.
‘We have a large body of evidence. Most of that has come from the United States, and if you are looking for clear evidence in rugby then it might not be there, but that’s only because no one has looked for it.
‘But the overall evidence for repeated concussion in sport [being linked to brain damage] is almost incontrovertible.’
Rugby’s authorities have also repeatedly attempted to differentiate it from American sports, especially from the research that led to the NFL paying out $765million after a lawsuit by 4,500 former players suffering from concussion-related brain injuries.
In August the International Rugby Board released a statement saying that ‘rugby is not American Football’, which again rankles with Belli.
‘I can’t really think of any logical explanation for that claim,’ Belli said. ‘I can’t see how you can produce an argument that rugby players are not at risk of developing neurological conditions, because in any sports where you do get a concussion or repeated concussion [the players] are at risk.’
Grey agrees with his colleague. ‘American sports may have protective gear, but the fact is that you have a brain encased in a skull that does not move,’ he said.
‘If you decelerate that structure quickly enough, then the brain is going to shake. It does not matter if you are wearing a helmet or not; the brain is shaking inside the cranium that does not move which causes the damage.’
Grey and Belli’s research is focusing particularly on how long the brain remains in a parlous state after an initial concussion and the terrible damage that can be caused by a second impact during that timeframe.
Yet, as Michael Lipman reveals below, rugby’s safeguard against concussed players returning to action too soon — the CogSport Test — is routinely abused.
‘The timing is crucial because the brain becomes vulnerable after the initial injury,’ Belli added. ‘If there is another event, even a mild blow, within that window then you are very likely to have effects comparable to a severe head injury.
‘The players are professionals and they want to play. They learn how to manipulate those tests very quickly and deliberately underperform in the baseline test so when they do have a concussion there’s no significant difference.
‘It goes back to the denial culture. But by allowing players who have experienced a serious event to go back and play they are putting lives at risk.’
Grey and Belli fully endorse The Mail on Sunday’s Concussion Campaign and hope their research, which will be conducted over three years at Birmingham University, will lead to a more objective test than CogSport being developed. But Belli says that rugby urgently needs to take its head out of the sand.
‘They say they take players’ welfare seriously, but then at the same time they’re saying there’s no problem concussions,’ Belli said. ‘They are contradictory statements to say we are taking the welfare of players to heart but then in the same breath to state that concussions are not a real problem in rugby.
‘The last thing we want to do is create paranoia about the sport — we just want to make it safer. Rugby is a wonderful sport with huge benefits, but at the moment there’s a culture of denial.’
ENGLAND STAR REVEALS HOW PLAYERS BEAT THE TESTS
Michael Lipman used to view it as a badge of honour that he was prepared to put his head in places where most people would not place their boots.
Now the former England and Bath flanker fears he could be a ‘vegetable’ by the time he is 65 after suffering more than 30 incidents of concussion in his career.
A final blow to the head while playing for Melbourne Rebels last year forced Lipman to retire. But with more research suggesting a strong link between repeated concussions and the onset of neuro-degenerative problems, the 33-year-old is afraid of what the future holds.
‘It concerns me massively,’ Lipman told The Mail on Sunday. ‘In 10, 20, 30 years’ time, I could have Alzheimer’s or Parkinson’s because of it.
‘I don’t know if by the time I’m 65 I won’t be a vegetable. It’s hugely worrying. As a player, you don’t tend to think about these things, but now you can’t help but be concerned.’
While the number of concussions that Lipman suffered in his playing days is staggering, very few of them prevented him being back on the field the following week because of what he describes as institutionalized cheating of the CogSport Test — the main tool rugby uses to determine when a player is ready to return to play after a concussion.
Lipman confirmed fears voiced by leading scientist Dr Jon Patricios that players routinely manipulate their baseline CogSport Test score in pre-season so future concussion symptoms go undetected.
‘I used to think those tests were a bit of a laugh,’ said Lipman. ‘I’d try to do as badly as I could because I knew that I was going to get concussed.
‘That’s exactly what a lot of players still do because when they get a knock, they want to be back playing. They have careers and reputations and, at the end of the day, they just want to get out there and play rugby.’
Lipman blames no one but himself for his actions. In 2009, after a run of five concussions in five months, two neurosurgeons told him to retire when he was still at Bath — advice he ignored and hid from the Premiership club and the Rebels.
Slowly but surely, the consequences caught up with Lipman. Friends would sit next to him and he would forget their names; and his whole world became a constant haze.
‘I thought, “There’s no point in this”,’ he said. ‘The more you get knocked out, the longer it takes to recover. Initially, it can take a week or even two or three days.
‘In the past few years it took me a lot longer, which is why I retired. The more concussions I had, the easier it was to get knocked out and the little knocks used to be the worse.
‘I’d play with blurred vision all the time, but you kept playing through because you didn’t want to let your mates down.