Explained: Why Former Rugby Players Are Being Diagnosed With Dementia

In the first week of December, eight former Rugby players announced their intention to sue the sports governing bodies after claiming that the sport left them with permanent brain damage.

The group, which includes England's former World Cup winner Steve Thompson, have claimed that all of them have been diagnosed with early signs of dementia which is the result of taking repeated hits to their heads. Former English player Michael Lipman and former Welsh player Alix Popham are two other players who have come forward with their diagnoses.

Thompson has claimed that his memory has been severely impacted over time so much so that he has no recollection of winning the 2003 Rugby World Cup with England. "I can't remember it. I've got no memorabilia. I've got no feelings about it. You see us lifting the World Cup and I can see me there jumping around. But I can't remember it," he told The Guardian. Given the chance for a do over, Thompson said that he would have never chosen to play rugby in the first place.

The group's lawyers, Rylands Law, have claimed that a further 80 former players between the ages of 25 and 55 are displaying symptoms of the neurodegenerative syndrome. The former players are also probably suffering from chronic traumatic encephalopathy (CTE). Rylands Law's Richard Boardman has said that the law firm is in touch with over 100 players and is expecting the number to rise.

The players have also put forth a list of 15 demands for World Rugby to improve player safety and aftercare. These include adopting better tests to detect concussions during games, authorising concussion spotters to removes players showing symptoms and undertaking comprehensive medical tests for a player for every three concussions suffered. Also among the demands are more research into CTE and educating players and coaches on concussion.

What is CTE?

CTE is a neurodegenerative condition that is associated with repeated trauma to the head and is usually diagnosed in military personnel and athletes from contact sports. CTE is primarily diagnosed post-death by conducting brain tissue analysis using special chemicals.

Typical symptoms of CTE include irritability, impulsivity, aggression, depression, short-term memory loss and heightened suicidality and can lead to dementia.

CTE and sports

Head injuries and concussions have been commonplace in contact sports like boxing, MMA, rugby, football and American football. However, increasing research has shed a light on the long-term impact of concussions and trauma to the head.

A 2019 study found that the risk of developing CTE was higher in players with longer sporting careers. Researchers have also found that the risk and severity of CTE increases in players who begin playing contact sports at a younger age. A rugby or American football player who started playing the sport at age 5 is 10 times at risk of developing CTE than a player who started at 14.

A Boston University study found that CTE was found in the brains obtained from 99% of NFL players, 91% of college football players and 21% of high school football players.

Dr. Harrison Martland, a forensic pathologist coined the term punch drunk to describe the condition where boxers displayed slow movement and slurred speech due to being hit on the head.

CTE's long-term impact became public knowledge after the US' National Football League finally acknowledged a possible relation between on-field concussions and CTE in 2009. In 2016, it finally agreed that playing football could lead to CTE. The NFL's admission was the result of research conducted by forensic pathologist Dr Bennet Omalu into CTE.

Omalu published the first evidence of CTE in an American football player after the death of former player Mike Webster in 2002. Multiple players since been diagnosed with CTE following their deaths.

In 2011, former players sued the NFL for alleging that the league knew the risks associated with repeated head injuries and concealed it from players. The league settled with the players and has paid close to $850 million to players

The recent deaths of former English football players with dementia has led to calls for heading to be regulated in football.

How can sports deal with CTE?

Given the nature of sports like rugby, American football, boxing and MMA, trauma to the head and concussion will always be a major consequence of playing the sports. The major problem facing sports bodies is the inability to diagnose CTE in living people.

Sports bodies can reduce the risks of CTE by implementing rules which give more protection to players as well as better concussion management.

The UK's National Health Service advices patients with probable CTE to access supportive treatments as is the case for other types of dementia.