The Wrap: 'This is World Rugby's problem to fix and the longer it takes, the more the sport will be damaged'

By Geoff Parkes / Expert

Rugby wouldn’t be rugby without a north versus south divide over something or other.

While these flash points often feel intense, invariably things settle and the rugby caravan moves on without lasting damage done to the fabric of the game.

The latest stoush – Australia and New Zealand defiantly continuing on with 20-minute red cards, and World Rugby and northern hemisphere nations insisting that transgressors pay full freight for their misdeeds – is different.

Why so? If rugby is to flourish into the future, after this generation has drained its last pints and shut down its Twitter accounts, the existential challenge that is head injury must be solved.

And it can only be solved if all parties are furiously aligned.

The general view from the north is that Australia and New Zealand are watering down efforts to lower tackle heights at precisely the same time concern about head injuries in rugby has never been higher.

The counter-view is that rugby in these parts competes for eyeballs in a highly competitive market, and paying audiences are overwhelmingly in favour of contests not being reduced to 15 versus 14. More particularly, when current frameworks provide for red cards that, in some instances, are for accidental collisions.

(Photo by Peter Meecham/Getty Images)

This kind of binary framing is unhelpful, because it conflates two separate issues into one. The incidence of concussion, the construct of rugby’s laws, application of the laws (refereeing), and the judicial process are all linked, but they are also separate and distinct.

Blunt use of any of the latter to effect change on the former might be well-intentioned, but is flawed.

One of the biggest problems with the whole concussion debate right now is how it has been framed as a refereeing issue.

Let’s pluck out an obvious starting point. ‘Does rugby want or need to minimize incidences of concussion?’

Another important discussion point might be: ‘Does rugby want or need more accuracy and consistency in refereeing?’

These are not the same question. Most people would answer yes to both, but a solution to the second question – to what extent this is actually possible – does not automatically address the first.

The story that captures the headlines thus becomes the inequity in the recent treatment of Angus Ta’avao and Andrew Porter, not what is the best way to prevent the injuries suffered by Garry Ringrose and Brodie Retallick.

(Photo by Fiona Goodall/Getty Images)

In allowing itself to become bogged down arguing the toss around initial points of contact, degrees of force, absorption, the ball-carrier dropping in height and so on, rugby is in danger of losing focus on the bigger picture.

Last week, a new research paper published in ‘Frontiers in Neurology’ nailed that big picture.

The paper, compiled by nine researchers across six different countries, detailed how “there was a consistent association between repetitive head impacts and CTE”, and that “there was a plausible mechanism between the cause and the effect, and that greater exposure led to greater incidence”.

Lead author Chris Nowinski, CEO of the Concussion Legacy Foundation, said the analysis “gives us the highest scientific confidence that repeated head impacts cause CTE”.

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Since 2011, rugby (along with a number of other sports) has employed assessment and return to play processes and protocols recommended by the global Concussion in Sport Group (CISG).

Discontent has grown about potential conflicts of interest – the vast majority of members have been or are employed by various sports – and the group’s reticence to acknowledge the links between head injury and CTE.

Earlier this year, the CISG was rocked by plagiarism allegations against its chair, Dr. Paul McCrory, who subsequently resigned.

This felt like a watershed moment; an opportunity for the CISG to produce a new concussion statement that more accurately reflects the latest research and current concerns, or an opportunity for World Rugby to step out of CISG’s shadow of convenience, and forge a bolder path forward, demonstrating a willingness to protect players and the future of the sport.

No longer can World Rugby hide in the grey area that is conflicting or yet to be determined science. Causation is causation, and if the age-old argument ‘we didn’t know what we were dealing with’ ever did apply, it applies no longer.

Six recent Test matches in Australia and New Zealand, involving England and Ireland, delivered 12 failed HIAs or notable head injuries.

Seventy-five times capped, triple grand-slam winning Welsh second-rower Ryan Jones, aged only 41, has just announced that he suffering from early onset dementia and probable CTE.

There are many others suffering like Jones. He joins a host of other recently retired, afflicted players attached to an action against World Rugby, which appears destined to be run through the UK courts.

In this environment it isn’t hard to imagine players all around the globe wondering if their own experiences with concussion represent a ticking bomb. And to imagine how increasingly negative publicity influences parents, and what impact this will have on junior, and eventually adult, participation rates.

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This is World Rugby’s problem to fix, and the longer it takes to do so, the more the sport will be damaged.

What makes the issue so difficult – and why much of the noise around referees and cards is misplaced – is that the danger to rugby comes from a place far broader in scope than that what is posed by high-contact foul play.

Of major concern is the accumulation of sub-concussive hits, including those suffered by junior players before their brains are fully developed, and also the accumulation of seemingly minor ‘head knocks’ collected by players whilst training.

With respect to how the game is played, data collated and released recently by Ross Tucker of ‘Science in Sport’ details how the risk of concussion to either the ball carrier or tackler increases markedly if both players enter contact upright, compared to instances where the tackler is bent and the ball carrier is upright.

James Parsons of the Blues walks off with concussion during a Super Rugby match (Photo by Hannah Peters/Getty Images)

In this regard, the focus on getting tacklers to lower their body height is easily understood.

But there remains significant risk in all cases, including where the tackler and/or the ball runner are bent over. Thus, while it is important to address foul play, it is crucial not to conflate this into the issuing of different types of red cards being the solution, or even a major part of the solution, to the concussion problem.

What is far more likely to change matters is leading thinkers and coaches in the game continuing to come together to work on ways to modify behaviours, so that upright tackling is eliminated, and the safest tacking techniques are employed.

That this might result in more off-loading and ball movement, and a depowering of the gain-line collision would naturally force consideration and examination of flow-on effects, and likely lead to other law changes and modifications.

Complex and difficult for sure, but nothing less than what will be required.

It feels almost inevitable that contact rugby will be disallowed for juniors and gradually introduced for teenagers, after age 14.

Given concerning research around the deleterious effects of concussion on females, contact in girls and women’s rugby will potentially be even more severely curtailed. Expect contact minutes during training, at all levels, to be strictly limited.

Foul play will remain an important consideration, but with respect to the current red card debate there is no evidence that full-match red cards versus 20-minute red cards serve as a greater deterrent or change player behaviour, or are more effective in preventing concussions.

Particularly so when the red card – once reserved for egregious acts of foul play – is now a catch-all for everything from intentional kicking and eye gouging through to unintentional head clashes.

(Photo by Cameron Spencer/Getty Images)

This is precisely why the legal system recognises different levels of culpability with respect to homicide. Distinctions are made not because these effectively deter people from killing each other, but because they more appropriately reflect degrees of culpability and intent.

What is ironic is that fans are not so much being frustrated and turned off the game by the extent of the head injuries – at least not yet – but more so by the ham-fisted way in which the game is dealing with the issue.

It is not downplaying the importance of acting on concussion to recognise that there is a real opportunity cost in tasking match officials with assessing each event via a clunky, time-consuming framework which detracts from the overall rugby experience.

Particularly so for fans who are live at matches, who are often in the dark about what is unfolding.

Match officials have been forced into the role of ‘concussion removalist’. This places expectations upon them that are grossly unfair and which have no hope of being satisfied.

Rugby’s law book is complicated enough as it is; let the officials focus on that, have them send players off for the whole game who commit the gravest fouls, and have everything else dealt with by a yellow card and a citing and judiciary process. One with appropriately lengthy suspensions that will drive change in player behaviour.

So, if it is not the referee’s job to solve the concussion problem, whose is it?

It is for World Rugby to form a full understanding of the issue, develop a comprehensive plan that appropriately covers all areas of the game (professional, amateur and junior), and to administer and communicate in such a way that all of rugby’s stakeholders – players, coaches, administrators, medics, match officials, judiciary, media, parents and fans – combat the issue in a cohesive, joined-up manner.

World Rugby might believe they are doing that already but, despite best intentions, that is patently not the case. The concussion issue is galloping ahead of the ability of the game to grasp what is required and act upon it.

Witness the incoherence surrounding World Rugby’s recent announcement of a mandatory 12-day stand-down for players who are concussed or fail an HIA.

(Photo By Ramsey Cardy/Sportsfile via Getty Images)

Within days, Ireland’s Johnathan Sexton was being navigated through a series of return to play exemptions that saw him take the field in the second Test against New Zealand, a week after he failed an HIA in the first.

Whatever justification offered by Sexton and Ireland’s medical staff, such an outcome merely fosters cynicism and confusion and, more broadly, waters down efforts to educate people on the issue.

It is time for World Rugby to appoint a concussion commissioner. This needs to be a highly visible, high-level appointee on the same level as director of rugby Phil Davies, charged with overarching responsibility on all matters relating to head injury.

This is not to downplay work currently being done across areas including medical research and data collection, legal, laws, coaching and refereeing, but to ensure that actions are better coordinated and that rugby’s responses to the issue are proactive rather than reactive.

One reason sports have been slow and cautious is because of concerns over legal liability. This is where a change in policy may potentially be interpreted as acknowledgment that prior policy was deficient, thus opening the door for legal action.

Conversely, with all of the money and legal might at its disposal, there should be no impediment to World Rugby being able to demonstrate appropriate responses given the information it had at its disposal – then and now.

In this respect, new research coming to light is helpful, in that it offers World Rugby new markers from which it can fairly reset its policies and operating frameworks.

One of the Concussion Commissioner’s responsibilities must be to ensure better communication. Rugby badly needs a simple, honed common message that is easily understood and repeated by everyone in the game.

The commissioner must also strive to ensure that broadcast media steps up to the plate. By all means let supposed expert TV commentators argue the toss on tactics and selection etc, but there must be no space for commentators to spout misinformation and ill-informed personal opinion on a matter this serious.

It is precisely because there is an information and communication vacuum that the current debate has become mired in such a hopeless and ultimately irrelevant spiral around the worth of 20-minute red cards versus full red cards.

Neither of these is a solution.

Rugby can, and must, do better.

The Crowd Says:

AUTHOR

2022-08-03T23:28:54+00:00

Geoff Parkes

Expert


I believe WR is on to this aspect AJ, and we will soon see changes to how the bench operates. There is a definite push to try to introduce more fatigue and space. As for signing waivers, informed consent has a role to play, but isn't a solution in itself. Waivers still don't protect or absolve an organisation if the organisation is aware of information that the player/employee isn't, at the time of signing consent, for example.

2022-08-02T14:34:38+00:00

Dusty10

Roar Rookie


I completely agree with your point that education is key. Absolutely right. Players need to know the risks, and managing players is a work in progress. We need to be considering things like obtaining baseline (pre-morbid) measures of cognitive function for later comparison, and developing and genuinely applying medically informed management/treatment protocols for players with clear signs of concussion. The recent debacle with Sexton was ridiculous. My point is that every single player who makes or takes a tackle incurs damage, it's really just a matter of severity. This is a part of our game and we can't remove it without turning it into soccer. Personally, I bloody hate soccer. I'm a psychologist and I've worked in a brain injury unit, I certainly understand the consequences of loss of cognitive function, but I also grew up loving rugby and I don't want to see it ruined.

2022-08-02T12:27:29+00:00

HiKa

Roar Rookie


NFL generates a lot more money than rugby (not a bit more - way, way more), so they may have made a business decision to treat the string of broken players as a mere cost of doing business. Rugby simply does not have that sort of cash flow to make that choice, and I hope they wouldn't in any case.

2022-08-02T12:00:05+00:00

HiKa

Roar Rookie


Ask yourself how well-informed that "informed consent" is. How many players genuinely understand what cumulative brain injury like CTE is and what life looks like for those who get it? A lot more research is needed to better understand and assess the risks individuals face so they can make real informed choices about their participation, and rugby organizations (rule makers and employers) can also make better decisions around how the game is played and how players are managed.

2022-08-02T11:05:05+00:00

ajhreds


Geoff – I think the issue could be easily avoided by communicating risks that prospective players are made aware of and signing disclaimers not to sue on the basis to that they signoff on the known risk and accept to Play. Also once Rugby went to for tactical bench replacements rather than only through injury and the use it or lose it rule. It encouraged bigger bodies in the backline, cleanouts and greater physicality. I believe if we went to back to attacking going forward or stationary gets the put in, along with back to legal rucking we’ll get back to the way Rugby was played in the 8os, and not making so league like with loosies being more committed to the breakdown, more room for the smart, fast steppers to show their skills. The current game does not allow the players Like Ken Wright and Tony Melrose to flourish. Fitness has to be a factor in n opening the game up in the 2nd half.

2022-08-02T07:46:39+00:00

FunBus

Roar Rookie


I take it the ‘appalling NH officiating’ was, as usual, in a game the Wallabies lost?

2022-08-02T07:42:51+00:00

FunBus

Roar Rookie


Yes, like all proposed changes in the laws, the toffs at WR (probably all Poms) only asked one question – will it hurt or help the ABs. Geez…

2022-08-02T07:39:12+00:00

FunBus

Roar Rookie


Might be more manageable by looking at the background of those with early-onset dementia. This is the canary in the mineshaft.

2022-08-02T07:33:47+00:00

FunBus

Roar Rookie


…and the lawyers will lovingly provide a list of all those quotes from administrators when the court cases start.

2022-08-02T03:33:38+00:00

tsuru

Roar Rookie


I believe this is precisely the point that is generally being missed, Piru. People are assuming that CTE is caused by big head clashes, whereas, according to the research, it is just as bad to have multiple “sub-concussive” hits which, as you put it, “rattle” your brain a bit and the effect build over time.

2022-08-02T02:56:19+00:00

elysiusrugby

Roar Rookie


Great article Geoff. The whole red card argument is an easy target, but the contact nature of the sport and training will cause more damage to more people in the long term than the occasional foul play or head clash. The most damage coming from insufficient healing after minor or major head injuries, making the Sexton situation even more ridiculous I wonder if moving to an external governing body is the way to go. Boxing and MMA have stand down notices given from the medical boards controlling the states. It's common for fighters to be stood down for 3 months after taking too much contact in a fight.

2022-08-02T01:32:59+00:00

piru

Roar Rookie


Yeah the NFL learned that one the hard way, the helmets only make concussions more likely

2022-08-02T01:31:31+00:00

piru

Roar Rookie


Yes, that works fine for deliberate or careless actions I'm asking how it has any impact at all on accidents

2022-08-02T01:29:36+00:00

piru

Roar Rookie


Perhaps I was doing it wrong, but I don't think your neck muscles have all that much to do with how your brain rattles about inside your skull! Agree to disagree

2022-08-02T01:14:04+00:00

Dusty10

Roar Rookie


As a practising psychologist, former player, passionate fan, and survivor of multiple concussions (the first and most serious of which happened at age 17) I'm probably better placed to comment here than most. The issue really boils down to two questions: 1) how much do we love rugby, in its current form? 2) how much risk are we willing to accept? Rugby is a collision sport. Concussion is CAUSED by collision. While we can tinker around the edges with rule changes and tackle technique, we can not remove the collision. I was coached, and have coached, to hit and hit hard, usually with a shoulder to the gut whilst wrapping with the arms and driving through with the legs. If done properly, there is no direct head contact with this technique. BUT... this is STILL enough to cause serious concussion in some instances. This is because concussion is the result of the brain moving around in the skull, compressing against the skull, causing damage. Lesions are usually small, but with increasing numbers of collisions these lesions add up and the cognitive impact becomes more noticeable. Whenever there is a collision between two bodies the force has to be absorbed and the head will always take some of that force, it's really just a matter of how much. Yes, it is true that DIRECT head contact is often more severe than bodily contact (e.g., to shoulders and torso), but both forms of contact frequently result in concussion. I have become extremely frustrated with recent rule changes at the tackle and the ignorant approach of administrators; dropping tackle heights is a good thing, yes, but mainly just because it's good defensive technique and great to watch (think David 'Cement' Gillespie), NOT because it will remove or even reduce concussion in our game. There are also times when tackling low simply isn't possible, and is in fact MORE dangerous. Think about most pick-and-drives you've seen lately, with ball runners bent over at the waist essentially running with their head down low looking to go to ground. Tackling low would mean either throwing yourself underneath the player, or letting them run past and jumping on top from behind! Neither is a solution. Sometimes, in the helter-skelter of an unpredictable collision sport, you just have to put your body on the line, line up a ball carrier, take aim at the best 'legal' target they're offering you, and tackle hard. Head contact is unfortunate, but it happens. When unintentional, it should NOT result in a card. Now, I am not advocating recklessness, and foul or negligent play should be scrutinised, but the very 'black and white' rule interpretations around head contact are unfair, unhelpful, and unrealistic. We take risks to play an amazing game. We take those risks, knowingly. We either change the game and remove collisions, or we accept the risks. This is called informed consent. I, for one, do not want to see my game ruined any more than it already has been.

AUTHOR

2022-08-02T00:46:33+00:00

Geoff Parkes

Expert


Smart observation, Ben. Ball carrier lowering his head at the same time the defenders are directing their force upwards = potential trouble. I think the mindset needs to change from considering these as maul situations. They're not, they're upright tackles which have stayed up long enough for other peoples to join it and form a maul. Def needs to be a big rethink about upright tackles and how these can be disincentivised, and potentially removed.

AUTHOR

2022-08-02T00:40:30+00:00

Geoff Parkes

Expert


Hi AP The use of helmets/headgear come up quite often. The nature of concussion/brain injury is that the damage occurs when the brain reverberates inside the skull. So, in that regard, helmets provide no protection against a concussion event. They are useful for preventing lacerations and cuts but really, and some players, including children, feel more comfortable wearing them, but their value is really not much more than that.

2022-08-01T23:12:02+00:00

AndyS

Guest


By all means, feel free to quote the bit further on that goes on to say that actually, all the professional club training regimes are completely unchanged and no-one is really being affected by this anywhere, anytime. Or maybe even find some articles and study links...

2022-08-01T22:21:44+00:00

Anibal Pyro

Roar Rookie


Dear Geoff, congrats for an excellent article. Some questions to add. No tackle up to 10 yrs old? mandatory helmets like locks, for everyone from 11 to 18 years old??? Here in Argentina, all the kids and junior coaching staffs do not want the kids to use helmets, they said, ” it gives the kids a false feeling of security and ends with more head clashes”. I do not know what is happening in other countries about that. Been a father of 3 kids of 12, 14 and 16 years old, all playing rugby, training 3 to 4 days a week, i´ts really a big issue for me.

2022-08-01T22:12:19+00:00

Anibal Pyro

Roar Rookie


Agree, simple change, scrum for the attacking team. A lots of upright defences won´t simply happen. I guess this big issue it´s about small changes to the rules (several). one at a time, but starting now ASAP.

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