Is rugby any closer to answering the complex brain injury question?

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Your help makes all of the distinction. Learn extra “So long as I don’t over-do it, issues are manageable,” begins Alix Popham, slowly, tentatively, as if heeding his personal recommendation whilst he solutions my mild opening enquiry. It's the Thursday earlier than the beginning of the Six Nations, and we're in an upstairs room of the clubhouse of London Welsh RFC at Outdated Deer Park, a brief stroll from Richmond Station. It's a place that echoes with tales of the game’s previous, of days of Dawes and Davies and JPR Williams – however as Popham and I sit down to speak, it's to confront tougher conversations over rugby’s future.

It's approaching six years now since Popham, capped 33 occasions by Wales throughout a distinguished taking part in profession, was identified with early onset dementia. Medical doctors estimate that he suffered greater than 100,000 sub-concussions throughout a 14-year taking part in profession. His day by day routine now features a stint in a hyperbaric chamber; he additionally has a sauna and chilly plunge at dwelling. Popham works two days per week – he want to work three for monetary causes, however previous expertise has confirmed {that a} dangerous thought.

<img src="https://static.independent.co.uk/2026/02/26/14/53/Alix-Popham.jpeg" srcset="https://static.independent.co.uk/2026/02/26/14/53/Alix-Popham.jpeg?quality=75&width=320&crop=3%3A2%2Csmart&trim=0%2C14%2C0%2C12&auto=webp 320w, https://static.independent.co.uk/2026/02/26/14/53/Alix-Popham.jpeg?quality=75&width=640&crop=3%3A2%2Csmart&trim=0%2C14%2C0%2C12&auto=webp 640w" loading="lazy" alt="Alix Popham (right) won 46 caps for Wales" class="sc-1mc30lb-0 ggpMaE inline-gallery-btn"/> open picture in gallery

Alix Popham (proper) received 46 caps for Wales (Getty Photos) “I have a look at my mind as an previous Nokia battery – I’ve solely acquired a lot bandwidth,” he explains. “I’ve needed to pull again and recognise that. Earlier than that, I didn’t know I had this concern, so I’d simply plough on, and that might be the place I’d have this explosion. I simply couldn’t management it. Now I'm understanding it a bit extra, it's positively higher. But it surely’s not good.”

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Kat Service provider remembers her first concussion, or mind damage, vividly; her final fairly much less so. At all times a prime expertise, the 2014 World Cup winner was already taking part in within the Premiership for Worcester as a 16-year-old when she suffered a primary main incident that made her as much as 3 times extra prone to get one other. “I acquired knocked out totally, threw up, went to A&E,” she recollects. “I began having an increasing number of via my profession, however it wasn’t one thing we knew about again then. It was identical to one other damage.”

<img src="https://static.independent.co.uk/2026/02/26/14/57/Kat-Merchant.jpeg" srcset="https://static.independent.co.uk/2026/02/26/14/57/Kat-Merchant.jpeg?quality=75&width=320&crop=3%3A2%2Csmart&trim=0%2C0%2C0%2C0&auto=webp 320w, https://static.independent.co.uk/2026/02/26/14/57/Kat-Merchant.jpeg?quality=75&width=640&crop=3%3A2%2Csmart&trim=0%2C0%2C0%2C0&auto=webp 640w" loading="lazy" alt="Wing Kat Merchant won the World Cup with England in 2014" class="sc-1mc30lb-0 ggpMaE inline-gallery-btn"/> open picture in gallery

Wing Kat Service provider received the World Cup with England in 2014 (Getty Photos) By the point of World Cup triumph 13 years later, Service provider knew she was completed, retiring after the event. “In 2013, I had a seizure throughout a recreation. Individuals have been me going, ‘will you play once more? Are you okay?’ My household have been there and I didn’t recognise them. I used to be fully all over. I didn’t see it, so didn’t know and didn’t get the magnitude of it.”

“After I was 16, I wished to play the following day. In 2013, that took me nearly 4 months to even be capable to train. It was an actual battle. I knew that I couldn’t reside like that, and in that means. I nonetheless wished to play in that World Cup, so I did, however after that, that was it. These 4 months have been darkish.”

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Not like Popham and Service provider, Damian Bailey by no means performed on the elite stage. “I used to be as soon as the world’s smallest scrum half dodging individuals,” he quips. His curiosity in concussion in rugby comes from a special place. A professor of physiology, the Welshman is the director of the Neurovascular Analysis Laboratory on the College of South Wales. “I’m fascinated with what occurs within the mind when it's bashed about,” is how he bluntly places it.

“There's quite a lot of hypothesis, controversy and misinformation in the meanwhile about what are the long-term implications of recurrent contact and impression,” Bailey explains. “I don’t like to make use of the phrase concussion. We’ve completed a variety of medical research the place we've seemed on the penalties of recurrent impression as a way to determine that we're detecting gentle traumatic mind damage, and it's manifesting itself in modifications that might align to accelerated cognitive decline.

<img src="https://static.independent.co.uk/2026/02/26/15/36/Maro-Itoje.jpeg" srcset="https://static.independent.co.uk/2026/02/26/15/36/Maro-Itoje.jpeg?quality=75&width=320&crop=3%3A2%2Csmart&trim=0%2C47%2C0%2C46&auto=webp 320w, https://static.independent.co.uk/2026/02/26/15/36/Maro-Itoje.jpeg?quality=75&width=640&crop=3%3A2%2Csmart&trim=0%2C47%2C0%2C46&auto=webp 640w" loading="lazy" alt="Lions captain Maro Itoje suffered a concussion during the British and Irish Lions tour" class="sc-1mc30lb-0 ggpMaE inline-gallery-btn"/> open picture in gallery

Lions captain Maro Itoje suffered a concussion through the British and Irish Lions tour (Getty Photos) “The sport has modified extremely. We’re seeing large impacts with forces as excessive as 200G, it’s simply phenomenal. We now have acquired gamers on the pitch which are nearly like bodybuilders, so the impression that the gamers are experiencing is simply huge. We’ve acquired lots of people who at the moment are within the discipline, which for me is admittedly essential. We’ve acquired physicists, mathematicians, chemists, biologists, neurologists, clinicians, all with a wholesome urge for food to take a look at this, all to reply a query that I believe is a no brainer: Is rugby related to mind damage?”

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It's that tough query that rugby can't disentangle itself from. Like all contact sports activities, there's a important damage danger every time a participant steps on to the pitch or coaching discipline, however the scenario surrounding mind accidents is more durable to evaluate. A big proportion of gamers at any stage may have skilled signs that align with concussion, or been identified throughout their profession – however the long-term impacts of sub-concussive blows are nonetheless, to some extent, unclear. Anecdotally, although, the tales are troubling. “Individuals have died too younger due to this,” Popham claims. “Individuals are struggling. Households are struggling.”

Head for Change, a charity based by Popham and spouse Melanie, attempt to pioneer optimistic change in prioritising mind well being in sport. The latest findings of the inquest associated to the loss of life of former Manchester United and Scotland footballer Gordon McQueen exhibits that that is removed from only a rugby concern, however Popham’s expertise inside the sport implies that he speaks from a spot of each understanding and care when he suggests what it's doing incorrect.

<img src="https://static.independent.co.uk/2026/01/26/16/7ff621e5ece125b30acc4e465f23407aY29udGVudHNlYXJjaGFwaSwxNzY5NTI3NTA1-2.82963594.jpg" srcset="https://static.independent.co.uk/2026/01/26/16/7ff621e5ece125b30acc4e465f23407aY29udGVudHNlYXJjaGFwaSwxNzY5NTI3NTA1-2.82963594.jpg?quality=75&width=320&auto=webp 320w, https://static.independent.co.uk/2026/01/26/16/7ff621e5ece125b30acc4e465f23407aY29udGVudHNlYXJjaGFwaSwxNzY5NTI3NTA1-2.82963594.jpg?quality=75&width=640&auto=webp 640w" loading="lazy" alt="An inquest found that heading a football is " likely="" to="" have="" contributed="" the="" brain="" disease="" suffered="" by="" gordon="" mcqueen="" class="sc-1mc30lb-0 ggpMaE inline-gallery-btn"/> open picture in gallery

An inquest discovered that heading a soccer is "doubtless" to have contributed to the mind illness suffered by Gordon McQueen (PA Wire) “It’s not placing the participant first. That’s all I care about. I nonetheless love the game. Individuals assume, ‘you are attempting to kill the sport’, however I’m not. The sport is killing itself. It’s not the sport on a Saturday, that's as protected as it may be. Nearly all of modifications that we wish to make are via the week, Monday to Friday, the size of the season, the variety of minutes of contact coaching.”

Popham has discovered renewed function since his prognosis. He finds his work with Head for Change extremely rewarding; he's coaching for one more Ironman triathlon in Portugal, not wishing to push his limits however as a substitute simply cross the end line with pals and lift consciousness. He's additionally one in all 787 claimants from rugby union in a lawsuit in opposition to World Rugby, the Rugby Soccer Union (RFU) and Welsh Rugby Union (WRU).

The case, introduced by legislation agency Rylands Garth, is being run in tandem with a lawsuit introduced by former rugby league gamers in opposition to the Rugby Soccer League (RFL). The following hearings are set for 18 and 19 March at London’s Excessive Courtroom, with trial decide Justice Lambert anticipated to attend. That may come practically five-and-a-half years since The Guardian first reported authorized motion was on the best way.

No one concerned thought that it could be an easy course of however Popham is annoyed that the delays have maybe held up progress for the gamers of right this moment.

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World Rugby says that participant welfare is its prime precedence (Getty Photos) “There's a playbook that the opposite facet have gotten to play. It’s deny, deny, delay, deny, kick the can down the highway so long as attainable,” Popham says. World Rugby denies that that is the case. In December, in the meantime, enchantment decide Lord Justice Dias, held that at an earlier listening to, Senior Grasp Jeremy Prepare dinner, had been proper to seek out that the claimants’ agency, Rylands Garth, had did not fulfil its obligations to reveal crucial medical materials to the defendants.

“I do know what has been put collectively from our authorized crew, and I do know that they get a nasty rap within the press, however there's a 150-page medical report on every participant,” Popham suggests. “They’ve completed it proper. It's irritating as a result of boys are struggling, households are struggling, and it’s the entire ripple impact. I can’t wait to go to trial and have the proof of what has been completed.”

World Rugby insists that participant welfare stays a prime precedence. Dr Brett Robinson, a former 16-cap Australia worldwide who has a doctorate of Philosophy in Medical Orthopaedics at Oxford, was elected as chair of the governing physique final yr. “I’m actually happy with all the things we've completed and proceed to do,” he tells The Impartial. “However that’s one thing we might be doing in any case. We're doubling down on extending all the nice issues we’ve completed. It’s an unimaginable story of understanding what the problems have been that we have been dealing with.

<img src="https://static.independent.co.uk/2026/02/27/6/25/Brett-Robinson-mcqobhzg.jpeg" srcset="https://static.independent.co.uk/2026/02/27/6/25/Brett-Robinson-mcqobhzg.jpeg?quality=75&width=320&auto=webp 320w, https://static.independent.co.uk/2026/02/27/6/25/Brett-Robinson-mcqobhzg.jpeg?quality=75&width=640&auto=webp 640w" loading="lazy" alt="Dr Brett Robinson is the chair of World Rugby" class="sc-1mc30lb-0 ggpMaE inline-gallery-btn"/> open picture in gallery

Dr Brett Robinson is the chair of World Rugby (AFP through Getty Photos) “The opposite fantastic initiative that World Rugby has invested in over the past couple of years is a mind well being service. I’ve truly gone via it myself as an ex-player. It helps determine at-risk gamers who would possibly want help, and we’ve launched I believe six or seven of these internationally, and are meaning to launch extra.”

These with information of the proceedings nonetheless consider a trial is a way off. World Rugby will proactively publish its generic defence on Friday.

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The authorized case is only one strand of a extra difficult panorama for rugby. Like most leisure sports activities around the globe, the pandemic hit participation numbers considerably however there are wider considerations about gamers of all ages strolling away from the sport. In October 2024, an independently chaired evaluate commissioned by the RFU urged the union make radical modifications in colleges rugby to keep away from changing into a “declining minority sport”. The RFU has since launched a non-contact type of the game known as T1 Rugby.

World Rugby, in the meantime, will quickly advocate that the permitted deal with peak be lowered to the sternum locally recreation following trials in 11 unions over the previous 18 months. That change will even be trialled on the U20 World Cup in Georgia later this yr to take a look at the way it might impression the elite recreation.

“I believe it's roughly 150,000 tackles that we’ve checked out, and from the worldwide work we've completed, we will see that decreasing the deal with peak has had an impression. We will likely be recommending on the subsequent council assembly that it turns into a world expectation,” Robinson mentioned.

<img src="https://static.independent.co.uk/2026/02/26/14/21/Under-20-rugby-George-Pearson-England-Ireland.jpeg" srcset="https://static.independent.co.uk/2026/02/26/14/21/Under-20-rugby-George-Pearson-England-Ireland.jpeg?quality=75&width=320&crop=3%3A2%2Csmart&trim=0%2C77%2C0%2C77&auto=webp 320w, https://static.independent.co.uk/2026/02/26/14/21/Under-20-rugby-George-Pearson-England-Ireland.jpeg?quality=75&width=640&crop=3%3A2%2Csmart&trim=0%2C77%2C0%2C77&auto=webp 640w" loading="lazy" alt="A lower tackle height will be trialled at the U20 World Cup" class="sc-1mc30lb-0 ggpMaE inline-gallery-btn"/> open picture in gallery

A decrease deal with peak will likely be trialled on the U20 World Cup (Getty Photos) “We'd be foolish not to take a look at that by way of the elite recreation, so the 20s goes to be that atmosphere. However I believe it could be an enormous step to take. There are different issues we do on the elite recreation that we don’t do locally recreation. You don’t have a great deal of cameras, you don’t have instrumented mouthguards, you don’t have clinicians on the sideline. So you need to place the context of the wrapping across the concern and the way completely different it's to the group recreation. That’s most likely the nuance in that dialog, however we're positively looking at it as a result of quite a lot of the unions wished us to take action.”

Bailey, for his half, would take contact out of the sport altogether, although recognises that's not a majority view. “Finally, for me, sport is about holding us wholesome and holding us protected,” he says. “Train is unequivocally the most effective drugs. Rugby has taught me a lot, and I’ve taken a lot from the sport. However the impression is the elephant on the room.

“It's one thing that we can't flip a blind eye too. From an moral standpoint, we've to seek out the chance and have that clear dialog with faculty kids, with gamers. We now have to control contact much better; I’d like to drag it out of the sport fully myself, which is sort of tough, in fact. You’ve acquired audiences which are baying for the gladiatorial large hits. However it's about encouraging exercise and social inclusion, and taking care of our gamers in order that they've a beautiful three or 4 many years of life forward of them.”

On the elite stage, there can nonetheless be a tradition of silence round concussion, each inside environments and past. For that purpose, it was optimistic that Garry Ringrose self-reported signs having been named within the beginning British and Irish Lions crew for the second Check in opposition to Australia in Melbourne final July. Instrumented mouthguards have offered one other instrument to assist document impacts, and it's understood that the producers are hoping to do extra with the know-how in time.

<img src="https://static.independent.co.uk/2025/07/29/10/47085ead55f9f837fc3a74407247bef6Y29udGVudHNlYXJjaGFwaSwxNzUzODY4Mjc4-2.81086648.jpg" srcset="https://static.independent.co.uk/2025/07/29/10/47085ead55f9f837fc3a74407247bef6Y29udGVudHNlYXJjaGFwaSwxNzUzODY4Mjc4-2.81086648.jpg?quality=75&width=320&auto=webp 320w, https://static.independent.co.uk/2025/07/29/10/47085ead55f9f837fc3a74407247bef6Y29udGVudHNlYXJjaGFwaSwxNzUzODY4Mjc4-2.81086648.jpg?quality=75&width=640&auto=webp 640w" loading="lazy" alt="Garry Ringrose stood himself down from featuring in a British and Irish Lions Test" class="sc-1mc30lb-0 ggpMaE inline-gallery-btn"/> open picture in gallery

Garry Ringrose stood himself down from that includes in a British and Irish Lions Check (PA Wire) “I believe the dialog has modified lots,” Service provider, who has had a mind scan and never proven any indicators of a neurodegenerative situation, says. “I believe if I performed these days. I’d have retired at 24, fairly than 28. They’d have known as it lots earlier. I at all times take into consideration that – I wouldn’t have gotten to win a World Cup…

“I just like the mouthguards; I like all the things they're making an attempt to herald. It’s not good, however they're making an attempt to deliver issues in. Some gamers are nonetheless scared to speak about concussion. It's nonetheless saved hush-hush, and it wants to not be.”

Extra analysis, too, is required. Service provider notes that research have discovered that mind accidents are each sustained and suffered otherwise by ladies to males. “When the boys’s recreation went newbie to skilled, there have been guys who went from coaching twice-a-week to abruptly coaching much more,” she factors out. “The ladies are going via that now; they should be protected.”

<img src="https://static.independent.co.uk/2025/11/23/14/37/GettyImages-2237727968.jpeg" srcset="https://static.independent.co.uk/2025/11/23/14/37/GettyImages-2237727968.jpeg?quality=75&width=320&auto=webp 320w, https://static.independent.co.uk/2025/11/23/14/37/GettyImages-2237727968.jpeg?quality=75&width=640&auto=webp 640w" loading="lazy" alt="The women’s game is professionalising rapidly" class="sc-1mc30lb-0 ggpMaE inline-gallery-btn"/> open picture in gallery

The ladies’s recreation is professionalising quickly (Getty Photos) It's, in fact, a fast-moving, fast-changing and fast-developing discipline. After Lewis Moody’s prognosis with motor neurone illness final yr, the Motor Neurone Illness Affiliation mentioned that the most recent analysis suggests a correlation between traumatic mind accidents and MND, however that the identical analysis has not confirmed that traumatic mind accidents are a explanation for MND. Research are maybe additional alongside into different neurodegenerative circumstances, however a few of these can solely be clinically identified after loss of life.

“The research we're doing in the meanwhile, and Head for Change are serving to to recruit lots of the members, is the bit in between. The massive information hole,” Bailey explains. “These are gamers which are center aged, 30-59 years of age, which have been given a prognosis of possible continual traumatic encephalopathy (CTE). This is called traumatic encephalopathy syndrome.

“We will’t clinically diagnose CTE till after loss of life, so what we're fascinated with right here is that these are gamers which are symptomatic. We're a wide range of blood-borne, saliva-borne, neuroimagery-borne biomarkers that we hope will likely be extra delicate and particular so we will perceive the pathophysiology behind the medical signs. After which, finally, we would like to have the ability to have an effect on counter-measures to attempt to gradual this down with out altering the sport.”

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The general backdrop is advanced and regarding for a sport so usually riddled with contradictions. A part of what attracts spectators and viewers to rugby is that “gladiatorial” nature referenced by Bailey, however it can't survive if participant numbers start to dwindle. Financially, too, the ramifications of a serious settlement might be important, if that's the place the courtroom case finally ends up. Already, the spend on authorized charges and related prices is critical, which is having an impression on World Rugby.

However Popham, and others like him, recognized that there are many previous and current gamers who will likely be in want of assist. After taking his personal life in 2023, the previous Maori All Black Billy Guyton was identified with stage 2 CTE. Shane Christie, his pal and former teammate, arrange a basis in his mate’s reminiscence to assist gamers with concussions; Christie died a day earlier than his fortieth birthday final August in a suspected suicide having advised pals he believed he had CTE, too.

“To me, I look within the mirror and I'm doing this for the best purpose,” Popham concludes. “This nice recreation can nonetheless keep it up – we simply must take care of our gamers higher.”

<img src="https://static.independent.co.uk/2026/02/26/14/42/Billy-Guyton.jpeg" srcset="https://static.independent.co.uk/2026/02/26/14/42/Billy-Guyton.jpeg?quality=75&width=320&crop=3%3A2%2Csmart&trim=0%2C0%2C0%2C0&auto=webp 320w, https://static.independent.co.uk/2026/02/26/14/42/Billy-Guyton.jpeg?quality=75&width=640&crop=3%3A2%2Csmart&trim=0%2C0%2C0%2C0&auto=webp 640w" loading="lazy" alt="Billy Guyton took his own life in 2023" class="sc-1mc30lb-0 ggpMaE inline-gallery-btn"/> open picture in gallery