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An open letter to Sir Bill Beaumont,
Chairman of World Rugby

Dear Sir Bill,

RE: Brain Trauma in Rugby Union

We write in response to your open letter to the rugby community on 17 December 2020.

This letter is a collaborative effort led by a new alliance of progressive voices in the game under the title ‘Progressive Rugby’. 

This group includes representatives from all echelons of the game – players, coaches, match officials, club representatives, sports doctors and senior members of the teaching profession.

Both the content and sentiments of your open letter are acknowledged. However, we consider in view of the evidence of risk for traumatic brain injuries occurring in Rugby Union that more should be done to protect the rugby-playing community from the dangers of injury and that World Rugby has a moral and legal duty to minimise risk and to inform players and parents of the risk of brain damage from repeated knocks.

Evidence of the existence of brain disorders in retired players supports the contention that participation in Rugby Union can cause brain damage. The awareness of the association with traumatic brain injury and participation in Rugby Union is of paramount importance for both the players and the sport itself. 

We believe that this issue is the greatest threat to the worldwide game.

Set out below are changes we argue World Rugby should facilitate to our game as a matter of urgency. These are set out in the following categories:

  1. Reducing Injury Risk
  2. Prophylactic Player Welfare
  3. Concussion Management
  4. Post-retirement Welfare
  5. Access for All


This list is not exhaustive, but more a launching pad towards a safer, more sustainable game. Where appropriate, we have prepared preliminary costings for these proposed changes to show that we are sensitive to the practicalities involved.

  1. Reducing Injury Risk


Training:

  1. Limit on contact in training


Games:

  1. The ruck to be refereed as set down in the laws of the game
  2. Straight put in at the scrum
  3. Tackle area: review of ‘double teaming’ tackles; upper level of tackle height; timely release of ball following the tackle
  4. Limiting substitutes for injury only


Workload:
 

  1. Careful control of workload in training
  2. Limit to the number of annual international matches for players

  1. Prophylactic Player Welfare

  1. Career health passport for players
  2. Health MOTs pre-season and at end of career (to be included into ‘passports’)
  3. Central World Rugby Concussion database for incorporation into ‘passports’
  4. Increased education at all levels of head injuries and concussion management

  1. Concussion Management


Research:

  1. To always include an independent ‘broad church’ of experts to appraise current research, risks, and protocols


Training:

  1. Training ground protocols and access to experienced assessment should be equivalent to game time


Protocols:

  1. Extension of the minimum number of days before ‘Return To Play’ to at least three weeks
  2. Mandatory comprehensive screening as in other sports after recurrent concussions

Personnel:

  1. Review of minimal clinical experience (additional to educational courses) to be present pitch side

  1. Post-retirement Welfare

  1. Concussion Fund to be established by World Rugby
  2. Ownership of Player Passport (see above)
  3.   Establishing a more empathetic relationship with insurers

     

  1. Access for All

  1. Each national Union to be responsible for developing databases of medical specialists able to provide appropriate assessment and advice post-concussion (Public and Private Practice)
  2. Training packages to teach safe tackling techniques for young players

 

We firmly support the core physicality that comes with an 80-minute game of rugby union and understand that the game cannot be turned back to a ‘rose-tinted’ memory of the pre-professional game. Our backing extends to maintaining tackling in schoolboy rugby. However, the above proposed changes are essential to ensure the survival of the game in terms of long-term player welfare and playing numbers at all levels.

Whilst we acknowledge the importance of continuing well-constructed longitudinal prospective research, the rapidly accumulating anecdotal evidence has reached a point that the answer is to err on the side of caution. The alternative is to ‘kick the can down the road’ for future generations of administrators to deliberate upon. 

The NFL has metamorphosed from a sport in denial to a proactive organisation with initiatives like concussion funding and changing protocols to the game, such as the regulation of contact in training, concussion spotters and a concussion tent at each game. 

Despite the current negativity surrounding the game, there is an opportunity for rugby to turn the page and follow the example of our American cousins. The current and future generations of players require urgent action to be assured that they will be adequately protected and cared for.

As a next step, we request a chance to speak – as team-mates, not as opponents – with senior figures at World Rugby to discuss how we can work together to get control of this issue that threatens the very future of our game.

Kind regards,