Rugby’s card-happy approach to concussion is just not working | Michael Aylwin

Another year, another set of concussion statistics as high as the last. Higher. This year’s, revealed on Tuesday in English rugby’s perennially comprehensive Professional Rugby Injury Surveillance Project report, is actually the highest recorded since PRISP began in 2002.

Surely at some point the penny will drop that the red-card wild-west rugby embarked upon officially on 3 January 2017, five and a half years ago, but unofficially before even that, is not working – and it never will work. To send players off and ban them for the ugliest (though far from the only) examples of contact with the head is meant to act as a deterrent, but deterrents in the wider world work only when the infringements targeted are the result of deliberate decision-making by the perpetrators in their own good time.

No rugby players these days hit opponents in the head deliberately (because they are liable to be sent off for it apart from anything else), and the time for deliberation over their acts is measured in fractions of a second. Anyone who repeats the mantra that they just need to aim lower is invariably sitting in an armchair with Twitter open.

The idea is to root out upright tackling, but watch any match for five minutes and count the number of upright tacklers. They are everywhere and very often the safer option. So what we are really telling players is: “Don’t tackle upright. Apart from when you should. And if you get it wrong in that split-second you’re off.”

These players we yell at are the very best in the world. If they are still catching each other in the head five and a half years on, maybe, just maybe, it’s because reliably avoiding it is next to impossible. So never expect these red cards – or the debates around them – to end. And never expect them to work, if the aim is to save rugby from the dementia apocalypse towards which it is hurtling.

A concussion advert during the Scotland v Ireland Six Nations match in 2019
A concussion advert during the Scotland v Ireland Six Nations match in 2019. Photograph: Ramsey Cardy/Sportsfile/Getty Images

The reasons it will not are manifold. There is not the space to go into all of them here, but from the point of view of simply lowering concussion incidence the Guardian has already crunched World Rugby’s own numbers to calculate the maximum reduction in head injuries we could expect if, hypothetically, we never saw another upright tackler again, which would be impossible and undesirable. The answer, to cut a long story short, is 8%.

Which is better than nothing, but the real figure in an actual, physical world, assuming no unintended consequences, will be much lower than that and hardly worth the assault on the sport’s integrity this insane persecution of players represents. The evidence so far is that there is no reduction at all, let alone a tiny one.

Worse still, if preserving the future health of rugby players is the ultimate aim, which it is, this policy targets the wrong metric. Independent neurologists the world over – and not those in the discredited Concussion in Sport Group, behind whose findings so many governing bodies, including World Rugby, have hidden for so long – continue to supply us with evidence that concussion is not the driver of the risk of developing neurological conditions in later life.

The key factor is what neurologists call the “cumulative dose” of energy injected into the brain. In other words, how often over a long career the players’ brains are shaken, which is constantly in a sport such as rugby union. There does not even have to be direct contact with the head. As the instrumented mouthguards used by Harlequins and others reveal, more than half the cumulative force experienced at the skull by a Premiership player comes from collisions that do not involve the head at all.

World Rugby has this week announced its first attempt to step out of the wreckage of the CISG, which came up with the notion in 2011 that the minimum return-to-play programme after a concussion should be six days. The latest release pledges that most concussed players in elite rugby will not return for at least 12, which has always been the case. But, in the absence of a concussion history or lingering symptoms for a given player, the actual minimum RTP has been extended by a full day to seven.

All this is to chip away at the tip of an iceberg. We have to stop seeing concussions as separate from the hundreds of other times brains are shaken in a rugby match. All of them sit on the same scale, and they all count. Those deemed concussive are only the ones that trigger immediate and observable symptoms. At least they result in a break from the pummelling when the concussed player is pulled from the fray. It’s the players who do not present with symptoms we should worry about, because they carry on.

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For a way out of the CTE crisis, realistically, rugby is in the hands of science. The development of some sort of therapy that might mitigate brain injury during a player’s career is the most plausible solution. Who knows? Neuroscience is on the verge of all kinds of breakthroughs.

What will never mitigate brain injury, though, or even just the degree to which rugby is a laughing stock in the eyes of so many in the world, is to send innocent players from the field for incidents they have no hope of avoiding. That is not looking after them; it is betraying them. That is rugby blaming the players for the way rugby is.