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Shane Williams, Wales' most successful try-scorer, made a BBC documentary about concussion in 2020
A new study suggests that one season of professional rugby could lead to a decline in blood flow to the brain, and cognitive function.
Research by the University of South Wales followed a professional rugby team for a season. They tested players pre-season through mid-season and afterward.
It will appear in the September issue of Journal of Experimental Physiology.
Researchers followed a team that was playing in the United Rugby Championship.
They believe that more research is required to determine the long-term effects.
The BBC exclusively viewed the study. It found that a rugby team saw a decrease in blood flow and cognitive function over a single season. This is the ability to reason, recall, form ideas, and perform mental gymnastics.
It is also suggested that the declines in players' performance could not be due to concussions alone. Instead, repeated contacts or sub-concussions sustained through rugby may have been responsible.
Shane Williams, a former player for the Lions and Wales, suffered head injuries while playing. He says that fatigue increases the chance of injury.
He supports the call for a limit to replacements because newer players could do more damage.
The new study is a joint effort by Rylands Law firm and 200 ex-players, Welsh and English, male, female, professional, and amateur, to take legal action against the game's governing bodies, World Rugby, Rugby Football Union, and Welsh Rugby Union.
Some former players were diagnosed with early-onset dementia. They claim that the authorities failed protect them against the risks of head impacts and concussions.
World Rugby welcomes new research.
"Has my memory been affected by the hits that I've taken?"
Shane Williams, former international from Wales
Williams, a former Wales winger, took some major hits and head impacts which affected his career. His most notable was in 2004's legal but brutal tackle by South Africa’s Bakkies Botha.
He told BBC that he only realized he wasn't well when he returned to the hotel hours later.
"That was one the greatest hits I've ever taken actually, I believe.
It was blurry getting changed afterward - I saw the players, my family members afterwards, it was hard to remember. The next thing you know, I'm back in the hotel, sitting in the reception and thinking, 'Gosh, what happened?'
Williams is now questioning whether the game has had any effect on his brain.
"I am always asking myself: Is my memory worsened by my age?" My age is why I am always writing down things. Or maybe it's because I've had hits over the years. He said.
The 2015 law did not allow for Head Injury Assessments (or HIA protocols), to be commonplace on the field. They are used to determine if a player has suffered a concussion.
Williams believes that if Williams had been in the same situation in 2004, knowing what he now know, he would have taken his own life off the field.
He said, "I believe a large part of it is education. If I'd been hit like this today, I would have known right away that something was wrong."
People still ask me if I would have changed how I played. Because I loved the game I played, I wouldn't have changed it.
What is the conclusion of this new study?
Professor Damian Bailey is one the report's author.
Research suggests that professional rugby players could be exposed to up to 11,000 contact events per year. More research is showing that it's not just concussions that can impact the brain but also the cumulative effect and the volume of contact events.
The peer-reviewed University of South Wales study was funded by the Royal Society Wolfson Research Fellowship. It recorded six concussion incidents in all players who took part during the year.
All participants in the study noticed a decrease in blood flow to brain and cognitive function in between the pre- and post-season results.
The involved team plays in the United Rugby Championship, formerly known as the Pro14. It has not been identified to protect confidentiality according to research governance guidelines.
Professor Damian Bailey was one of the researchers of the study. He stated: "Even in a short time, we're seeing a greater rate at which the brain function of rugby players is declining."
"And we assume our baseline is normal and healthy, but many of these players are already playing for many years so the baseline is likely still impaired."
Additional findings include a correlation among an increase in contact quantity, playing position, and rate of decline for the main measures tested.
Prof Bailey explained that because the forwards are in more contact than one would expect, they're experiencing more impairment relative to backs.
This paper is about one team of professional players. Can any comparisons between the professional and grassroots levels be made?
Prof Bailey states that professional players have less chance to recover and repair, have larger bodies and can sustain more damage from contact. However, amateur players may have poorer technique and could be at greater risk.
He said, "It's hard to say, but it's not difficult to imagine why it would be so different."
"The larger question, and the reason for this research is to look into the future to see what the long-term effects of this reoccurring contacts?"
"There are every reason to believe that cumulative damage could occur over time."
A similar study is being conducted by the university team. It compares retired rugby players with a control group. This will determine if there is a greater decline in brain function among these players. The university team believes that more research is required to determine the long-term effects of this decline.
The RFU states that 20% of concussions on a professional level are caused by training.
American football's NFL has taken measures to reduce contact between practice sessions and training. This was requested by many former rugby players.
Williams, however, says it's difficult to limit contact in training because practicing good technique reduces the risk of injury.
Williams believes that replacements should only be used in the event of injury to players. Williams was part of this group.
He stated that he believes the game has changed in the area of 'finishers' (replacements).
"You have 21-stone players who come on the field when players get tired, and you get hurt more when you're tired.
"But, another important thing for me is to educate the players so they know when they have these injuries."
World Rugby, the sport's governing body says that research continues to examine the issue of injury and replacements.
To check for concussion, players are subject to Head Injury Assessments
What does World Rugby have to say?
World Rugby, the sport's governing body, responded to the University of South Wales research. It stated: "World Rugby welcomes any research that can inform or support our recently launched strategy external link to cement rugby as the most advanced sport on player welfare.
It is the core of all that we do as a sport.
"World Rugby has recently pledged to double its investment in player welfare, new concussion research, and other initiatives.
"We are currently conducting a broad-ranging evaluation on contact training volume across all the game. We look forward to the Otago Rugby Community head impact detection study using instrumented jawguards which is the largest study of training and playing head impacts in both men's and woman's community rugby."
The body stated that the Otago study was due to be completed soon.
