ifeel at home here. according to world rugby, the sport's governing body, there are more than eight million players worldwide and more than half of them are younger than 13. in 2023, the men's rugby world cup was broadcast to more than 800 million across the globe, a lucrative business fuelled by tv money, sponsorship and ticket sales. it's not quite the same for the amateur game, which devizes coach steve played from 1989 onwards. tell me about your career, steve, and where you played. bristol was probably the highest level i played at really, and some england trials as well. i've just been unfortunate to have a few injuries that have worried me, you know, through the years or so. what did you first notice? family names, i would forget. you know, i'd be like... oh, you know. and i'd be... and the more i think about it, the more frustrated i get. fall about three, four

times a week sometimes, you know, because you just lost your balance. couldn't explain it. go to the doctors about it, explain to them, you know, can't find anything wrong with you. does that scare you? it did. it does. you know, i don't know what to do. steve had a car accident years ago and hit his head, but thinks his symptoms are down to repeated hits playing rugby. you know, the scrummaging was a hit. the contacts in the rucks and mauls were the same. very hard. but you don't realise probably until the latter parts of where we are now that they were significant, you know, to possible brain trauma. you're suffering now, the fact that you think it is linked to your rugby playing years ago, how is it you're still involved in the sport? how is it you're still coaching? i want them to know that what's happening to me, you know, we can try and prevent that or reduce the possibility of that by making sure that they're going to be safe on the rugby pitch, whether they're training or whether they're playing. now steve's hoping to get answers for himself. what happens next? i've got a functional mri scan,

which is a little bit more... a deeper sort of investigation into brain injuries. do you think you'll be a bit nervous? iam nervous, yeah. yeah. seriously. yeah, iam nervous. the early onset dementia's the type of thing that i'm, you know, that i'm majorly worried about. if i could rubbish all that and say that it's not me, you know, i can put my family at ease. are you ok for us to catch up? stay in touch? by all means. yeah, absolutely. i think it's important. steve's not the only former rugby player concerned about his health. not a bad place, is it? it is beautiful. not a bad place to call home. jason hobson and neil clark are former professional rugby

team—mates and old friends. i don't know what the odds are of two people being as close and playing next to each other positions, and then you to do your knee, i'll do my knee, you do your shoulder, i'll do my shoulder. you do your neck, i'll do my neck or the other way around. it's always, like, one—upmanship. and who can get hurt the worst? you know, godfathers to each other�*s kids. married, married, you know, and then... divorced, divorced. yeah, well, this was it. it worked out when i was down, you were there and when you were down, i was there. they started their rugby careers together in 1999 and played for exeter and bristol, amongst other clubs. and jason went on to play for his country. but both also received some nasty hits. did you suffer concussions during your playing career? yeah, i got knocked out and i'm looking up, and i don't know where i am for 20 minutes. you just tend to just get up and get on with it.

i can remember blacking out a few times. i couldn't put a figure on the amount of collisions i've had where i'd have sustained damage, but it'd be in the hundreds of thousands easily. the amount we trained, played over 14 years. many professional athletes struggle emotionally when they retire, but after injuries forced them to stop playing in 2014, jason and neil noticed unexpected behavioural changes which they put down to repeated head impacts. i went off the rails, caused a divorce. i wasn't in a good way. personality massively changed. alcohol, substance abuse. everything to take you away from what's happening in your head. forgetfulness, anger and... ..suicidal thoughts. how bad did it get? when i was ready not to be here. i thought, genuinely thought that my children

would be better off, and my wife, without me in their life. i get emotional thinking about it now, but ijust wanted everything to st0p. _ the pain, the pressure. not knowing what's happening to you. the changes. yeah, it was really tough. jason and neil have been diagnosed with probable cte, chronic traumatic encephalopathy — a condition linked to repeated blows to the head, which leads to dementia and can't be formally diagnosed until after death. symptoms include mood swings, depression and suicidal thoughts. but you weren't aware of the risks. no one was telling you? no idea. no. no—one was telling you? no idea. no. and i had this... i've had this thrown at me so many times. "well, you know what you were signing up for." i broke my neck. i'm suffering with nerve damage for the rest of my life. i take that. but i didn't sign up

to get diagnosed with early onset dementia at 38 years old. no. you had brain scans done. what did they show exactly? i think it was between seven and nine spots on the brain, in the frontal cortex, that had been damaged. but basically, in layman's terms, that it affects your ability to reason, your anger. at 41, yeah, i'm living with dementia every day. there's only one way it's going to go. it's not going to get better. jason, neil and steve don't blame the individual clubs they played for, but are part of a group taking action against rugby authorities. our position is that the governing bodies have been negligent in their duty of care towards our rugby—playing community, to protect them from all the varying neurological impairments that they are now suffering from.

richard boardman�*s firm is suing world rugby, the welsh rugby union and the rfu, the rugby football union, on behalf of hundreds of players with a range of symptoms. we believe approximately 40% have probable cte. but importantly, but importantly, this isn'tjust about dementia this isn'tjust about dementia and chronic and chronic traumatic encephalopathy, traumatic encephalopathy, this is about motor neurone this is about motor neurone disease, disease, this is about this is about parkinson's disease. parkinson's disease. we believe it's a catastrophe we believe it's a catastrophe and the true scale and the true scale of the damage will play out of the damage will play out like a car crash, like a car crash, in slow motion, in slow motion, as players continue as players continue to deteriorate. to deteriorate. in a statement, in a statement, world rugby haven't yet gone to trial. world rugby and the welsh rugby union and the welsh rugby union told us... told us... they said they will "never they said they will "never stand still when it comes stand still when it comes "to player welfare "to player welfare at all levels of the game." at all levels of the game." all three of the rugby all three of the rugby governing bodies contest governing bodies contest

the legal claims, which the legal claims, which haven't yet gone to trial. one of the key parts of the case is how the rules around concussion changed. when the sport turned professional in 1995, and the elite men were training every day of the week, they were getting bigger, stronger, heavier, faster. and the result of that is it became a pure collision sport. and at the same time, some of our allegations pertain to some of the concussion protocols we say were diluted. so what were rugby union's rules on dealing with concussion, and how did they change? in 1998, the rfu handbook of safe rugby said: "potentially serious complications can develop "many hours after an apparently minor head injury."

"a player who suffered a definite concussion "shall not participate in any match "or training session "for a period of at least three weeks, "and may then only do so after being declared fit "by a proper neurological examination." but then, in the early 2000s, these proposals come along, which were to significantly change rugby union's approach to concussion.

how do theyjustify getting players back suddenly within just six days? so, part of this document is essentially introducing the idea of a baseline test, which the players would undergo during preseason, essentially an assessment of their cognitive ability before they've been exposed to brain trauma. and that was a reference point for the medical staff to go back to, when a player had been suspected of having a concussion. these baseline tests were trialled from 2002 by the rfu in the english premiership. but there was a problem. lots of players were coming out and telling me it was incredibly easy to cheat. players like neil said they wanted to play on, as their livelihoods depended on it. when you're doing your baseline, you deliberately get it wrong so, you know, when you are bad, then you've got more of a chance of passing it.

another proposed change in the new handbook was instead of an independent neuro—specialist giving permission for players to return, it was left to the clubs�* medics. if you had a doctor employed by the governing body or employed by the team who also had this duty of care to the player, they were being put in extremely difficult positions. the rfu operates within the guidelines of world rugby, who set the rules and protective standards for the game globally. in 2011, world rugby implemented the minimum six—day return to play and allowed team doctors to sign this off. they said it would enhance the protection of players at all levels of the game, by requiring them to complete six stages of recovery before they could return. they later reported that the average amount of time concussed players sat out after the changes was around 16 days.

but there was one man who was fighting these changes from the inside. probably my first year in practice. as dr barry! as dr barry, yes. dr barry 0'driscoll was a gp and an adviser on the international rugby board, now known as world rugby. also a former ireland international, barry has recently been diagnosed with dementia. do you fear or worry that that was caused by your rugby playing? i do. i do very much. barry has given us exclusive access to his emails with the rugby authorities. he was critical of the changes to the safety rules. going back through some of your earlier emails, actually, it's really clear that you were challenging the system and you were sort of fighting these changes in the decade before you resigned. the game had gone professional. i'd been a thorn in their side because i didn't follow their line.

barry repeatedly lobbied dr simon kemp, the medical director of the rfu, who was one of the driving forces behind the changes. i've got an email here of yours from 2005. this is you writing to simon kemp. you say, "i note that a properly qualified "and recognised neurological specialist has been replaced "by, quote, �*independent and competent physician'," and you wrote, "i don't think we can do this." idid. and i told him that in committee and in writing, and i wasn't getting anywhere. there was always a feeling in me that we were, we were doing wrong. in 2012, a new rule was trialled on players at the junior world cup. as before, clearly concussed players were supposed to be removed from the game, but those with suspected cases of concussion were given a standardised five—minute assessment to see if they, too, would have to be taken off. world rugby said this would add an extra layer of protection but, for barry, it was the final straw.

then they brought in this head injury assessment where you would get a player with a head injury, having a 5—minute assessment and i thought, "i cannot have my name associated with this." and that was when i resigned. the effects may take ten, 15, half an hour. it doesn't bear thinking about, really, that symptoms and signs were coming on later, and you were basing everything on a 5—minute assessment. commentator: | think - george north has taken a boot to the head there. in 2015, the assessment was increased to ten minutes. during the six nations that year, welsh player george north sustained a head injury. he had an assessment and was controversially returned to play. he later received a second blow to the head and stayed on. there he is, george. in 2019, the head injury assessment became 12 minutes. recently, premiership rugby

started using independent doctors instead of team doctors, and world rugby extended the minimum recovery period after a concussion from six days to 12. that handbook, which seemed to have an influence on all those initial changes, was written in the early 2000s by dr paul mccrory, with modifications for england rugby by dr simon kemp. but who are they? well, simon kemp's a sports doctor who was the england team doctor at 2003 world cup and 2007 world cup. now the head of medical services at the rfu, and i would say is one of the most, if not the most influential voice on concussion in sport and return—to—play protocols. and paul mccrory? paul mccrory was, and is, an australian sports doctor. he was one of the driving forces behind the concussion in sport group. the rfu and other major governing bodies in rugby

and other sports essentially relied on the concussion in sport group, and it was constantly telling people that there were no proven causal links between repetitive head injuries and long—term neurodegenerative problems. the concussion in sport group says it provides guidance on the latest research. it's made up of voluntary members. most of them also work with the governing bodies of contact sports worldwide. its chairman, paul mccrory, was forced to resign in 2022 after being discredited for copying other people's work. what's been evident now is that a lot of his work wasn't fit for purpose, and i wasn't surprised when mccrory was exposed as a plagiarist a couple of years ago. the challenge now, for sport, is to really understand his denial of previously accepted medical science, and how that's still influencing sport to this day.

are the rfu, are world rugby tarnished by their association with mccrory? yes, i believe they are. and the concussion in sport group, upon which they relied on for so long, while, at the same time, ignoring credible evidence that was around and available from other research groups. we tried to contact dr mccrory but got no response. world rugby told us their protocols don't rely on the work of any one group or individual, dr mccrory included. they said the work of the concussion in sport group is considered alongside all the other studies. they added: "the concussion protocols in place today "are informed by the latest science "and world—leading independent expert opinion." but there are still concerns. we've spoken to a wide selection of academics and experts across the world. many are leaders in theirfield. some claim their work was not taken seriously

by the rugby authorities. i've come to america to meet one of those who felt her work was dismissed by many sports bodies, including rugby. these are freezers, are they? yeah. each one has about 150 brains in it. we have a total of over 1,500 in the brain bank. professor ann mckee is a world—renowned neuropathologist and runs the world's largest brain bank. and of course, mostly football, but increasingly rugby, ice hockey, other sports. and families send these to you and then you keep them here, you analyse them and then... we analyse them and we keep them in perpetuity. the brain bank was set up around the time former american football players were taking legal action against the sport for brain damage. in 2013, the governing body,

the nfl, agreed to settle out of court and has since paid out $1.3 billion. tell me about your work, what you were finding and what impact that had on the nfl settlement. we were getting hundreds of brains, hundreds of nfl players, and what we were seeing, in nearly every case, was some degree of cte. it was absolutely shocking and absolutely unacceptable. and this is head trauma caused by concussions or subconcussive blows repeated... it's just the hits to the head. it doesn't have to cause a concussion. it's the hits that are non—concussive, non—symptomatic that, over time, create this disease. in 2012, you went to the concussion in sport group conference, didn't you? yes, idid. at that point, we only had one paper out. but i was invited to go to this conference with, you know, very serious representatives from all sorts of leagues. paul mccrory from australia, world rugby was there.

i presented what i thought was overwhelming evidence of this neurodegenerative disease. they were very quiet. i certainly got the impression that the reason i had been invited was so that they could give the appearance of having listened, and then decided it was rubbish. i've looked at thousands of brains, but they consider themselves the expert. that same year, the concussion in sport group said the way the research had been carried out on the brains of deceased players meant it couldn't be used to prove that contact sports had caused cte. we asked them about this, they said... adding they... world rugby said, in recent years, their independent concussion working group has met with representatives from boston university and,

as a result, they now acknowledge recent research suggesting the potential for long—term brain health consequences. they said they're. .. ..with projects such as smart mouthguard technology to monitor head impacts. so, what about the grassroots game? someone with an intimate knowledge of the devastation head injuries can have is karen robinson, mother to 14—year—old benjamin. he's vibrant, he's animated. he's lovely. he's also very mischievous. he's my only boy. in 2011, karen's son was playing school rugby... i'm watching him play and watching just, you know, contact after contact. there was a lot

of stoppages for him. karen saw benjamin take repeated hits. and there was another stoppage. and ijust started running. i got to my son and he's lying on his back. i told him i was there. i told him that i loved him. when i get to hospital, it's benjamin's stepdad that asks... ..you know, out of cases that you have dealt with before like this, what is the survival rate? "none." none.

benjamin never recovered. his death was caused by second impact syndrome, where someone suffers another head injury before recovering from a first. his family have led a campaign, "if in doubt, sit them out," but say more education is needed. should the rugby authorities, and the professional game at the highest level, be taking more of a lead on this, do you think? it has to come from the top. benjamin is not the first. he's certainly not the last. if it comes from me, i'm just some mum who lost her son... ..in a rugby match. deaths on the rugby pitch are extremely unusual, and the safety rules for youth rugby have been tightened up in recent years. in england, under—eights play a non—contact version. for ireland, it's

under—sevens and, since 2023, tackles at all ages must be waist—height or lower. but injuries do still happen. an rfu—funded study found an under—18 team should expect an injury every 1.7 matches. concussions the most common. some of the academics we've spoken to argue contact rugby should never be compulsory in schools due to the safety risks. today, steve sugar, the coach i met in devizes, gets his scan results. his daughter'sjoined us for support. the white matter in the brain is kind of the superhighway. the grey matter is where the thinking happens and the white matter are the connections between them. dr andre gouws

is a neuroscientist. first of all, this is the white matter of the brain and we would expect, in this scan, that that would look pretty uniformly grey and dark grey. and i'm not a clinician, but there are quite a few white dots in there. we've compared your brain to 132 other people — same age, same sex as you. and what we see is that the chemistry in those white matter tracts is abnormal in many of them. we can't say specifically whether it's damage, and we can't say whether it's related to rugby, but the tracts that we've seen it in are consistent with those we see in other rugby players. it sort of helps me accept that, obviously all the changes that i've noticed, worrying and anxious, you know, about why things have changed. so, yeah, it explains a lot. thank you _ but i'm also thinking about the other rugby players as well because, you know, these are... you know, these are people that, you know, i've either played against or played with,

you know, and i want them to be open and transparent about it because we need to make things better. steve must now have further tests to get a diagnosis. players like him are left asking what the future holds for them and the sport they love. but my worry is the grassroots rugby. that's my biggest worry and that's why i coach. you know, if we're going to protect rugby, which i'm passionate about — this is not me against rugby, it's about making things better. good. great work.

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