It’s heartbreaking to watch my World Cup hero suffer so much

CONCUSSION and its associated neurological issues is the most important debate in the modern game and I would urge you to read Steve Thompson’s new book. His story is an important one.

I was asked to contribute a chapter on Thompson the rugby player and bloke and I will be interviewing him on stage at the Hay Festival, where I hope we can dig down into what the game can do to reduce head and brain injuries.

There is also a forthcoming ITV documentary, to which I am contributing, on his story and other former players suffering with premature dementia. The entire rugby community must start taking this seriously.

Tommo was a superb player. He was a backrower by nature. He was the best hooker at the 2003 World Cup and for a few years after that. Extremely physical, confrontational but also blessed with skill and composure. At the lineout he was totally dependable. Indeed, while Jonny Wilkinson’s dropped goal settled the final, it was Steve’s gutsy and brilliant lineout throw, over some 20 yards under extreme pressure, that made it possible.

It really saddens me that Steve (right) wishes he had never been part of the tournament, so painful is the knowledge that he cannot remember any of it. I find it heartbreaking that he is suffering all the problems associated with early-onset dementia. It’s hardly surprising that he describes rugby as ‘lethal’.

Here we come to the first hurdle rugby must negotiate. People play the game because they enjoy the physical contact, the combat it offers that can never really be taken out of the game’s DNA. You can be tackled perfectly legally around the legs and still knock yourself out or get concussed as your head hits the ground. Stray elbows and opposition knees can accidentally hit your head at any time or you can drive in with a textbook tackle, hip height and hit the bony part of your opponent and come off much worse. We have nearly stamped out reckless challenges for high balls and there has been a clampdown on tackles directly to the head, the most obvious cause of concussion injuries. It hasn’t been easy because many of those challenges can still seem accidental or more like a rugby incident than foul play, but gradually that awareness of needing to keep the tackle height down will become part of the game’s DNA.

Top-flight rugby will look increasingly different and the next generation will tackle differently. Shaun Edwards summed it up a while back: from now on the tackler must always start as low as possible and drive up. That must be drilled into all players at all levels. But there must be moderation in training.

Even 20 years ago we limited our defensive coach Phil Larder to one full contact session for seven minutes every Wednesday and we would have the clock dictate when the session was over. My thinking then was about avoiding injuries generally and I can’t recall any major injury during an England session in my seven years, but clearly a by-product of that was a reduction in unnecessary head contact during the week.

There is still much work to be done at the breakdown. Some of these flying clear-outs are extraordinarily dangerous to heads and limbs and referees are not doing enough to eradicate them. They are illegal but are not being penalised. We are a long way from being on top of this.

Scrummaging is tricky. It would be dangerous and frankly negligent going into an international match without your pack putting in some serious scrummaging practice. But equally we must guard against overdoing it. The buzz phrase now is not to overdo the axial loading, the weight going through the top vertebra of a prop or hooker’s neck and, with new smart mouthguards, we are getting to a point where we can measure the pressure applied. Meanwhile the concussion protocols seem to be open to interpretation. When I was coaching it was an automatic three-week stand-down if you were suffering from concussion. Now you can be back a week later if you pass certain tests. It is less than ideal.

Science will enhance our knowledge and allow us to advise players on concussion and its associated neurological issues.

Let’s keep on top of this.