A sad case...yet one which tells us rugby is tackling this grim problem
JUST days before the Rugby World Cup kicks off, a 29-year-old man is forced to retire from the sport he loves. Not because of some ‘tragic’ hamstring pull or ‘devastating’ ACL tear. But to protect his brain from the repeated damage caused by playing at the highest level.
Anyone who tells you that rugby doesn’t have a problem with concussion and associated brain injuries is hiding from the truth.
The good news is that player welfare has improved beyond all recognition, even in the last decade. David Denton’s retirement is, ironically, proof of that.
The unpalatable truth lurking beneath all talk of progress, however, is the understanding that any sport where the head is repeatedly at risk of heavy contact can never be entirely safe.
Scotland forward Denton’s decision to walk away is undoubtedly the right call, the smart call. A move guaranteed to draw only unanimous approval — if a little regret — from anyone who cares about their fellow human beings.
His description of waking up every morning — that’s every single morning — ‘not really knowing what was going on’ as his vision blurred and pressure built inside his skull should serve as a harrowing warning to all who cross that line.
For those who spend their lives dealing with the consequences of brain trauma caused by repeated concussions, the latest case of a high-profile professional standing down causes understandably mixed emotions.
Luke Griggs, deputy chief executive of the brain-injury charity Headway, told Sportsmail: ‘The first thing I will say is it’s a sad day for David Denton, just as we’ve seen sad days for other rugby players who have had to retire.
‘Nobody wants to walk away from a game and a career they love at the age of 29. But the consequences and implications of ignoring medical advice are clearly worth listening to.
‘He is making the right decision, putting his health before any short-term gain. And the benefits of retiring are clear.’
For a very long time now, pathologists and neurologists have been finding evidence of CTE — chronic traumatic encephalopathy — in the brains of retired rugby players. A new report published in last month’s
Journal of Neurotrauma found that repetitive impacts to the head — not necessarily just those identified as concussions — are likely to induce changes to the micro-vessels of the brain, increasing the risk of serious damage.
Once known as dementia pugilistica, because experts believed it only really affected boxers, the threat of CTE has caused even the hard-bitten team owners who run the NFL to rein in some of the helmet-to-helmet hits deemed beyond the pale.
In rugby, where even a scrum cap doesn’t offer much in the way of protection, the dangers are obvious.
World Rugby have at least been saying the right things, of course, and we are told that rules on HIA — Head Injury Assessments — will be rigorously enforced during the tournament in Japan.
Any player who takes a head knock will have to be assessed by an independent doctor. Any player showing the slightest sign of concussion on the field of play will be removed.
There are checks and follow-up checks from three to 48 hours after the game, with players required to be symptom-free and pass a ‘cognitive assessment’ before being cleared to play again.
Headway welcome the progress already made, Griggs saying: ‘We’ve known for a long time about the link between repeated head injuries and serious conditions like Parkinson’s disease and dementia. Hence our opposition to sports like boxing.
‘But the good thing is that so much research has been done into concussion — and the links between one-off injuries and later problems.
‘So the positive is that more and more people are being protected.
‘The case of David Denton, or any other rugby player, can’t be seen as definitive evidence of a long-term trend.
‘We’ve got a greater understanding of concussion, we have better testing than ever before. And there are greater opportunities for players to get full medical support.
‘So the upshot is that we will be able to protect more and more players in the future.
‘I think it’s just common sense to say that a player starting now will be better protected. Simply because we know far more about the subject.
‘Go back 20 or even just ten years and a blow to the head was seen as a badge of honour. You were brave if you managed to shake it off or run it off.
‘We are now much better at protecting players. A single one-off concussion managed properly, with proper rest, with the player removed from the field in time, won’t result in long-term damage.
‘So the key is in making sure that we manage this better. Making sure correct protocols are observed.
‘That means monitoring players throughout the season and keeping an eye on the bigger picture.
‘Elite-level sport has a responsibility to set a good example.
‘At grassroots, they don’t have the medical back-up on hand if anything goes wrong.
‘But they look to their idols on how they handle these situations. They copy what they see on television.
‘We have got to move away from a win-at-all-costs mentality at the grassroots, undergo a real cultural change. That’s why we say: “If in doubt, sit them out.”
‘Not every head injury will be concussion. But you can’t take a chance.’
A lot of the groundbreaking work in this field has been done in Scotland, with Glasgow-based consultant neuropathologist Dr Willie Stewart having repeatedly taken on the sporting authorities with his findings.
James Robson, Scotland team doctor and a veteran of several Lions Tours, meanwhile, is on record as saying: ‘Concussion is singularly the most important topic in rugby at the moment.’
Players have certainly become more open in talking about it, with a number of internationals opening up about the symptoms that have kept them on the sidelines for months at a time — and which have put their very careers, if not their lives, at risk.
We have at least moved beyond the stage where team-mates would laugh at the unlucky sod suffering the after-effects of a head knock. Woozy players are no longer helped around the pitch for another five or ten minutes while they ‘run it off’.
But strength and conditioning has become, to quote one expert in neurology, a monster.
Players have become so powerful and fast that the human brain will struggle to cope with even unintentional, secondary contact from the biggest units travelling at full speed.
As for anyone caught with one of those no-arms shoulder charges, well, there’s a reason why they are now so severely punished.
Still, the World Cup will go on. Players will keep putting themselves in the firing line.
Scotland will be cheered on by everyone back home, including a certain former back-row forward who was interviewed by Sportsmail at Twickenham following the quarter-final loss to Australia four years ago.
On the night in question, David Denton was clearly devastated to have missed out on a place in the semi-finals.
Little did he realise at the time that it would be his last-ever World Cup.
Concussion has claimed its latest victim.