This article is taken from the May 2023 issue of The Critic. To get the full magazine why not subscribe? Right now we’re offering five issues for just £10.

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Twenty years ago, Steve Thompson lifted the Webb Ellis Cup, surrounded by teammates and cheered on by millions. He had helped to propel England towards its only rugby world cup triumph.

Today he suffers from early-onset dementia, and together with almost 200 other players, he is suing the governing bodies of rugby union for negligence — claiming the sport he loved has caused him permanent brain damage. Thompson’s argument is not that contact sport is inherently wrong, but that the policies in place to protect players from serious injury were too thin. He was part of the generation that played as rugby turned professional in the 1990s, and the strength of the players, the physicality of contact, and the time put into training all increased.

Rugby players were more than twice as likely to get dementia, three times more likely to get Parkinson’s disease

“If you were knocked out and you came back to,” Thompson told the BBC, “you were just told to get on with it.” If you had a headache, you were given headache pills, and told if you could still run you were not really injured. He describes training sessions that left him blacking out and with burst blood vessels in his eyes.

He is far from alone. Fergus Slattery, the former Ireland and British Lions flanker, is older than Thompson, and he also has dementia. According to his doctor, “What Fergus has is not normal dementia. If you ask me, ‘Is his career the cause of this?’ I would say, ‘Yes’.” His doctor says he probably has Chronic Traumatic Encephalopathy.

Slattery’s family are not suing the Irish Rugby Football Union, although after his death his wife and children plan to donate his brain to scientific researchers in Dublin. But whether the response from the families of former players is anger — as with Thompson — or sad resignation — as with Slattery — there is a desire to get to the truth.

But really, we already know. According to a study at the University of Glasgow, former Scotland international rugby players were more than twice as likely to get dementia, three times more likely to get Parkinson’s disease, and had a 15-fold increased risk of getting motor neurone disease.

Slowly but surely — and of course prompted by these threats of legal action — sport is starting to wake up to the problem

The problem is not only limited to rugby union. Seventy-five former rugby league players have begun legal proceedings against the Rugby Football League, with claimants including Bobbie Goulding, a former Great Britain scrum-half who also has early-onset dementia. The same examples of brain damage are listed, along with depression, aggression, drink and drug addiction, and suicide attempts.

In football, 30 former players and their families are seeking damages from the English and Welsh football associations, claiming the governing bodies failed to take reasonable action to reduce the danger of brain damage caused by repeated blows to the head.

Campaigners include the families of footballers who have since passed away, such as Nobby Stiles, who won the World Cup with England in 1966, and Jeff Astle, a former England and West Bromwich Albion centre forward. But among those who are engaging with the problem of football-related brain damage is Ryan Mason, who retired from the sport early after fracturing his skull.

The statistics in football are almost as worrying as those in rugby. Research in Scotland suggests former players are up to 3.5 times more likely to suffer neurological diseases. Similar research in Sweden has shown that former players are 50 per cent more likely to develop dementia than the rest of the population. Goalkeepers, however, do not have the same increased risk of degenerative conditions — because unlike outfield players they rarely head the ball.

Slowly but surely — and of course prompted by these threats of legal action — sport is starting to wake up to the problem. World Rugby has produced new guidelines that set out weekly limits for full contact training (15 minutes), controlled contact training (40 minutes) and live set piece training (30 minutes). Steve Thompson, by contrast, says he used to participate in around ten hours of contact training every week.

In football, there is now a recommended limit — for adult grassroots players as well as professional footballers — of ten high-force headers per week in training. There is also guidance which advises coaches not to practise heading in training for children aged 11 and under, and suggests a graduated introduction of light heading from under-12s up to under-16s.

This season, the Football Association is trialling the complete removal of heading the ball in certain grassroots competitions and leagues, and may change the law to remove heading from under-12s football later this year.

All of this makes sense, and of course the changes will be made in the full glare of public interest, monitored by academic researchers, and scrutinised by players’ representatives and families. The Professional Footballers’ Association, for example, is calling for dementia to be recognised as an industrial disease.

But where does professional sport go if these changes do not do the necessary job of protecting players from irreversible, long-term harm? Sports like rugby and football are by definition about contact between players. Limits to training, better monitoring and medical support, and innovations like concussion subs can all make a difference without challenging the fundamental essence of the contests we love to watch.

But if these changes fail to make a difference, the pressure to change will grow even stronger. Less contact, lower tackling in rugby; maybe even new restrictions on heading in football. It sounds unthinkable — and certainly feels that way — but sport will need to fix its silent crisis.