Rugby is clearly in crisis as it attempts to address the escalation of concussion and its consequences in the modern game (World Rugby’s brain health service finds 25% of ex-players ‘at risk’ of problems, 30 April). Unfortunately the crisis will continue unless the regulatory authorities understand, accept and address the brain’s vulnerability to repetitive brain trauma. The human brain is an extremely fragile organ, having the consistency of soft butter, while it functions as a superb supercomputer. It is resilient to a few injuries but when these occur regularly in the fierce modern game over several years, this may lead to cognitive deterioration and dementia.
The maintenance of a healthy brain must become a public health priority at every level, while every player at risk should receive regular cognitive assessment. If early cognitive impairment develops, serious consideration must be given to early retirement. Without the implementation of these steps, this crisis will simply continue.
Dr Donald Williams
Honorary fellow, Swansea University Medical School
