Short-term cognitive deficits are symptoms some way down the chain of reaction triggered by each injury and may appear some time later or not at all. They’re all contact events.” Worse, the diagnosis of those concussions is “blunt”, as Bailey describes it, because it relies currently on cognitive tests. “Sub-concussive blows, concussive blows, it doesn’t mean anything. “I don’t think we understand what concussion means,” says Bailey. 
.And that is what speaks to one’s risk (not certainty) of neurodegenerative conditions in later life. But they all contribute to what the neuroscientists like to describe as “cumulative dose”. What remains ever clearer is the need to shift the dialogue away from terms like “concussion” and “that’s a red card!” and towards a conception of each contact event as sitting somewhere on the same sliding scale, some of which surpass the arbitrary threshold designated for concussion. Science is still a long way from joining all the dots from a career in rugby to a later life suffering from neurodegenerative conditions but these studies are beginning to unearth the clues of contributory factors, which will likely affect the individuals in a variety of ways. None of which is to predict the worst for the players affected. One concern is how retirement affects these mitigating factors in athletes. Mild cognitive impairment was also recorded, which the Drake Foundation study a couple of weeks ago did not find, but the cardiovascular fitness of elite athletes does much to protect their neurological health, which means it is likely muffling the effects of these molecular changes. Photograph: Andrew Fosker/BPI/REX/Shutterstock Rugby’s problems are far deeper than one-off injuries on the pitch. Further studies will compare these player groups with control groups not exposed to such contact. Forwards, of course, were subject to greater exposure - and they suffered a corresponding decline in their ability to regulate blood flow to the brain, compared with the backs. His team are due to publish a string of papers on this, delving ever deeper, but this introductory study tracks a group of 23 elite players in the Pro14 and compares biomarkers and functionality across a season, as well as each player’s exposure to contact events. He was also a handy scrum-half in his time. And it just builds up over time.” Bailey is the director of the neurovascular research laboratory at USW and works, among other projects, with the European Space Agency on blood flow to the brain of astronauts. “You’ve got this noxious, cumulative, recurrent contact that doesn’t actually need to be anywhere near the head, so long as there’s some sort of torsional movement imparted to the brain.
“You cannot interpret it any other way,” says Professor Damian Bailey, lead author of the USW study. They do play a part, as the outward manifestation of a distressed brain, but the damage to those brains is constant in a sport like rugby and correlates to the sheer number of blows each brain takes, directly or indirectly, over a prolonged period. The crippling hypothesis that firms up with each and every paper published in this area – and there are plenty more to come – is that rugby has been, if not wasting its time on this, completely missing the point. We associate it with the odd “big hit” or “vicious blow to the head”, depending on how charitable the observer feels towards those poor stooges smashing into each other in the arena for our entertainment. The definition of this phenomenon is continually changing but, whatever it is, to address concussion feels manageable, since it remains occasional.
To date sports like rugby, and the furious debates therein, have focused almost exclusively on what has become known as “concussion”.
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