Everyone wants answers for former rugby players like Lewis M...

Lewis Moody, 47, is the latest in a long line of players who has been diagnosed with a neurodegenerative disease that may or may not be linked to his career in collision sport. Over the past decade I’ve interviewed more of these men, and their friends and families, than I ever wanted to. Many of them chose to first reveal their diagnoses in the Guardian. First there’s the shock, then the sorrow, then the expressions of sympathy and support. And after all that, a lot of hard questions that are left unaddressed.

The one thing everyone involved wants is clear answers, and unfortunately, they are very hard to come by. The current science can only tell you so much. The Motor Neurone Disease Association’s position is that the latest research suggests a correlation between traumatic brain injuries and MND, but that the same research has not proven that traumatic brain injuries are a cause of MND. Such injuries are just one on a long list of genetic factors and environmental factors.

Studies have found possible links with electrical trauma, mechanical trauma, high levels of exercise, exposure to assorted heavy metals and agricultural chemicals, and, yes, concussions and other traumatic brain injuries that occurred while playing sport.

A 2022 study on a group of more than 400 former international rugby players found that their risk of MND was 15 times greater than the members of the general public who also participated. But then similar studies have also shown that the risks are just as high, or higher again, among cohorts of farmers and veterans. The difference is that their stories don’t lead the news. Moody is one of more than 2,100 people in the UK who will be diagnosed with the disease this year. If there’s a public perception that rugby players are especially prone to the disease, it is partly because the players who have been diagnosed have done so much to raise awareness about it.

The more you learn, the more you know you have to learn. Last year another study, out of Durham University, was widely misreported as having found that “players who have suffered multiple concussions had biological differences that make them more prone to developing MND”. According to the team who actually worked on it, it did nothing of the sort.

The science is never straightforward. As the MND Association says, the evidence “has often been conflicting and clear conclusions cannot be given”. They also point out that the numbers involved in some of the studies themselves are so small that it is impossible to rule out random chance as a factor in the findings. No one wants to scaremonger people out of playing. Over a decade of reporting on traumatic brain injuries in sport, and rugby union in particular, I’ve found that the only thing two scientists in the field are likely to agree on is that we need to do more research. They ask for longer studies, bigger studies and better-funded studies.

In the meantime it’s up to the governing bodies to educate the participants about the potential risks, and provide the best guidance it can on how to mitigate against them. One aspect I have come to believe to be unequivocally true after all this reporting, all those interviews, documents and court hearings, is that rugby union failed to do this in the years after the sport turned professional in 1995.

Moody grew up in that era. If you’ve read this far it should be clear that his diagnosis can’t necessarily be attributed to the brain trauma he suffered during his playing career. And, while he’s said he would go about things differently if he were playing today, he has never joined the group of players taking legal action against the game’s governing bodies for failing to better protect them from the long-term consequences of playing. He has said that he thinks the idea anyone else was to blame for any damage he may have suffered from playing makes him uncomfortable. There are plenty of men he played with and against who disagree with him on that.

There are five other players who have been diagnosed with MND who have joined the three legal actions across league, union and football.

Moody’s own autobiography, Mad Dog, is an invaluable insight into the culture in professional rugby union during this era. He describes being knocked unconscious for five minutes in a match against Tonga in 2007. “The team doc suggested I should come off. I told him where to go,” Moody wrote. “I’d waited this long to get my chance in the World Cup, and there was no way I was walking off after five minutes. A lineout followed and I had no idea what was going off.” He was hit in the head again later in the same game. Moody didn’t just play on each of the following weekends, he even went along on a team outing to Disneyland Paris on the day after the game, and spent the day riding rollercoasters.

“Every loop the loop was torture, every jerk of my car was like having a needle shoved through my head,” Moody wrote. It is unthinkable behaviour now. It shouldn’t have been unthinkable then.