Durham University: Rugby, concussions and mental health

The issue of repeated concussions in rugby is very much in the spotlight, with questions surrounding pitch-side assessments, players’ welfare and long-term neurodegenerative risks.

Now, a new study led by our sport scientists shows that former professional rugby players are more likely to show signs of depression, anxiety and irritability compared to amateur rugby players and non-contact athletes, such as cricketers and runners.

The retired elite rugby players who took part in the research suffered more concussions during their playing days than those in other groups and the researchers say this could be linked to their poor mental health later in life.

Repeated concussions
Players who had suffered five or more concussions were almost twice as likely to report signs of depression, anxiety and irritability compared with players with fewer concussions. These players were also more likely to struggle with feelings of covert anger.

Signs of depression and irritability were also more common in rugby players who had suffered three or more concussions in their playing career compared to those who had experienced fewer concussions.

Alcohol, sleep and help
There were no differences in alcohol scores between the retired sports groups or in relation to concussion history.

However, the study did find that the former professional rugby players were more likely (1.8 to 2.9 times more likely) to suffer from sleep disruption compared to the amateur rugby players and non-contact athletes.

One in five former elite rugby players said they would not seek help from anyone if they had a problem or were upset.

Brain health
The scientists say further research is needed to explore if there is a direct neurobiological connection between repeated concussions and longer term psychological health and to investigate any possible links with the development of neurodegenerative disease.

The researchers acknowledge that forced retirement due to injury also played a part in players’ well-being post retirement. They also stress that while this study does not conclude cause and effect, the findings are important for player welfare and add to a growing body of evidence on the impact of repeated concussions.

Injury load
In the study, 83 retired elite rugby players were compared with 106 age-matched amateur rugby players and 65 non-contact athletes. They were between 22 and 82 years old, with an average age of 47.

Research by the same team has previously shown that rugby players continue to suffer from their high physical ‘injury load’ after retirement from the sport. In that study, concussion was the most common injury amongst rugby players which was most likely associated with reported longer term impact.

World Rugby and International Rugby Players (IRP) have recently published new guidance to limit contact training aimed at preventing injuries and protect player welfare.