Former All Black prop Carl Hayman is one of several former players taking legal action against World Rugby over brain-related injuries suffered during their careers. Photo / Photosport
Leading concussion expert Dr Barry O'Driscoll has accused World Rugby chief executive Alan Gilpin of "not living in the real world" following his controversial comments on brain injuries.
In an exclusive interview with the UK's Telegraph Sport, Gilpin hit back at the lawsuit triggered by former and current players against the global governing body, as well as the Rugby Football Union and the Welsh Rugby Union.
Concussion lobby group Progressive Rugby recently published a seven-point plan to limit brain injuries which includes a minimum 21-day non-negotiable blanket stand down after a brain injury, irrespective of a player's concussion history.
Gilpin strongly disagreed with the mandatory stand down proposal instead claiming there should be an individualised return-to-play protocol. But Dr O'Driscoll, a former medical advisor to World Rugby, believes these comments are extremely irresponsible.
"He doesn't live in the real world does he, and it shows they [World Rugby] haven't got an answer to any of this," said the former Ireland international.
"Their answers have all proved to be wrong scientifically. Medically, if their brain is damaged it is damaged, and therefore you stay off until it is right which at this stage can take a long time.
"If you do it on a player-by-player basis it can be interfered with by a player lying because he's under so much pressure to play. We know from some fairly intense scientific research there are brain changes as a result of head knocks that can and do go on for three weeks or more.
"We do know that if the brain hasn't fully recovered it is more vulnerable to further knocks.
"This Head Injury Assessment protocol is also a joke. The symptoms of any head injury surfaces in the first 35 hours, and they are doing a test which lasts 10 minutes before putting them back out on the field to suffer more knocks. What I told World Rugby 10 years ago, and they ignored, has now come true. Where have they been over the last 10 years?"
Only last month former Wales captain Ryan Jones revealed he had been diagnosed with early onset dementia at the age of 41, following on from former England internationals Steve Thompson and Michael Lipman along with ex-Wales international Alix Popham.
Dr O'Driscoll also found Gilpin's comments on head knocks in the community game not being "comparable" to professional players deeply troubling.
Speaking to Telegraph Sport, Gilpin said that discussions around concussion and reducing head impacts remain a "very detailed, complex area", but he was eager to stress that head impacts in the community game "are not comparable" to professional players.
Findings from an extensive study undertaken by the University of Otago and New Zealand Rugby, set to be published by the end of the year, are expected to reinforce that head impacts in community and age-grade rugby are "very dissimilar to the elite level of the game", Gilpin said.
He added: "Those important experiences of former elite international rugby players are being conflated into the question of whether it's safe for my son or daughter to play mini rugby, and they are two different debates. Ninety-nine per cent of our global playing population in the sport are not playing at the elite, professional level. We're confident that the type of head impacts that are occurring in the community game are not comparable to what's happening in the elite game."
'There should only be substitutions for injury'
While concussions have been at the forefront of discussions surrounding the links of repeated head trauma and conditions such as dementia, O'Driscoll insists non-concussive blows to the head are just as serious.
"For World Rugby to say that degenerative brain disease is not yet established as a consequence of repeated head injuries is a travesty," he said. "They say it is not established but that's not the right message I'm afraid.
"It's a very irresponsible comment because he's [Gilpin] taking responsibility for the strength of knocks which causes brain damage. It's the non-concussive knocks at every tackle which we know causes massive issues.
"We also know smashing a player in the chest causes whiplash and causes massive problems because it shakes the brain and the head. They've got to research brain injuries which I'm afraid can come from non-concussive knocks to the head as well.
"Which is the bigger? We don't know. I've treated people with serious brain disease who have hardly had any concussions during their rugby careers.
"It's about continuous knocks to the head. It's probably more the non-concussive knock because you get more of them."
Dr O'Driscoll is also an advocate for scrapping tactical substitutions which he believes could make the game safer. It is very common to see international sides such as South Africa bring on almost an entirely new pack of forwards during the second-half in order to physically dominate the opposition into submission.
"I would ban tactical substitutions," he said. "They are coming on playing against tired players, who have slowed down a little bit, and whose reflexes aren't quite where they were at the beginning of the game. It's not like for like. There should only be substitutions for injury."
Progressive Rugby, in response, say they are extremely offended by World Rugby's viewpoint that they and others involved are looking to benefit from the action or use the media to attract further complainants.
Gilpin also claimed the number of players involved is lower than the near-200 reported, and said those involved should engage with World Rugby rather than take legal action or comment in the media. World Rugby said they had been in dialogue with Progressive Rugby, but talks ended due to some of its members being involved in the legal proceedings which were submitted to the three governing bodies last month.
"We know from speaking with players currently in the elite game that changing rooms have never been more receptive to information around the importance of looking after their brain health," said a Progressive Rugby spokesperson.
"World Rugby reject a mandatory minimum stand down period following brain injury because of the alleged behaviour of those playing prior to 2011. We believe this is a disrespectful assumption of the modern player who now has vast amounts of knowledge compared to the prior generation."