School of hard knocks: the effects of rugby on long-term health

The three-year study was undertaken by World Rugby in conjunction with AUT University. Photo / Thinkstock

Concussion remains rugby's number one issue, however arthritis and damage caused by alcohol consumption have also been flagged as areas of concern following a major study of the impact our national game can have on players' health.

After three years of recruiting, quizzing and testing retired sportspeople, a World Rugby-funded study conducted by AUT produced few solid findings.

The main message from the research, said professor Patria Hume of AUT's Sports Performance Institute of New Zealand, is that participants should consider the potential negative health impacts as well as the positives when they consider lacing up a pair of boots or grabbing a cricket bat.

"I'd like to think it raises awareness of people thinking about long-term health implications," professor Hume said. "Usually we just live in the moment and we don't consider what is going to happen next month or a year out. The initial indications form this snapshot of information is that potentially there may be some positive but also some negative health outcomes that need to be considered."

Issues include a possibility that rugby players are more prone to arthritis in later life that their counterparts from non-contact sports. Rugby players also drank more heavily, although not as often, as the cricket and hockey players that made up the non-contact study group.

Those hoping for definitive answers on pressing questions such as just how damaging frequent head knocks might be will be disappointed. The study found players from all codes that suffered four or more concussions during their careers performed worse on some but not all neuropsychological tests. They also reported a higher number of injuries, had more hospitalisations and rated their current health lower than other study subjects who reported three of fewer concussions. But the research stopped well short of identifying definitive or causal links between rugby and long-term cognitive health issues.

A shortfall in the number of participants - just 73 of a targeted 200 non rugby players took part - meant some findings were statistically less relevant than hoped. And the nature of the research made identifying cause and effect impossible.

There were positives for sportspeople, with study subjects in general reporting better health, higher incomes and lower levels of smoking than national norms. Attributing that to the fact they played sports was not possible, but neither could it be discounted.

"This has been a difficult study," admitted World Rugby's chief medical officer Martin Rafferty. "It has been difficult to recruit, difficult to analyse and difficult to interpret.

"Maybe the outcomes haven't been as conclusive as we'd like them to be but that's life.

"What we do know is that we need to do more investigation."

How that plays out will be interesting, particularly AUT's recommendation that "education on the harmful effects of excessive alcohol ingestion should be a core inclusion in all sports education programmes".

Rugby and booze have long been inextricably linked, the relationship enshrined through multi-million dollar sponsorship deals and sweetheart brewery deals.

Solving that inherent contradiction would fall to the sport's commercial powerbrokers, Mr Rafferty said. He did, however, foresee a time when alcohol sponsorship would follow in the footsteps of tobacco and become defunct.

"I think that probably will happen as well."

Rugby and wellbeing

• Three-year study of retired players undertaken by AUT
• A "sub-optimal" number of participants and variance between sample groups impacted on "significance" of results
• No definitive or causal links between rugby and long-term cognitive health issues found
• Concussion, osteoarthritis, cardiovascular health and alcohol consumption identified as areas in need of further research