Rugby players face 15x higher MND risk, study urges dramatic rule changes

A study from the University of Glasgow has delivered sobering news for rugby: former players face a 15-fold increase in the risk of motor neurone disease compared to the general population, and more than double the risk of any neurodegenerative disease. The research examined 412 male Scottish international rugby players—spanning both the amateur era and the professional years that followed—and compared their health outcomes against over 1,200 matched individuals from the broader population. The findings, published in the Journal of Neurology Neurosurgery & Psychiatry, paint a picture of accumulated neurological damage that researchers believe stems from repeated head injury exposure in the sport.

Prof Willie Stewart, the consultant neuropathologist who led the research, framed the results as a call to action rather than merely a cautionary tale. He expressed genuine concern about the trajectory of the modern game, noting that if the study were repeated in two decades, the findings might prove even more alarming. The research builds on earlier work from 2019 that found former professional footballers had roughly three and a half times the expected rate of death from neurodegenerative disease—work that was part-funded by the Football Association and Professional Footballers' Association. Stewart's hypothesis centers on a straightforward mechanism: head injury exposure in sport increases neurodegenerative risk, and the modern game, particularly since 1995, has seen that exposure climb steadily.

The implications for how rugby is played and organized are stark. Stewart argued that contact training during the week should become virtually obsolete, and that rugby authorities should be restricting rather than expanding the sport's calendar. Instead of introducing new competitions or global seasons, he said, the game should be cutting back on the sheer volume of rugby being played. He questioned whether it remains credible to ask young men and women to play week after week for most of the year, even if the entertainment value is high. The message is not that rugby should disappear, but that less rugby, played at higher quality with players less damaged and more fit, might ultimately serve the sport better than the current trajectory.

The human cost is already visible. Steve Thompson, an England World Cup winner, is battling early-onset dementia at 44. Morgan Parra, the French scrum-half, has dealt with concussion. These are not abstract statistics but names attached to lives altered by the sport they played at its highest level. Stewart acknowledged that the numbers themselves came as a surprise and that more research—including broader studies—will be needed to fully understand what the data means. The 15-fold increase in motor neurone disease risk is particularly striking because motor neurone disease is rare; the matched control group in this study had no cases of MND at all, which means the absolute numbers are small even if the relative risk is enormous.

Dr Susan Kohlhaas, director of research at Alzheimer's Research UK, called for further investigation while noting important gaps in the current work. She pointed out that the study focused on male players and did not examine women, grassroots rugby, or the modern game in its full scope. She also emphasized that uncertainties remain about the exact size of the risk. Nonetheless, Alzheimer's Research UK has committed £500,000 to additional research into brain injury and long-term dementia risk. The challenge ahead is to understand how to minimize the risks associated with head impacts while preserving the genuine benefits of physical activity—a balance that researchers acknowledge is difficult but essential to strike. For now, the question facing rugby authorities is whether they will treat this research as a stimulus for dramatic change or as one more study in a long conversation about head injury management that has, by Stewart's assessment, moved with frustrating slowness.