Study finds rugby players face 15-times higher motor neurone disease risk

A study of former Scottish rugby internationals has surfaced evidence that demands immediate action from the sport's governing bodies. Researchers at the University of Glasgow compared health outcomes for 412 male former international players against more than 1,200 matched individuals from the general population and found something stark: ex-rugby players carried more than twice the risk of developing a neurodegenerative disease overall, and faced a 15-fold increased risk of motor neurone disease specifically.

The research, published in the Journal of Neurology Neurosurgery & Psychiatry, examined players from both the amateur era and the professional period that began in 1995. It built on a landmark 2019 study that had already flagged elevated neurodegenerative disease mortality among former professional footballers—roughly three and a half times higher than expected. The rugby findings surprised even the researchers. Prof Willie Stewart, the consultant neuropathologist who led the work, described the numbers as a "big surprise" and acknowledged that more expansive research would be needed to fully parse what they mean. But he was unambiguous about what the sport should do now.

Stewart's central hypothesis centers on cumulative head injury exposure. He pointed out that since rugby turned professional in 1995, the collision intensity and frequency of head impacts have only climbed. The modern game, he argued, has created conditions where players absorb far more trauma than in earlier eras. His prescription was direct: contact training during the week should become "virtually a thing of the past." Rather than expanding seasons and adding new competitions—moves the sport has been considering—rugby authorities should be cutting back on matches, reducing the volume of rugby played, and eliminating as much contact work as possible from training schedules. "Less is more," he suggested, if it means better-quality rugby played by healthier, less-damaged athletes.

Progressive Rugby, a nonprofit advocacy group focused on player welfare, seized on the study as vindication of warnings the sport has been resisting. John Fairclough, speaking for the organization, called the findings "further troubling evidence" and accused rugby's governing bodies of "avoiding the inconvenient truth." The group had published a seven-point plan in August that included reducing contact training exposure, restricting the number of games players compete in, mandating protected rest periods, and implementing more cautious return-to-play protocols after injury. Fairclough framed these not as radical departures but as essential steps to protect both short-term and long-term player health at the elite level, where collisions have become so brutal that the current model is no longer tenable.

Dr Susan Kohlhaas, director of research at Alzheimer's Research UK, acknowledged the concerning nature of the findings while flagging an important caveat: motor neurone disease is rare enough that the control group in this study contained no cases of it, which means much larger studies would be needed to establish the true size of the risk. She called for further research into head injuries across different populations—women, grassroots players, and the modern game specifically—none of which were the focus of this work. Her organization announced £500,000 in new investment to investigate brain injury and long-term dementia risk.

The study's implications ripple outward from a single uncomfortable fact: men who played rugby at the international level, even during the amateur era before professionalization intensified the game, now face measurably elevated risk of neurodegenerative disease. The question facing rugby authorities is no longer whether head injury in the sport poses a health risk—the evidence has moved past that debate. The question is what they will do about it, and how quickly they will act.