The Drake Foundation chairman James Drake gives his verdict on brain injuries in rugby

Opinion: Rugby must do more to protect players

I decided to set up The Drake Foundation in 2014 because as a huge sports lover – particularly of rugby union – I had become concerned that players were sustaining significant head injuries on an increasingly regular basis. The advent of professionalism in rugby union in 1995 had appeared, in my mind, to have ushered in a more dangerous era for the players.

I started the Foundation in order to personally fund research in the likes of rugby and football to investigate what the impact of these head injuries might be on the brain, with the idea that ultimately sports could then use this evidence base to create robust safety protocols to mitigate against risk, so that sport could be enjoyed safely by everyone.

For anyone who follows the sport, unfortunately it’s clear that there is a major problem with brain injuries in rugby. The incredibly tragic story of 2003 Rugby World Cup winner Steve Thompson – and others who have revealed they have early-onset dementia – highlight the need to continue taking the issue of head impacts with the seriousness it deserves.

This is compounded by a host of early retirements announced this season and numerous controversial incidents throughout the men’s Six Nations and U20 Six Nations.

It’s cases such as these that make it imperative that a player-led, research-based and also pragmatic approach is taken to welfare protocols, and this is where organisations such as mine can work with the governing bodies to help understand what is happening to players and how to protect them.

There is certainly no lack of appetite from the players themselves. We’ve been encouraged by the will from players themselves to learn more about this issue. Shortly after I started The Drake Foundation, I approached a Premiership rugby club who just happened to have moved close to my home. I was surprised and encouraged when the whole team agreed to participate in a study.

After recruiting more players from more teams, this study eventually became the Drake Rugby Biomarker Study, the neuroimaging results of which were released last year. The study found that 23% of a group of 44 players had unexpected changes to their white matter (the wiring of the brain) or blood vessels, with 50% of a subgroup showing a reduction in white matter volume.

Now, if you ask any cardiac surgeon if a structural change is compatible with good functioning of the heart they will immediately say, “No it’s not”. Why should it be any different for the brain just because we know less about how it works?

Since the Drake Rugby Biomarker Study, the first results have also been released from the BRAIN Study, which found that former elite rugby players from the pre-professional era who experienced three or more concussions during their career did not have worse cognitive function before the age of 75 than those who had experience none, or just one or two, concussions. Although there was a difference in cognitive function linked to concussions in those over aged 75, these findings are broadly reassuring for players from the pre-professional era.

However, we see more collisions in today’s games than pre-1995, as well as bigger, stronger players. My concern is that player safety is travelling in the wrong direction and that more needs to be done to find out what is happening to the brains of players – retired and active – from the professional era.

One answer, of course, is more research and continued collaboration between funders, researchers and governing bodies. We were delighted to host our fifth Drake Sports Head Impact Research Symposium at Wembley Stadium last month, bringing together the leading minds in sports head injury research across the UK’s major sports.

This spirit of collaboration and inclusiveness is crucial to enhancing our understanding of head injuries in sport, and we heard about the incredible work being done in this area through research and the exploration and implementation of new technologies – including advanced brain imaging, the use of blood biomarkers and cutting-edge instrumented mouthguard technology.

Scientific research, however, takes time and so that’s why – as well as funding research – we continue to call on governing bodies to do more to protect players in real time, in order to make sport safer for people to play at all levels.

We’re not experts on the laws of the game, but taking rugby as an example, I would like to see a mandatory and enforced limit on contact in training; a longer mandatory rest period for players who experience a sizeable head impact; and a reduction in the number of substitutes allowed in a match, to prevent tired players being exposed to bigger impacts from a set of fresh legs.

These are changes that could be made immediately. In the meantime, The Drake Foundation will continue to work with our partners and fund some of the critical research that we hope will help protect the sports we love and the players we so enjoy watching.

James Drake is the Founder and Chairman of The Drake Foundation, a not-for-profit organisation committed to funding research into head injuries in sport and beyond. For more information visit

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