#339. Rugby’s Brain Injury Concussion Crisis - Dr. Sam Peters & Alix Popham

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0:40Dr. Sam Peters: We'll have chat more out of the box than a Dominic Sobbers live pre-kick, more panellists than Chelsea of players, and unlike VAR, we know where to draw the line. For fine margins, fun debates, and full-blooded tackles, Football Weekly, listen wherever you get your podcasts and watch the full episodes on YouTube. Taking care of your eyes shouldn't be a hassle. That's why Warby Parker is a one-stop shop for all your vision needs. Our prescription glasses and sunglasses are expertly crafted and unexpectedly affordable. Stop by a nearby store or use our app to virtually try on frames and get personalized recommendations.

1:13Dr. Sam Peters: Did we mention we offer eye exams and take vision insurance too? For everything you need to see, head to your nearest Warby Parker store or visit warbyparker.com today. That's warbyparker.com. From when I turned professional to when I finished, I had over 100 ,000 sudden aggressive hits. Chronic traumatic encephalopathy. CTE. Is linked to the length of rugby players' careers. There's no known cure. How old were you when you first found out? 40 when I got diagnosed. I got 14 areas of damage in my brain. And my neurologist described it as a leak in town. I want to know about this Australian doctor.

1:51Dr. Sam Peters: What was he saying?

1:52Alix Popham: He was essentially rubbishing any science that put a counter position to his position.

1:59Dr. Sam Peters: 1 ,200 players. Diagnosed players suing World Rugby.

2:03Alix Popham: How safe is the sport and how safe can it be?

2:07Dr. Sam Peters: How long has this legal case been going on for? Five, six years.

2:10Alix Popham: How long more can this go on for until we get an answer? Currently, there are players in and around national setups at youth level being prescribed painkillers at the age of 18, 19, 20, just to get through a weekend. It's happening on an industrial scale. It's happening right now.

2:27Dr. Sam Peters: This is wild, isn't it?

2:35Hey, guys.

2:36Dr. Sam Peters: We've been running this podcast now for five and a half years. We've had some most amazing business guests on here. Simon Squibb, Daniel Priestley, Barry Hearn. The list just goes on and on, from billionaires to people who have built brands. If you want to come on the podcast and talk about your business and sit here with me in the studio and tell your story, go check out dodgewoodall.com forward slash guest and check out the three-minute video. We've also left the link below as well. Alex, Sam, welcome to the show. Thank you for having me. Great to be here. Yeah, very much looking forward to this one.

3:05Dr. Sam Peters: This is a different one for me, but it's one that Alex and I have been chatting for a couple of years now, and it's something that's really important that people need to know about. But just a bit of background, you've got Alex Popham here He was a Welsh international, former Welsh international, back row player, quality player. I remember when you come on scene, you had bright peroxide there and I saw this lunatic running around, smashing people. It was amazing to watch. And the last time, I think we were on the piss somewhere, but we'll come back to that. We were at a wedding somewhere. I think the last time I saw you were doing shots.

3:33Dr. Sam Peters: Anyway, years ago. Sound like you, really? No, no more. No, no more. Sam, author, journalist. You've been very well respected over the last 20-odd years. You've written a wonderful book called Concussed. So today is about rugby and talking about concussion. So we'll start with you, Alex. Why did you write the book called Concussed?

3:54Alix Popham: Well, I mean, Dodge, it was basically a culmination of about 20 years of work for me. I grew up like you guys, playing rugby, loving rugby, watching rugby, living, breathing rugby and all sports, really. But I became a journalist after I got injured playing and became a professional journalist until around 2003. eight years after the game had turned professional. And it became really clear to me really early that the severity of injuries that players were suffering and the frequency of injuries and the way that they were being managed was basically reckless. It was much more extreme than anything I'd witnessed growing up.

4:32Alix Popham: And I could see the game changing radically. And through that process, there were evidently far more concussions happening. Players were routinely being sent back on the field when previously they would have left the field. and it became clear to me that there was a sort of untold story here. I was a rugby correspondent for the Mail on Sunday 2013. We launched a rugby concussion campaign. I interviewed Lewis Moody back then 12 years ago and Lewis said we used to treat concussion as a joke and now he was concerned about developing neurological problems later on in life. And really around 2021 when the legal case came about, which I'm sure Alex will talk about.

5:15Alix Popham: But lots of people were saying to me, you know, you've got to write the story. You've got to tell your story. You've been on this case for well over 15 years. And I'd seen so many examples and knew so much of the sort of history that a lot of people said to me, particularly my dad actually said, you've got to write this book. And that's really where Concussed came from. And, you know, pleased to say it's been incredibly well received and been nominated for a few awards and won an award or two. And it's really opened a whole new chapter really for me in terms of how I recount this story and we keep the pressure on the authorities to accept that change needs to be made.

5:57Dr. Sam Peters: How nervous were you in the lead up to launching a book like this? Because there's times when you're a correspondent, you're being paid to be correspondent rugby in all the years from 1995 to 2003 World Cup. And then in 2013, you come up with the idea and obviously you launch the book a lot later. But what did you really notice with players who were smashing each other in training and smashing each other in matches? What were you noticing? Was there no protocol whatsoever?

6:25Alix Popham: I mean, there were protocols in place, but they just were not being followed. I mean, there was really easy stuff like if a player's lost consciousness, they do not go back on the field. So that was like the starting position that anybody can really tell if you write up close to someone whether they're conscious or not. And yet, again, mentioned Lewis's name, but 2007, he was knocked out twice in the same game against Tonga playing for England. I covered that game. That game was brutal. Absolutely brutal. Lewis was brutal,

6:52Dr. Sam Peters: the tackles he was flying in.

6:53Alix Popham: Unbelievably tough player, unbelievably good player and a great man. I'm sure we'll talk about Lewis through the course of the podcast. But yeah, it was just really clear that all these protocols were just being completely ignored and what had previously been abnormal, which was players playing on having been knocked unconscious became normal and this sort of cultural change happened as the game went professional where brain injuries basically seemingly stopped really being taken much notice of and I felt that was profoundly wrong and you asked how I felt before bringing out the book. I mean, frankly, I felt nervous.

7:28Alix Popham: It's the third book I've written but definitely I would say the most important and the one I invested the most of my life into. The publishers tell me no book that they've ever published has ever had such an in-depth legal read. There was lots taken out. I was challenged a lot by lawyers over comments I made, scenarios that I presented. I had to stand everything up. I've not been sued. And I see that as testament to the fact that what's in this book is certainly my truth, but it's rigorously researched. And, you know, that's something I've been really proud of is the compliments and the credit that's been given to me for the quality of the research.

8:14Alix Popham: It is.

8:15Dr. Sam Peters: All I've heard is amazing compliments about the book. Thank you. Amazing. Thanks. Alex, when did you turn professional? When I was 18. So, what was that? 98, 99. Okay. Yeah. And how many years were you playing professional rugby for? For 14. For 14 years. Yeah. What did you notice when you were playing rugby with the sort of pressure to earn money versus training with other players, competitors who want your number six or seven shirt or number eight shirt? And if you weren't playing, you weren't earning money. What were you noticing there for you personally? It was just part of the job with regards to being a rugby player from painkillers every day that you would take to get through training, to get through a game, sometimes being jabbed up to mask the pain that you would put under pressure to be on the training pitch every day because you didn't want someone taking your spot or you wanted someone's spot.

9:16Dr. Sam Peters: So you had to turn up and do what you had to to get through that. In the middle of the changing room, there would be a bowl of painkillers that you just help yourself to, and that was the norm. When I get up now in the mornings, I take a load of tablets from my vitamin C, my Amiga 3s and things like that. But when I was playing rugby, it was always a painkiller, paracetamol, ibuprofen. Sometimes there was, after operations and things like that, Tramadol and lots of boys who've got addicted to those drugs. And yeah, that was just the norm, to be able to move and get functioning and then you're into training.

9:57Dr. Sam Peters: Did you know what concussion was when you were playing? Again, as Sam said, it was treated as a joke. Many analysis sessions where somebody got knocked out or was walking around with bambi legs, that would always get rewound and play back. And all the boys would be laughing. The things that I remember that was asked if you had a head injury was, do you feel sick? And if you didn't feel sick, then you would just carry on. Or if you felt sore stars, felt fuzzy-headed, you'd just be given some sniffing salts, splash of water, and you just carry on. And that'd be more or less every day in training and quite a few times during the game.

10:41Dr. Sam Peters: And now I know each one of those is a brain injury, which I wasn't aware of when I was playing. Yeah. Wow. So let's go back, Sam. We're talking about each concussion is a brain injury. Can you actually break down what is actually concussion?

10:55Alix Popham: Well, it's essentially that when your brain moves around within the skull, the brain is a soft jelly like matter. The skull is a hard, protective, essentially it acts kind of like a helmet would to protect the most precious organ in the body, essentially. And a concussion occurs when the brain bounces around, whether you're hip from the side or whether it's a rotation or a sort of head-to-head collision. That impacts inside the brain where there's bruising, there's structural damage done to the brain. the brain essentially stretches out, the matter inside stretches out and causes damage. And for many, many years, we were told and players were told that it's just a sort of transient thing that comes and goes.

11:43Alix Popham: Some doctors, sports doctors compared it to turning off a computer. You could just reboot and go again and everything was fine. And evidently, and partly through the research I've done, but largely through the work of other campaigners, That myth has been debunked. We now know that every time a concussion happens, there's a brain injury, and that can lead to long-term consequences as well as short-term. I'll write about something called second impact syndrome in the book, a report on a young man called Ben Robinson, whose father Peter, has gone on to be one of the most important campaigners in this.

12:20Alix Popham: But Ben suffered multiple concussions in the game, and adolescent brains in particular are very susceptible, or much more susceptible, I should say, to second impact syndrome where the brain essentially is inflamed and the risk of severe injury, if not death, is heightened after one head injury. Has anyone actually died from a head injury in rugby?

12:43Dr. Sam Peters: Yes. How many people are we talking here?

12:46Alix Popham: Is there a list of people? On the field. On or off the field? In the history of rugby, you're talking many, many, many, many deaths. I write about a young man, Ian Tucker, in 1996, Oxford University. I just mentioned Ben Robinson. Yes, I mean, deaths occur on the field of rugby. I recount other stories in the book about tragic cases of spinal injuries where young men have subsequently committed suicide or even gone to Dignitas and had their lives ended in that scenario. But yes, it's happened a lot. It's gone unreported. I think what I've tried to do in the book is piece together some of those severe injuries and possibly present a slightly different picture to the ones that sports governing bodies, rugby's governing bodies in particular, would like to paint in the post-professional era, which was that these are somehow freak injuries when actually they're not.

13:49Alix Popham: But the severity of injuries in rugby is held, the data is held by the RFU and World Rugby and is publicly accessible. The severity of injuries since the game went professional in 1995 is significantly higher. The number of concussions that are suffered today compared to pre-professional 1995, significantly higher.

14:11Dr. Sam Peters: Why do you think that is? Do you think because people are training in the gym, they're getting faster, quicker. There's more pressure on the players from the director of rugby. Most directors of rugby would have played early doors professional era or before. And when we grew up with it, if you got a bang, get up your fanny. Come on, let's get cracking. And that was the WFAR case. This is what we do, isn't it? Is it only now, Alex, when you've got time to reflect, to look back and go, I wasn't treated well. Well, with what I know now since being diagnosed and what is a head injury, all the stars that I was seeing, why you were having to use sniffing salts every day, why most mornings, most afternoons I would have a headache.

14:55Dr. Sam Peters: yeah it's wrong with how we were treated how it was taken or it was a joke within the changing room the pressure that was put on you to just brush it off and carry on much head injuries any injury really and for me I want to say I still love rugby I want it to survive I want it to carry on but we need to be honest with what is happening and And a head injury is just not a direct hit to the head. It can be a hit to the body where there's whiplash and the brain smashes against the skull. And since I got diagnosed, there's a term called subconcussive hits. And that's a hit that there's no symptoms, there's no stars, but that is still causing damage.

15:43Dr. Sam Peters: And they worked out from when I turned professional to when I finished, I had over 100 ,000 subconcussive hits to my brain. and my neurologist described it as a leaking tap and a leaking tap dripping on a, as a subconcussive hit, a leaking tap dripping on a piece of mud once or twice, they'd be in your mark. But if it dripped for 14 years, there'd be a big hole. That's what's happening over a player's career. When you look back, and how old do you know, Alex? 46. 46. When you look back at your career, knowing what you know now, how many concussions do you reckon you had in sort of training before a game?

16:22Dr. Sam Peters: Because we only see matches on the telly. We see you in an international shirt going around tackling everyone, hard tackles, big tackles. Same with Lewis and all the other wonderful players who have played over the past. But people don't see what goes on in training. My memories of my career aren't great. I know I played for certain teams for this period. I know how many times roughly I played for them. But being in the stadiums, the weather, the score, I've got no memories of those. So times I've been knocked out, I thought KO'd, and that's what I thought a concussion was. I know of two. One, I met Nelson Mandela playing for Wales in South Africa.

17:03Dr. Sam Peters: It was a freak accident. My temple hit somebody's hip. I can't remember it, but I had a fit and swallowed my tongue on the pitch and woke up in hospital. So I know that one happened. The second one I know that happened was playing for Leeds. I don't know against who, but my two front teeth knocked out. That game was on a Sunday, woke up in the changing rooms, played the following Friday, five days later. And then they were the two that I thought I had. Then I was speaking to people I played with and they would, or my family, they would say, what about that one? What about that one? I've got no memories of them, unfortunately.

17:40Alix Popham: Alex mentioned coming back five days later. And I think when people look at this case and sort of look at the legal case that's coming about now and wonder why is this happening is that around that time that Alex was talking about was that I was looking at all these concussions happening I was looking at all these players getting knocked down playing on looking at the players getting bigger faster stronger the volume and frequency of collisions were getting bigger the whole time there was also this piece going on in the NFL which I don't know how many people are aware of of your listeners but in In 2013, there was a$765 million payout to former NFL players.

18:16Alix Popham: So people may have watched the Will Smith movie, Concussed, which came out a few years after that. And they were ex-American footballers who had been suffering from neurodegenerative problems, which were linked to head injuries, repetitive head injuries during their career. So that was going on in the background here. Even when Alex was talking 2008, there was a growing awareness that there were long-term associations with concussion. I go into the book why that understanding had almost been suppressed for a time, because previously there was a three-week mandatory stand-down in rugby union. And that's what we all knew, right?

18:50Alix Popham: We all grew up with it. Yeah, that's right. We all grew up with that. And actually, so interestingly, very interestingly, I would argue, around 2010-11, at that very point where the game was getting more extreme, the risk was getting higher and higher, the head injury risk was higher and higher, the understanding of the long-term risk was greater and greater. At that very point in time, World Rugby, RFU and other governing bodies agreed that they would actually reduce that three-week mandatory stand-down following a brain injury to six days.

19:20Dr. Sam Peters: It was six steps that fitted into six days.

19:23Alix Popham: Okay, six steps that fitted into six days.

19:26Dr. Sam Peters: Just break that down, sorry. So they went from 21 days, you just got to sit on the sideline and no contact. They reduced it to six days. Why? Six steps that fits into six days so you don't miss a game. So it was put together in six steps. So each 24 hours is a step. Yeah. And then a player could be KO'd on the Saturday and then play the following Saturday after passing each six steps. Oh, God.

19:52Alix Popham: And there was no scientific basis for that. There was no evidence. I've still to this day not seen where the evidence was. You know, world rugby talk a lot about evidence-based decisions. Yeah. That's fine. But where was the evidence that six days or six steps was a reasonable amount of time?

20:09Dr. Sam Peters: There must be one person heading this up to say, yes, this is going to head. I don't want to be to 21 days. Let's bring it down to six. Who was that person?

20:17Alix Popham: Well, there were certainly people leading that, which who I write about in the book. I talk about a professor, Paul McCrory in Australia, who coincidentally, and in a weird way, I'm going to say happy coincidence. I'm not sure if it was. It was a bittersweet sense when I realized that this bloke that I always thought was fraudulent and was making very broad claims and big claims around how essentially all the NFL case was a hoo-ha. He used the word a hoo-ha in America, media scaremongering he talked about. And he was proven about three years ago, just literally as I sat down to write the book, thinking, how am I going to finish this book?

20:56Alix Popham: I won't give it all away, but let's just say my initial sense that this guy was a fraud was correct. So my gut instinct on this guy was correct. He was a fraud and his influence on sport broadly, not just rugby union, league, football, other sports, AFL, is still going on today. He was a massively influential doctor, probably the most influential sports doctor of the 21st century. And everyone believed him. He was believed because what he was saying was the thing that sport wanted to hear. I talk about other people who've led this, people like Dr. Simon Kemp, who's still employed at the RFU, very influential figure in the sport.

21:34Alix Popham: People can draw their own conclusions from what I've written in the book.

21:38Dr. Sam Peters: What have you said about Simon Kemp?

21:40Alix Popham: Well, I point out that he was the doctor when Lewis Moody went back on the field in 2007. I've pointed out that he was extremely influential in lots of the decisions that were made around that time and has been a very influential figure in this case. and in the concussion in sport more broadly. So there's a lot in there. There's other doctors, I think, who were complicit in essentially not looking rigorously enough at this issue. There wasn't enough urgency around 2013 when I was saying to people like Kemp, many others as well, if there's one case here where we could end up with a case of MMD or where we could end up with players getting early onset dementia in their 30s or 40s, If there's going to be one case in professional rugby, bearing in mind we had a cohort of guys like Alex, Steve Thompson, Lewis, others who were the first professional players to have their whole careers playing professionally.

22:39Alix Popham: Were you entirely professional, Alex? Yeah, you were. So they were the guys we were really concerned about because these were the guys that were training five days, six days a week, playing sometimes back-to-back, having had brain injuries. And my argument was why not be overly cautious now? and protect them in the long term and look back in 20 years time and go, you know, we probably didn't need to move as fast as we did then. Rather than take it steady, consistently say the sport's safer than it is when evidently it was not in 2011. It was really, really obvious to those of us who were watching the sport week in, week out, who loved the sport dearly, that the game had changed irrevocably or beyond recognition.

23:23Alix Popham: So I was urging for more urgency.

23:27Dr. Sam Peters: And still going on today. I want to know about this Australian doctor. What was he saying?

23:34Alix Popham: Well, he was essentially rubbishing any science that put a counterposition to his position, which was that there was no real evidence to suggest that chronic traumatic encephalopathy, which is CTE, which is quite out there now. But again, when I started writing about this in 2013, if you put CTE into the NHS's website, it didn't know. No one, we weren't talking about this issue. This is essentially kind of what was previously known for boxing fans. You might have heard of something called Punch Drunk Syndrome, Dementia Pugilistica, which was first found in 1928 by a man called Harrison Martland, a neuropathologist in America, him retired boxers.

24:16Alix Popham: For a long time, it was believed it was only boxers that could experience this. and that was very convenient for other sports. But actually, as rugby's dynamics changed on the pitch and concussions got more and more frequent and more severe, there were many of us in the game that became concerned that actually the risk profile was catching up with boxing. But McCrory went to enormous efforts, enormous efforts. He was the editor-in-chief of the British Journal of Sports Medicine. He was editor of multiple medical magazines. he was one of the most published doctors, researchers. He did call himself a researcher in the history of medicine.

24:55Alix Popham: Hasn't he been caught with 80 cases of plagiarism? Yeah, I mean, I think - You're joking me. Is he still alive, this bloke? He is, yeah.

25:03Dr. Sam Peters: I don't even call him that. What's his name? Absolutely. Paul McCrory, Professor Paul McCrory. Paul McCrory. Everyone, please go and check out this bloke. I don't want to use expletives on it, but the stuff I'm hearing right now, how on earth have you come up with this information? I do not know. Has he just blacked everyone?

25:17Alix Popham: It was back of a fag packet stuff as far as I could see as a sports journalist with a little bit of rudimentary education in what a research project or paper should look like. I spent a lot of time around 2013, particularly when I really started getting interested in this, going into research papers. And it was just pretty clear to me that the stuff McCrory was coming out with was really unbelievably simplistic. He was also saying the same thing that he'd been saying for 15 years previous to that, which is always a bit of a red flag with research. He just wasn't changing his position at all. It felt, and also his attitude and the way he presented felt to me overly bullish, overly defensive, overly aggressive.

26:05Alix Popham: and as I say in 2021 he was exposed as a fraud on an industrial scale which is the number one no-no for research. He was copying other people's work, presenting it as his own. He was misrepresenting other people's work. A guy called Augustus Thorndike which was the work that had been carried out which the three-week mandatory stand down and McCrory essentially blew it all out of the water and gave sport and particularly rugby union the science, his science, pseudoscience, I'd call it, to change all the protocols. And that, I'm afraid, was incredibly damaging to a whole generation of players. And I would say, and others have said that Paul McCrory's got blood on his hands.

26:48Dr. Sam Peters: And they're still using that science and protocols today. Has Paul McCrory been sued? He's going through...

26:55Alix Popham: There's a lot of people going after him in Australia, but he's a well-protected man. And he's got a lot of very influential people in his corner. My God.

27:06Dr. Sam Peters: For someone like you who's been around the block playing all these years, how do you feel about hearing this story about Macquarie? Well, the more that I find out and what was known, when it was known, like Sam just said then, the conversations we're having in rugby now were happening 100 years ago in boxing. This knowledge has been around for a long, long time. And we just need to be told the truth. and then we can make changes to make the great sport of rugby safer. From 80 % of my damage was done in training. And since the NFL case, they've taken that on board and they hardly do any contact in training.

27:43Dr. Sam Peters: When I started out and it's most probably not as bad now, but training was like the Wild West. It was the last person standing on a Thursday would get picked for that game. And there was no referees. There was no medical team out on that training pitch. And there was people flying in from everywhere. You were getting hits in the head, the rest of your body. And that can be managed. And if they brought in guidelines to the amount of contact players should be doing, but they haven't brought in mandatory amounts of contact like the NFL. And that won't happen, I believe, until the legal case is settled.

28:20Dr. Sam Peters: and they won't make any changes that need to be made to make it safer or as safe as it can be until the legal cases result. And what legal case are you on at the moment? So there's 1 ,200 players. 1 ,200 players. Diagnosed players suing World Rugby, RFU, and the Welsh Rugby Union for the damage from their playing careers. and there's a range of diagnosis from early onset dementia, probable CTE, post-concestrian syndrome, Parkinson's, Alzheimer's, motor neurones disease. There's a big, big list of, yeah. How old were you when you first found out? 40 when I got diagnosed. With? Early onset dementia and probable CTE.

29:18Dr. Sam Peters: They can only say it's probable until they can only say it's 100 % CT after you've died. I most probably noticed things, and my wife more so, Mel, about 12 months previous to that, where we were having conversations. An hour later, I had no recollection of the conversations. I was having outbursts. Of anger. Anger. Yeah. Ripping the banister off over nothing. thing i'm a pretty chill yeah as long as i eat and train i'm i'm easy to get a bit of sun on me i'm i'm pretty easy going but i was just losing it where i couldn't understand what was going on in my brain uh things were just making me frustrated is it yeah frustration and understanding felt like spaghetti junction where to start with simple things from sending an email phoning somebody back paying a bill all those things which are really simple when you break them down but when it was all in there and I was doing the kids, everything that normal people with normal brains can do easily, I was finding it really, really difficult.

30:28Dr. Sam Peters: What is dementia? I think there's a range of symptoms, but for me, from seeing it in black and white from the scans I've got 14 areas of damage in my brain compared to a, at the time, 40-year-old person who's not done, male person who's not done contact from short-term memory, concentration, taking on new information. I was suffering really big time with headaches most afternoons where I'd have to lie in a dart room. This is post-rugby? Post-rugby, yeah. Wow. Um, yeah, it's, um, it was tough to take, but I thought it was going mad. Yeah. I didn't understand what was going on. So having, even though it was shit news from the neurologist, um, at least there was a reason why I was struggling in this way.

31:26Dr. Sam Peters: Did they give you a timeline on dementia? No, they, they, yeah, they, they said to me within 10 years, I could, could be in a needed care or needed assistance in but there's um things that you can do to slow down yeah uh with regards to stress is the biggest one okay and that's what i found now i've taken as much stress from my life as possible things are easier i'm not exploding as much i don't get as bad headaches um i do my wife calls it alex spa i do a cold forward dip every day i got i got a hyperbaric chamber I've got a red light sauna do I am I so I'm training good for you and just trying to keep focused and as positive as as possible on this issue but I know I can look in the mirror every day and with what I'm doing with putting pressure on the governing bodies and being honest with what is happening because they aren't I'm on the right side of history good for you with this good for you why are they not being honest legal case and how long has this legal case been going on for?

32:32Dr. Sam Peters: Five, six years. And where are we at in these five, six years as we see it today? The next tier in is early next year and we will get a date to go to trial. And that's the RFU, the Welsh Rugby Union and World Rugby. And World Rugby. Are they taking full responsibility? No. No.

32:49Alix Popham: I mean, the NFL settled without admitting liability. I mean, we've had multiple cases, you know, not just in sport, but even look at other very, very high profile cases where payouts have been made in the, which we've read about in the media recently where essentially liability isn't accepted but the payouts are made. Payout by who? By the governing bodies. Okay. I mean, you know, NFL paid out a vast amount of money. It's about 1.5 billion now. Yeah, it's gone up, you know, so huge amounts of money.

33:17Dr. Sam Peters: Has anyone in Great Britain or the UK paid out anything

33:20Alix Popham: as we see it today? That is a good question. I believe there may have been a UK bobsleigh, but I don't want to be... No one in...

33:28Dr. Sam Peters: I don't...

33:29Alix Popham: No one in rugby has had any payout whatsoever.

33:32Dr. Sam Peters: No. Out of those 1 ,200 players, are they all British players? Was that worldwide? They've played in Wales and England. Have they? Yeah. And it's only the tip of the iceberg with regards to what's going on. I know probably 30, 40 players I've spoke to in New Zealand, Australia, who are struggling, but there's not a legal case going on over there at the moment. Have you come... Because I've had Steve Thompson on. That was a very emotional one, if you listen to it, but it was a very emotional one. And what a lovely human being. Dylan Hartley on as well. These are hookers. You know, we're talking back row.

34:07Dr. Sam Peters: We're talking other friends of ours who are back row. These are full-on physical contact in training five, six days a week when it turned pro. From the age of four. From the age of four. Yeah. And now they're retiring at 36, 37, 38. Are there any players out there who haven't come on board with you, but you know they have brain injuries? Yeah. Why would some of those players not come on board, you think? Because they're still involved in the game. Okay. That was it. Append it. I know another three or four who were World Cup winners who were having problems. English World Cup winners. Yeah.

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35:19Dr. Sam Peters: With the World Cup around the corner, join me, Max Rushton, and the Guardian's expert soccer journalist on Football Weekly for all the latest soccer action and news throughout the week. We'll cover more ground than Drew Bellingham in a Champions League final with conversations sharper than an Arsenal set-piece. For fine margins, fun debates and full-blooded tackles, Football Weekly. Listen wherever you get your podcasts and watch the full episodes on YouTube.

35:44Yeah.

35:45Dr. Sam Peters: Have you mentioned their names before? No, I won't mention their names. No, because that's for office reasons. Is that because they're getting paid to go to Twickenham, getting paid to do shows, getting paid to be on telly, whatever it may be? Exactly. And I respect what the decision is. You don't want to bite the hand to feed you, right?

36:01Alix Popham: No, I know, yeah, that they're not in a good space. I mean, you asked why perhaps I could have been concerned as a rugby correspondent. You know, it's not a million miles away from the scenario I found myself in, which I write about in the book, where one of my colleagues wrote, Sam, why are you shitting on your own doorstep? I was seeing what I was seeing and I was having the conversations off the record sort of privately with friends, other colleagues. And yet what we were clearly talking about and concerned about wasn't finding its way into publication for various reasons. And I just decided to pull the pin essentially and go, I am going to write about this.

36:40Alix Popham: This is what I believe. It needs to be done. This is what I'm a journalist for. I'm not a PR man. I'm not here to cheerlead for the sport. I love the sport, but I believe there's a real problem in the sport. I still love the sport. I still believe there's a problem. I believe there's more awareness thanks to shows like this and people being prepared to talk openly and honestly to go, right, if this is the problem, what are the solutions? And that's what I think the sport is moving that way, definitely. And since the publication of the book, I've been massively encouraged, actually, especially by going into schools.

37:09Alix Popham: I've been invited into a lot of schools where rugby is a dearly loved part of the curriculum. the schools want it to be continued they all see great value in playing sport as I do and as I did there's a huge benefit to playing rugby unquestionably but there are risks and the risks have got bigger and the risks have got bigger because the game's gone professional and that has absolutely seeped down into the youth game as well so what's happening now in a lot of schools I went to a school called St Paul's in London who are doing a great piece of piloting work around a new version of rugby, which basically rewards not colliding with opposition.

37:50Alix Popham: It rewards finding space. It rewards scoring tries out wide. It tries to reward skill over brute force, basically. And I am massively behind that. I'm a massive advocate for that

38:04Dr. Sam Peters: because you see kids training now. Bam, get to the ruck. Right, pop ball. First line's like, hold on, get the ball spun wide. Let's see some skills. Let's see some flicks. Learn the fun. Yeah, learn some fun in the rugby rather than a coach going, this is what we must do because that's what we were taught

38:17Alix Popham: in the 80s and 90s and 90s. There's got to be a change. And that's so simplistic, that type of coaching, just bang, bang, very, very methodical, very sort of structured, overly structured. I've been down to France actually with a bunch of guys, an organisation called Le Plessis de Mouvement, which is a French movement run by a guy called Pierre Villepra, which is real rugby noses, no Villepra. But one of the great coaches of all time, Toulouse coached Toulouse the greatest most successful clubs in the world have based all their training throughout the whole of Toulouse something I wrote a piece for Rugby World last year which people didn't realise I didn't realise that every single rugby organisation in Toulouse is based on the principle of LPM Le Plessis movement which is all about avoiding space supporting the ball runner going forward going into space offloading running for space always running for space never running to take the collision we've talked about dominating the collision winning the collision in English the lexicon of rugby has changed love it I think there's a there's a great movement of people and coaches really enlightened coaches who are looking at different ways of playing the game which is less about collision rugby

39:25Dr. Sam Peters: that's what we need in England my boy's 11 he plays at Bournemouth Rugby Club fantastic great kids fantastic and then when we go and watch them in a tournament do you have a tournament like five or six games no word of a lie I'm on the sideline each game I'm seeing two or three kids flat out on the floor. Flat out, been smashed. Bang, bang. I'm just seeing it around. I'm like, my God, this is actually a really brutal sport. It's only because we grew up with it and that's what we did. And that's what we did. It's only when you're a dad on the sideline, you're seeing it around you going, there's two kids on the front.

39:55Dr. Sam Peters: It's just a massive collision. On that pitch, there's two down there. Parents are running on to do, we need, we need spin the ball wide. We need switches. We need flicks. We need people with vision rather than just going in. Right, first man, pop off your shoulder. Bam, take the tackle. It's rugby league defense as well with what's been brought in from the professional and then that's brought down. But for me, my thoughts have changed on now with kids and when they start contact. Yeah. As I said, I was four. Now it's ten. Nine, ten. Nine in Wales. For me, that is still too young. Too young. Okay.

40:32Dr. Sam Peters: Yeah. So I believe - What do you think? What age would you go? 16 that they need to win. Yeah. because you've got to look at the damage that is being done from 9 till 16. Every contact is causing damage. Is there an age where your brain is fully formed?

40:52Alix Popham: It's well into your 20s. Yeah. Normally, I think I'm right in saying around 23, 24. So your adolescent brains are - There's no safe age. Oh, God, there is no safe age. I think a really important point to make here as well is that, as Alex rightly said, it's annoying that we have to even state that we love rugby and we want rugby to continue. The thing in my mind, I was told it was like that old shoot the messenger thing. By reporting this, you are going to damage the game. And my argument was by this happening, it is damaging the game. My job is to report what happens. So I believe that change.

41:30Alix Popham: And I was arguing this a long time ago that if the game gets too brutal, we've always loved it as a physical. We might lose it, yeah. People will turn away from it and the parents will just look at it and they will go, do I want my kid playing the sport? And the reality is, as we all know, there's loads of reasons kids aren't playing as much sport as they used to. Mobile phones, lack of access to playing fields, all sorts. But in rugby's case, it has a unique challenge, I believe, because it's changed so much. And believe me, Dodge, all my mates who know me know how much I've lived and breathed this game of rugby in my life.

42:04Alix Popham: and I'm not the only one going, would I want my lad to be a professional rugby player? And the answer is no. And that's a big problem. That is a big problem. So they're losing their core audience essentially and that was always going to be a risk. So what I'm talking about and what lots of people and I'm really grateful to you for having us on to hear this is we need to change it. If we want the game to survive and still be going in 50 years time, then it needs to change and that's fine. You know, rugby's always changed and evolved. I write about in the book where some, again, big rugby fans will remember the hit that came into the game after the scrum, the scrum engagement hit, where there was loads of evidence showing.

42:46Alix Popham: And again, I was speaking to guys like Steve Thompson, Andrew Sheridan, guys I'd grown up playing with and against and knew. They were all getting spinal injuries. They were all getting neck problems, severe neck problems. And there were lots of issues going on at the scrum. And that hit was just removed. it was just taken out and there was a bit of an uproar at the time people didn't like it at the time did they? not at all people were not happy the game's going soft you know what is this nonsense rugby's a tough man's game all this sort of stuff but they took it out and no one even remembers it anymore and actually the scrums stay up more it's a much better way of restarting the game and the game flows more as a result and by the way players don't get loads of spinal injuries do you remember like I used to see some of you the front row going in and just headbutting each other bang Well, Dylan Hartley speaks brilliantly about that, doesn't he?

43:32Alix Popham: He used to do it himself, he admits, but, you know, yeah, it was brutal. I was just glad I wasn't up there. Yeah.

43:38Dr. Sam Peters: I was just up from the back. That's one positive. And that was in training as well. We had, and Steve talks about it, but the scrummage machine up against a tree. Yeah. And they'd be smacked. The tree's not going to go anywhere. And it was just a brick, like against a brick wall. And then the front row would be passed out on the floor. and then they expect to go again, 100 scrums on the bounce. What are you hoping for? I want to make the game as safe as possible and bringing all this to light, the damage on myself, my brain, Steve Thompson, Michael Lippman, the first players to get diagnosed and go public, that's when the governing bodies have started to sit up a little bit.

44:22Dr. Sam Peters: And listen, okay. Yeah, and not make the changes that need to be made, but they're checking out PR spins on the gum shields. They increased the protocol to 12 days, but there's still loopholes in it that you can get back in six days. But they're just trying to... The awareness now that people are talking about this is a positive for me. But as I said, 80 % of my damage was done in training. If we can make mandatory amounts of contact in training for professional players over their career, their brain damage won't be as severe when there is brain damage when there is a concussion somebody's KO'd they're not rushed back in six days they're given 28 days to rest also what's happened since the professional era is the number of games the length of the season now it's an 11 month season there needs to be a window where players have rest the South Africans the Argentinians are playing 12 months a year they don't have any rest at all so we need to look at that the NFL play a six month season they have six months on six months off they're not even allowed to be contacted by the Clibber Club

45:32Alix Popham: and the coaches they're limited in terms of how much time the coaches how much face time the coaches get with them each day each week very limited to stop sort of in the workplace bullying that kind of thing there's loads of pressure put on the players not least by themselves a lot of the time but they need protecting from themselves and that's something I've What are your thoughts

45:51Dr. Sam Peters: What's on the new business model, the R360 rugby, where they're saying a lot less games? Do you think that's the way forward? 100%. Yeah. Yeah. For me, the boys should be earning a lot more than they're currently earning. And rugby has become saturated. You can watch rugby 12 months a year, all around the, and there's no hunger to be excited for the new season because it's continuous. It's constant, isn't it? Yeah. And I never know which channel it's on. I never know where it's going. I feel like it's lost its place at the moment, but Sporzy and a few other boys who are heading up the R360, on paper, it looks absolutely fantastic.

46:25Dr. Sam Peters: If I was a player and looking at it, I'm thinking, I'll have some of that. You're going to take me around the world, and I play one game on each one, and I can have rest, and I'm going to get paid double bubble, and we're going to be on TV. But World Rugby hasn't got a say in it, and that's why they're trying to turn it down at every... And they're trying to block it.

46:40Alix Popham: Quite unbelievably, the really incredible line they put out the other day was that they weren't happy that the player welfare protocols were going to be looked at properly. I mean, you couldn't make it up. I mean, while rugby and RFU have overseen, essentially, as Alex said, essentially a 12-month-a-year calendar. It's insane. You know, the Lions were playing their last test 4th of August and then the premiership starts in September. It's crackers. And those rest periods have not been properly defended. They haven't been properly policed. Maru Ochoje played for England in New Zealand last summer, which broke the cap of games that he should have played.

47:17Alix Popham: That was the RFU's own choice. How many games did he play? So it was 34, 33. In one season. Yeah, and that's still, by most people's parameters, about seven or eight too many. Yeah.

47:31Dr. Sam Peters: But it's only guidelines, isn't it? Yeah, and that guidelines is put in place. The RPA negotiate that there's no real power in the RPA or the guidelines because if like Matoji has gone over he just carries on playing so what's the point in having him do you know there's one player I see at the moment who I look at and think he's flying in everywhere ridiculous tackles putting his body on the line Tom Curring I look in and think my god how does he how does he get up the next morning and just like aches pain and then go back again and smash it or get concussed and he's back on the field again he's a beast of a man wonderful player I didn't think what he's going to be like in retirement and this is where the annual testing, the annual scans, and make sure it's the correct scan.

48:17Dr. Sam Peters: Because when I got diagnosed, there's a scanner called a DTI, Diffusion Tensor Imaging, and that's what picked up the damage in my brain and the 1 ,200 other diagnosed players. And the governing bodies won't use those scanners to scan the players because they're worried about - You're joking me. So basically, you retired and then got your brain scanned with the other 1 ,200 people. Yeah. What you're saying now is the players who are professional work players can't go and get their brain scanned? No. Those scanners are only in academic settings. And James Drake has done a study with current players, and 23 % of those players show damage on their brain.

48:56Dr. Sam Peters: Can a player not go and check out his own brain and just go, I'll pay 500 quid or grand or whatever. I want to go and see what's happening before I start committing to another six, seven years being a professional work player. It's more than that. I think it's like three or four grand for these to have a scan done. But also I don't think players would want to.

49:15Alix Popham: I was just going to say, it's asking their salaries on the line. Their salaries on the line, but also these are young guys. I'm thinking back to when I was 19, 20, 21. You care about it. I wouldn't necessarily have cared. I definitely wouldn't want it to know. And also if you're listening to people who are telling you information that's not 100 % straight down the line, then you're going to listen to the stuff that is being fed, the sort of stuff that Paul McCrory used to feed players and governing bodies. And then that becomes, you know, that seeps down throughout the whole game. I mean, I report on a scenario that happened at Twickenham in 2013 in a book, which was basically where the doctors were up on stage, the doctors who were leading the conversation in rugby at that time and other sports.

49:57Alix Popham: And they were basically making a joke. I mean, I say the only thing missing from one of the presentations was Benny Hill music in the background because it was just a series of jockeys falling off horses and getting knocked unconscious. And the room was laughing. It was intended to make people laugh. There were people on stage, the doctors who the players were listening to, who were watching players and athletes getting knocked unconscious and openly laughing. And my point being in the chapter of that book was even the doctors are laughing. So, of course, the players aren't going to take it seriously.

50:26Alix Popham: So, that I think has changed to a degree.

50:29Dr. Sam Peters: And you trust that bubble that you're in. You're in because that's what you know. Yeah. But a prime example, Lewis making those big hits against Tonga. Me knowing Lewis really well, I know that he would never have wanted to have gone off that field. How can you override someone who is an England legend on that field, putting his body on the line when you're a doctor running on the field again? Lewis, don't feel you look too well. He'd look around and go, I'm playing. I'm carrying on. You ain't stopping me carrying on.

50:56Alix Popham: And that's a fair point. He absolutely was adamant he wasn't going off the field in 2007. and my point has again been all the way along take the decision the last person in the world you should be asking if they're fit to play on having suffered a brain injury is the bloke or woman who suffered a brain injury like it shouldn't have been down to Lewis it absolutely shouldn't have been down to Lewis and that part of the work I've done you asked what Alex wants to achieve I would like to see a sports-wide shift in the account who really has the ultimate call and when a player goes off, we know right about, you know, for my sins, I'm sorry I've come on here, but I'm a Tottenham fan.

51:37Alix Popham: Oh no. I'm sorry. I'll get him off. I'm so sorry. I'll get him off now. Some people might remember Hugo Loris, the goalkeeper, Andre Villas-Boas back in 2013, the goalkeeper played on because Villas-Boas basically just totally overrode the doctor, said Loris absolutely should have gone off the pitch and he didn't because, and I cite lots of examples of managers and directors of rugby basically taking a call that had nothing to do with the welfare of the player or was not based on any medical science or anything. It was just, I'm determined to get that guy back on the pitch because it serves my interests.

52:16Alix Popham: Of winning. Of winning. And again, this was another interesting bit that spun out of my research was actually there's lots and lots of evidence to show that performance of players, whether it be footballers or rugby players or cricketers, drops off significantly after they suffered a brain injury sort of stands to reason doesn't it so actually coaches misguidedly believed that they're more likely to win by keeping that player on the pitch they were actually more likely to lose yeah 2015 another incident I report in the book George North was knocked out twice playing against England in the Six Nations on a Friday night in Cardiff another game I covered and then subsequently North brilliant brilliant defender as well as a brilliant attacker, missed a tackle on Jonathan Joseph in the second half that he'd have made 99.9 times out of 100.

53:05Alix Popham: Was it coincidental that he'd suffered two concussions in that game? I'd argue not. So, you know, actually once you drill down on the data and the detail and understand it, actually this is about performance just as much as it is about player welfare and doing the right thing.

53:20Dr. Sam Peters: And after a head injury, you're more susceptible to get another injury as well. Yeah, so ACL or shoulder. And it can be out longer. Yeah. Being the position you played in, back row, and you were a very aggressive player and a wonderful player, how many injuries have you had and what injuries have they been? The ones that I know, again, have happened, but I've snapped my tricep, popped my shoulder, this shoulder eight times, had three reconstructions, two reconstructions on here. my forearms, not my forearm as well. They're the bigger ones that, um, I had, uh, yeah, time out of the game, but yeah, lucky with my knees.

54:04Dr. Sam Peters: My knees are okay. Isn't it funny? Like we just thought they had time out of the game. I'm just holding on to that point there because having a brain injury, you can tell your doctor or your club manager or your director of rugby, I'm fine. Yeah. But if you pop your shoulder or you've snapped a thing, you can't play because it's physically seen. Yeah. It's a bit like, It's a bit like an addiction of being a gambling addict. People can't see the gambling addict, but they can see the alcoholic because they can smell it on the breath or the cocaine addict or whatever or food addict. But the gambling one is like the same as kind of a – do you know where I'm coming from?

54:38Dr. Sam Peters: Absolutely. You can't see. It's a hidden addiction. It's a hidden injury. You can hide it. You can pretend to be wherever you want. And that's where this needs to be taken from the player's hands with regards to the return to play protocol is all on how the player is feeling. Do you go to stage one, stage two, stage three? And this is where there needs to be independent baseline testing from a scan that then means can they go to base two, base three? So you know the hardest thing here? If I got a concussion and I was on 150 grand a year and I was on three grand a week and I was getting paid to play for Leicester Tigers or Wasp or Newport or whatever, there's no way that I'm going to go to stage four and go I don't want to play I can't play there's no way I want my money and also not just want my money I don't want that fella to nick my shirt and if he's got my shirt and I'm out for three weeks and he plays well for three weeks I might be out for another seven weeks and I'm not getting my money so it's this horrible catch 22 for a player

55:40Alix Popham: and this is where I'm sorry to jump in but I'm actually quite optimistic here because again since the book's come out I've been approached by lots and lots of people I'm pleased to say most of them very very positive about the book but also understanding I probably know the landscape here as well as most people and some of the stuff that I've seen around technology that is developing the use of I know AI is held up as the answer to all things or the end of the world whatever it may be but it's probably somewhere in between but there's no question that taking the subjectivity out of the decision making is the ultimate that that's the that that really is the golden bullet um silver bullet and there there is a company there's several companies i'm associated i don't know if i'm allowed to mention anything there's one one called luca health that i've become close to in the last couple of years who i've been massively impressed with they're not making massive claims yet but what they believe they will be able to do um is essentially use something called vestibular ocular detection using the eyeballs, basically tracking, say that the eyes are the window into the brain.

56:48Alix Popham: There's mobile phone technology that can essentially track that, how your eyes are moving. And actually, because we talked about symptoms being one of the basic ways that the judgment's made. Do you still have headaches? Do you get dizzy when you're exercising? So it's symptom-led. But you can hide behind that. You can hide. But you can't hide behind the eyes. Exactly. You can't hide behind the AI detection of scanning your eyeballs. And that is progress. And that technology is speeding. That's wonderful. Let me just shout out for the company. Called Luca Health. Luca Health. Yeah. Really interesting group run by a great guy called Nick Greenhouch.

57:24Alix Popham: And I've been massively impressed with him. Anyone out there, go and check out Luca Health. I'm all over checking it out. Thank you for that.

57:29Dr. Sam Peters: And the beauty of that is it can be for the amateur game as well. Yeah. Well, it needs to be. Yeah, exactly. Grassroots, our kids. Exactly. Exactly. when you've had an injury for you personally your body you can take that I'm out for three weeks because of this or my hammy's gone or my arm's gone when you have a head injury I know you say you can't remember but has there been lots of times that you pretended you haven't had a head injury

57:57Dr. Sam Peters: it's difficult to say is it yeah from being in there but I still hide injuries now okay that is in you in your DNA Here's another one then. Come on, just carry on. I had a, I'm doing a bit of triathlon now and enjoy that training. And I had a pain in my hip. This was about a year, 18 months ago. And it was affecting my training. It was affecting my running. So I went for a scan and I had a tear on my hip. And the doctor said to me, he said, you're not allowed to run on that for six weeks. I went home and I said to Mel, I said, I'm allowed to run on the runner in the house. So that's. Yeah. It's in your blood.

58:36Dr. Sam Peters: It's in you. Yeah, it's in you. Yeah. Another question then, if you never recognized you had a head injury, do you reckon you had head injuries all the time? Yeah. Okay. Yeah. So it's like you're just used to being banged in the head because you're going in. For example, a training session on a Tuesday, Wednesday, Thursday before your Saturday game. Yeah. Full contact. Yeah. How many tackles would you be putting in one session? I'd imagine knowing you're probably six, seven, eight, nine in a session. And some. And some. And you times that by four. or there's 50 tackles, then you go into a game.

59:07Dr. Sam Peters: But people like us who are watching in the game going, this guy is a lunatic. The tackles he's putting in is mad. You might put in 12 tackles in a game, but no one's seen the 50 tackles in the lead up to that.

59:16Alix Popham: And this is the thing that I think really it's important people need to understand. The data and the evidence is there to show that the amount of carries, the amount of contacts, the amount of tackles, the amount of every type of contact scenario has gone up and up and up. The ball is in play more now than it's ever been. The game is faster than it's ever been. And, you know, look at the guy that you mentioned, Tom Curry. I was thinking back to someone like Jack Berger at Saracens. I remember covering a European Champions Cup final game that he played in for Saracens. I think he made upwards of pushing 40 tackles in the game, but also carried about 15 or 16 times.

59:53Alix Popham: He was an unreal player, by the way. Unbelievable player. But, you know, he's carrying 16 times. So that's 56 collisions. In 80 minutes? In 80 minutes. Oh, God. That's one less than one, more than one every two minutes. And, you know, That just did not used to happen. Guys never, ever carried that much. They never, ever made that many tackles. There just weren't that many tackles. Back in the day, in the mid-80s, there were probably barely 50 tackles made in an entire match. And they certainly weren't the sort of tackles that you see now, that collision-based dominant tackle.

1:00:24Dr. Sam Peters: What's Sir Clive Woodward's thoughts on the whole of this and your book?

1:00:28Alix Popham: Well, he was kind enough to write a very, very kind forward, which meant a lot to me. You know, the names on the book, the quotes around it, supportive quotes around the book are hugely important to me. People like Clive Woodward, people like David Flatman, but others, you know, high-profile rugby people, we call them. But Clive has said that, you know, my legacy will be that I'll have helped to make the game safer. And, you know, I can live with that. But, you know, it's come with a few challenges, that's for sure. I've had lots of people who are angry at what I've done, believe I've jeopardized the commercial future of the game.

1:01:06Alix Popham: I can, like Alex said, I can look myself in the eye when I go to bed at night and know that I've tried to do the right thing here. It's not been easy, that's for sure. You know, it's often doing the right thing isn't the easiest thing.

1:01:18Dr. Sam Peters: You know, like Clive was way ahead of his time. Did Clive understand what was going on, do you think, back in 2003 or after the World Cup?

1:01:25Alix Popham: That's a really good question. I mean, Clive came to an event I ran in February. He was gracious enough to come and attend that with Barry O'Driscoll, one of the lead doctors, Brian O'Driscoll's uncle, who's one of the most important people in this whole story because he resigned as the medical advisor to World Rugby in 2011 in protest at the protocols, the change in protocols around that time. I think there's been a nagging concern from lots of people including Clive because he's talked about this a lot I ghosted his column for quite a long time at the mail and he talked to me about it that this was always a risk this was always a concern in the back of people's mind as the game got exponentially more brutal physically brutal it was going to come at a price for the players and we're now seeing it sadly we are seeing it there's still a massive, massive effort being done to diminish and distance that damage from the evidence on the field that we're seeing, which is more and more head injuries and more head injuries than we've ever seen before.

1:02:31Alix Popham: And you guys have both rightly identified training as a big problem. Again, the RFU's own data shows that injuries in training, including brain injuries, concussions are as high as they've ever been. It's completely crazy. We should not be beating up the players during the week.

1:02:49Dr. Sam Peters: You nailed it, the Wild West. When I was at Mr. Tiger, I think one day of the week, it was a Wild West full-on, smashing everyone. Being a 20-year-old kid there against these big lumps, like all of them, you just kept quiet. Everyone just kept quiet. But it was legalised violence.

1:03:04Alix Popham: Absolutely. And quite a few ex-policemen involved in it, weren't they? Yeah, there was lots

1:03:09Dr. Sam Peters: back in that sort of 97 time.

1:03:12Alix Popham: Dean Richards, you got the ABC. Wells and... John Wells, He was hard as nails. Hard as nails, yeah. Yeah, there were some brutes, absolute brutes. And it was seen as a rite of passage. I mean, you know better than anyone dodging that. And, you know, yeah, it was absolutely brutal. And, you know, I think the painkilling thing that Alex talks about in terms of just getting through as a professional player, what's normal with that. And that's still going on. I will state this as an absolute fact because I know it, that currently there are players in and around national setups at youth level in and around Wales.

1:03:47Alix Popham: Just taking painkillers. Being prescribed painkillers, naproxen, codeine, high-strength addictive painkillers at the age of 18, 19, 20, just to get through a weekend, the following weekend. It's happening on an industrial scale. It's happening right now.

1:04:14Dr. Sam Peters: the Premier League to the Champions League and all the way to the World Cup. We'll have chat more out of the box than a Dominic Sobber's life free kick, more panelists than Chelsea have players and unlike VAR, we know where to draw the line. For fine margins, fun debates and full-blooded tackles, Football Weekly. Listen wherever you get your podcasts and watch the full episodes on YouTube. Taking care of your eyes shouldn't be a hassle. That's why Warby Parker is a one-stop shop for all your vision needs. Our prescription glasses and sunglasses are expertly crafted and unexpectedly affordable.

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1:05:08Dr. Sam Peters: This is wild, isn't it? but we've got to be honest no I get it you know I had people funny you mention this before you come on Sam I have people around me I said oh I've got Sam Peters come on who's written a book called Concussed I've got my friend Alex Popham coming on who has got early set dementia in a Welsh rugby legend they said why you want to talk about this Dodge you own a Bournemouth Sevens Festival 400 competing teams you've got an 11 year old I said I don't care This needs to be out there. What am I going to do? Just hide behind this? And I said, I don't want to mention this or bring this up because I've got a business in rugby.

1:05:48Dr. Sam Peters: This is more important than anything right now. And what I want to go back to is those 1 ,200 players, can you just give me some of the big names that are part of that 1 ,200? Well, they've all been named now with the legal case, but Steve Thompson, Michael Lipman, Phil Vickery, Harry, Alice, Carl Heyman, Lee Byrne. My memory now to remember. Yeah, yeah, yeah. But they had some big hitters in there. Oh, yeah. I just want to break down what this 1 ,200 looks like. 1 ,200 has said, we've all got brain damage, and we are not happy the way that we were treated for our professional career. Is that what's happening?

1:06:33Dr. Sam Peters: Yes. And they're trying to sue the RFU World Rugby. And the RFU World Rugby, this has been going on five years. How long more can this go on for until we get an answer? Well, I think with all litigations like this, for the other side, it's about kicking the can down the road. Hopefully you'll run out of money and we're fighting this.

1:06:53Alix Popham: But we've secured it. All the players will lose the faith that it's going to be concluded. We've seen this in cases like the post office inquiry and the infected blood scandal where the victims are basically, justice is not served and it's delayed and it's delayed and it's delayed and people die, you know, people... Before it get an answer. Absolutely, you know, and it's cruel what's happening to the person.

1:07:14Dr. Sam Peters: We've secured 20 million in funding to fight this all the way. Okay. And I genuinely can't wait to that date of going to court if it ever happens. When it happens. When it happens, because I want the people with the evidence we've got of the decades of shit that's gone on and been hidden and suppressed to have that in the public knowledge and not have people say to me, signed up, basically. You know what you're letting yourself in for. I didn't know when I started playing rugby that I was going to get early on set to that. But do you know, also on the other flip side of it, do you think that with rugby being so embryonic in from 95 to where we are today, a 30-year in the professional era, the flip side of that, do you think the RFU and World Rugby knew what they were letting themselves in for going professional and having all this damage as well?

1:08:01Alix Popham: I think they should have known. There was enough people around them saying this is reckless, this is crazy. Like, you know, it had never been okay to let an unconscious player in any sport carry on playing. It definitely never been okay to let an unconscious player play on and then get unconscious again and then carry on play. We've just seen on the weekend in rugby league, a case, desperately sad case, Eli Katoa, the Tongan rugby league player who suffered a concussion pre-match in the warm-up, then two concussions, clearly evident, very clearly diagnosable concussions on the field, played on, so three, and then had seizures off the field.

1:08:42Alix Popham: He's subsequently been diagnosed with a bleed on the brain. He's undergone emergency surgery. So there's still work to be done. I think it is being dragged out. It is being dragged out. Could I just go one step back, Dodge, if I could, to say to your point about you've got a commercial interest in sport, in rugby particularly. Why are you having this conversation? If I was a parent and I knew that the owner or the guy who's in charge of running a competition that my child was taking part in was absolutely on the money on this and prepared and open-eyed about the potential risks, I'd be far more likely to let them play in that competition.

1:09:20Alix Popham: I think good on you for doing this. good on you for being honest and open enough to have the conversation to me the schools the clubs and the organizations that are very much out there saying we see this risk we're going to look after your kids we believe in the value of playing rugby but we if we believe they've got a brain injury or head injury we're going to get them off the field because nothing's more important than their health.

1:09:44Dr. Sam Peters: 100 % and I've seen that and what I've loved about this conversation is learning about this is what I've seen while taking my boy and my boy's mates to tournaments and on the weekend against loads of other teams. The protocol is amazing at grassroots. So whatever's gone on, whatever the knock-on effects of you done, the knock-on effects of everything else, when it comes to concussion, it is really strict at grassroots level. And it was never strict when I was growing up at grassroots level. It was like, get up, you big fan. Get cracking on. You're an eight-year-old, a six-year-old, or whatever.

1:10:15Dr. Sam Peters: Magic sponge. Yeah, that'll do it. So there's lots of positives that have come out of this.

1:10:19Alix Popham: Absolutely. And I try to reiterate that all the way through. I think I've said how impressed I've been with schools. I think there is a real sea change that's happened and a really significant change lower down the game. And in many ways, that will inevitably probably educate the professional game because the professional game can't survive without the grassroots game. So I'm really optimistic, much more optimistic on that front than I've probably ever been actually in this. So there's lots of reasons to be optimistic. So, Alex.

1:10:46Dr. Sam Peters: No, no, no. We'll wait and see. I'm just, I mean. I think in the kids game, would you not accept there's been a big change there? Yeah, definitely. And just having this, it's a difficult conversation that we're having, but having it and parents coming up to me, contacting Head for Change. Yeah. And it's for the right reasons and it's positive. If we didn't start this, then we'd be just as guilty, I think. Early onset dementia, you're five years in. Yeah. Have you noticed a difference each year? with regards to changes that I've made I've been away I've spoke to you about this for some experimental treatment that has helped with headaches and concentration and things like that I notice if I do too much my brain gets tired so I've got to respect that join the club yeah so I only work two days spread over the five and it's good to be focused and have that in the diary, but I can't do too much.

1:11:49Dr. Sam Peters: So it's just understanding that, but putting myself first with regards to my different therapies that I do every day and making sure that I'm on point with that and just trying to be as positive as I can throughout this, which definitely helps. But supporting other players from, since my diagnosis, we've had 32 people commit suicides. 32 rugby players have committed suicide globally yeah yeah and we were away on holiday last week and we had two people contact us where we had to make interventions and I

1:12:28Alix Popham: could I just say you know Alex is a humble guy I've seen what he in particular there are others and he's supported amazingly well by his wife Mel but the Alex carries a pretty heavy burden on his shoulders because he's become the kind of focal point for all these guys coming to him and you know some of these they're not all as organized and have the support networks around them that Alex has and you know dare I say you know at times you know financially it's a massive it's not easy for these guys at all they weren't earning big money but some of the stories that you hear are absolutely desperate these guys are desperate and Alex is quite extraordinary a in the discipline that he shows in the way that he looks after himself to try and sustain his own mental health and mental um well-being for the long term for his family um even though he's suffering and experiencing the challenges that he is um but then on top of that he says he's taking the stress out of his life but he actually i think carries an enormous burden and you know full credit to you for doing what you've done nothing it's worthy of a massive respect extraordinary it is

1:13:42Dr. Sam Peters: has ever crossed your mind over the years suicide fortunately i've never gone down that road of i'm pretty good at controlling the controllables the the thoughts that if i do have a negative thought or it's better off me not be in here i had those at the beginning when i first got diagnosed and was overthinking how quickly uh things would get bad but I try and part those of there because I've got no control over them and blocking them out same with negative comments pricks who put we signed up and showed like that online that I've got no control fair play

1:14:25Dr. Sam Peters: MND

1:14:31Alix Popham: it's a worry to say the least in rugby right now it's a big worry you know we I was starting to get concerned around the case of Jus van der Vessezen the 1995 South African World Cup winning scrum half who died with motor neuron disease around 2012 13 there were a cohort of players in that group again who were probably ahead of the curve as professionals the reason South Africa won that first 95 World Cup, the first one during professional, the game went professional right afterwards, but they were already well and truly professional in every sense. But there was a cohort of brain and damaged players in that group.

1:15:18Alix Popham: There'd been a guy, Jared Cunningham at London Irish. You know, I started to look at it more and more. There was evidence in Turin of footballers, a big research study, M &D was six times more prevalent in professional, ex-professional footballers than the wider population. And then latterly, obviously, we've had Doddy Weir, Rob Burrow in Rugby League, Ed Slater, very recently, desperately, sadly, Lewis Moody. You know, and there's, I think, multiple factors around this, you know, clearly extreme sport. There's some sort of link. but also the one common denominator in all of those players is repetitive head injuries you know there's all sorts of potential lifestyle factors that we're unsure about but there's this saying that your genetics load the gun and the environment pulls the trigger and all of those guys have been exposed to repetitive head injuries there is no proven causal link partly i would argue because the research hasn't been invested in enough to understand it there's clearly a correlation and I would also say that an absence of evidence doesn't mean there's evidence of absence.

1:16:34Alix Popham: There is clearly enough players coming forward now to be really worried about it. How could we not be? How could we have someone like Lewis come out recently and hammer blow to all of us who knew him? We all know him around this table. I think we all admire the guy immensely. July this year, Lewis and I sat in a room in central London and I hosted an event with him where we talked about his concussion history and his concerns, his long-term concerns. Look, I totally understand and I don't expect, I absolutely don't want to put words in Lewis's mouth. I do understand why he won't come forward and say, I think this was to do with concussion.

1:17:20Alix Popham: I don't really expect him to. We'll never know absolutely for sure. Um, but you know, when I was interviewing him in 2013, he was certainly concerned that there was going to be long-term implications for all these concussions that he'd had. Um, and, uh, yeah, what can we say other than it's, it's going to be a tough, tough few years. Um, we send, well, I'm sure we've all messaged Lewis privately and, and, and wish the guy and his family, you know, all the love in the world and, um, amazing family, amazing man. And yeah, I think we do need to be worried. And like this broader conversation, we should have our eyes wide open to it and insist.

1:18:06Alix Popham: You know, I think there was some stuff that came out around then, around the announcement, which I think I've read comments by high profile people, again, heavily invested in rugby. You said it's dangerous to make the link. Well, I'd say it's dangerous not to make the link. It's dangerous not to at least examine the link and have the conversation. because if we just go, there's no link, don't talk about it. Throw it under the carpet. Throw it under the carpet. That's worked really well over the last however many years. So I'll keep pushing for the conversation to be had. I know Alex will as well.

1:18:39Alix Popham: Yeah, there is no proven causal link yet, but that was exactly the line we were getting around CTE 12 years ago. And I think that line's used less and less frequently now because over time that proof is coming about, just as it did with tobacco and cigarette companies with lung cancer in the 60s and 70s. And the playbook of denial and obfuscation and corporate cover-up is horribly similar.

1:19:07Dr. Sam Peters: Lewis is loved by millions. The outpouring of love I've seen over the last month has been another level. Beautiful. It is.

1:19:18Alix Popham: And that is where the rugby family and the community absolutely come together. So, you know, and it's, you know, Twickenham on Saturday against before the Australia game, you know, it's a desperately difficult thing to watch, but also emotional. And, you know, the most important thing, I think, above all else at this point in time is that Lewis gets the support he needs and the people around him that are going to help him through this, him and his family and, you know, what happens afterwards in terms of the science and what have you can wait in that case. But yeah, it's desperately sad and yeah, send him huge amounts of love.

1:20:00Dr. Sam Peters: I've really enjoyed this conversation, Led. Really, really enjoyed this and it's something that needed to be spoken about. Thank you. No, thanks for having us on. I want to go back to the bit in France. what was it the resistance the basically le plaisir de mouvement le plaisir de mouvement how can we translate that's pleasure of movement so why don't we create the pleasure of movement in rugby like for my festival Bournemouth 7s festival it's 7s so there are hits it's not like 15s but people are spinning the ball wide flicking missed two missed flue flicking inside and going that is what we need this is what we need the kids to be brought up with and I am a massive believer in this the pleasure of movement we need to start something do you have a try of the tournament?

1:20:45Dr. Sam Peters: Do you know what? I can't stand how woke it's gone. It doesn't even get a semi-final and a final and every kid gets a bloody medal. Like, my kid's got about 30 medals. I said, how many medals have you actually won a tournament for? I was only three dead or whatever. But you could call the try of the tournament

1:20:58Alix Popham: the LPM. Yeah. It's comfortable. They're doing it over here. I'm speaking at a school called Cokethorpe School in Oxford next week. There's a guy called Tom Phillips there who's running LPM over here. Great guy called Richard Dixon. who's just got a job at Toulouse Academy, who's at Claysmore School down in Dorset, near where I live, who's massively involved in LPM. It's LPM Le Pleasure de Movement.

1:21:21Dr. Sam Peters: Pleasure of Movement. My boy is playing at Surrey Sports Park in a rugby festival this weekend. Let's get Pleasure of Movement. Bam, start spinning the ball, lad. Just teach him. Have some fun.

1:21:30Alix Popham: Get the joy of it. Get the joy. Running around.

1:21:32Dr. Sam Peters: Running around rather than coaches going, right, pop one, smash. All of you ruck over. Get straight. It's painful to watch. These 11-year-olds, 12-year-olds.

1:21:40Alix Popham: You watch these sessions that Vilpa runs down in a place called Lubasac in the south of France where I went last year. You guys should come down. It's absolutely joyous. It's brilliant. There isn't a tackle bag in sight. There isn't a ruck pad in sight. There's nothing. It's just unstructured play with a ball, and the coaches just get the guys moving. They don't penalise for knock-ons. They don't stop the game at every opportunity and lecture the players. They just let the kids play, and it's absolutely inspiring to watch. Let's grab this. Yeah.

1:22:06Dr. Sam Peters: Let's grab this. Gentlemen, I've really enjoyed your company. Alex, you're a superstar, mate. I've got a lot of respect for you for years. And what you've achieved on the field is unbelievable. And the amount of caps you got for Wales. But what you're achieving off the field is extraordinary. Thank you. Yeah. Amazing. Sam, for you to have the kahunas to write this book, anyone out there to go and check out this book, Concussed by Sam Peters. But you must have been nervous writing this book. You must have been nervous the night before, before you pressed that button. The amount of law, the lawyers are saying, take that out, take this into the, But you're going to have people go against you for what you've done here.

1:22:43Dr. Sam Peters: But this is for the good of rugby, what you've done. This is for the good of people, the kids coming through and the adults.

1:22:48Alix Popham: Well, I hope so. Thank you. It means a lot. And the response to it, being shortlisted for the William Hill Sportsbook of the Year, it won the UK Sportsbook Award for Outstanding Sports Writing. So there's something in it, hopefully. And the response I've had and the feedback and the people that have opened their doors and their arms to me and said, you're talking our language. We see this problem in the same way that you see it. Yeah. And a lot of that, as I said, is coming from schools, and that's incredibly exciting. And this isn't about going, slagging off rugby.

1:23:17Dr. Sam Peters: No way. This is just about to make, how do we make rugby safer? Simple as. On that note, boys, I thoroughly enjoyed this. Loved it. Enjoyed your company. Thanks for having us. Cheers, mate. Good, mate. Thanks, mate. Sam, good man. Cheers. Fantastic, boys. Cheers. If you'd like to see someone on the show, leave a comment below. And if you haven't already, do us a favour, share us a bit of love, press the subscribe button, and allows us to grow the show even bigger and bigger each week. Nice one.

1:23:44Dr. Sam Peters: Looking for soccer analysis? More knowing than a Carlo Ancelotti eyebrow raise? With the World Cup around the corner, join me, Max Rushton, and the Guardian's expert soccer journalist on Football Weekly for all the latest soccer action and news throughout the week. We'll cover more ground than Drew Bellingham in a Champions League final with conversations sharper than an Arsenal set-piece. For fine margins, fun debates, and full-blooded tackles, Football Weekly. Listen wherever you get your podcasts and watch the full episodes on YouTube. Security program on spreadsheets, new regulations piling up, and audit dread?

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