A new study has found that elite rugby players of both codes in the UK typically suffer more than five times the number of injuries in their careers than athletes do in non-contact sports, while amateur rugby players suffer three times as many. Most of those who took part in the study played a decade either side of 2000, before rugby union instituted measures to improve the management of player welfare, but as the current generation prepares to return from their lay-offs, the paper published in Sports Medicine reminds them of the toll. The research, led by Durham University’s department of sport and exercise sciences, also puts figures on the long-term effects, with 51% of the sample of retired elite rugby players reporting diagnoses of osteoarthritis, which can be linked to their time in the game, more than twice the number reported by retirees of non-contact sports. Concussion features highly in the results, with 81% of elite players and 76% of amateurs reporting at least one concussion in their careers, compared with 24% of non-contact athletes, taken from cricket, cycling, swimming and running. The study, part of the Global Rugby Health Research Network, is the first to attempt to quantify incidence of injury across a player’s career and the repercussions beyond it. “It’s all well and good to look at injuries from season to season,” says Dr Karen Hind, leader of the research team, “but I think it’s really important to see what these players are exposed to across their careers. This will lead on to their health in later life.” The gnarled veteran with a walking stick is well known to rugby, but as the first wave of players to have spent their whole careers in the professional era reach middle age, the fear is of an ever-greater toll in the decades to come. From 2012 to 2015 World Rugby funded research in New Zealand that has since grown into an independent worldwide study on rugby health, further results of which are expected to come out over the next few years from universities in Canada, Australia and USA, as well as the UK and New Zealand. Professor Patria Hume of the Auckland University of Technology, a co-author of the Durham study, led the research in New Zealand, which arrived at similar conclusions, particularly regarding concussion. “This UK study is completely independent,” she said, “with no funding from World Rugby, and it’s showing the same story.” Of the injuries most often reported to carry lasting after-effects, all rugby players had particular problems with knee ligament injuries (27% of elite players) and shoulder dislocations (21%). Also 15% of the elite rugby players reported the lingering after-effects of concussion, compared with none of the non-contact control group. Since most of the players in the Durham study retired, rugby has woken up to the concussion crisis that enveloped American football. At World Rugby level and in individual unions, measures have been instituted not only to mitigate the risks of head injury but also to try to control the escalating intensity of the sport, both on and off the field. The long-term positive effects of rugby on quality of life were also established in the New Zealand study, but management of the physical impact continues to preoccupy the sport.