There is a link and a problem between Rugby and CTE, but nothing like football because heavy head-first hits aren't a feature of rugby.

One feature that makes a difference is the American football system of downs: the next play begins where the last play ended, to the inch, and on many plays there is a nonlinear point. One inch short of a first down is vastly better for the defenders than just making it. In rugby someone taking another foot or two to go down isn't going to hurt the outcome the way it can in football. The goal in football is to stop the person in as little space as possible, which means maximizing the deceleration and thus the impact to the brain.

With the NFL, they also spent a decade and a half purposefully covering the link up and publishing biased science trying to obscure the link, so there is scandal on top of the horrors of the physical consequences.

I disagree with the notion of lack of padding that makes rugby safer. I think it's the structure of the game.

In football, once the receiver or running back has the ball, he is going to take a hit - likely from a defender who has been in full sprint for a good distance. Once he has the ball, he has 11 other players containing/funneling him and focused on crushing him.

In rugby, the ball carrier can pass or kick. That makes the game more one-on-one because the opposing team has to cover their guy. The width of the field needs to be considered. As a defender, you can't be reckless, you have to make sure you make the tackle. This means you go lower, you tackle the waist and slide down the legs of the runner.

I played at a decent level of rugby when I was younger... rugby players are not afraid of getting hurt. They do not ease up on a tackle because "i'm not wearing a helmet".

The NFL could limit some of the injuries to receivers and DB's by allowing illegal contact (less space = less speed prior to contact), but it'd hurt the offenses, and the league doesn't want low-scoring games. They could also limit the amount of zone that teams are allowed to play, but at that point, the sport begins to look very different.

They could counteract the disadvantage to offenses by allowing holding by the offense in the tackle box. This would have the extra benefit of protecting backs better from being blindsided.

It's hard to gauge the effects of these kinds of changes without letting them play out, but I for one would love to see the NFL try this combination for a year.

> They could also limit the amount of zone that teams are allowed to play

How would that even work?

They could literally mandate where defenders line up to make zone more difficult.

They did the same with offensive lines after all.

Yeah, it would have to be something similar to illegal defense in basketball. Trying to officiate that does sound like a nightmare, though.

According to this article[0], concussions are just about about prevalent in rugby as in professional football.

[0] http://www.espn.com/espn/story/_/id/16029747/rugby-nfl-concu...

I played rugby for a few years in high school (not exactly stellar credentials but bear with me).

The first thing we were all taught to do was tackle. The technique was to wrap your arms around the opponents legs, particularly below the knee as that would guarantee their stoppage. This was a simple but very effective technique. We never tried to go for the head, or lower our heads and hit them.

I never played football so I can't say if this technique would work there but it's at least one reason no one on my team suffered a concussion in two seasons.

The single biggest difference between rugby and American football tackles is that (typically) in rugby you put your head behind the the runner while in American football you put it in front, i.e., across the body of the runner. The latter technique is only really possible without frequent facial injury when you're wearing a helmet and is used because it is more reliable (harder for the runner to run through). It also leads to more head, and especially head-to-head, contact.

I'm getting sick of telling people this: CTE is not correlated with the number of concussive injuries.

source?

This is recent, but this has been the belief/data for years: https://www.cnn.com/2018/01/18/health/cte-concussion-repeate...

CTE is almost by definition not concussion-related. The effects of concussions are part of the concussion.

Modern research is showing that sub-concussive hits play a bigger role in CTE than we expected, so it isn't enough to just show that Rugby concussions are as prevalent as football concussions if Rugby has far fewer(or maybe far more) sub-concussive hits.

The fact there are no pads or helmets actually makes Rugby safer. In American Football people rush into each other at almost full speed, which can lead to serious brain damage. In Rugby, if you were to rush into each other at that sort of speed you would become seriously injured, so brain damage isn't as prevalent.

>> The fact there are no pads or helmets actually makes Rugby safer.

This is oft-cited but before helmets, NFL players were dying at a pretty rapid pace [0], and this is before advanced strength and conditioning.

NFL players rush into each other at full speed knowing the risks. Why would that change if you removed protective padding that has been proven to do very little?

[0]: One such article on the topic: https://paleofuture.gizmodo.com/19-football-players-died-in-...

Yes, Teddy Roosevelt is credited for saving football. In 1904, there were 18 deaths in college football alone, and there weren't that many colleges and not that many games.

http://www.history.com/news/how-teddy-roosevelt-saved-footba...

It's the hard helmets vs leather that's the the issue, the hard helmet lets players use their head as a weapon.

Injuries were also caused by a lot of plays that are illegal today - flying wedges and various dirty blocks (clipping, chop blocks).

"In American Football people rush into each other at almost full speed"

300lbs, running 5seconds for 40 yard, 2% bodyfat -- straight at you -- head down -- helmet first. Oh yeah. They trained on smashing into bags for this for 10 years.

It's true that NFL players suffer enormous head injuries, but let's not be hyperbolic. No one in the NFL is anywhere near 2% body fat; people are not trying to spear other people head first (there are rules explicitly banning this as well as any intentional helmet to helmet contact); most players are well under 300 lbs; most hits aren't occurring anywhere near full speed etc.

>people are not trying to spear other people head first (there are rules explicitly banning this as well as any intentional helmet to helmet contact)

Really? Because someone did just that in the AFC championship a week ago in order to (successfully) take out Rob Gronkowski.

It happens and some people are malicious, but he was penalized and it was considered a dirty hit. The point is that is the only hit of it's type that was seen during the game which contained thousands of collisions.

>...take out Rob Gronkowski.

Context https://www.youtube.com/watch?v=JwALEoMUHrk.

All of these points ignore the fact that the main source of the issue is the repeated, small blows to the head. Larger blows have a higher tendency to be noticed and treated. Smaller, continuous blows happen dozens of times a game for a lineman.

Many of the more serious impacts occur at high speeds, some at full speed. Special teams (kickoff, punt return, etc) are particularly bad for this. There are players on the payroll that are kept for just this purpose.

Player positions with more high speed impacts aren't necessarily linked to greater lifetime CTE risks because they might have fewer total impacts during their career. Linemen might even be worse off with many more "lesser" impacts. The big high speed hits from a safety draw attention, but they're pretty infrequent. A lineman is pretty much guaranteed a consistent head impact every play.

https://www.inverse.com/article/37934-nfl-funded-study-brain...

You can't really live at 2% bodyfat. Even top bodybuilders "only" get down to like 4-5% for competitions. Plus you'll be weak and small. I wouldn't be surprised if 300 lb football players are more like 20%.

Very few players that big are that fast or that trim.

Lots are a bit faster and around 230 or 250 lbs though.

>2% bodyfat

Do NFL athletes really have 2% bodyfat? That's elite bodybuilding physique, and only sustained temporarily for competition. I find it hard to believe that football players can compete with so little fat.

Well. probably more injuries, but much less serious. American Football, if you get hurt, you get hurt really bad

Worse - you get hurt irreversibly, sometimes mortally, very slowly over time. A broken leg is often the least of your problems compared to multiple concussions or the cumulative effects of CTE.

Removing helmets in football without removing almost all forms of contact will likely lead to deaths, which would hard to describe as "much less serious" than brain damage.

Along with what others have said about the pads possible being part of the problem allowing you to hit harder, there are other factors that contribute to the danger.

The American football is played in a series of short plays with long stretches of non-action between plays. This allows plays to be more explosive allowing players run at faster speeds for shorter distances. Also some of the rules lead to greater specialization, which favors some players become much larger (offensive linemen in particular) than rugby players. So the combination of greater mass and greater speed can lead to more dangerous play.

At least that's my take on it.

Are we sure it's not prevalent? Concussions & CTE weren't widely reported in the NFL until recently. Googling for "rugby cte" turns up articles like this one (http://www.telegraph.co.uk/sport/rugbyunion/11857548/Rugby-u...), which suggest that it might be more of a problem than you're implying. It's even a problem in non-American football/soccer (source: http://www.businessinsider.com/soccer-heading-brain-damage-d...).

I suspect over the next decade, and especially as we develop better diagnostic tools, we will find more details about which sports have significant links and be able to effectively modify the rules (banning heading the ball, for example) or steer children towards the sports that don't.

Sports you wouldn't necessarily expect, like ice skating, have problems with concussions.

A lot of comments here talk about the defense padding, and that's certainly part of it when it comes to long-term, low level concussive hits to the head. The idea is also mentioned in other comments that the problem is not sufficiently realized in rugby: that is also probably true.

There are also other factors. The forward pass often puts receivers in dangerous positions, as they often have to turn and track the ball when it isn't thrown perfectly. Also, the stop and start nature combined with the spread in position that the threat of the forward pass creates more high speed head-on collisions. Extreme specialization among the positions also mean that there are a lot of very large, very fast people out there whose job is just to hit as hard as possible.

Those game mechanics also combine negatively with the amount of money at stake due to the extreme commercialization. A lot of these players grew up in high school or younger programs being told that if they want to go pro and make the big money, they have to be out there hitting the hardest, or there's always someone to take their spot. That isn't really incorrect, but it leads to poor outcomes.

Players tackle harder and in more dangerous manners (head first) because the pads lessen the apparent impact. They make it not hurt, but they don't actually prevent damage.

After I started riding a motorcycle, hearing this explanation started to get a serious eyebrow raise out of me. Not the explanation itself, but the thought process behind those who accept it.

The last thing I want to do is just let my helmet do its job. I'd rather do almost anything else to prevent that if I can, because there's a point when I realized that it simply keeps me alive. It doesn't save me from everything. A broken bone heals, road rash heals, CTE does not heal. If my options are to go head first into a car or lay down and take a slide, I'll take the slide every time.

I treat my helmet as just another line of defense, one of many that includes e.g. body gear, situational awareness, keeping up on riding ability, and things like that.

In case it's not clear to anyone reading, yes, I wear a helmet and gear when I ride. I'm not arguing against wearing helmets, only the incorrect assumptions made about them.

Football players purposely spear other players with their helmets with full force. They had to make rules against doing this, and it still happens, although with less frequency. They are not using their helmets as a last line of defense like your motorcycle helmet. They use them as weapons.

It's not happening much at all in NFL football, since it's a major penalty if caught, and it's hard to hide.

I do hope helmet technology improves to handle inadvertent contact.

Disagree, it happens all the time. Its a 'major penalty' in that you get fined many thousands of dollars, but I'm pretty sure the team pays it anyway, and that is a drop in the bucket.

http://bleacherreport.com/articles/2757235-rob-gronkowski-sa...

And furthermore, in that article Gronkowski is quoted as even preferring to take dangerous hits in the head like that, instead of risking re-injuring a bad knee. Not a great policy.

This is exactly true. Technically there are rules against it, but this happens on essentially every play.

side note: can you imagine anybody ever purchasing a self-driving motorcycle?

i. would. never.

Just like boxing gloves make boxing far more dangerous and even deadly than UFC, despite UFC having a more violent appearance.

Something I was told when I was new to training in martial arts is that lighter gloves used in MMA and, for example, traditional karate dojos (simple cotton gloves with light padding -- same design as many MMA gloves, just different materials) simply protect your hands, not the other person's face.

Boxing gloves, by contrast, can and do cause the same sort of faulty reasoning as football helmets when education isn't properly included: there's padding, therefore I can hit harder. Except, no, it (clearly) doesn't work that way. Certainly not when mass is a variable in the equation.

There isn’t a lot of long term evidence that suggests the hitting in UFC is less damaging than the hitting in boxing.

It is just as likely that the brain trauma differences are due to the dramatically less number of hits taken. This has more to do with the rules than the gloves.

We can be reasonably sure of that because boxing could change the glove types trivially and haven’t even in places that have changed other rules for safety (youth & Olympic boxing).

> This has more to do with the rules than the gloves.

How did you arrive at that conclusion? It's fairly well established that boxing gloves have dramatically increased both number of punches to the head as well as the force of the punch. You don't bare-knuckle punch someone in the skull much, it hurts the person doing the punch not just the one being punched. Gloves change that dramatically, resulting in not just more punches to the head but also harder punches to the head (more weight behind the punch from the gloves themselves if nothing else).

Boxing hasn't changed back to bare-knuckle because it would make the sport more gruesome visually even though it would almost certainly be safer for the participants.

I arrived at it simply by looking at the evidence. There is virtually none that indicates that given the same number of punches, glove size matters much.

any change that would bring the head punch count down to ufc levels would likely have similar safety improvements.

The evidence is really sketchy but early research indicates Thai boxing has a bigger incidence of brain trauma than western boxing than ufc and boxing do. The glove is essentially the same.

The issue does exist in rugby and soccer as well. Here is once source I found talking about it:

http://bleacherreport.com/articles/1728218-rugby-player-welf...

I know time in the game is a factor, but idk what rugby is like for that. When do rugby players retire typically?

Some players will be forced to retire due to injury, so I'm not sure of the actual statistics, but it's not abnormal to find players well into their 30s.

If it helps, here's the current squads for a few of the northern hemisphere teams with their ages listed. Lots in their 20s but a few current players have passed 30.

https://en.wikipedia.org/wiki/Wales_national_rugby_union_tea...

https://en.wikipedia.org/wiki/Scotland_national_rugby_union_...

https://en.wikipedia.org/wiki/Ireland_national_rugby_union_t...

https://en.wikipedia.org/wiki/England_national_rugby_union_t...

https://en.wikipedia.org/wiki/France_national_rugby_union_te...

https://en.wikipedia.org/wiki/Italy_national_rugby_union_tea...

I was under the impression that the issue stems from sub-concussive blows which occur every snap between offensive and defensive lines as they rush toward each other. Otherwise, it wouldn't make sense for CTE to appear in defensive/offensive linemen, as they are rarely the ones taking/making big hits, but rather taking/making small hits far more frequently throughout a career, even just a game.

> Otherwise, it wouldn't make sense for CTE to appear in defensive/offensive linemen, as they are rarely the ones taking/making big hits

Uh... what?

Lots of big hits happen on the line, both associated with tackles and not (a “pulling” offensive lineman hitting a defensive lineman or linebacker coming through an apparently open lane being a prime place big, non-tackle hits occur.)

Now, it may be true that because linemen are—compared to, e.g., wide recievers—built like tanks they visibly respond differently to the impacts (but that just means that something cumulatively bad for the brain won't be as likely to be limited by other more acute injuries), and it's definitely true that a lot of those impacts happen off the ball or as the play goes by, and so aren't as much a focus of attention and camera priority.

Fair enough, I misspoke, I meant to say they are rarely the ones coming off the field due to concussions. The bigger, concussive hits are usually taken by the receiving corp and defensive backfield.

Other high collision football codes are not immune to concussion.

In Australian football, AFL not rugby, we have recently seen a change in the rules where dangerous contact to the head is to be avoided and tightening medical governence on diagnosis of concussion during games. The initial reaction from fans was that making the game less rough bordered on pedantic but there's now an acceptance that degenerative brain injuries as mentioned in the article are a huge concern.

Starting contact football at a young age, repeated low impact hits with head contact or sharp movement of head, since rugby players don't wear helmets, players take care to not impact their heads. That said, there is still evidence of smaller CTE problem with rugby and soccer.

Probably no helmets is what makes the difference.

I heard that in early boxing (no gloves) fighters very rarely knocked down opponents, because you don't want to attack head without gloves. Only after introduction of gloves deaths on the ring became an issue.

> Only after introduction of gloves deaths on the ring became an issue.

Which, face it, is actually a big draw for some folks. The lethality of the sport is by design.

IANASportsFan, but... isn't football a bit more play-by-play than rugby? seems like there's more time to get ready for the next iterative sprint-smash in football than in rugby. maybe I'm remembering Aussie-rules.

It's more akin to rugby league than rugby union.

I guess one main factor is that in rugby you tackle the guy with the ball, in NFL they hit/tackle players without the ball so you are much more likely to be hit in every play, in rugby you are not.

I've never really understood the appeal of football (or sports in general) myself - can it be made to be safer without removing whatever it is that appeals to the people that it appeals to?

Out of the major, popular sports, racquet sports (tennis, badminton, table tennis) and golf are the only ones that don't carry significant risk of horrific injuries (head injury or compound fractures). Most contact sports and non-contact sports using hard balls (e.g. baseball, cricket) have some amount of risk, and removing the risk factors would change those sports fundamentally. Strength and power are significant factors in even highly technical contact sports such as soccer or basketball - reducing them would probably reduce the appeal of those sports in my opinion.

>This issue is not prevalent at all in Rugby

Concussions are the most common injury in the England professional rugby league so I would be surprised if Chronic Traumatic Encephalopathy (CTE) is not an issue. CTE injuries in American Football are more common because because defensive players (primarily) use their helmet as projectiles when making tackles either intentionally or by accident.

The pads and helmets make players more likely to smash into each other head-on as there's an illusion of safety.

I wonder if that is true, or if rugby will eventually be studied to have the same consequences too.

Leading a hit with the head, even wrapped in a helmet, is violently concussive. Rugby is awesome, as is Aussie rules football. [I'm American born]

>This issue is not prevalent at all in Rugby, which is arguably more dangerous (no pads or helmets)

The pads allow for you to hit harder, and constantly.

Speculation: Just as boxing with gloves results in more head injuries than boxing without, so too it is with football and rugby.