“We were the first group of guinea pigs in professional rugby”
This article is by www.dylancleaver.substack.com
Alix Popham is a man in a hurry. The former Wales loose forward has little time for procrastinators. There’s an urgency to everything he does.
One of the original signatories to a lawsuit against World Rugby that could have enormous ramifications for the sport, Popham’s post-career legacy promises to outweigh his 33-test career.
Popham is in a rush to see World Rugby admit that it let its most important commodity, the players, down by not being honest about the risks the sport carried; he wants fundamental changes to the way the game is coached; he wants the medical science community to stop dancing around the edges and to reach consensus on the link between rugby and brain disease; he wants players to be cared for.
He wants it now.
This haste is in stark contrast to the way he approaches his personal health where the aim is to slow everything down; to arrest the progress of a disease that will eventually rob him of lucidity.
Popham, who turns 42 this weekend, was diagnosed with early onset dementia and probable chronic traumatic encephalopathy (CTE) last year, the culmination of a disorienting year in which he thought he “was going mad”.
In the middle of 2019, Popham’s wife Mel started noticing he was mixing up his words, among the most classic symptoms of a deep-lying state of confusion.
“I was drifting off in the middle of conversations and my ability to communicate in group situations was poor,” he says, noting that he couldn’t take in new information if there was any competing noise.
He came close to burning his house down when he turned the stove on and forgot about it but it was an incident on his bike that forced him to confront his condition.
“I got hopelessly lost on a bike ride I had done 100 times before.”
The distress of that situation saw him start a process that would end up with brain scans, his diagnosis and his subsequent involvement in a groundbreaking lawsuit against World Rugby (and the Rugby Football Union and Wales Rugby).
Popham won’t talk about the suit other than to say there are now more than 200 players involved and more than 70 of them had received similar diagnoses to him and the rest were in the process of being tested or awaiting results.
He will talk, however, about the strange relief of the diagnosis, when MRI and DTI scans showed significant deterioration of his brain.
“It’s weird because I didn’t know if I was going mad. You have all these feelings so it was good to have an answer as to what was happening. Even though it was a shit answer, it was an answer.”
The diagnosis came in a time of Covid and he was cut off from his family, so “difficult” Zoom calls with his wife and daughters followed. They were forced to confront the fact that in all probability he had a limited time to make a positive impact.
Then he got busy.
“I realised there was nothing out there for people like me so my wife and I started Head for Change,” he says, referencing the charitable foundation that supports ex-rugby and football players who are affected by neurodegenerative disease.
“I’m a glass half full guy, so I decided to take positive steps forward.”
He is a founder member of Progressive Rugby, a non-profit lobby group that includes stakeholders from all areas of the game, which demands better protection for players to ensure the game continues to thrive.
He refuses to run from his condition. He devours literature on the subject. He understands the science behind it and counts some of the foremost minds on the subject among his close contacts. He has an entrenched cynicism, possibly even disdain, towards those he believes are stalling progress by not conceding there is a causal link between rugby and degenerative brain disease.
It was Popham who reached out to me initially, wanting to know the status of a research project in New Zealand similar to Dr Willie Stewart’s axis-shaking FIELD study that determined that professional footballers had an approximately three-and-a-half-fold higher rate of death due to neurodegenerative disease than expected. Drilling down further, the rates were shown to differ between playing position and career length, but not by the era they played.
New Zealand Rugby has partnered with Statistics NZ to try to determine whether the lasting impacts of concussions while playing rugby increase the risk of dementia. Popham was worried that the project had been shelved and every couple of days a message would land: “Any word yet on that study?”
Inquiries by The Bounce to NZR have determined that the work, led by Dr Ken Quarrie, has been slowed due to the pandemic, but it is very much alive.
I ask Popham if he’s angry? If he thinks rugby is moving at a glacial pace and, if so, whether he thinks it is deliberate?
He mulls this for a time before offering an unconvincing: “No.”
“I mean, how much research do you need?” he continues. “There’s research that’s been out there and verified 100 percent. We were the first group of guinea pigs in professional rugby but there was research before us and there’s been more since.”
One of the key planks of the lawsuit is likely to be that after Gronwall and Wrightson wrote in The Lancet of “the cumulative effect of concussion” in 1975, World Rugby, then the IRB, had a duty of care to warn its players and coaches about the specific long-term risks involved, rather than just stand players down for three weeks following a concussive injury.
A recent biomarker study commissioned by the Drake Foundation and carried out by Imperial College London found that slightly less than a quarter of elite adult rugby players had changes in their brain structure and 50 percent showed an unexpected reduction in brain volume.
“It’s not a very good selling point to mums and dads,” Popham deadpans, referencing the recent comments of former England centre and long-time rugby administrator Simon Halliday, who said his children did not play rugby due to safety concerns.
“Get all the research out there now. Make it all easily available and then leave it up to personal choice.”
While there is no silver bullet, Popham said the move to vastly reduced full-contact training - 15 minutes per week - was not only screamingly obvious but easy to implement. It disturbs him that it will be “advisory” rather than “mandatory”.
“The NFL did it 11 years ago and guess what? There’s more concussions in rugby than American football. We have to err on the side of caution.”
Not making non-contact training mandatory, Popham says, is just another example of administrators procrastinating.
He has no time for that.
““I was drifting off in the middle of conversations and my ability to communicate in group situations was poor.”