Rational choices in irrational games: concussion, risk and youth sport
By Dr Daniel Walker is an Assistant Professor in Psychology at University of Bradford's School of Law and Social Sciences. His research examines the negative psychological consequences of concussion in sport, which often include poorer mental health, impaired cognitive ability and reduced quality of life. Here, he argues we need to be more aware of the risks involving sports such that can result in head injuries, such as rugby and football.
OPINION
In August 2025, Shane Christie became yet another rugby player suspected to have died by suicide having suffered from Chronic Traumatic Encephalopathy (CTE). CTE is a neurodegenerative disease often found in players of contact sports like rugby - it can only be diagnosed after death. Symptoms in those living with CTE include cognitive and behavioural issues such as memory loss, confusion, impulsivity, depression and suicidal ideation.
Christie died one day short of his 40th birthday having retired from playing rugby back in 2018, aged just 32, thought to be due to the negative effects of concussions sustained in rugby.
As a psychologist of sport, I have dedicated my career to-date to investigating the negative consequences of concussion in sport and the potential reasons for continuing to take part.
In some of the work colleagues and I have published we provide evidence that those who have sustained concussion may be 57 times more likely to develop depression than those who have not.
However, when speaking with sportspeople, the risks associated with concussion rarely deter them from competing in their sports. Despite players claiming they understand the potential consequences of concussion, they continue to engage in sports where concussions are common.
For example, when interviewing rugby players in England, we found that all had sustained a minimum of three concussions, with one estimating they had suffered twenty. As though this was not concerning enough, all participants also reported having continued to play rugby with a suspected concussion in the past – a dangerous behaviour that can exacerbate symptomology and lead to second impact syndrome.
The health-belief model can partly explain why rugby players may choose to continue participating as the model explains how people perceive threats to their health and the benefits and risks of taking action.
Key components of this model include:
- perceived susceptibility - an individual's belief of the likelihood of suffering a particular health issue
- perceived severity - the severity of said health condition
- perceived benefits - the benefits of positive change to prevent the illness
- perceived barriers - the obstacles that make it difficult to make these changes
- self-efficacy - the confidence in their own ability to make these changes
- cues to action - the internal or external influences that may encourage someone to implement change
These components can be observed in many negative health-related behaviours such as smoking cigarettes, alcohol consumption, lack of physical activity and the way that sportspeople view injury in sport.
However, this model is limited by assuming everyone behaves and makes decisions rationally. In fact, humans are often irrational in their decision making, and there is a theory that we place more emphasis on the decisions that affect us right now rather than potentially in the future. Put simply, we are more concerned with the cat in front of us right now rather than the lion potentially in front of us twenty or thirty years from now.
Despite high-profile cases like Shane Christie’s suspected CTE-related death, and the devastating impact of motor neurone disease (MND) on players like Doddie Weir, Rob Burrow and now Lewis Moody, many rugby players continue to compete. While the causes of MND and CTE differ and are still being investigated, both highlight the long-term risks associated with contact sports.
Kevin Sinfield has raised over £10 million for MND research, inspired by his friend and former teammate Rob Burrow. His efforts have been nothing short of extraordinary. Yet, even Sinfield has acknowledged the tension between rugby’s benefits and its potential risks, stating that he believes the positives still outweigh the negatives. This illustrates how even well-informed adults can wrestle with complex health-related decisions, a reminder that behaviour is not always driven by information alone.
If adults struggle to navigate these choices, we must ask whether children, with their limited capacity to assess long-term risk, can truly make informed decisions about participating in sports that carry potential brain health risks. Just as we protect children from other adult domains like alcohol, gambling, and sexual activity, we must ensure sport is as safe as possible, especially when it comes to brain health.