Injuries in Football and Rugby were once thought to be an occupational hazard. Many people would brush off the notion that life-threatening injuries were a serious problem in contact sports because “hey, he signed up for it.” Those days would seem to be behind us now, especially with the emergence of chronic traumatic encephalopathy (CTE) in the mainstream. CTE is a degenerative disease of the brain synonymous with head trauma that can result in memory loss, aggression, depression, and dementia, among other symptoms. In 2014 Boston University studies the brains of 79 former NFL players, concluding that a staggeringly high 76 of them tested positive for CTE.

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Junior Seau, an NFL Hall of Famer, was diagnosed with CTE after committing suicide.

The Department of Veteran affairs took the study a step further, examining the brains of 128 former football players from various professional or amateur ranks. The findings concluded in 101, nearly 80%, of the players being diagnosed with CTE post-mortem. At first resistant to the research, the NFL has implemented various concussion policies both in game and during practice to curb these numbers, though many criticize the league saying it is still not doing nearly enough.

In an unprecedented class action lawsuit, over 4,500 former NFL players sued the NFL for concealing the dangers of concussions to continue profiting from the hard hitting brand of football it was famous for. Actuarial reports from the case show the NFL estimated a third of retired players to develop some form of debilitating brain disease from playing football. The two parties reached an agreement to settle for $765 million, with an additional $85 million being designated for research and medical exams. The NFL now requires players to undergo mandatory sideline tests if they show any symptoms of concussions during games, and have set up specific concussion protocols for players to go through before they can return to practice.

Though concussions are arguably the most dangerous injury in football, they are not the most frequent, with that honor being designated to knee injuries. Rugby however, boasts more concussions and spinal damages than any other injury. A systematic review of rugby union concussions conducted by Andrew J. Gardener concluded men’s rugby players suffer from concussions 4.73 of every 1,000 match hours, or hours of playing time per person. Because of the way concussion data is collected for rugby, and the way the NFL is played, it is difficult to compare the two sports. Though an NFL game can last anywhere between two to four hours, the actual time spent playing the game between the whistles is rarely over 15 minutes. Rugby plays two non-stop 40 minute halves, and because of this it is easy to collect data based on how much time players actually play. But in this 2008 study conducted by the British Journal of Sports medicine, it was concluded that collegiate rugby players suffer injury rates similar to soccer players, and lower than the NCAA reports for football.

So does this mean you’re more likely to be concussed playing football than rugby? It’s hard to tell. Reuters World Health actually reports that youth rugby players suffer concussions at a rate 18 times higher than average, whereas youth football players only suffer the same injury at a rate double the average. Now this could be for a bevy of reasons, mainly the emphasis on smart football and the wave of “heads up” football sweeping the nation post-Concussiongate. World rugby estimates a little over one million people under the age of 19 play rugby, compared to the three million who play football. This chart shows nearly 400,000 football players under 19 suffer some form of injury, compared to just over 12,000 for rugby. Even if you inflate the numbers to match the amount of athletes who participate in the respective sports, football still has a staggeringly greater injury rate.

The problem with comparing the dangers of the two sports, is that they are really both dangerous, and it is hard to quantify how so. According to neurosurgeon Peter Hamlin, who is a consultant to the NFL and rugby union, one sport isn’t necessarily more dangerous than the other, their injuries are just different. “they are very different sports, and the patterns of injury are different. A guy in the front row of the scrum in rugby will get neck problems. When you have a pack that big, and that aggressive, the front row have to do so much work to build up their neck muscles that they’ve worn out their necks before they even get to the game. So we see young guys with lots of neck problems and spine problems. There is a problem with chronic arthritis in the neck and to some degree the lumbar spine in these guys.” Spinal and neck injuries are actually a major problem in Rugby. In England alone over 100 players have been left with some form of paralysis due to rugby.

A scrum between the Argentinian and New Zealand national teams. Scrums are the most dangerous aspect of rugby with over 100 players being paralyzed during the set piece.

There are many arguments to be made for both sides. Rugby loyalists will tell you rugby is actually safer because of the lack of padding and the style of play. Because football players are armed to the teeth they have the luxury of playing slightly more reckless. Players will often launch themselves through the air like a missile twirling in the October sky, with the head of the missile being… well, their heads. In Rugby however, it’s actually a penalty to leave your feet on a hit. Rugby players are also more disciplined in safe hits, as any hit above the breastplate is a penalty.

Another major factor in the safety of the respective games is the nature of the pass. Many gruesome football injuries happen to players who don’t even see their opponent until after they’ve been hit, or sometimes not at all. Whether it be a quarterback getting slammed from his blindside, a receiver coming across the middle, or a pass catcher looking behind him for the ball, unaware of the defender closing in to his 12 o’clock. In rugby, there really isn’t such thing as a blindside. Sure, you can lose focus of the defender and get creamed, but only if you’re not paying attention. In rugby you cannot pass the ball anywhere but behind you, so a receiver who wants to be ready for the ball can have his eye on both the pass and the defender, as they are both in front of him. In rugby, the offside line is where the ball is, a defender cannot pass this line, therefore your targets are always in front of you. Former Welsh national team rugger Martyn Williams elaborates on the element of surprise and its impact on the NFL’s injury plague. “I would say American Football is more dangerous… there are far more hits put on players who are not expecting it. You can fly in without using your arms when attempting tackles, so knees and so on are far more exposed. I believe all that protection makes them feel invincible.”

Bengals linebacker Vontaze Burfict hits an unaware Steelers reciever Antionio Brown over the middle.

Rugby player numbers are on the rise, as is the size and strength of rugby players. This won’t come as a surprise to most as rugby has really started to take off as a global sport, but some recent numbers in rugby may shock people. ACL and MCL injuries, quite common in the NFL, actually doubled in premiership rugby from the 2013-14 season to the 2014-15 season. These numbers are based off of the Professional Rugby Injury Surveillance Project. However, according to the same study, concussions still led rugby in the injury rankings, with 17% of all injuries being concussions.

Rugby and football have long had their parallels, and the perils of playing have always been a major factor in these comparisons. Both sports boast large men violently thrusting towards one another hoping to move a ball into a particular zone, and another group of men trying to prevent them from doing so. There is no doubt both sports are dangerous, and they both have serious repercussions from these injuries. Though more injuries occur in rugby, football still has the potential to be the most dangerous sport because of the manner in which the game is played, but maybe not for long. The uptick in knee injuries in rugby, and the increase in size of the players point towards the fact that the game isn’t getting any safer, despite mass concussion awareness efforts. Rugby may be becoming more like football every day. And its paralysis problem in the scrums have led many to call for a ban on the most dangerous aspect of the game. Both sports are dangerous, and could learn from each other on how to fix their problems. Any rugby player will attest to the fact that the first thing you are taught in tackling is to keep your head out of it, rugby players will lock their ear to their opponent’s hip and wrap their legs, something the NFL could utilize in neck and head injury prevention. Rugby could also learn a thing or two from the NFL’s handling of the concussion problem, as rugby’s current state in the world of concussions looks a lot like where the NFL was at a few years ago. Both games require blood, sweat and tears, and often times more than that.