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Engaging in just 12 hours of intense physical exercise might increase the risk of developing motor neurone disease (MND), according to one of the UK’s leading neurologists.
Earlier this week, fans were surprised when England rugby star and World Cup champion Lewis Moody disclosed that he had been diagnosed with MND at the age of 47.
His diagnosis raised fresh concerns about the potential role of certain sports and strenuous activity in the development of the disease.
Scottish international Doddie Weir, another rugby player, passed away from the disease in November 2022, and England rugby league player Rob Burrow also succumbed to it in June 2024.
Leicester and Gloucester rugby star Ed Slater was also given the same diagnosis in 2022.
Professor Dame Pamela Shaw, a top neurology expert and researcher at the University of Sheffield, has stated that there is a connection between ‘intense physical exercise’ and MND, particularly among men.
Her research, she added, has shown it is more likely in those who undertake ‘more than 12 hours a week of vigorous clinical activity’.
The incurable condition affects the brain and nerves, robbing sufferers of their ability to move, to eat and eventually breathe.
Professor Dame Pamela Shaw, known for her research on neurology at the University of Sheffield, emphasized that there is a connection between ‘intense physical exercise’ and MND, especially in men.
This week, rugby fans were taken aback when England rugby icon and World Cup champion Lewis Moody announced his diagnosis with motor neurone disease (MND) at the age of 47.
Speaking on the Sports Agent Podcast podcast, she said: ‘I’ve always been struck as an MND neurologist, that MND tends to happen to people who are fit and active, whether professional sports people or little old ladies that walk their dog five miles every day.
‘So, it very rarely happens to people that lead a sedentary lifestyle.
‘The studies that we’ve done do indicate that there is a link, particularly in men rather than ladies.
‘But it’s complicated, because clearly exercise is usually a good thing for you.
‘We’ve defined it in our studies as more than 12 hours a week of vigorous clinical activity.’
She added: ‘It seems to be about really pushing your motor system.
‘So, strenuous training every day. I think normal exercise that people do probably isn’t a risk factor. Most athletes don’t develop MND.
‘We’re very cautious and careful about it, because we don’t want to dissuade people from doing healthy levels of exercise which are protective against many different diseases.
At just 47, Lewis Moody is more than a decade younger than the average person diagnosed with MND. In an interview with the BBC on October 6, he said he was ‘overcome with emotion’ when telling his sons — 17-year-old Dylan and 15-year-old Ethan — the news
Lewis Moody’s diagnosis has raised fresh concerns about the potential role of certain sports and strenuous activity in the development of MND. Pictured, during the 2007 World Cup
‘But I do think there is a link, but it’s not just the strenuous physical activity. It must be something to do with the genetic makeup of a person.’
One recent study, co-authored by Professor Shaw and published in the journal EBioMedicine, found that ‘frequent strenuous exercise’ increased the risk of MND — but only in people who are genetically vulnerable.
It is thought low levels of oxygen in the body during strenuous exercise could be leading to a process called oxidative stress in the motor neurones — some of the biggest and most oxygen-demanding cells in the body.
This may lead to damage and eventually cause the cells to die in people who have that genetic vulnerability.
The results also echoed findings from a Swedish study, published in the European Journal of Epidemiology that involved cross-country skiers who took part in the Vasaloppet, a gruelling 90km race.
The fastest skiers, those at the very top of the performance spectrum, were four times more likely to develop MND than the general population.
However, skiers who finished in the middle of the pack had a 50 per cent lower risk than average.
Last year, Durham University researchers also found multiple concussions in retired rugby players made them more prone to developing MND.
The team who looked at 30 retired players with a history of concussions found they caused changes proteins in their blood that make them more prone to the illness.
But, many studies assessing specific sports and the risk of developing MND have produced mixed results.
Experts believe this is likely due to the fact that they are small studies involving too few participants to produce robust findings.
Professor Shaw also told the Sports Agent podcast that because of this, it is too early to give out firm advice on how people with genetic risk factors to MND should manage their exercise.
‘But if we can understand the biology of it, people can then make informed choices,’ she added.
‘There also might be preventative strategies. Taking a cocktail of antioxidants before you run, for example.
‘But we’re not that stage yet. There’s more unravelling to be done.’
Earlier this week, Dr Nick Cole, head of research at MND Association, also said: ‘We know that MND is caused by a mixture of environment, lifestyle and genetics.
The rare and incurable condition affects the brain and nerves, robbing sufferers of their ability to move, to eat and eventually breathe. Pictured, Rob Burrow in 2013
Leeds Rhinos star Rob Burrow (pictured) died last year at the age of just 41 after a four-and-a-half-year battle with MND
‘Sport could be one of the contributing factors, but there are many other subjects within the biology of MND that we are investigating to find the effective treatments we need.’
The condition is most common in people over 50, with the average age for a diagnosis standing between 60 and 67.
At just 47, Lewis Moody is more than a decade younger than the average person.
In an interview with the BBC on October 6, he said he was ‘overcome with emotion’ when telling his sons — 17-year-old Dylan and 15-year-old Ethan — the news.
‘There’s something about looking the future in the face and not wanting to really process that at the minute,’ he said.
‘It’s not that I don’t understand where it’s going. We understand that. But there is absolutely a reluctance to look the future in the face for now.’
MND is typically not easy to spot or diagnose at first — sufferers may find they have stiff or weak hands, legs or feet.
Experiencing twitches, spasms or muscle cramps are other common signs.
The progressive disease is often separated into subtypes but symptoms frequently overlap.
Amyotrophic lateral sclerosis (ALS) — the most common type of MND which typ Lewis Moody is suffering with — is one of the most severe, along with progressive bulbar palsy (PBP).
This primarily affects the muscles controlling speech and swallowing, both of which have a more rapid progression than subtypes like primary lateral sclerosis (PLS) and progressive muscular atrophy (PMA).
There are no effective treatments to halt MND’s cruel march — around 5,000 adults in the UK have MND and there is a one in 300 risk of developing the condition over the course of a person’s life.
