THE C word is being uttered with increasing regularity at rugby grounds – concussion.

Last week Newport Gwent Dragons winger Matthew Pewtner retired at the age of just 25 after failing to recover from a blow to the head suffered in August.

With Will Smith's Hollywood blockbuster 'Concussion' – a medical drama about brain damage suffered by players in America's NFL – there are fears about the safety of rugby, concerns that have been heightened by a spate of high-profile incidents.

Last season Wales and Lions wing George North took an extended break from the game to recover after a nightmare that started with a blow to the head against New Zealand.

He was then knocked unconscious against England at the Millennium Stadium and then suffered a collision when playing for Northampton against Wasps.

Harlequins full-back Mike Brown sat out the end of the season after being knocked out playing for England against Italy while Ireland's Jonathan Sexton was stood down for 12 weeks in late 2014 owing to four concussions inside 12 months.

It's not just a problem for rugby – on Friday Stoke's Andy Wilkinson retired from football at the age of 31 – but the nature of the modern game is leading to some scary statements.

"We have moved on with our knowledge and we're more ready to advise players to retire," said Dr Barry O'Driscoll, uncle of Ireland great Brian and a former adviser to World Rugby.

"Every case of this saddens you and worries you just that little bit more. It does seem that with the much bigger impacts and speed of the game that these repeated sub-concussive and concussive knocks are becoming more damaging more frequently."

More resources are being put into research – English champions Saracens are gathering information by putting impact sensors behind players' ears in matches – while education and awareness has improved.

The Welsh Rugby Union are working hard at grassroots level with every course run by the governing body, be it refereeing, coaching or playing, featuring the issue.

But the view of Ashley Smith, who was forced to retire last May, is unlikely to allay the fears of any worried parents.

The centre captained his country at Under-20s level and made 161 appearances for the Dragons, becoming a key figure at Rodney Parade with his organisational skills and distribution from midfield.

He gained so much from taking up the sport at Newport High School Old Boys so it comes as quite a shock that he doesn't plan on introducing his two-year-old son Archie to the oval ball.

"I was asked by a lady if I would let my boy play rugby and my honest answer was that I wouldn't stop him but I won't encourage him to take it up," said Smith.

"That's sad in a way because rugby has been brilliant for me; I loved every minute of my career, learnt so many life lessons and made so many friends, but it's my honest answer.

"It's because I think that we have only scratched the surface. It's a fantastic sport but we need more research and awareness.

"Sure, it's a contact sport but when you have been through what I have you realise how serious this is.

"I had mood swings and couldn't get off the sofa. I had memory problems that have improved but I still can't run without getting a headache.

"I was never told to play after a head injury but it does make you think twice about rugby. It's good that the issue is being highlighted and that can only be good as we look to prevent injuries in the future.

"I am pleased that concussion is being brought into focus at grassroots level and that people are being educated with the focus on erring on the side of caution."

The WRU recognise the challenges facing the game and national medical manager Prav Mathema has been at the forefront of the governing body's efforts to educate about concussion, launching the 'recognise and remove' campaign in 2014.

Wales' national medical team are learning themselves, and it was the North incident against England that led to them introducing a medical 'spotter' with access to live replays, and Mr Mathema is keen to help those that don't have their experience or knowhow.

The hope is that through education the next generation will have a culture where they recognise the symptoms of a concussion in themselves and in others.

He said: "At the professional level we have excellent medical care, both on matchdays and during training periods.

"Rigorous, baseline testing is in force to ensure we don't return to play before we are fully ready so it is vital we do as much as possible to ensure amateur players are also protected."

A concussion guidance document was sent to all senior and junior sections of clubs throughout Wales outlining the signs, symptoms and some of the myths – including the fact it doesn't have to be a knockout blow for there to be a concussion – surrounding the issue.

The message is clear: once symptoms of concussion are recognised the player should be removed immediately and referred to a doctor. They should then follow a clear, graduated return to play programme.

"The WRU guidance is easy to follow so players, referees, coaches and volunteers on the touchlines could all have a role to play in recognising symptoms and taking the appropriate action," said Mr Mathema.

"We all know the positives of playing rugby from a health perspective and through the values it fosters and represents, so this guidance will no doubt prove to be a great tool in encouraging greater participation."

The concussion guidance document can be seen at