Rugby Returns to the Games with New Concussion Risk, Respect

Four things to watch for in the Olympics’ rugby concussion protocol


Image from Six Nations Rugby:

( – July 24, 2016) For the first time since 1924 when USA won gold, Rugby will be played in the 2016 Summer Olympic Games in Rio de Janiero, beginning on Aug. 8 and bringing a new sport with inherent concussion risk, but also a healthy respect for the injury.

Although playing Rugby sevens, in which teams are made of seven players playing seven-minute halves, unlike 15 players playing 40-minute halves, the game is a high-contact sport, in which players wear limited padding. A 2014 study shows rugby may have the highest incidence rates of any other full-contact sport. Rugby is also the fastest growing sport in America, according to the Sports & Fitness Industry Association, with the number of rugby players in the United States doubled between 2008 and 2013, reaching almost 1.2 million.

Concussions and rugby have gone hand-in-hand since the World Rugby union formed in the early 1800s, and today the sport faces NFL-like concussion lawsuit problems as well.

Despite the risks, incidence rates and popularity, USA Rugby offers a good benchmark for comparing any concussion protocol.


  • If a player shows symptoms of concussion before, during or after a match, that player must be removed from play immediately, not to return during that match. No Exceptions.
  • The player needs to be evaluated by appropriate medical staff. Best practice would be evaluation by a medical physician who has training in concussion evaluation andmanagement. A player must do this before returning to play rugby in any form.
  • If a concussion is diagnosed, that player must sit out of activity with full rest for the minimum guidelines listed below: Adults – 1 week (seven full days) AND be symptom free before beginning the 5 day Graduated Return to Play Protocols. Not returning to contact rugby before GRTP fully complete and symptom free.
  • Youth and HS players (18 and under) – 2 weeks (14 full days) AND be symptom free before beginning the 5 day Graduated Return to Play Protocols. Not returning to contact rugby before GRTP fully complete and symptom free.
  • Once a player is cleared by a physician, they should be closely monitored for any lingering symptoms by coaches, parents, teammates and medical staff and be removed from play immediately if symptoms occur.
  • (*

4 Things to Watch in Rugby Concussion Approach

  1. Rugby players are taught different “tackling” styles that avoid head contact.
  2. Notice the guidelines above recommend a seven-day sit out period, and 14 days for athletes under 18 years old, before starting the recovery protocol. This shows a healthy respect for the injury.
  3. In the recent rugby World Cup, hawkeye visual technology and press box spotters were used to identify potential concussions. Expect that trend to continue.
  4. Rugby is serious. In a recent semifinal, officials pulled the “scrum half” from Australia’s team out of the game. This is akin to an NFL team benching its quarterback in a conference championship that determines who plays in the Super Bowl.

Finally, new low-cost, high-tech tools like are still growing in popularity, and provides a missing link in most sports concussion protocols.

Missing Link?

The missing link with all of the “best practices,” is a fully integrated, end-to-end tool that can be used with any sport—any level that is practical, and relies on the evidence-based guidelines. In other words, the guidelines need help with actual application in the currentenvironment. The term “fully-integrated” refers to one system that seamlessly integrates all the necessary components including education, baseline testing, balance testing, sideline assessment, tools, post-injury assessment, monitoring, and recovery guidance. And, “end-to-end” refers to the ability to apply this program from the pre-season preparation all the way through to returning the athlete to normal activity and gameplay. Of course, this data and technology could also follow the athlete throughout this career and lifetime.

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