USA Rugby places player welfare and safety at the very top of our priorities. This is especially true with concussions and head injuries. USA Rugby’s concussion policy is intended to follow the International Rugby Board’s Regulation 10, and follows the “5 Rs” of concussion awareness: Recognize, Remove, Refer, Recover and Return. We must ALL play smart and be smart when it comes to concussions (see below Concussion Education and Resources section).

Official USA Rugby Concussion Policy

  1. 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.
  2. 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 and management. A player must do this before returning to play rugby in any form.
  3. 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.
  4. 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.

Know the 5 Rs

USA Rugby’s policy requires that ALL rugby players, staff, parents, referees, volunteers, and even fans follow these five basic steps when dealing with suspected concussions:

  1. Recognize – Learn the signs and symptoms of a concussion so you understand when an athlete might have a suspected concussion.
  2. Remove – If an athlete has a concussion or even a suspected concussion he or she must be removed from play immediately.
  3. Refer – Once removed from play, the player should be referred immediately to a qualified healthcare professional who is trained in evaluating and treating concussions.
  4. Recover – Full recovery from the concussion is required before return to play is authorized. This includes being symptom-free. Rest and some specific treatment options are critical for the health of the injured participant.
  5. Return – In order for safe return to play in rugby, the athlete must be symptom-free and cleared in writing by a qualified healthcare professional who is trained in evaluating and treating concussions. USA Rugby strongly recommends that the athlete complete the GRTP (Graduated Return to Play) protocol.

See USA Rugby's Step by Step Guide For When Someone Suffers a Concussion


Concussion Chart


Watch USA Rugby Director of Medical Services Michael Keating explain the correct steps to return to play



See USA Rugby's Concussion Return to Play Protocols >>


“USA Rugby believes in a ‘brains over brawn’ philosophy when it comes to player welfare and head injuries in particular. There is no single play or game worth suffering from a brain injury, and we must all be smart, educated and informed when it comes to player safety issues. Players need to throw pride out the window and NEVER attempt to ‘tough out’ a head injury,” said Nigel Melville, President and CEO of USA Rugby. “Let’s play head’s up rugby out there and commit to taking good care of one another through education and responsible action.”

CONCUSSION EDUCATION AND RESOURCES

World Rugby Concussion Management and News

World Rugby Concussion Guidelines

World Rugby Learning Modules

American Academy of Pediatrics

Centers for Disease Control (CDC) Resources

ImPACT Testing

Developed by clinical experts who pioneered the field, ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is the most-widely used and most scientifically validated computerized concussion evaluation system. ImPACT provides trained clinicians with neurocognitive assessment tools and services that have been medically accepted as state-of-the-art best practices -- as part of determining safe return to play decisions. Utilize ImPACT Testing for your team.

Download the 5 Rs Posters

NFHS Resources

National Federation of State High School Associations (NFHS) and Centers for Disease Control and Prevention (CDC) have teamed up to provide information and resources to help educate coaches, officials, parents and students on the importance of proper concussion recognition and management in high school sports. View the course description here.

Rocky Mountain Youth Sports Medicine Institute, Center for Concussion.

Concussion Fact Sheet