Medical and Safety

It is vitally important that rugby programs provide the tools necessary to create a safe environment for all athletes. USA Rugby has developed this guide to explain what is needed to prevent injuries and improve medical coverage at local events, league competition, and all other development activities. This guide also serves to provide information to athletes and parents so they feel comfortable with rugby. When working to establish safety standards, local rugby administrators and coaches must consider:

  • Injury Prevention
  • Emergency Action Plan Development
  • Return to Play Procedures after Injury

A wealth of documentation focusing on safety in youth sports is available to all rugby enthusiasts.  This guide consolidates information to encourage every program to follow a baseline of safety considerations.  With preventative measures in place, athletes and parents can find security in knowing the risk of injury is significantly reduced through responsible preparation.

Injury Prevention

Injuries in rugby are no different from those in other sports.  The key to prevention is identifying associated risk factors.  Rugby programs can work towards decreasing the rate and seriousness of rugby-related injuries by implementing research-based preventive interventions.  The first step towards making rugby safer is addressing the following key factors:

  • Coaching/Officiating
  • Medical Equipment & First Aid Supplies
  • Medical Documents
  • Facilities & Playing Conditions
  • Physical Conditioning
  • Player Education
  • Pre-Participation Examination
  • Biomechanical or Functional Movement Screening 

Coaching/Officiating

As rugby is a contact game, those who manage participation must posses a necessary knowledge base.  Coaches and officials must be proficient in communicating information to athletes which will transfer over into competitive situations.  Rugby coaches need to be aware of their athletes sport background.  Cross over athletes from sports such as American Football pose a challenge for coaches as these athletes need special instruction in rugby specific skills such as tackling and scrummaging.  The best way to learn how to properly instruct all athletes is to become a USA Rugby certified coach. The process concludes with a face-to face workshop featuring the practical application of coaching young athletes.  It is also strongly recommended that coaches and officials seek CPR and first aid certification which can be achieved through the Red Cross at http://www.redcross.org.  An additional resource available through the iRB is the RUGBYREADY Program.

Proper officiating in rugby is a great responsibility as referees must learn to manage imbalances in strength, technique and level of experience.  Coaches and officials must work together to ensure a fun and safe competition takes place.  Officials can gain tools needed to mediate varying circumstances on the field through educational channels similar to those of coaches offered by USA Rugby.  It is the responsibility of all volunteers to seek proper certification and important for athletes and parents to demand this level of expertise.

Medical Equipment & First Aid Supplies

With proper education comes the need for the proper tools.  Rugby requires a low level of start up cost as only a few essential pieces of equipment are needed to participate.  A program priority should be to ensure that equipment for personal or team use during matches and training sessions is safe and iRB approved.  A complete list of accepted equipment required is available at www.irb.com.  In addition to these regulations, a fully stocked medical kit should be available for use by all participants.  For a detailed description of medical kit materials please consult the National Center for Sports Safety at www.sportssafety.org. 

Medical Documents

A complete medical and safe practice binder should be included in the medical kit.  Necessary paperwork consists of:

  • Physician Evaluation Documentation
  • Liability & Eligibility Waiver
  • Injury Incident Report
  • Participant Roster
  • Emergency Information/Medical Release Form
  • Facility specific Emergency Action Plan
  • Photocopy of Insurance and ID card
  • Medical History Questionnaire

 In addition to these items, physician notes, training attendance records, match rosters and other documents may also be included.  All of the information within the binder provides everything needed to properly treat an injured athlete.

Facilities & Playing Conditions

Securing a safe area for training sessions and matches is important.  Programs should make every effort to use adequately sodded or turf surfaces to prevent injuries.  Fields must be void of hazards such as broken glass, protruding rocks, sprinkler heads and holes.  When examining playing surfaces, size, availability, access for emergency vehicles, available parking, lights, and usage requirements should also be considered.  As a member of USA Rugby, all clubs have access to liability insurance which provides protection in case of property damage or bodily injury to third parties. These parties may include the venue owner, coaches, referees, sponsors, spectators and others.  Most venue owners will require this type of insurance before a club is allowed to step on the field of play.   

Beyond the actual playing field conditions, programs must be conscious of the impending weather.  If it is hot and humid coaches must plan to compete early in the morning or later in the evening to avoid the heat.  Having ample fluids and water breaks in shaded areas helps to lessen the incidence of heat exhaustion and heat stroke.  Coaches must know the signs and symptoms of these conditions and take them seriously.  In cold weather coaches must consider ground conditions.  Impact on a frozen field of play can increase the severity of any injury.  Awareness of the signs of hypothermia in extreme cold conditions is also important.  Proper clothing, warm up, and cool down activity is crucial to injury prevention and optimum performance.  

Lightning Concerns 

In case of lightning everyone must evacuate the area to a safe location.  A large building is the best location while sheds, dugouts and bleachers are to be avoided.  If a sturdy building is not available, a vehicle with closed windows will work instead.  The recommend method to help determine when cover should be taken is the flash-to-bang method.  To use this method, begin counting on the lightning flash, and stop counting when the associated thunder is heard.  Divide this number (in seconds) by 5 to determine the distance (in miles) to the lightning flash.  For example, if the time in seconds between the lightning being spotted and the thunder being hear is equal to 30, divide that by 5, and you get 6 (30/5=6).  Therefore, that lightning flash was approximately 6 miles away from the observer.  If a game, practice, or other activity is suspended or postponed due to lightning activity, it is important to establish criteria for resumption of activity.  Waiting at least 30 minutes after the last lightning flash or sound of thunder is recommended.   Each time lightning is seen or thunder is heard the 30-minute clock should be reset. 

Physical Conditioning

It is recommended that player’s receive a physician’s evaluation and clearance prior to participating in rugby.  This is standard procedure for all interscholastic sports and rugby should not be an exception.  Competing in the best possible physical condition not only prevents injuries, it also makes the game more enjoyable.  Pre-season conditioning programs can help prevent fatigue related injuries such as sprains and strains.  Weight training with special attention on the neck and shoulders should be applied.  An emphasis on stretching of all muscle groups decreases the incidence of injury.  Even fitness testing can be applied to assess the condition of the athletes and help better their match performance.  Competitive matches between high school and adult clubs should be discouraged.  Discrepancies in size, strength and experience may result in mismatches leading to injury.  Common sense should be applied to avoid unequal competition.  If athletes perform at their physical best they are more likely to be safe and successful.  Please visit the USA Rugby Strength & Conditioning page more details. 

Emergency Action Plan Development

Each program needs an established emergency plan unique to each place of assembly.  The action plan includes naming the individual trained to assess the situation, secondary assessment, 911 involvement protocol, parental contact responsibility, directions/contact information for the nearest hospital, and notation of a volunteer responsible for accompanying the injured athlete to the hospital.  A detailed emergency action plan should be drafted prior to any activity, reviewed by all medical staff and made available on-site as a reference.

In developing an action plan, it is important to recruit all necessary medical staff and volunteers.  Finding the right medical personnel can pose a challenge in terms of financial constraints and availability.  Developing a strong relationship with local area sports medicine and physical therapy clinics can help solve this issue.  A program might offer to refer all players and family members who need treatment in exchange for services from dedicated medical professionals.  By any means necessary a program should aspire to provide at minimum a Certified Athletic Trainer and ideally an appointed Medical Director, ATC and EMT at all major events.

Additional Resources

USA Rugby has worked to form partnerships with non-profit organizations to provide cutting edge health and safety information.  The Positive Coaching Alliance, Rugby RIO and the National Center for Sports Safety are among the list of recognized contributors.  Parents should encourage athletes to participate in safe activities such as rugby.  We strongly encourage all administrators and coaches to view and use the tools included below to create a safer environment for all athletes.