Player Welfare

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 World Rugby Regulation 10, and follows the "5 Rs" of concussion awareness;

• Recognize
• Remove
• Refer
• Recover
• Return

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:
4. 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.
5. 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.
6. 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.

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:

Learn the signs and symptoms of a concussion so you understand when an athlete might have a suspected concussion.

If an athlete has a concussion or even a suspected concussion he or she must be removed from play immediately.

Once removed from play, the player should be referred immediately to a qualified healthcare professional who is trained in evaluating and treating concussions.

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.

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.

This tool represents a standardized method of evaluating injured athletes for concussion and can be used in athletes aged from 5 years and older. SCAT 5 is the most recentedition published in April of 2017, as reviewed by the International Olympic Committee and World Rugby.

• Concussion Management for the General Public
• Concussion Management for Doctors and Healthcare Professionals
• Medical Protocols for Match Day Medical Staff
• Concussion Management for Elite Level Match Day Medical Staff

• What is a concussion? The Centers for Disease Control and Prevention offers a variety of information on concussions and steps for concussion prevention.
• Heads Up Online Training Coursefor coaches, parents and athletes a free, online course available to coaches, parents, and others helping to keep athletes safe from concussion. It features interviews with leading experts, dynamic graphics and interactive exercises, and compelling storytelling to help you recognize a concussion and know how to respond if you think that your athlete might have a concussion.
• Heads Up Online Training Coursefor health care professionals

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.