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Official USA Rugby Concussion Policy- “Know the 5 Rs”

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 andbe smart when it comes to concussions (see below Concussion Education and Resources section).

Official USA Rugby Concussion Policy

As part of the USA Rugby policy in accordance with IRB regulations, if a player has suffered a concussion or a suspected concussion, he or she must be immediately removed from play. The player should then be referred to and evaluated by a qualified healthcare professional to determine if the athlete has sustained a concussion. It is imperative that the athlete does not return to play until he or she is symptom-free and has been cleared for return to play by a qualified healthcare professional. USA Rugby strongly recommends that the player complete the GRTP (Graduated Return To Play) procedure prior to return to full play and competition. Know the “5 R’s”

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 beingsymptom-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.

“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.”


IRB Concussion Management and News

IRB Concussion Guidelines

IRB Learning Modules

  • Concussion Management Interactive Learning Module: Medical practitioner and/or Healthcare Professional IS PRESENT AT TIME OF INJURY
  • Concussion Management Interactive Learning Module: Medical practitioner and/or Healthcare Professional NOT PRESENT AT TIME OF INJURY
  • SCAT2 – This tool represents a standardized method of evaluating injured athletes for concussion and can be used in athletes aged from 10 years and older. It supersedes the original SCAT published in 2005. This tool also enables the calculation of the Standardized Assessment of Concussion (SAC)3,4 score and the Maddocks questions for sideline concussion assessment.
  • Pocket SCAT2 – Download and print this abbreviated version for easy reference.

Centers for Disease Control (CDC) Resources

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.

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