Concussion in Rugby Requires a Gradual Return to the Game

Rugby is one of the most popular sports in the United Kingdom, along with football and cricket. The popularity of the sport has expanded to the United States, where 80,000 people ranging from primary school students to adults play with a team that has registered with USA Rugby. The UK ranks third for registered rugby players with 382,154 as of July 2020. Regardless of a player’s country of origin, the problem of concussion in rugby is becoming more serious with each passing year.

Concussions One of the Top Three Injuries in Rugby

Any sport that involves speed and direct contact with others presents the risk of causing a concussion. Rugby is no exception. Common symptoms of a player who has sustained a concussion in rugby include:

  • Balance problems
  • Blurred vision
  • Dizziness
  • Headaches
  • Memory issues
  • Mental confusion
  • Nausea or vomiting
  • Sensitivity to sound and/or light
  • Sudden fatigue

Unfortunately, the symptoms of a concussion in rugby do not always appear right away. Even when players insist they are fine and do not display the above symptoms, they should sit out the rest of the game if there is any possibility they sustained a brain injury. Team doctors should evaluate possible concussed players immediately. A rugby player should not return to the field until a medical professional skilled in current concussion management protocol gives the okay.

Other Common Injuries in Rugby

Rugby players often run the entire time they are on the field, and the constant motion increases the likelihood of overuse injuries. Bursitis, medial tibial stress syndrome, and tendinitis of the ankle or knee are all common among rugby players. While overuse injuries are not as common as a concussion in rugby, the pain may become chronic if not addressed promptly by the team doctor.

Traumatic injuries other than a brain injury are also common in rugby. Typical examples include:

  • Cuts
  • Deep muscle bruising
  • Dislocated elbows and fingers
  • Fractured bones, including bones in the face
  • Sprained ligaments, tendons, or muscles

These traumatic injuries are more common in rugby than many other sports because players do not wear protective gear or any type of helmet.

World Rugby Concussion Guidance

The World Rugby Association has implemented concussion guidance that requires any player with a suspected brain injury to sit out the remainder of the game or practice session. The association recommends that players complete a Graduated Return to Play programme to prevent returning to the field too soon. The team doctor should arrange emergency medical transportation for any player demonstrating these severe signs of a concussion in rugby:

  • Behaviour that is unusual for the player
  • Decreasing consciousness
  • Double vision
  • Frequent vomiting
  • Increasing irritability or confusion
  • Numbness or weakness in an arm or leg
  • Seizure
  • Severe neck pain
  • Slurred speech

World Rugby recommends that players with a diagnosed concussion rest for at least one week. The injured player should remain in bed for the first 24 hours and avoid activities that require deep thinking and concentration for the remainder of the week. Players should also avoid using computers and smartphones or subjecting themselves to bright lights or loud sounds. Team doctors and coaches should insist on it even if the player complains of feeling bored. Resting the brain and reducing stimulation is necessary to make a complete recovery.

The Graduated Return to Play programme recommended by World Rugby allows for increasingly complex activities after a period of rest. For example, the concussed player may engage in light aerobic exercise one day, sport-specific exercise the next, and non-contact training drills the day after that. Provided these experiences go well, the final steps are full-contact practice and returning to the game.