The HEADCASE Essential Guide provides details of the programme and key information including concussion rates in rugby union, potential short/medium and long-term problems and the effects of second impact syndrome.

What is concussion?

Sport related concussion is a traumatic brain injury resulting from a blow to the head or body which results in forces being transmitted to the brain. This typically presents as a rapid onset of short-lived impairment of brain function that resolves spontaneously.

This impairment results from a functional disturbance, rather than a structural injury, and no abnormality is seen on standard hospital scans. A range of signs and symptoms are typically seen, affecting the player's thinking, memory, mood, behaviour, level of consciousness, and various physical effects. Clear loss of consciousness occurs in less than 10% of cases.

Recovery typically follows a sequential course over a period of days or weeks, although in some cases symptoms may be prolonged.
A more detailed definition and description can be found in the 5th Concussion in Sport Consensus Paper.

Concussion in Rugby

How common is concussion in rugby?

Concussions occur in everyday life and not just in sport. As a contact sport, rugby does involve frequent body impacts and a risk of accidental head impacts, and therefore a significant potential risk of concussion.

According to the data collected through the RFU’s Community Injury Surveillance & Prevention Programme (CRISP) in age grade rugby (age 15 – 18) the most recent rate shown equates to 1 concussion per team every 10 games and 1 concussion per team every 25 games in adult male rugby. In professional rugby it is 1 every 2-3 team games.

The rise in the rates seen since 2012/13 are almost certainly due to the increased awareness and the much lower threshold for suspecting concussion, and reflect the success of the awareness and education programmes, and media coverage.

Concussion and the RFU

The RFU recognises that concussion is an important player welfare issue in rugby, and takes its responsibilities very seriously. The RFU has a comprehensive risk management strategy which covers the key priorities of:

• Education & Awareness,
• Prevention,
• Management,
• Research,
• Communication.

The strategy is managed and monitored by the RFU Concussion Risk Management Group, The Group is supported by an Independent Concussion Expert Panel advising on concussion policy and monitoring emerging research, and the Economist Health Intelligence Unit who, on a six-monthly basis, provide summaries of all research published, and a qualitative analysis of the key studies.