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Concussion information for rugby coaches

Key points about concussion information for rugby coaches

Concussion is the most common head injury in sport and may occur with or without loss of consciousness.
When a player receives an impact to the head or body, this can result in force being transmitted to the brain.
If a player receives any knock or contact with their head, you should suspect concussion.
As the coach, you have a key responsibility to make sure the affected person is given the help they need.
Within parts of Aotearoa New Zealand, new Concussion Management Procedures are being introduced.

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A concussion is a type of mild traumatic brain injury (mTBI). It occurs when a bump, blow or shake to your head or body transmits a force to the brain. This does NOT cause any bleeding, bruising or swelling in the brain, which is why scanning your brain isn't helpful. However, it causes a change in your brains cells, essentially altering their function.

You don't have to get a blow directly to your head – impact anywhere on your body can transmit forces to the brain. You also don't have to be knocked out to get a concussion. In fact, loss of consciousness only happens with 10% of concussions. Read more about concussion and what to do.

A player is shown a Blue Card if, during the course of a match, a referee identifies they have suffered a blow and consequently show indications to suggest they may be suffering from concussion. The issuing of a Blue Card triggers a formal off-field follow up procedure.

At the conclusion of the match the referee will inform the Union person responsible for the Blue Card procedure.

The provincial union will draft a letter to the club/school and player concerned confirming that the player has been stood down from playing rugby because of concussion or suspected concussion. This letter outlines the process by which they can ultimately return to play.

This process is as outlined in the New Zealand Rugby guideline for Community Rugby Returning to play following concussion(external link)

The essential parts of this guideline are that a player must have:

no on-going symptoms
completed the minimum 14 days symptom free before engaging in any team based training
completed a minimum of 21 days post injury before returning to play
ideally have been cleared by a doctor.

Graduated return to play

Image credit: New Zealand Rugby

The Community Concussion Management Pathway (CCMP)(external link) is designed to provide a clear plan for players, coaches, physios, and parents to follow when a player may have been concussed. it provides information for relevant people at appropriate time points to improve concussion management in the community.

The way the CCMP will be offered is under review and is currently being trialled in 4 regions (Otago, Hawkes Bay, North Harbour and Wairarapa-Bush) with the aim of making it nationally available in 2025.

(New Zealand Rugby, NZ, 2023)

Information about the following can be found on the ACC concussion in sport(external link) page:

Recognition of concussion including physical, memory, clinical signs and red flags for the need of emergency care.
Removal of the person from play and how to do initial first aid.
Referral to medical services – it's useful to have a list of nearby providers on hand.
Recover fully before they return to play – follow the Rest, Recover, Return guidance:
- initial concussion management involving physical and mental rest until the acute symptoms resolve
- a graduated programme of physical and mental activity, guided by a person trained in concussion management
- medical clearance and return to sport.

More information about concussion can be found on the New Zealand Rugby Toolbox site.(external link)

Concussion
Head injury
Concussion apps

Sport concussion in New Zealand – National Guidelines [PDF, 117 KB] ACC, NZ
Concussion notification form(external link) New Zealand Rugby
Community rugby concussion management protocol(external link) New Zealand Rugby
Concussion in sport(external link) ACC, NZ
ACC SportSmart(external link) ACC, NZ