World Rugby change concussion stand-down period to 12 days

World Rugby will announce on Tuesday that players who suffer a concussion are likely to face a 12-day wait before being allowed to resume training under extended return-to-play protocols.

Under a new individualised approach, all players who have a history of concussion or who fail the off-field Head Injury Assessment during a match face a minimum 12-day layoff before returning to play, meaning the majority of concussed players face missing their team's next game the following week.

Only players who have no concussion history and show no symptoms following a medical test taken after two night's rest (36-48 hours) will be able to return to play after a minimum of seven days following a review from an independent concussion specialist.

Similarly all players with a history of concussion will need to be signed off by an independent concussion specialist in order to return after a minimum of 12 days.

A history of concussion is defined by World Rugby as players who have been diagnosed with concussion in the previous three months, had three concussions diagnosed in the previous 12 months, have been diagnosed with five concussions in their career, with psychological issues which may lead to it being harder to diagnose concussion, and who have taken longer than 21 days to recover from a previous concussion.

The new individualised approach to concussion cases comes as a result of the latest review of scientific evidence and rugby-specific research by the federation's expert independent Concussion Working Group.

Professor Bob Cantu, a professor of neurology and neurosurgery who is part of the Concussion Working Group, said following World Rugby's decision to take the group's recommendations on board: "I believe World Rugby has a head injury assessment protocol that is gold standard, second to none and superior to most.

"As a working group, we discussed the full range of options from mandating a longer stand down period for all players through to keeping the existing protocols in place and the consensus of the group is that an approach based on the circumstances of the individual involved is undoubtedly the best way forward.”

Regarding the long-term battle to make the sport as safe as possible for all players, Alan Gilpin, World Rugby's chief executive, added: "We're making progress. There are lots of areas where we have advanced. You can never do too much in this area, we can't stand still and have to keep evolving.

"It's never a battle we're probably going to win, but the key for us is to keep advancing with the science and as quickly as possible. One the independent Concussion Working Group had made a recommendation, we moved that through our executive committees and process in World Rugby really quickly to make sure we were responding to that change. We just have to keep evolving.

"We're a contact, collision-based sport, there's always going to be head impacts. What we're trying to do is reduce them by teaching better tackle technique, ultimately. From mini rugby through to the international game, improving tackle technique is what will help us improve in this space. There are always going to be head impacts and concussions, we're never going to eradicate that with the nature of the sport we have is what I mean by a battle we won't ever ultimately win, but we want to win it enough that people are comfortable with our game, that it's safe to play at all levels and the sport is doing its best to look after those players' safety and welfare."

Incidents during the weekend's Gallagher Premiership final and England's game with the Barbarians were also referenced, with Aled Davies' high tackle in particular causing some confusion among the public when a red card was expected, yet Davies was shown yellow.

"I do think we're getting the message across, but are we getting it across as universally quickly as we would like - the answer is probably now," Gilpin added. "There is a lot more briefing for us to do through broadcast and media about trying to change player and coaching behaviour around tackle height. Diagnosis of concussion is really important, but ultimately we want to reduce the number of head impacts and that is about changing behaviour."

The organisation International Rugby Players have called for players to now be open and upfront regarding head injuries and concussions in order for the new protocols to work efficiently.

Head of Player Welfare Conrad Smith said: “The key to this working - and the important part in changing the culture around concussion - is that players report their head injuries and any symptoms. Seeing first-hand the amount of work and research that is going into this extremely complex issue, I have confidence in the approach taken and that the authorities are looking after the player’s best interests.”

Longer lay-offs will require larger Rugby World Cup squads

by Ben Coles 

The ramifications of World Rugby's new extended return-to-play protocols could actually have been spotted on Monday morning following Eddie Jones' squad announcement for the upcoming tour of Australia, with England taking a larger group of 36 players compared to the 32 who toured six years ago.

Given the new concussion protocols come into effect on July 1st, a day before England face Australia in the first Test in Perth, the risk of losing a player for a minimum of 12 days has led to Jones taking more players than in the past given the logistical issues of flying extra bodies out on short notice all the way to Australia. Ireland, who also play midweek matches against the Maori All Blacks, have selected a 40-strong squad for their summer tour of New Zealand.

Looking ahead it seems likely that Rugby World Cup squads will also need to be increased to account for players being sidelined for longer periods during the tournament. Teams selected squads of 31 players for the 2019 Rugby World Cup in Japan but that number could increase by four or five, particularly when it comes to front-row specialists. Should that come to pass it would lead to fewer selection headaches for head coaches in the run-up to the tournament.

As for the regulations itself, opting for "an approach based on the circumstances of the individual involved" was described as "undoubtedly the best way forward" by Professor Bob Cantu, rather than simply implementing a blanket longer stand-down period for players of 12 days. Whether lobby groups such as Progressive Rugby take the same view regarding that statement will be interesting. The Rugby Football League currently operates with a minimum 11-day recovery period for players who suffer concussions.

The new regulations will certainly avoid scenarios such as Kyle Sinckler's concussion during this year's Six Nations, when the England tighthead prop came off the bench against France seven days after failing an HIA against Ireland.

“There are protocols in place to ensure the safety of the players and it is not for me to second-guess the medical staff," Eddie Jones, the England head coach, said at the time. "He goes through all the protocols, we get an independent professor to judge his status to play the game and then we take all that into consideration and if it is all positive then he is fit for selection.”

Having failed his HIA, under the new regulations Sinckler would have been ruled out for 12 days and missed the game with France.

While player safety is absolutely paramount for Gallagher Premiership clubs, the prospect of losing players for longer periods due to the new return-to-play protocols follows clubs being forced to trim squads due to the reduction in the salary cap from £6.4 million to £5 million next season, which may in turn lead to more teams fielding academy prospects to fill positions.