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Is rugby a safe sport for America’s youth?
by Lyle J. Micheli, MD
Commentary by a past president of the American College of Sports Medicine
I support efforts to establish rugby teams in American high schools and colleges, and wish to alleviate any possible concerns about the sport’s relative safety.
I think I offer a unique perspective on the subject given that:
A popular sport worldwide
Rugby is a dynamic contact sport that is played all over the world by men and women of all different classes, creeds, and races. It fosters friendship and camaraderie between players. To celebrate one recent Christmas, men from the American and New Zealand research stations in Antarctica played a game of rugby against each other on those southernmost frozen wastelands. Most rugby players have played with and against people from other nations.
Rugby is played in over 100 countries and is the most popular team sport in nations such as Japan, Fiji, and Wales. This sport could not be as popular as it is among the peoples of so many different cultures if it were dangerous! In fact, the risk of injury in rugby is relatively low compared to sports Americans embrace – such as football, ice hockey, and lacrosse – a fact borne-out by numerous studies to ascertain the risk of sports injury in different activities. The reasons for this are quite straightforward to those of us who study sports medicine.
Why rugby is a safe sport – paradoxically
The main reason rugby players have a relatively low risk of injury compared to football players is paradoxical – rugby players don’t wear protective equipment. Thus the rugby player doesn’t have the same disregard for the safety of his or her head, neck, and shoulders when tackling or trying to break through a tackle. The other reason is that unlike football, rugby is a game of possession, not yardage. Consequently rugby players don’t tackle by “driving through the numbers,” as football players are taught to do with their heads when tackling a player. In rugby, players are taught to use their arms to wrap a player’s legs and let the momentum of that player cause him to go to ground. Furthermore, in rugby there is no blocking, and so players who don’t have the ball don’t get hit when they’re not expecting it.
One of the reasons rugby has a reputation for being “dangerous” in the United States is because when the average American sees rugby being played, he or she sees a free-flowing contact sport. Because it doesn’t have the familiar stop-and-start character of football and other TV-shaped sports, to the uninitiated rugby can appear confusing and “scary.”
Furthermore, while the bumps, bruises, and scrapes you see on the elbows, knees, and faces of many rugby players can appear alarming, they are of considerably less concern than the anterior cruciate ligament ruptures, finger fractures and dislocations, and chest contusions characteristic of a sport such as football in which heavy protective equipment is worn.
Injury rates
I performed one of the first studies of rugby injuries in the United States, which showed that compared to football, the incidence of injury in rugby is quite low (10 percent in American club rugby compared to 52 percent in NCAA college football). My study was published in the peer-reviewed American Journal of Sports Medicine. Subsequent studies have supported my results.
It would be disingenuous to suggest that rugby players never get injured. However, based on the numerous studies that have been done, the scientific conclusion we must reach is that rugby is not as injurious as certain other contact and collision sports that most of us believe deserve NCAA status, and is a relatively safe sport in the panoply of athletic endeavors available to our young men and women.
Since the early study I did, sports medicine has grown as a specialty and there has emerged a considerable body of literature on the safety of all sports, including rugby. If you review the literature you will find no evidence to suggest that rugby should be denied a legitimate place in high schools and colleges around the world.
For all the reasons outlined above, I have no hesitation based on my personal and professional experience to declare that rugby is worthy of a place in American colleges and high schools.
Dr. Lyle Micheli is director of the Division of Sports Medicine at Boston Children’s Hospital and an Associate Clinical Professor of Orthopaedic Surgery at Harvard Medical School. He is a past president of the American College of Sports Medicine and currently serves as chairman of the Massachusetts Governor’s Council on Physical Fitness and Sports. Dr. Micheli is chairman of USA Rugby’s Medical & Risk Management Committee.
Rugby Indiana places player welfare and safety at the very top of our priorities. This is especially true with concussions and head injuries. Rugby Indiana’s concussion policy is intended to follow World Rugby Regulation 10, USA Rugby Concussion Policy, and follows the “5 Rs” of concussion awareness;
If a player shows symptoms of concussion before, during or after a match, that player must be removed from play immediately, not to return during that match. No Exceptions.
The player needs to be evaluated by appropriate medical staff. Indiana State Law requires a player is evaluated by a licensed health care provider trained in the evaluation and management of concussions and head injuries, and not less than twenty-four (24) hours have passed since the student athlete was removed from play
If a concussion is diagnosed, that player must sit out of activity with full rest for the minimum guidelines listed below:
The minimum return to play time for a player (who have completed an appropriate individualized rehabilitation program) returning from a concussion is 21 days.
NOTE: The day of the suspected concussion is day zero (0). The soonest a player may return is on day 22
All players suspected of a concussion or having a diagnosed concussion must complete and submit the Rugby Indiana Return to Play Form in order to be cleared to play.
Click Here for Rugby Indiana Concussion Return To Play Form
Rugby Indiana Concussion Policy –
World Rugby Requirements & information about concussions – Concussion Guidance | World Rugby
World Rugby Concussion Management for the General Public (Free Online Course) https://playerwelfare.worldrugby.org/?documentid=module&module=21
CDC What is a Concussion http://www.cdc.gov/concussion/index.html
CDC Heads Up Online Training Course for Coaches, Parents, and Athletes (free) http://www.cdc.gov/concussion/HeadsUp/online_training.html
CDC Concussion in High School Sports http://www.cdc.gov/concussion/HeadsUp/high_school.html
CDC Concussion in Youth Sports http://www.cdc.gov/concussion/HeadsUp/youth.html
Sport Concussion Assessment Tool Version 5 – https://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097506SCAT5.full.pdf?v=1661221630664
Sport Concussion Assessment Tool for Children Aged 5-12 https://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097492childscat5.full.pdf?v=1661221630664
Rugby Indiana does not require players complete a physical exam before playing, but it does strongly recommend it. Individual clubs, including school rugby programs may require physicals. Parents should also consider a Heart Screen for their child in an effort to prevent the possibility of sudden death in an athlete.
Indiana High School Athletic Association Physical Evaluation Form 2022-23 Physical Form.pdf (ihsaa.org)
Player safety includes travel to and from matches regardless of if there are a local match or overnight club travel.
> Players who are minors travel to practices and/matches should have a transportation consent form on file with their local club.
> Players may only drive themselves to local events/tournaments in Indiana.
> When local travel does occur, the participating adults who are not acting as a legal guardian, are prohibited from traveling alone with an unrelated athlete who is a minor. They must also ensure that there are at least two other athletes or another adult present at all times.
> Adults who are around players must be registered as volunteers with the club, pass a background check, and complete SafeSport training
> Meals must be planned and budgeted
> Lodging (if overnight) Each player must be provided a suitable bed for sleeping.
> Travel Itinerary must be made available via email to parents at least 14 days before any scheduled trip
The full travel policy can be accessed below.
