Concussion and the Impact on Rugby

Racepoint Global

How much has changed in the approach of sporting organisations towards concussion? What does the future hold to help tackle this serious issue?

Concussion affects athletes in all levels of sports, from the social sports enthusiast, to the professional athlete. Over the last couple of years there has been an elevated awareness of concussion in sport and an increased focus on the importance of diagnosis and dealing with this issue promptly and safely. Unfortunately until recently there has been an “old-school” attitude of toughing it out and turning a blind eye for the sake of the team, however this is changing, and concussion awareness and guidelines are becoming more prevalent. But with admin-heavy guidelines and confusion over how best to implement them, there’s still some way to go before individuals, Governing Bodies, schools and teams can start getting over this complex issue.

One such sport that has come under increasing scrutiny in the UK in relation to concussion is Rugby Union, which is currently being played by more than two million people across the UK. The Six Nations tournament attracted on average 72,000 people per match, making it the best attended sporting competition in the world. Yet, the discussion leading up to the Six Nations was less about the talent, skill and entertainment on show but more about the wider issue of concussion that has plagued the game for a number of years.

According to England Rugby, research has shown that head injuries are common in rugby and account for about 25% of injuries during play, with research showing that it occurs at a rate of about 3.9 per 1000 player hours[1].

In July 2005, a paper was published by Nigerian American physician, forensic pathologist and neuropathologist Dr.Bennet Ifeakandu Omalu titled “Chronic Traumatic Encephalopathy in a National Football League Player.” What ensued was a saga that would not only expose the issue of concussion in American Football but for contact sports all over the world from the elite level to the amateur and junior leagues.

The NFL accepted Dr Bennet’s discovery eight years ago and this brought the issue of CTE to the forefront of sport, but has there been a significant change in how organisations approach this issue?

Currently, when a player or players are involved in a collision that involves the head the medical team must conduct a Head Injury Assessment, or HIA, consisting of a series of cognitive, balance and memory tests, to ascertain whether the player is fit to continue. Even as recently as last month, there have been calls from the rugby world to produce routine brain scans for those that play the game and have experienced some kind of trauma. However, a number of incidents involving high profile players who were allowed to continue when they perhaps should have been withdrawn have resulted in the HIA protocol coming under scrutiny, with calls to have it changed all together. Ex-World Rugby medical advisor Dr Barry O’Driscoll has said the system is “not fit for purpose”[2].

In light of this, what alternatives exist for Rugby, and indeed many other sports, that remove any chance of an error occurring when figuring out if a player has or hasn’t suffered from concussion? The major flaw currently with the HIA system is the degree of subjectivity and room for human error. By introducing technology into the HIA system, the speed and accuracy at which these assessments are conducted can be improved dramatically removing any doubt as to whether a player should or shouldn’t be allowed to return to the field of play.

Below is a list of companies that are hoping to have an impact on concussion in sport, or in some cases, are already being used by a variety of organisations around the world to make their sport safer.



Return2Play are a concussion management specialist, which responds once the player’s concussion has been logged. As soon as a player’s concussion has been logged via the system, Return2Play sends out a notification to every team they play for. They also issue medical advice on warning signs to look out for, and explain the player’s next steps.

X Patch

X Patch Pro has already been trialled by domestic and European rugby champions, Saracens, and a number of NFL teams who have recorded up to a 70% reduction in incidents that can lead to concussion injuries. The X Patch Pro device is taped just behind the ear of the player which records head impacts which then sends data to the Sensor Data Management app on a mobile device to be reviewed instantly.


Hiji Band is a concussion detector for all sports and is capable of alerting the exact moment a concussion is about to happen. As soon as a traumatic brain injury occurs, the band beeps to alert players that they have to leave the field and consult expert advice. The connected app will also send an instant alert to players’ parents and coaches.

Fit Guard

FITGuard is a smart mouth guard that detects the severity of the impact and uses LED light embedded inside the wearable to indicate the intensity of the force. It also links up with an app to provide coach or parent with real-time insight into the injury and the impact.


Quanterix’s Simoa technology takes a slightly different approach towards diagnosing concussion in the form of a blood test rather than a wearable. After an athlete suffers a concussion, he or she displays higher levels of the protein tau in their blood, and Quanterix’s Simoa technology is able to find and measure proteins like tau that had previously been undetectable and provides immediate feedback.