Concussion return to play in amateur rugby: the GRAS timeline explained

Concussion is the injury every rugby player worries about, and the one with the most confusion around it. How long are you out? Can you train? When can you play? This guide explains the current guidance for community rugby in England: the RFU’s HEADCASE programme and its Graduated Return to Activity and Sport (GRAS) timeline, and the UK-wide Concussion Guidelines for grassroots sport. It isn’t a substitute for medical advice. If you think you have a head injury, follow the steps below and speak to NHS 111 or a doctor.

Step one: recognise and remove

A concussion is a brain injury. It can happen from a blow to the head or from a hit elsewhere that jolts the head. You don’t need to be knocked out. Common signs include headache, dizziness, feeling dazed or “not right”, blurred vision, nausea, memory problems, confusion, unusual emotions and balance problems.

The UK Concussion Guidelines for Non-Elite (Grassroots) Sport, published in 2023, sum up the approach as “If in doubt, sit them out”. Anyone with a suspected concussion should be removed from play immediately and not return to sport within 24 hours. They should contact NHS 111 within 24 hours UK Concussion Guidelines 2023.

The GRAS stages, day by day

England Rugby’s GRAS programme (updated August 2023) applies to players of all ages. Day 0 is the day of the suspected concussion RFU GRAS 2023.

In practice, the minimum time out is 21 days: you’ll miss at least two weekends and could play on the third, but only if you’ve been symptom-free at rest for the 14 days before and through contact training. The UK grassroots guidelines also advise avoiding matches with a risk of contact for at least 21 days after a confirmed concussion UK Concussion Guidelines 2023.

The rules that make it work

• Symptoms set the pace. At each stage, activity should make symptoms no more than mildly worse. If they get worse than that, or new symptoms appear, stop, rest until the next day and drop back a stage.
• No skipping and no shortcuts. Each stage has an earliest day. Feeling fine on day 5 doesn’t mean contact on day 6.
• School and work come before sport. Get back to normal daily life and work before returning to full training.
• Long symptoms need help. If symptoms get worse or don’t improve by 14 days, seek advice from NHS 111. If they’re still there at 28 days, see your GP RFU GRAS 2023. Around two-thirds of people are back to full sport by 28 days; some take longer, and that’s not a failure.
• The plan is individual. These are minimums. Your doctor may advise a slower return.

Who decides when you can play?

A doctor decides when you can return to play. Not you, not your coach, not your teammates and not an app. Following the stages is necessary, but it isn’t the same as being fit to play. If your club has a medical lead, involve them too.

Be honest about symptoms. Amateur players often feel pressure to get back for a big game or because the team is short. The 21-day minimum exists for good reasons, and playing with symptoms puts you at risk.

Training while you’re out

The early stages are about rest and a gradual return to normal life, not training. From stage 3 you can do easy aerobic exercise and light bodyweight work. From stage 4 (no earlier than day 8, and only with no symptoms at rest) you can lift weights and do non-contact rugby. Keep sessions short and stop if symptoms rise.

Use the time to stay involved: go to training to watch, help out, keep a routine. Being cut off from the team can affect mood. If you feel low for two weeks or more, talk to your GP. If you’re struggling, Samaritans are free on 116 123, any time.

After you return

Research suggests the risk of injury is higher in the period after returning from concussion Moore et al. 2022. Sensible steps for the next three months:

• Do a full warm-up that includes balance, landing and neck work before every session and match. See the rugby warm-up guide.
• Train your neck 2–3 times a week. See neck strength for rugby. It’s good contact preparation, but it isn’t proven to prevent concussion.
• Work on tackle technique with your coach: head on the same side as the ball, cheek to cheek, eyes open, chest up, aim below the sternum Hopkinson et al. 2025.
• Wear a mouthguard. A 2023 meta-analysis linked mouthguards with about a 26% lower concussion risk Eliason et al. 2023.

If you’ve had two or more concussions in 12 months, see a doctor before going back to contact work.

How Match Ready handles a head injury

Every game and training log in the app has a Possible head injury button. Press it and contact work, sprints, jumps, lifting and conditioning lock straight away, with the NHS 111 and 999 guidance on screen. The app then schedules each GRAS stage from the day of injury, checks your symptoms daily, drops you back a stage when symptoms rise and won’t let you skip ahead. It never tells you you’re fit to play: that’s a doctor’s decision. The feature is free for everyone and can’t be turned off. See how it works.

Match Ready isn’t affiliated with England Rugby. Read the official guidance on the RFU HEADCASE pages and the UK Concussion Guidelines for grassroots sport.

Common myths

• “You have to be knocked out to be concussed.” Most concussions happen without loss of consciousness.
• “Rest in a dark room until you feel better.” Early on, the guidance is relative rest: easy daily activity in short slots with limited screen time, then a gradual return to normal activity as symptoms allow RFU GRAS 2023.
• “If I feel fine, I can play next week.” The minimum is 21 days, with 14 days symptom-free at rest before full contact, whatever you feel like.
• “A strong neck stops concussion.” Neck training is good contact preparation, but it isn’t proven to prevent concussion.

Tell your club and your workplace

Let your coach or club medical lead know as soon as possible, even if the injury happened outside rugby, so selection and training can be planned around your return. If your job involves driving, operating machinery or other safety-critical work, speak to a doctor about when it’s safe to return, and remember that work and normal daily life come back before sport.