How long must a concussed player stay out, and who can clear them to play again?

Question

Accepted Answer

Under the SARU Concussion Regulations (effective January 2026), for all players with a suspected or confirmed concussion:

24-48 hours of physical and cognitive rest (no exceptions).
Light exercise that does not significantly aggravate symptoms.
At least 2 weeks with no contact rugby, even if symptom free.
A graduated return to play (GRTP, or "Individualised Rehabilitation") programme. The player must be symptom free before the high-intensity stages (4, 5 and 6).
Medical clearance before the full-contact training stage.
Earliest return to a match: 21 days after the concussion.

Who does what (Appendix 1):

Step	Who
Diagnose concussion	Registered medical doctor versed in concussion management
Clear the player to start the GRTP	Registered medical doctor
Monitor the GRTP	A doctor, or if none is available someone who knows the player, preferably an HPCSA-registered physiotherapist, biokineticist or nursing sister
Clear return to full contact and matches	Registered medical doctor

Exception: a player managed directly by an SA Rugby or World Rugby recognised Advanced Care Concussion Doctor (ACCD) may return before 21 days, but no sooner than 14 days. Extra caution applies to players under 19.