Five and a half years into a pioneering instrumented mouthguard project, SARU and World Rugby have established a player welfare technology programme that surpasses anything currently deployed in American professional sport.
Managed by sports scientist Ross Tucker and SARU's GM: Medical Clint Readhead, the programme began during the COVID era in 2020 — three years before World Rugby formally integrated the technology into its Head Injury Assessment protocol in October 2023. Trials are running at both elite and school level in South Africa.
The mouthguards contain a chip fitted with accelerometers and gyroscopes that measure linear and rotational head acceleration, transmitting data in real time via Bluetooth to independent pitchside doctors. Newer models also flash a red LED light when impacts breach threshold levels — 65G for women, 75G for men. Critically, the threshold trigger initiates a medical evaluation; it does not constitute a concussion diagnosis.
"The mouthguard is not a concussion diagnostic tool," Tucker explained. "Concussion is too complex for a simple head acceleration to diagnose it. You measure a head acceleration and then test for a concussion."
Tucker is clear on the distinction between impact and clinical outcome. "You can have an enormous impact and no concussion, and you can have a small and innocuous one, and you might be knocked out."
Early calibration issues that produced false readings have since been resolved. Tucker says the system now operates at 99.8 percent measurement accuracy.
Policies governing how threshold alerts are acted upon have also been refined. The initial approach mandated immediate player removal on any alert; the current protocol allows pitchside doctors to evaluate triggers first, balancing player welfare with match flow.
The advantage over NFL methodology is technical as well as procedural. American Football relies primarily on helmet sensor data, whereas mouthguard measurement captures head acceleration from inside the mouth — a more accurate location, since helmets shift on impact and do not precisely reflect true head movement. The NFL uses booth-certified athletic trainers and independent neurological consultants who initiate medical timeouts through video review when a head blow is observed, a reactive system compared to SARU's real-time data approach.
SARU's programme forms part of a broader six-point plan to position rugby as the world's most progressive sport on player welfare.