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Single Organ Guideline

Guideline summary

Athletes with single organs are permitted to play Rugby pending individual assessment and clearance by the appropriately qualified medical practitioner. This clearance must consider the available published information on the risks of participation, the current health of the athlete and the potential negative impact of accidental collision.

This guideline only applies to athletes whose single organ is normally functioning and includes but is not limited to the following organs - eyes, kidneys, testicle, ovaries.


Controversy exists around whether athletes with one paired organ should participate in sport, especially collision sports. Recent legal decisions have permitted athletes with known medical risks to participate in sports in some jurisdictions.


A single kidney is defined as “a morphologically normal kidney without congenital abnormalities that resides in the usual anatomic position”1.

Current information suggests that the incidence of catastrophic sports-related kidney injury is 0.4 per million per year2. Cycling is the most common cause of sports related kidney injury being more than three times more responsible than American Football1.

Grinsell, who undertook an extensive investigation of sports participation with a single kidney concluded, “Restricting participation of patients with a single, normal kidney from contact/collision sports is unwarranted”.

1 Grinsell MM et al. Single Kidney and Sports Participation: Perception versus Reality. Pediatrics 2006;118;1019

2 Wan J, Corvino TF, Greenfield SP, DiScala C. The incidence of recreational genitourinary and abdominal injuries in the Western New York pediatric population. J Urol. 2003;170: 1525–1527


Athletes with one functional with less than 20/40 corrected visual acuity require further evaluation by an ophthalmologist. Protective eye wear if allowed in the sport can reduce the risk of injury but must comply with Regulation 12 and Law 4.


The use of a protective cup in contact sport is recommended but must comply with Regulation 12 and Law 4.

Confirmed by IRB EXCO - October 2012

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