NRL Mailbox: Player safety and concussions
There has been some talk lately about concussion and player safety in the NRL.
It’s firstly important to reiterate that player safety continues to be a key priority for the NRL and the game has taken a strong stance on dangerous play in recent years.
We certainly never want to see players injured and we will continue to do everything possible to ensure the rules are followed and the game is safe for all our players.
The game has long had strict procedures on concussion and last year, in looking to ensure the ongoing review of safety measures, we reviewed the game’s concussion procedures.
The assessment, amongst other things, looked at whether there was a case for standardising post-concussive procedures and testing across all NRL clubs, and also whether there should be further investigation into standardising game-day procedures across all clubs when dealing with concussed players during a match.
As a result of that review, the NRL’s concussion guidelines were strengthened, with all 16 clubs now required to use a computer-based testing system called ‘Cogstate’, - also used by the NFL - that assists in both the diagnosis of and the tracking of concussive episodes.
The review determined that the current guidelines applying to the initial on-field assessment by suitably qualified trainers in the management of concussion would remain as follows:
- Maddock’s Modified Questions
Importantly, if a player failed any of the above assessments, he is to be removed from the field for further assessment by the Club Medical Officer.
The game’s concussion guidelines were also amended to reflect the following:
- If after sideline/dressing room assessment by the club doctor the player is diagnosed with concussion he should not return to the field of play on the same day.
- If after sideline/ dressing room assessment by the club doctor the player is not concussed or a diagnosis is uncertain he is free to return to play.
- If a player returns to the game he will be regularly re-evaluated by the head trainer.
The current concussion guidelines are detailed across seven pages in the NRL 2012 Operations Manual, and include Cogstate testing on all players in the pre-season, post injury testing until recovered (as necessary), testing at the end of the season and also on separation from the club, with the aim of monitoring a player’s psychometric state over time.
It also includes guidelines around pre-season education of players, coaching and training staff in relation to concussion, instruction for assessment by the sports trainer on the field, six-step sideline assessment by club medical officer and instruction for a post-concussion assessment at various intervals including post-match, the next day, the following week and for complex concussions where symptoms persist for greater than 10 days.
Included also is a four-page Sports Concussion Assessment Tool (SCAT2) which provides extensive recommendations and examples of how to test the extent of injury.
The existing steps are in line with world standards.