Player wellbeing in the spotlight with improved HIA system

There is nothing quite like the contest in rugby league - the pure physicality and passion shown by players willing to put their bodies on the line.

However the game comes with risks, so the Queensland Rugby League has worked hard to ensure the welfare of the players is always front of mind, which is why there is currently so much focus on the proper management of incidents of concussion.

To support this developing area in the game, this season saw the QRL introduce a new education component for all doctors in the statewide competitions, encompassing the Intrust Super Cup, Hastings Deering Colts and Auswide Bank Mal Meninga Cup.

As well as improved care for players, the new management systems also provided upskilling opportunities for people involved in the game off the field.

One of the new systems introduced to the QRL statewide competitions in January this year was Management of Sporting Trauma (known as MOST).

The program was created by Australian College of Sport and Exercise Physicians to provide core knowledge around treatment and management of injuries that occur on the field and outside of the usual clinical setting, with a particular emphasis on sport and exercise medicine.

There was also the addition of two new concussion database management systems.

They were implemented into the competitions and education was provided to all club doctors earlier this year, with the sessions providing an introduction to the two key programs; CSx Elite (an app-based head injury assessment tool) and Cognigram (a medical cognitive testing program for doctors).

This training has been provided by QRL competitions support coordinator Cassie Davis, who has acted as the main conduit for communication regarding the programs. 

Davis has also been monitoring the education process between the platform providers, club doctors and club staff, as well as other QRL staff in the Football and Pathways and Performance departments and external stakeholders including the NRL and NSWRL.

As part of her initial role, Davis did an analysis of last season’s concussion and injury information to help introduce a concussion management system.

Cassie Davis with Dr Roy Saunders and Mackay Cutters medical manager Danell Curtis. Curtis is a qualified nurse and Mackay’s Level 2 Sports Trainer who has worked closely with Davis during the implementation of CSX as ground support and has also provided club feedback regarding the benefits of working with the database in order to manage player well-being.
Cassie Davis with Dr Roy Saunders and Mackay Cutters medical manager Danell Curtis. Curtis is a qualified nurse and Mackay’s Level 2 Sports Trainer who has worked closely with Davis during the implementation of CSX as ground support and has also provided club feedback regarding the benefits of working with the database in order to manage player well-being.

Working in collaboration with NRL chief medical officer Dr Paul Bloomfield, QRL chief medical officer Dr Roy Saunders and QRL statewide competitions manager Dave Maiden, Davis worked to align the organisations to implement the NRL concussion management protocol into the QRL statewide competitions and it has been a great success.

Saunders has provided overall medical support to all Queensland doctors and has worked closely with Davis to help make this happen.

“We are united in our main focus to protect the integrity of each players’ wellbeing,” Davis said.

“We are happy to also be able to provide an upskill opportunity to our current club and game day doctors. 

“By providing the MOST course, along with the induction to the new resources and programs available to them (such as CSx and Cognigram), we continue to provide a quality service to the game.

“CSx is an app-based product used by the doctor on game day to perform a head injury assessment (HIA) on a player.  It is also used to perform a follow up HIA and return to play clearance.

“Cognigram is a web-based cognitive program designed to assist doctors with diagnosing concussive symptoms post injury, and to assist with a clearance in conjunction with CSx.

“In order to manage historical data within both concussion management systems; all players are required to perform baseline cognitive testing during pre-season."

The data collected can assist doctors in their assessment process and can also help other medical professionals to monitor the player of concern, avoid further injuries and focus on player welfare, including follow-up recovery and precise return to play protocol.

“Player profiles are individualised and designed to move with the player," Davis said.

“Aligning the protocol with the NRL has been positive and ... (helps provide) a clear transitional pathway for developing players selected in representative programs or the NRL competition.

“It has been a great success in the Queensland Rugby League statewide competitions."

Davis said overall, the educational components, combined with the new assessment platforms, provided a holistic and contained process for the participants that ensured the QRL were doing everything possible to preserve the wellbeing of everyone within the game. 

There is an understanding that game day doctors can interact with community leagues to improve standards across the board.

Since the initial introduction before the season began, there has been an increase in awareness around concussion on and off the field and QRL will continue to host an annual education session for QRL doctors and clubs.

Club doctors from various statewide competitions clubs during their training session earlier in the year. Photo: supplied
Club doctors from various statewide competitions clubs during their training session earlier in the year. Photo: supplied