Concussion Protocol
In 2013, a new feature known as the concussion protocol was introduced into the NFL. Steve Mariucci, a member of the NFL’s player’s safety advisory panel and former NFL coach, says each game has independent neurologists at every sideline of every game. These independent doctors are not associated with the teams whatsoever to ensure an unbiased judgment for when a concussion may occur.
“The NFL realized some team doctors or medical personnel were making decisions in lieu of the player’s health and to help the team still win the game and put the player back on the field,” said Seattle Seahawks Scout, Todd Brunner. “So that’s why they have an independent person so they make the decision and its final. It’s moving in a positive direction.”
The concussion protocol features guidelines detailing what the independent person must do to check – in a sideline medical tent – for a concussion. The test in the tent includes questions about the history of the play that just occurred. Then “Maddock’s questions” are asked, such as “which venue are we at today?” and “did your team win the last game?”
Moreover, the NFL requires that each athlete undergo preseason education as well as a baseline test depicting the brain’s condition.
The former NFL tight end, Gregg Guenther, played for the Tennessee Titans in 2005 and the Cincinnati Bengals in 2006. He says the NFL is much more careful about what happens on the field than when he played.
“There wasn’t a baseline pre-concussion test,” Guenther said. “So once you got hit, or once you got your bell rung, and you were completely out of it, they sprang into action. Now they’re much more on top of knowing where your baseline is and being able to go back and reference that point in the future.”
That starting point, as Guenther said, is the baseline marker in the on-field medical assessment.
“They get observed in the tent. And if they look like they have any sort of symptoms, then they’ll send them in the locker room and have to do more checking in the locker room until they give you the determined ‘yes they have a concussion’ or ‘no, they don’t have a concussion. they can go back on the field.’” Brunner said.
Not only do these doctors evaluate the players directly after a concussion has occurred, but evaluations continue after an athlete gets cleared to go back on the field. In some cases, a concussion can have a delayed onset.
“They are there to not only watch for concussions and try to identify them but to evaluate them after it happens,” Mariucci said. “We have spotters up in the press box that are watching every play and trying to say, ‘hey, so and so’s wobbling, we need to get him out of the game.’ We have given the referees and the officials the right to stop the game and get the kid out of the game to be checked if they suspect anything.”
Thomas Williams, a former linebacker for six NFL teams in 2008-2012, says the NFL now takes precautionary steps that didn’t exist when he played. They didn’t have spotters or an independent doctor on the sidelines to assess a player’s brain health.
“They kind of left it up to the discretion of the player. If you felt you were OK and you passed the tests or did OK on some of the tests, then you could go back and play,” Williams said. “But now, from my understanding, the players are pretty much out of the final say. There is a certified doctor who’s going to have to clear you to say you can come back and play. It wasn’t like that before.”
Former wide receiver, Marques Hagans, played for four NFL teams in 2006-2010. He admits it’s difficult to protect the head from collisions in a sport where contact is a premium.
“Football is a gladiator sport. And I know there is a lot of backlash aboutCTE and the stress that’s put on the brain from so much physical contact. But I think that it’s hard to protect that when the game is based upon contact,” Hagans said. “So I think there are a lot of rules in place and a lot of things that place fines keep people from head-to-head contact. But I think it’s almost impossible because that’s what the game is founded on.”
Not only is football inevitably going to have head-to-head contact, Brunner says the “sticky point” about the concussion protocol is that it is still not perfect. The protocol doesn’t always correctly identify if a player has a concussion because the athletes are not physically being put into an MRI.
“You had the Cam Newton incident where he went to the ground and looked like he was woozy. But then after the fact, their coaches were telling him to just fall on the ground so the clock would stop. And he really wasn’t concussed,” Brunner said. “There was another incident where Russell [Wilson] got hit in the chin on a play. He’s just holding his chin and the referee sent him out of the game because he thought he was concussed. He went off the field relatively quick and really didn’t get checked. But he should have got checked. I think we ended up getting fined for that.”
The Seahawks did get fined for violating the concussion protocol in December 2017. As a first offense, the franchise was fined the maximum amount of $100,000. But this violation occurred before there was an unaffiliated doctor on the sidelines. Soon after this incident, the policy was changed to include such a doctor at each game.
Hagans said when he played, you were only diagnosed with a concussion if you were knocked out and couldn’t get up on your own.
“Whereas before, as long as you could convince the trainers on the sidelines that you were ok, you were able to go back in the game,” Hagans said. But now they’re really trying to minimize the amount of people going back with concussions and finishing games.”
Mariucci says the NFL is doing its best to keep the players off the field if a concussion is suspected. At the same time, it is also doing its best to monitor concussions because some number in any season is inevitable.
“Even with all the rule changes and all the awareness the players and coaches now have about using your head, the speed of the action still produces concussions,” Mariucci said.
For all the NFL’s best intent, sometimes the doctors, referees, spotters in the press box and other NFL personnel can only do so much.
“One thing I will say is that the players can be their own worst enemy,” Brunner said. “Half of the players won’t say they have a concussion or that they have symptoms because, one, it’s the competitor’s nature and, two, they just don’t want to come off the field and lose their spot,” Brunner said.
