NFL to teams: Pull players if you even suspect a concussion


The NFL distributed a memo to all 32 teams this week in which the medical staffs were reminded that there should be absolutely no situation in which a player sets foot on the field after he has suffered a concussion.

The memo, which was forwarded to PFT, also makes clear that if the medical staff thinks a player could have suffered a concussion but hasn’t formally diagnosed one, that’s enough to take him out of the game.

Under the heading, “WHEN IN DOUBT LEAVE THEM OUT,” the memo states: “If you have any suspicion about a player being concussed, remove him from the game. Always err on the side of caution.”

Dr. Hunt Batjer and Dr. Richard Ellenbogen, the co-chairs of the league’s Head, Neck and Spine Committee, wrote the memo, which also notes that once a player is pulled, he can’t go back in until both the team doctor and an independent doctor say he’s ready to go.

“Any player suspected of having a concussion is a ‘NO GO’ and does not return to play in the same game or practice, and cannot return to play at all until he is cleared by both his team physician and an independent neurologist,” the memo says.

Medical staffs were also reminded of what’s known as the “Madden Rule.”

“Named for John Madden, who suggested it, this rules states that, if a player is diagnosed with a concussion and removed from a game, he must leave the field and be immediately escorted to the locker/training room, and a member of the medical staff (e.g., an ATC, paramedic, MD, fellow, or resident capable of medical intervention) must remain with the player to observe him if his injury does not require immediate hospitalization,” the memo says. “There are no exceptions to this rule and the player is NOT to return to the field under any circumstances. The Madden Rule is intended to protect the players. It provides a quiet environment to permit the player time to recover without distraction. This rule has been endorsed by the NFL Competition Committee and approved by the Commissioner.”

We’ll surely see situations in which players think they’re OK to play and say they don’t want to be escorted to the locker room. The NFL is telling medical staffs that they have the authority to order a player to the locker room whether he wants to go or not.

35 responses to “NFL to teams: Pull players if you even suspect a concussion

  1. Some concussions are obvious after big hits but many go unnoticed because the player was not around the ball or the collision didn’t seem bad. There is no way to prevent every concussed player from getting back on the field. Many of these guys will knowingly do it anyway due to some stupid machismo aspect of their personality or reputation or from the fear of losing their job to “the next guy up”

  2. Strong policy but can it be enforced. Should be time for the NFL to mandate use of helmets that are proven to help prevent concussions.

  3. I love everything about this, except that if you are suspected of being concussed and are not, you cannot come into the game. As a practical matter, this will make trainers and coaches more wary of pulling someone.

    Give trainers the power to send them for testing upon reasonable suspicion, but if they pass with flying colors, why not let them back into the game? Might as well make a system that works practically to make concussion testing easier and more frequent, not another strict rule that 100% of the teams break without consequence, save for the occasional token scapegoat.

  4. This rule will not be followed unless not following it will be blatantly obvious.

    What team in their right mind will claim to suspect one of their star players has a concussion in the 3rd quarter of a crucial game?

    Answer: None.

  5. “Captian – If you don’t leave for sick bay right now I have the authority and WILL relieve you of duty”

    This is one of the few things the league has implemented in the name of player safety that truly is about player safety. Kudos….

  6. How many trainers will be fired after pulling a star from a game due to a suspected concussion? I agree with the rule, but these are the types of things that will make it difficult to enforce.

  7. I wonder how it would work if say Rex Ryan runs out on the field and says that he suspects that the opposing qb is suffering from a concussion.
    Does the other teams qb get pulled?
    I think that the league is trying to take a page from our national governments book-micro-management.

  8. At the end of the day, concussions are easy to diagnose if you examine them based on the testing protocol outlined… A player really can’t hide the symptoms because it is a brain so there are certain reflexes that are going to be impaired and out of the players control trying to pass the test…. I think a lot of these team physicians and trainers feel as though they are going to lose there job so there are times when they turn a blind eye, which is unfortunate.

  9. Take the helmets off. Take the shoulder pads off. Make it illegal to tackle above your opponents’ shoulders. The helmets and shoulder pads are the weapons that cause concussions. Without a helmet, nobody would try to go head-on-head. The Rugby World Cup starts next weekend and NBC is covering a few of the matches. Watch for yourself how tackle football can be played with more tackles and less injuries. And yes, they have kick-offs.

  10. Trainer: I have NO DOUBT that this guy maybe doesn’t have a concussion.

    Coach: Good enough for me. No doubts there. Get your ass back in there!

  11. “…Rex Ryan: “Mark, I think I suspect a concussion.” …”

    Jason G: “Tony, I suspect a concussion…”

  12. Is there any room for a player that passes initial sideline examination to return to the game? If a trainer starts looking in the players eyes and asking questions, doesn’t that in and of itself constitute suspicion and therefor require the player’s removal?

  13. Speaking of medical staffs, why does PFT not post about the Chargers team doctor? The head man for the Chargers medical staff is under DEA investigation for rampant prescription abuse. He also has a very checkered resume and disciplinary actions taken by the California Medical Board….

  14. I thought the “Madden Rule” was that if your face is on a video game, you have a crappy season.

  15. @willyalistentothis Rugby does not have the forward pass. You get a helmetless WR going across the middle and they get leveled, just watch that unprotected head bounce off the turf.

    Or how about hitting low and having a player flip and land on their head. Rugby is not a game of forward momentum like football.

    I agree with this rule, and hope it is implemented down to the lowest levels of football.

  16. “Under the heading, “WHEN IN DOUBT LEAVE THEM OUT,” the memo states: “If you have any suspicion about a player being concussed, remove him from the game. Always err on the side of caution.”

    Unless the game or season is on the line………….

  17. That’s great except now if a dirty player wants to knock an opponent out of the game he just needs to make sure he rings the players bell enough to cause doubt.

  18. That picture of Desean is exactly why the Eagles don’t want to pay him big bucks. He’s one more concussion away from never playing again. This years contract and franchise tag next year will be the extent of Deseans football career. He has yet to play 16 games and he’s good for one thing, blowing the top off of coverages. Without him Maclin dominated as a one and I believe they will spend the money on Mac vs Desean.

  19. Okay, NFL. Want to go there? Then the next time Suh slams a QBs head into the ground he should be expelled from the league and be liable for damages.

  20. mgp1219 says:
    Sep 1, 2011 12:24 PM
    How many trainers will be fired after pulling a star from a game due to a suspected concussion? I agree with the rule, but these are the types of things that will make it difficult to enforce.


    Do you honestly believe that with all of the national scrutiny on this subject a team would dare fire a trainer shortly after they benched a star?

    They would get killed.


    The specific situations you refer to with people hitting their heads on the ground probably account for 5-10% of NFL concussions. The vast majority are the result of over padded players crashing into each other.

    Willy is right on point. I have played high level rugby for 25 years and have seen less concussions, and other types of serious injuries for that matter in all that time than I do in one weekend of NFL football.

    There is absolutely no doubt in my mind that NFL injuries would go down if they took all the pads off, and adopted the rugby be rule of having to wrap your arms when you tackle.

    Of course, it wouldn’t be as entertaining as it is now for people who only watch football for the violent collisions and injuries.

  21. I saw an Eagles linebacker last year on opening day take a huge hit, looked knocked out cold, then regained consciousness and struggled to get up, got up then stumbled down again. Fox cameras capturing this entire thing and the announcers even commented on it. And he was back on the field BEFORE THE END OF THE FIRST HALF. Obviously teams have very strict guidelines on what constitutes a “concussion”. Probably that they have to be in a coma to be diagnosed with one.

  22. Concussions will put an end to sports. There aren’t many athlete’s who haven’t suffered at least a mild concussion.
    Before you know it there will be no one left to play the games.

  23. I’ve had this idea about a heavily padded, SOFT exterior, helmet. Seems to me the hard outer shell prevents as complete a cushioning to the blow as would be possible with a soft (think old fashioned leather helmets) exterior.

    Then again, the idea came to me after hitting my head…

  24. @willyalistentothis rugby players aren’t 6’5″ beasts that can bench press a 225 pound barbell 30 times and run a 4.5 40!

  25. How does Madden continue to get his name connected with injuries? First we had the Madden Curse, now the Madden Rule? What’s next?!

  26. We believe more mandatory safety equipment to help detect head injuries needs to be implemented at the youth football level. It’s great the NFL is continuing to implement policies to keep players safe but this needs to start right when kids begin to play at levels where contact takes place.

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