Dielman seizure could change the league’s concussion procedures


Proper procedures for diagnosing concussions represent the next frontier in the NFL’s handling of head injuries.  And a recent concussion and seizure suffered by Chargers guard Kris Dielman could bring about the type of change that is currently needed.

The league has revolutionized over the past two years the practices that apply after a player has been diagnosed with a concussion.  More recently, multiple incidents have shown that much more needs to be done before the C-word is invoked.  Chris Mortensen of ESPN reports that Dielman’s injury will be the  “subject of intensive discussion” at a Tuesday meeting of the NFL and NFL Players Association’s Joint Committee on Player Safety and Welfare.

“I’ve looked at the play at least a hundred times,” Dr. Thomas Mayer, the NFLPA’s medical director, told Mortensen.  “Not only does the broadcast footage provide a clear visual record, you can hear the collision loud and clear on the audio.  It really was an unfortunate event but this is a process and an opportunity to further strengthen our protocol.  There are a lot of lessons to be learned here. . . .

“You can see on the video when Dielman wobbles backwards that the umpire [Tony Michalek] is concerned and the referee [Ron Winter] notices something, too,” Dr. Mayer said. “Dielman waved off the umpire. I know he’s one tough dude but this is what we’re trying to avoid. We can educate the officials to treat this like a significant injury, stop time and call for medical attention. When Dielman continued to play in the game, he was subject to further collisions by the nature of the sport and his position.”

Dr. Mayer explained that the Chargers physicians, Dr. Calvin Wong and Dr. David Chao, didn’t know the injury had occurred and weren’t told about it when Dielman came to the sideline. Per Dr. Mayer, Dr. Wong was working on another player and Dr. Chow couldn’t see clearly what had happened on the field.

Mortensen reports that the Tuesday discussion will include the question of whether an independent neurologist should be present on the sidelines during games. As we reported after the Mike Vick “dirt on the face” incident, the NFL does not currently use independent neurologists during games. Instead, independent neurologists become involved only after the concussion diagnosis has been made.

Based on the various recent items I’ve written on this issue, I once again propose the following procedure:  (1) the placement of a safety official in the replay booth, who is charged with monitoring the field, the sidelines, and any available replays for evidence of a player who possibly has been concussed; (2) the presence of one independent neurologist per team at field level who would be buzzed by the safety official to conduct a comprehensive exam of any player who possibly has suffered a concussion; and (3) mandatory examination of the player who possibly has suffered a concussion in a comfortable area of the locker room, with shoulder pads off and the doctor and player able to engage in a candid and thorough exchange.

Here’s hoping that the doctors who’ll gather in New York tomorrow realize that these or similar measures will promote player safety at every level of football.  If the league begins to use better tools for diagnosing concussions, all lower levels of the sport will follow suit.

18 responses to “Dielman seizure could change the league’s concussion procedures

  1. NFL refs already do their own job very poorly, why give them more responsibility, especially when player safety is involved.

    Asking NFL refs to watch out for player safety would be like asking Ted Bundy to watch your teenage girl.

  2. How about making it mandatory that all players have to wear the new helmets..its a start and why not the nfl controls everything anyway.

  3. I know Dr Thom Mayer. He is a jock sniffer and doesn’t know WTF he is talking about. He is not a neurologist, not a neurosurgeon, he is an ER physician who hasn’t seen a patient in a couple of decades. He is grandstanding here and it makes me want to vomit.

  4. Soon, contact will be banned & we’ll have electronic touches with computer invention (like Tennis).

    Man up & keep the dresses in the closet, like the men trying to change the game.

  5. dbrnw: you realize slander and libel laws? Preface comments with “in my opinion” or somesuch, else you can be sued. And no. the internet is not anonymous.

  6. I agree on 1 and 3 of your suggestions. The independent neurologist is just overkill. The doctors that are there are capable of diagnosing a concussion but I do think you make good points on the other two.

  7. I hate to state the truth…but it’s probably going to take a player death due to one of these injuries before the NFL/NFLPA are going to agree to do the right thing, and take someone out AT THE FIRST SIGN of a concussion/head injury.

    What happened with Dielman is absolutely inexcusable. Praise the Lord he didn’t die on that flight back.

    We’ve seen no less than 3 incidents so far where this has happened. The NFL/NFLPA owe it to use today’s knowledge of head injuries to prevent the scourge of Alzheimers’ disease and mental illness that plague hundreds of retired NFL players today.

  8. The key item is the helmet. That is the cause of all of these injuries. People not wearing helmets do not put their head down and lead with it into a person.

    Is there some way to keep the helmets protective of the wearer and to also soften the outside of the helmet?

    We’re talking about a concept of: cushion-shell-cushion.

    Is that absolutely undoable?

    I feel like I’m taking crazy pills.

  9. Regardless of the rules, I hope your team takes care of you Kris. Been in the same boat dude. Yes it’s a contact sport and this stuff happens. Players have to say when as well. you can still be hardcore and say you need to check me out really quick. Nobody wants to be screwed for life at 30 man.
    Former USMC Sgt. Kris Vanmoerkerue

  10. Many people won’t understand this but one thing the NFL needs to mandate is for players to wear the helmets properly. A properly fitted helmet will not come off during the play. It takes two hands to remove a properly fitted helmet. The helmet needs to be pulled apart at the ear holes to remove it when it is fitted properly.

    I worked with Harry Moxley who sold Riddell to most of the NFL teams. He mentioned over and over how many players didn’t even have their helmets properly inflated.

    Also many players do not wear proper mouth guards. Mouth pieces were designed to protect a player from concussions.

  11. They might also want to consider penalizing teams when they purposely ignore ignore symptoms as the Chargers clearly did in this case.

    Even a first time viewer who knows little about the concussion rules could see Dielman needed to sit down and at least talk to the doctor/trainer. That they didn’t pull him for a play or two to do just that, is pure and simple negligence.

    Fine them big – $500,000 the first offense, $750,000 for the second in a season. On the third occurrence, you get a million dollar fine AND forfeit your next game. If it occurs again, you get fined 5 million, forfeit 5 games and lose a draft pick. Sounds harsh, but I can guarantee no team will get to the point of forfeiting games more than once.

    Fine money can go into a fund tor train and support the independent medstaff.

  12. the steve smith article kinda set this comment off, but really, why are nfl referees not highly trained, well paid guys? we have a multibillion dollar sport with multimillion dollar players and we have guys out there getting paid about 30k in basically a part time career ruling over the games. its time we got some guys out there that were athletes themselves and have gone though extensive and ongoing training on the game and other injury type things like this in basically a full time job. nba and nhl refs make over 100k…wtf is wrong with the nfl?

  13. “You can see on the video when Dielman wobbles backwards that the umpire [Tony Michalek] is concerned and the referee [Ron Winter] notices something, too,” Dr. Mayer said. “Dielman waved off the umpire. I know he’s one tough dude but this is what we’re trying to avoid. We can educate the officials to treat this like a significant injury, stop time and call for medical attention. When Dielman continued to play in the game, he was subject to further collisions by the nature of the sport and his position.”

    Did you continue to watch the remainder of the series and next series? I did, and I paid close attention to Dielman’s action the whole time. You really couldn’t tell there was anything wrong with him. This is going to be one tough issue to tackle.

  14. Like TMB333 said properly fitted helmets. Remember when the guys had impressions on their heads when they took them off. I know it hurts and takes time to get used to, but it would help. Also the mouthguards awould make a huge difference. You need to protect these he men from themselves. Proper pads and helmets would reduce injuries.

  15. What is sad is that this doesn’t seem to be trickling down to the lower levels of the sport. Every week in youth football (travel ball, high school, etc.) I see hits that would results in flags AND fines in the NFL being cheered for wildly by the coaches and parents in the stands.

    The refs at these lower leagues are not educated in this, and frankly, I don’t even know if the lower level rules even have provisions for helmet to helmet hits being penalties.

    Combine that with the “bloodsport” mentality of the parents and coaches and you are ending up with a bunch of scrambled brains that go totally untreated.

  16. Having 3 independent neurologists at each game is a fine solution at the NFL level, but that sounds far too costly for small high schools, jr high, and youth leagues

  17. TMB333 Great comments but Mouthgaurds do not prevent concussions. There is no prevention for a concussion other than education. Helmets are getting much better, but the brain is like an egg. You can wrap the egg in bubble wrap but the yolk is still going to move. The brain in the skull works the same way. These players need to take care of themselves and let the medical professionals (ATC, MD, etc.) know when something is going on. Definatly should not be up to an official to determine.

  18. Not to change the subject but there were a lot of what I refer to as deliberate helmet to helmet hits this Sunday. One especially where the player was headed out of bounds and the defender leaped up and tried to head butt him from the side.

    Where are the game ejections? The NFL should spend as much time examining concussions as examinin themselves as to why are players deliberatly trying to injure other players?

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