League clarifies “concussion-like symptoms”

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We’ve been critical this season of the Steelers’ handling of head injuries.  Instead of acknowledging that a player has suffered a concussion, the Steelers describe the condition as “concussion-like symptoms.”

Common sense indicates that it’s a distinction without a difference.  If a player has suffered a blow to the head and is exhibiting concussion-like symptoms, it’s probably not because he has some other health condition that suddenly has caused him to display the symptoms of a concussion.

Common sense also suggests that the Steelers are resisting the application of the “concussion” label for a reason, presumably one that in some way benefits the Steelers.

After pressing the Steelers and the league office for further information regarding the situation, the league office has elaborated.  “Concussion-like symptoms describe just that — symptoms — that may lead to a diagnosis of a specific injury — concussion,” NFL spokesman Greg Aiello said.  “For purposes of our rules, a player with concussion-like symptoms should be treated as if he has suffered a concussion unless a concussion is specifically ruled out.”

There’s the loophole.  If the Steelers’ doctors are able to specifically rule out a concussion, then the Steelers never have to surrender their handling of the player to an independent neurologist.  While we have no reason to doubt the substantive abilities of the Steelers’ doctors, the fact that the NFL even uses independent neurologists represents an acknowledgement of the possibility that a team’s doctors will at some level be influenced by their desire to remain the team’s doctors, especially when dealing with a relatively vague and subjective condition like a concussion.

And if a team’s doctors become overly cautious on the issue of concussions, the team eventually may decide to find other doctors.

In the end, the use of a term other than concussion becomes a matter of control.  The Steelers likely don’t want to surrender ultimate control over who can and can’t play to a truly independent neurologist.  Instead, the Steelers — like many teams — hope to retain some ability to persuade, expressly or implicitly, the team’s doctors to give a player who wants to play the ability to play.

51 responses to “League clarifies “concussion-like symptoms”

  1. How did you manage to make this non-story an issue with how the Steelers handle injuries? They are working within the rules the NFL has set forth and have done nothing wrong, including holding players out and subjecting them to proper testing before they play again. You completely blew this out of proportion and I didn’t see anything in the post that admits you were wrong about how the Steelers have handled these cases.

  2. After pressing the Steelers and the league office for further information regarding the situation, the league office has elaborated. “Concussion-like symptoms describe just that — symptoms — that may lead to a diagnosis of a specific injury — concussion,” NFL spokesman Greg Aiello said. “For purposes of our rules, a player with concussion-like symptoms should be treated as if he has suffered a concussion unless a concussion is specifically ruled out.”

    HMMMM seems as though thats exactly what the Steelers are diagnosing and doing. They dont know if the player has a concussion so they treat him as if he has had a concussion and KEEP HIM OUT OF THE REST OF THE GAME.

    So the Steelers are handling the situation properly. Keep digging though, because there has to be a scandal somewhere.

  3. Players think they’re invincible and don’t want to listen when they are told that they’re making a short term decision that has a long term impact.

    Teams have a history of ignoring player’s health and just focusing on the short term goal of winning a game.

    The League has a history of looking the other way while teams endanger their player personnel.

    It’s been this way for a long time – kind of like the Federal budget – voters typical refuse to listen to long term strategies, politicians typically ignore the long term needs and focus on the short term goal of winning their next election, and the FEC and the courts have history of looking the other way at blatent corruption.

  4. The editor of this web site is suffering from “delusions of grandeur-like symptoms.” Please, get over yourself.

  5. So now you’re suggesting that team doctors willingly make false diagnoses in order to keep their jobs? Your conspiracy theories are getting a bit ridiculous, and are making you lose credibility. You probably don’t believe that man landed on the moon, either.

  6. What would happen if/when a player sues the doctor/team for allowing them to play with a concussion? A concussed player doesn’t think clearly, the team clears them to re-enter the game, more damaged is caused to the player. Just doesn’t seem right.

  7. Team Doctor: We have officially ruled out a concussion, despite these “concussion-like symptoms.”

    Independent Neurologist: He doesn’t even remember his own name!

    Team Doctor: He’s just stupid.

  8. Yeah flo, the steelers doctors must be heavily influenced by not being independent.

    Thats why when the three times this year their players have displayed concussion like symptoms, that player has been held out the rest of that game and had to pass concussion tests throuout the week to pratice and/or participate in the next game.

  9. Why am I not surprised that no portion of Tomlin’s explanation below made it into any of the 5+ articles regarding this subject:

    “He was asymptomatic relatively quickly, and I am talking about Sunday night,” Tomlin said of Polamalu’s most recent head injury, in which he struck the knee of Kansas City tackle Steve Maneri. “If we are going to err, we are going to err on the side of caution when it comes to health, particularly from a head injury standpoint. I have no issue with that.

    “We lean on the expert advice of our medical staff. Troy has been good. We anticipate it being a nonissue moving forward this week. Like I said earlier, we are not going to assume anything with a player’s health, particularly when we are talking about a head injury.”

    Tomlin said the Steelers are aware of Polamalu’s history of concussions and will proceed accordingly.

    “Obviously, we are sensitive to his concussion history, and we are always going to exercise the necessary precaution when dealing with it.”

  10. The Pittsburgh Steelers using the term “Concussion-like-Symptoms” to describe their star player is like me using the term “non-story-like-story” to describe your journalism. Your disdain for the Pittsburgh Steelers is starting to get rather annoying!!!!!

  11. So, basically the league’s response showed that your criticism is unfounded. but instead of admitting it and moving on, in your arrogance you point out a “loop hole” that questions the integrity of team doctors. You have no idea how outrageously stupid you sound.

  12. Haha the steelers hate articles are funny. This pft makes non issue stories into some dumb loophole scandal. Dont hate on steelers cuz they swaggin!

  13. mikeypanic says:
    Nov 30, 2011 4:30 PM
    for the love of god, let it go.

    your hard on for the stillers is embarrasing.


    Right on, brother! Couldn’t agree more! Best post of the day!!!

  14. Maybe the editor was rejected when he applied for a position in the Steeler’s legal department. Must be some reason he/they have ax to grind. He’ll never have to worry about a concussion with that coif.

  15. My suggestion to the blogger of this site is to interview Merrill Hoge. He will be able to verify firsthand the Steelers have been at the forefront of handling concussions since the 1980s.

  16. Not a Steelers fan by any stretch, but those are some wild accusations. Possible? Yes. Plausible? Not so much.

    Oh well, gives the black and yellow fans something to talk about. Time to sit back and watch the words fly.

  17. Polamalu was asleep for a few seconds and when he came back to he couldn’t even keep himself upright. If this were MMA it would be a 90 day mandatory suspension. I hate the Steelers obviously but I think Polamalu is a fantastic talent and a class act and I would hate to seem him be half brain-dead by 45.

  18. So the league corroborates the Steelers use of the term, the Steelers do the right thing and Tomlin is on record (watch his news conference) as supporting the player and not willing to take chances, but Foolio still leaps to a conclusion the Steelers are doing something wrong?

    What exactly is the big “loop hole” here? That a player without a concussion doesn’t have to have concussion tests? What? That’s crazy!

    Let’s all go through this one more time Mike. Polamalu is it. He goes to the sidelines. The Steelers see something that says “he might have a concussion” and they sit him out for the game even though he almost immediately doesn’t show any symptoms. Troy puts his helmet on, of his own accord. It doesn’t matter as the Steelers continue to sit him. They then say he had “concussion like symptoms”, a term the NFL says is appropriate because not every situation displaying concussion like symptoms is a concussion. It doesn’t matter because Troy still has to pass the concussion tests, an approach the Steelers fully support. But somehow in all of this there is a story about how sleazy the Steelers are?

    Give me a break. The only thing sleazy about this is the sloppy reporting and Foolio’s arrogance. You are dead wrong on this one. Man up.

  19. jimbobobjr says: Nov 30, 2011 4:07 PM

    So now you’re suggesting that team doctors willingly make false diagnoses in order to keep their jobs? Your conspiracy theories are getting a bit ridiculous, and are making you lose credibility. You probably don’t believe that man landed on the moon, either.

    Yeah, because it’s SO crazy that someone with a cushy job might err on one side of a gray area to please their bosses. I’m sure that NEVER happens.

  20. Colts: Gonzalez and Collins with multiple concussions- IR
    Seahawks: Rice with multiple concussions- IR
    Lions: Best with multiple concussions- IR
    Jags: Sessions with a concussion- IR
    Vikings: Abdullah with a concussion- IR
    Saints: Thomas with a concussion – IR

    Steelers: Polamalu with multiple concussions…probable.

    Doesn’t take a genius to see where the writer is coming from. It does require you to not be a Steelers bandwagon fan though.

  21. I work in a place where injuries happen all the time (the army) and I have to fill out reports that say what the injury was and how it occured. The way Mike Tomlin reports to the media that a player was experienceing “concussion-like symptoms” is the 100% correct way a non-medical person should report an injury. Obvious signs are what any person can visibly see (such as bleeding, swelling, or loss of consciouness) and symptoms are what the injured person feels (such as nausea, malaise, or chills). Non-medical personel report these signs and symptoms to a doctor, and the doctor must make the diagnosis.

    Diagnosis of a concussion, however, is not like diagnosing a broken bone or torn ligament. Most professionals use the Glasgow Coma Scale to grade the patient, and if they score below a certain score, which means they may have a concussion, then they need to be given an MRI and/or CT scan. This is NOT done immediately and takes some time. There is no way that they could have a neurologist there that can do this befor the end of the game.

    One thing that nobody has brought up is that although he may or may not have had a concussion, he could have also suffered from something more serious, like a brain aneurism or even a stroke. Concussions and Intracranial hemmorhaging have a lot of the same signs and symptoms. That is why non-medical personnel are instructed to use terms like “heat-related signs and symptoms” instead of heat stroke or “concussion-like symptoms” instead of concussion when reporting what they see and know. You wait until the doctor runs his complete battery of tests and gives a diagnosis before officially telling people the diagnosis. Common Sense!

    Could you imagine what the uproar would be if Mike Tomlin were to have said that Polamolu only had a concussion, but when they got back to the doctor on Monday morning it was discovered that his brain was bleeding and he would need emergency surgery. The Steelers would look terrible. That’s why you report what you know…not what you think!

  22. Hopefully Polamalu won’t end up with dementia someday down the road from concussions. If he does Tomlin and the Steelers brass will be at least partly culpable.

  23. Yes, the Steelers are playing within the rules by using the “concussion like symptoms” . The again it’s only Polamalu’s scrambled egg they are messing with. Who cares!

  24. I love the haters. Keep it coming! I love anti-steelers posts.. Its part of what fuels steeler nation…keep it coming. Tell us were too old. Tell us we get all the calls. Tell us we neglect concussions. Tell us all the fake stuff you wanna make up in your pea brains. We love it all..we love the fuel you provide. We are one. We are steeler nation! Here us roar!!!

  25. @raqaiw

    Clearly, you are no genius.

    If Polamalu is not suffering from the symptoms of a concussion, there’s no way to keep him out of the game. He’s been medically cleared.

    All of the players that you mentioned were still experiencing symptoms–memory loss, nausea, headaches, dizziness etc.

    Your rationale means that any player who has had multiple concussions should not play…Say good bye to 70% of the league.

    Your comment was beyond hilarious.

  26. YOu only use Steelers as examples because it get you more traffic… this is getting old !! Troy sat out the rest of the game even though was on sidelines helping with defensive signals remainder of game. YOu guys here at PFT have kinda turned into TMZ TRYING to make stories rather than just report the truth… whatever will give you more traffic I suppose but as a long time reader of your site.. it makes me want to just go onto CBSsportsline.com.. I come for news, not journalistic editorials or political discussions… isnt there already enough of that.. very dissappointing… Troy sat out rest of game because they made him… leave at that and stop trying to make something more into it.

  27. How bout we let the doctors be doctors, I’m no doctor, but as human beings I’m sure every brain is different, and every situation is different. But as writers and posters, we can be armchair quarterbacks with some knowledge, but there is no such thing as an arm chair doctor. That’s what college is for. But considering none of us are on the field for these concussion tests and given teams secrecy with all injuries, all we can do is speculate. But judging what teams do in terms of concussions is pretty much out of the realm of story writers and posters alike. So let the doctors do their jobs, and we stick to football?

  28. The Steelers neurologist happens to be the same guy the league and other teams routinely consult regarding concussions. He is one of the top neurologists in the country. Personally, I’ll defer to his diagnosis over wild speculation by sports journalists.

  29. @ jimbobobjr:

    The idea that the trainers and team doctors will act in the team’s best interest, which does not always align with an individual player’s best interest, is not a conspiracy theory. The trainers are employed by the team, not by the players.

    The business side of professional sports is not pretty. As this article stated, the fact that the NFL even uses independent neurologists represents an acknowledgement of the possibility that a team’s doctors/trainers will at some level be pressured to represent the interests of the team (who employs them), not the players (who do not employ them).

    No one rises to the level of an NFL head coaching position without have made some decisions that have put winning over the long term wellness of an individual player. The coach’s job is to win games and that sometimes means persuading a player to do whatever it takes to play.

    There are NFL trainers (and trainers in other sports) who have admitted that they followed the orders from coaches and general managers to encourage a injured player take a shot to continue playing, even though the risk of severely worsening the injury was high.

    I suggest you take a look at the health records of the players who have been called “ironmen,” like Jim Otto. Look at the number of serious long term injuries Otto deals with every day, and ask yourself how that can happen without the team encouraging him to play when severely hurt.

  30. @hrdcorbengalsfan….hey idiot. we’ll see how bad steelers suck when your wannabe Bengals get crushed at our house this week! You’ve already been beaten by us at your house & the Ravens at m&t…so to sum it up for you chumly it is in fact the Bengals who suck. Enjoy another loss this week!

  31. @johntonioholmes:

    You continue to prove Steelers fan’s complete inability to look at their team objectively. I presented you with raw data that says teams are being proactive with their players that have been concussed and deactivating them for their own good while the Steelers are not, and you come up with an arbitrary made-up value(70%) and spout off about how I clearly don’t know what I’m talking about.
    Newsflash:70% of the league hasn’t been diagnosed with a concussion, but Polamalu has.

    I understand your want to have your best players on the field, as we ALL know the “vaunted” Steelers defense falls apart without him out there, but at least TRY to stop sucking on your terrible towel long enough to think clearly about what the article and I were saying without instantly making things up and insulting someone clearly making more sense than you.

  32. @raqaiw……dude just shut up. You dont know what youre talking about. Youre an anti-steeler so you will say anything to blast the greatest nfl franchise! So be quiet and go post on your ravens, browns or bengals post. Whatever loser team you love! Steelers nation hates you….have a crappy day hater!

  33. @steelersownyou:
    Thanks for proving my point about Steelers fans.
    I’m not anti-Steelers,I’m anti-idiocy which usually puts me on the opposite side of most (not all)Steelers’ fans. Some of you are quite reasonable and are capable of having an intelligent but spirited football convo. Then there’s folks like you,who are so wrapped up in their fandom that they can’t bear to accept that everything about their team isn’t perfect. Of course,no fanbase is without idiots;there are just alot more who cheer for the Steelers.

  34. I’m so tired of this. I’ve had 3 concussions I was five, fell off a slide and landed on my head. Refused a ride and walked home because Mom told me not to accept rides from strangers. Second time, hit a car with my motorcycle. I was not wearing a helmet. I walked home and had a beer to clean the dirt out of my mouth. Number 3 got hit in the head with a 5 lbs drop tank mounting lug. My buddy told me to stop whining and quit bleeding before we got in trouble. And I’m not half the man these guys are. JC…let them play.

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