NFL to reassess procedures for spotting concussions during games

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When it comes to identifying players who may have suffered concussions, there’s no margin for error.

That’s why the NFL can’t, and won’t, tolerate situations like the one that unfolded Thursday night in Denver, when Chargers safety Jahleel Addae needed to be removed from play after he suffered what seemed to be — and ultimately was diagnosed as — a concussion.

Per a source with knowledge of the situation, the league office was dismayed by the failure of the team, the game officials, the sideline medical experts, and the persons given the task of monitoring the game from the press-box level to spot what instantly was noticed during the game at 345 Park Avenue:  That Addae was in distress and needed to immediately come out of the game.

Similar concerns arose earlier this month, when Bears safety Chris Conte suffered a concussion and somehow made it back into the game.  In the wake of these incidents, the NFL is determined to review all current in-game procedures in order to improve the process of getting players who may have suffered concussions promptly evaluated and, where appropriate, prevented from re-entering the game.

Addae’s case, we’re told, left former NFL coach and long-time broadcaster John Madden livid.  The Hall of Fame coach, who chairs the Coaches Subcommittee to the Competition Committee, has developed into a passionate advocate for concussion safety.

WHEN IN DOUBT LEAVE THEM OUT” was the heading of the 2011 memo introducing the Madden Rule, which applies when a player has been diagnosed with a concussion.  A gap still exists when it comes to the application of the “concussion” diagnosis.  While players themselves have a responsibility to disclose their own symptoms and those spotted in teammates, no player input was needed on Thursday night.  It was obvious Addae had suffered a head injury.

“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 2011 memo explained.  For both Addae and Conte, the directive was not honored.  Which means that the procedures aren’t as good as they need to be.  And the NFL will be taking a closer look at improving those procedures.

All options are on the table, from increased audits of team records to imposing greater accountability on medical experts responsible for yanking players to requiring doctors to physically sign off, during a game, on the clearance provided to a player suspected of a concussion but permitted to return.

“This is not boxing,” one source told PFT. “There’s no such thing as a standing eight count.”

Instead, the desire outcome in football is that if it appears a player needs the equivalent of a standing eight count, he should be removed from play until he receives full neurological clearance.

Whatever happens, the current procedures must be improved.  Coach Madden has a high degree of motivation on this topic, and he strongly believes that the professionals charged with safeguarding player health must be expected to do their jobs — and that if they can’t, someone else needs to be hired to do those jobs.

He’s right, and the NFL knows it. Look for real changes to come, sooner rather than later.

26 responses to “NFL to reassess procedures for spotting concussions during games

  1. I had no idea that Madden feels that way. I always thought of him as kind of a neanderthal when it came to this kind of thing. You know, “rub some dirt on it and get back in the game”. Good to know that people can evolve.

  2. I think the only way to enforce this is by giving the team a competitive motivation to watch for the safety of their players. Like if they fail in pulling a player with a concussion, their active roster size decreases the following week. Otherwise teams like the Chargers will continue doing this because they truly don’t value player safety over wins.

  3. Some of that disconnect comes from players and coaches who maintain the old-fashioned mentality of “he’s/I’m the best player at that position, he has/I have to play for us to win.”

    We all know the stories of HOF players who would sneak back into games after injuries unless their helmets were physically removed from the sidelines. And if you responded to the ammonia whiff, you were good to go.

    Unfortunately, the suicides of Duerson, Seau, and others aren’t setting in. Now we hear the Jovan Belcher murder/suicide could have been a result of Belcher’s CTE as a 25-year-old active player. Hopefully it won’t take an on-field death from a head injury to get the protocol not only in place, but strictly followed by all involved.

  4. If a player suffers what looks to be a significant blow to the head and there’s even a remote possibility that he’s concussed…he should clearly stay on the sideline for the remainder of the game at least. There’s a reason why teams have 53 guys suit up for each game, players get tired, they get hurt, and having 50+ players ready to go on Sunday’s should put every team in a position where they can comfortably replace a potentially-concussed player with a suitable backup. The responsibility of making the tough decisions on whether or not a potentially concussed player returns to the field lies entirely with the coaches and staff of each team. Players, with their machismo attitudes and adrenaline pumping, will almost always elect to return to the field of play…even when it’s not in their best interest. They may not see it this way at the time, but later on when they reflect upon why their coach kept them off the field in an important game…they’ll probably come to the conclusion that their coaches simply had their long term well-being in mind.

  5. I had the displeasure of watching the Around the Horn pundits slam the Chiefs for not pulling Jamaal Charles just repeating the same tired lines. It’s the perfect situation for outlining just how complicated an issue this is. It’s not like he gave any physical indication of a concussion. You can’t stop the game after every play and check 22 guys for concussions. I’m all for making the game safer but I don’t envy the people who have to make these decisions.

  6. As I commented on another post this morning, you will never solve this problem as long as medical personnel are hired and fired by the team and not the league.

    The way it is now, the head coach is essentially the trainer’s boss. How many times can anyone defy the wishes of their boss before they start worrying about losing their jobs?

    They need to be hired, paid, and assigned to teams BY THE LEAGUE, with no accountability to the coaching staff or management of the team they are assigned to. Period.

  7. “You can’t stop the game after every play and check 22 guys for concussions.”

    LOL- nice straw man argument. As if anyone is recommending checking every player for concussions after every play.

    How ’bout we just check the ones who just practically had their heads taken off on the previously play? Can we check them?

  8. So….
    increase roster size.
    limit snap counts per season.
    extra bye week.

    build in rest periods. If a player gets hurt he needs to use up his rest period anyway. No motivation to stay in the game when you gotta be pulled some time.

  9. Anybody watching that game could see he was in distress, staggering around. Visible evidence should have been enough. I diagnosed it from my couch.

  10. I agree that the Chargers’ sideline dropped the ball on this. But does Addae have any responsibility for himself in this drama?

  11. This is a great way for the league office to sway games. I can see it now… 4th quarter time expiring and team A is driving for the winning score. Team A qb takes a big hit…. league office calls refs and mandates he is out for concussion eval…particularly if team B is packers or broncos. That will go over well.

  12. re: keylimelight
    A person with a concussion has reduced competence and hence reduced responsibility. In other words, if he’s not thinking straight, you can’t hold him responsible for thinking straight.

    As far as responsibility, that is ultimately the team’s. Slap a massive fine on the team/coach, or take away a draft pick, and you’ll see how quickly this problem resolves itself.

  13. San Diego’s total failure to identify the problem and care about the player is a disgrace to the NFL. They should be heavily fined ($500K+) and also lose a high Draft pick because the Chargers clearly don’t take the player concussion issue very seriously.
    If Goodell is smart, he will take swift and bold action on this.

  14. Elliot Pellman, NFL Medical Director, commented that it is really hard to diagnose concussions when you are rheumatologist.

    Richard Ellenbogen, Head of the NFL head, neck and spine committee, claims one can’t diagnose a concussion from video. I guess as speaking as an NFL Physician he is correct. Both NFL Doctors and the quacks selected by the NFLPA – independent neurological consultant can’t even diagnose them of the field.

    Remember NFL Doctors are selected on the basis of the highest bid. Not a great way to pick a doc.

    Roger Goodell needs to just admit that the NFL has been classifying concussions as a matter of policy so it could sell a bogus settlement to Judge Brody.

  15. The best thing the NFL could do for PR purposes and everything it does moving forward is clean house top to bottom, disinfect and do it again.

    Goodell is far worse than a severe concussion and his long term effects will make Mark Cuban look even smarter than he actually is.

  16. Answering uglydingo:
    Goodell is not smart, he is conniving: a crass opportunist who you wouldn’t want near your children, your house or your business.

  17. I bet it is much easier to see some of these things from the couch. You are doing nothing but watching a screen likely only between 24-70 inches wide. That is your entire field of vision/area to concentrate on. The guys on the sideline are responsible for watching multiple people at various distances moving in and out of their field of view while also handling other duties like calling plays within the next few seconds, looking after players with known/announced medical issues, etc. They also get only one shot to notice something while we get to see the play over and over and have the announcers call attention to something we might have initially missed. It is easy to assign a blanket level of blame but when you look at each individual’s circumstances and duties it may not be so cut and dried as it seems on TV. Maybe they should have the guy in the booth watch the national broadcast instead of scanning the field with binoculars.

  18. How hard is it to do a neurological test on a player? Can one be done on all 53 players that suited up for the game. Maybe the next day at practice or sometime throughout the week? Or can people smart up to these tests to pass them even with a concussion?

    That way no one slips through the cracks and teams will be penalized for every player shown to have a concussion with the severity of the penalties become harsher after every one.

    Could be anything from having less players suit up the next week to fines to losing draft picks or maybe even forfeits for constant violators.

    This way it’s in the teams best interest to not let this kind of stuff continue to happen.

  19. They need to be hired, paid, and assigned to teams BY THE LEAGUE, with no accountability to the coaching staff or management of the team they are assigned to. Period.
    Where have you been? The league already does this. Players can’t go back into the game unless they are also cleared by an independent doctor provided by the league.

    The problem is that diagnosing a concussion isn’t as black and white as some people think. For some players, they don’t show symptoms till a day after the game. The reality is that there is never going to be perfect system when it comes to concussions.

  20. Hey, what about his buddies out on the field with him. Speak up, let somebody know that the guy isn’t right. Hey player, don’t walk over and try to shake the cobwebs out, let the sideline know you’re not good. There’s a lot of action going on and some guys get missed. Heck, they might have been watching somebody doing a dance because he tackled a guy, or a lineman may have been stretched out catching his wind. Easy for us to call out the team and NFL when we have the luxury of a cameraman getting directions from a control room to zoom in on the guy acting weird.

  21. How can they spot a concussion when they can’t even see browns cornerbacks interfering with and holding Raiders recievers the whole game.

    How about the nfl officials call a fair Raiders game its corrupt!

  22. De-activating roster spots will only compound the problem of unreported concussion symptoms hired by teams…having the league hire doctors wont rectify anything either, being that they agreed to only pay out $765 million in settlements, accused one of the doctors that discovered CTE of performing ‘voodoo’ on brains, and hiring a rheumatologist for the head of the MTBI (mild traumatic brain injury) group before the Head, Neck, and Spine Committee was formed…the NFL has turned into a greedy organization that doesn’t pay taxes, denies players and former players financial assistance if needed, and overall shows a lack of consideration for the players making them money. It’s sad, but it’s the reality of the situation.

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