In evaluating head injuries, the player continues to be the least reliable source of information

Miami Dolphins v Cincinnati Bengals
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As the NFL hopefully goes back to square one and reviews its concussion policies and protocols from top to bottom and back again, there’s one very important reality that always needs to be remembered. The player is not a reliable source of information as to the true state of the condition of his brain.

Virtually every NFL player wants to keep playing. Virtually every player will accept the risk of a second concussion after suffering (or potentially suffering) a first concussion. Only a small handful of players have the luxury of voluntarily sitting down and letting their backups play.

Tua Tagovailoa is not a player who can comfortably step aside for his own good and watch his understudy take the field. He knows that it’s a critical season for him. He must answer questions both about ability and availability. So if, for example, he has gross motor instability against the Bills on Sunday, of course he’s going to say it was his back, or anything other than his head.

He’ll say what he has to say to get back on the field. He wants to get back on the field, like most players do.

That’s why nothing from the player ever should be taken with anything more than the smallest grain of salt. That’s why everything from the player needs to be viewed skeptically.

And that means everything. In 2011, Peyton Manning said that he deliberately tanked the baseline cognitive test so that it would be easier to pass it if a head injury left him cognitively impaired.

“They have these new [brain] tests we have to take,” Peyton said at the time.  “Before the season, you have to look at 20 pictures and turn the paper over and then try to draw those 20 pictures.  And they do it with words, too.  Twenty words, you flip it over, and try to write those 20 words.  Then, after a concussion, you take the same test and if you do worse than you did on the first test, you can’t play.  So I just try to do badly on the first test.”

Manning, after the shit hit the fan, claimed he was joking.

Not true; I wouldn’t do that,” Manning said. “I understand the seriousness of concussions. Our job was to be entertaining to the crowd. Got some laughs out of it, but it was really unfortunate.”

But was it really a joke? And wouldn’t it make sense for football players who are wired to play football to try to rig the system so that they can keep playing?

While it’s unclear what the NFL can do to account for the clear temptation to blow the baseline testing, it’s another factor that perhaps shouldn’t be given significant weight in the overall concussion protocol. There ultimately needs to be a more reliable and objective way to clear players to play, one that does not rely on any information that comes from the player — either after he suffers a potential head injury or weeks if not months earlier.

The solution may not be simple. But it’s impossible to ignore that the natural inclination to play will affect any and all information that comes from the player, since the player simply wants to play.

9 responses to “In evaluating head injuries, the player continues to be the least reliable source of information

  1. Football is inherently dangerous. All sports are to some degree. Playing them is a personal choice to assume that risk. Everyone knows it. But they also know a lawsuit can make you a lot of money.

  2. Mild concussions are very tough to detect if the patient is uncooperative. It’s the biggest flaw in all these protocols, but it’s tough to force compliance. Guys lose their jobs and lose future earnings all the time due to injury.

  3. This has nothing to do with reality or the facts.

    Tua was obviously concussed on Sunday.

    Miami lied behind Tua’s desire to keep playing.

    The “independent doctor” is clearly not independent and didn’t do his/her job.

    Miami, as an entire organization, openly tried to sell the “back” on Monday and throughout the week.

    Ask yourself this: If this was Mac Jones and BB doing this, do we honestly believe Goodell would be looking the other direction protecting NE?

  4. They looked more like neck stinger injuries than concussion injuries to me. In both cases he landed on his neck.

  5. Looking at the way Tua was tackled, any player would have had a concussion. When I first looked at the tackle, I could not understand how it looked like a quick whipping action. Then I saw a different angle. The tackler grabbed his belt, and then whipped him down hard. Similar to a horse collar.

  6. Everyone knows the risks of playing football. Everyone knows the risks of getting a concussion and playing with a concussion. I still put 95% of the responsibility on the player. They can choose for themselves and live with the benefits and consequences.

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