NFL Concussion Protocol Provides Template for Athletic Teams

Dorian Martin Health Guide
  • We’ve heard a lot about concussions in the news, whether it’s pro football players, college football players, soccer players or others. But how seriously are the powers-that-be taking the risk of concussions in players. Based on a story by the Houston Chronicle, I’d say it’s pretty seriously.

    Reporting on the concussion protocol used to assess Houston Texan wide receiver Andre Johnson, Houston Chronicle reporter David Barron detailed an extensive process that has been put in place to protect players. For instance, an observer in the upper reaches of the stadium scans the field to identify players who may require an assessment for a possible concussion. Players are assed by an independent neurological observer who is assigned to each sideline and who is not affiliated with a team.

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    The independent observer uses a sideline assessment tool that reviews a player’s orientation, memory, concentration, balance and symptoms if a player is suspected to have having a concussion. The assessment, which takes between 10-15 minutes to implement, can be administered on the field or in a quieter location. The results are compared with a baseline test that the player completed during the preseason.

    “If ANY significant abnormality is found, a conservative, safety first approach should be adopted,” the assessment states. “An athlete suspected of sustaining a concussion is a 'No Go' and does not return to play in the same game or practice.”

    The assessment offers six signs of disqualification that automatically removes the player from the field:

    • Lack of consciousness or unresponsiveness for any period of time.
    • Confusion.
    • Amnesia.
    • New and/or persistent symptoms, such as a headache, nausea or dizziness.
    • An abnormal neurological finding, such as balance issues, seizures, motor difficulties, sensory difficulties or cranial nerve issues.
    • Symptoms that are progressive, persistent or worsening.

    Players also take a 65-point exam as part of the assessment. This exam includes questions about orientation (day, month, year, etc.), word recall, orientation (what quarter of the game is it, who scored last, who was the last opponent, etc.), concentration (focusing on a string of numbers), balance (stumbling, falling, etc.), symptoms (experiencing neck pain, confusion, fatigue, feeling in a fog, sensitivity to noise, sensitivity to light, etc.), and changes in the player’s actions.

    A player who is diagnosed with a concussion has to be escorted into the locker or training room for observation. The player cannot return to the field under any circumstances. After the game’s conclusion, medical professionals determine whether the player can go home.

    The player is evaluated using the assessment and monitored to determine when they can start to return to the sport, which may be as soon as one to two days after the game in which they were injured. The NFL requires that players submit to the standard baseline testing once symptoms have subsided. In addition, they need to take the more advanced version of the assessment, which requires 30-45 minutes to complete.


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    If the player shows progress on these assessments, he can be cleared to start physical activity with a gradual increase in exercise intensity. The first level is cardio, followed by intense cardio with weight lifting and position-specific drills. If the player does not show any concussion symptoms, they advance to the higher stage. The players may complete up to two stages daily. For instance, they may do light cardio exercise in the morning and then moderate activity in the noon if cleared to do so. Additional stages include returning to non-contact drills, participating in contact drills, and returning to the playing field. The player also needs to be cleared by both the team doctor as well as an independent concussion expert that has been approved by the league and the NFL Players Association.

    I wanted to share this information with the hopes that others who are involved in leadership roles in sports – whether that’s a sport’s policymaking group or a Pony League coach – use this model to develop a process to protect athletes. Concussions are serious situations that require attention to make sure that athletes are not only ready to return to the game, but will have their cognitive function in tact once their playing days are over.

    Primary Sources for This Sharepost:

    Barron, D. (2013). Johnson faces detailed testing. Houston Chronicle.

    National Football League.  (nd). NFL sideline concussion assessment tool.

Published On: September 17, 2013