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The NFL Concussion Protocol Update with Recent Changes

The NFL concussion protocol was first introduced in 2009. Since then, there have been significant changes with more being added recently. In this post, we review the NFL concussion protocol in detail. Then summarise the most recent changes that have been made.

The History

Under the official title of the ‘NFL GameDay Concussion Protocol,’ the first adjustment was officially made. This was just two years after its introduction in 2011. However, disciplinary actions against teams for non-adherence were only introduced in 2016. Some seven years after its initial introduction.

The NFL also decided to punish teams for their non-compliance by not only fining them but by enforcing the forfeiture of draft picks. Which as we all know, can cause a team some serious discomfort!

Tighter protocols are in place

There has been a long history of head injuries in the NFL. However, in recent years, a greater focus has been placed on the long-term impacts on a player’s health. This has led to tighter protocols that fully take into account the correct diagnosis and ongoing management of concussions in NFL players.

You might recall the league opener for the 2016 seasons. This was when Quarterback Cam Newton (MVP) received a multitude of hits directly to the head and was poorly attended to by the Medical team of the Carolina Panthers.

‘Play Smart. Play Safe.’ Was the aptly named initiative the NFL launched in late 2016.

In a letter written by Roger Goodell who at the time was the NFL Commissioner, he laid out plainly to fans. That despite the NFL being a leader in Health and Safety in many different ways, head injuries were still an area where significant improvements were needed. His bold statement and assurances are outlined in this letter to fans and followers of the NFL.

Major changes in the protocol

As mentioned earlier, the concussion protocol has gone through many changes since its initial introduction in 2009. The Texans and The Seahawks were both subjected to investigations during 2017. The outcome for The Texans saw them completely cleared of any wrongdoing. Whereas for The Seahawks things did not go so well. The results of the investigation left them with a $100k fine to contend with.


What Are the Changes to the NFL Concussion Protocol?

Some of the latest changes to the concussion protocol took place following these investigations in a bid to better protect the NFL players.  Following the conclusion of the Seahawks investigation. A rule was added that meant coaches, teammates or officials were now required to take any player directly to the medical team for an immediate assessment.

Another investigation involving The Savages was also a major contributor to further changes. The NFL has now also written into the regulations that there must be an unaffiliated Neurotrauma Consultant to help with any evaluations for head injuries that may arise during a game. This was just one of the significant changes that were agreed on December 11th by the NFL head, neck, and spine committee.

This consultant will be based at the Central Command Centre and will monitor the games via their broadcasts to help with the implementation of the protocol. They will also be able to contact teams on the sidelines directly to ensure they are fully aware of anything which occurs. A consultant will also be present at any playoff game, as well as the Superbowl games to ensure adequate coverage.

Impact seizure is important

Impact Seizure will now be treated with the same severity as a total loss of consciousness . This will immediately result in the removal of a player from the game.

If a player falls or stumbles to the ground when trying to stand, they will be sent directly to the locker room for an immediate evaluation. If they pass the exam, they will be permitted to return to the game of play.

Any Injured player is to be taken directly to a member of the medical team for a concussion assessment.

Anyone who has an examination during the game will need to have a follow-up evaluation the following day.

Another finer detail that has been introduced now means that a player must remove themselves entirely from the field of play when undergoing any evaluation.

As well as the unaffiliated neuro consultant and the team medical staff, the NFL now also employs two additional medical personnel who act as spotters. These spotters work from a booth rather than being pitch-side. They carefully watch the game and a video replay to ensure they can effectively identify any head injuries that might get missed throughout the duration of play. They have the power to stop a game with what is called a ‘medical timeout’. This is so that they can remove an injured player from the field of play if they deem it necessary.


What Triggers the NFL concussion Protocol?

Essentially, there are seven different observable symptoms that classify them as having a concussion.

  • If they are slow to get up after a hit to the head or after the second stage of contact with the ground or playing surface.
  • A loss of consciousness for any period.
  • Holding of the head following a contact.
  • Disorientation.
  • Problems with balance or a lack of motor coordination.
  • A vacant or blank expression.
  • Facial injury in addition to any of the above six points.

If any of the medical spotters notice any of the above signs. This is when the Concussion Protocol will take effect.

What is the NFL Return-To-Play Process?

Alongside the protocol that determines what happens ‘in-game,’ there is also a specific protocol that is named the Return to Participation Protocol which can actually remove a player from both games and practice sessions until such a point they are given the all-clear to return.

This return to play process takes place over five different stages.

  1. R&R (Rest Up and Recover)

Only a limited number of stretch and balance activities are permitted. Until such a point that a player returns to a baseline level and has a complete neuro-examination. The use of social media, electronics, and attendance at team meetings is restricted during this period.

  1. Gentle Exercise

The recommendation as it is set out by the NFL states that only up to 20 minutes of gentle exercise on a running machine or stationary bike is permitted. No weight training or resistance training is allowed at this point. An athletic trainer is appointed to oversee the CV activities of the individual. This is to ensure that there are no persistent symptoms that are linked to the concussion.

  1. Strength Training and Ongoing CV Exercise

A slow introduction back into strength training and continuous aerobic exercise that builds upon the activities outlined in stage 2. Again, the Athletic Trainer will oversee this to ensure there are no signs of recurrence following the initial concussion.

  1. NFL Targeted Activities

Only non-contact activities are permitted. The player will be able to participate for the full duration of normal team practice.

  1. Clearance for Return

At stage 5, a player is able to return and participate fully in team practice. This is with normal contact and no restrictions whatsoever. Please feel free to check out ‘this post’ on the rules of the NFL, or ‘this post’ for some cool NFL gifts.


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