The 5 o’clock club is published Wednesday to Saturday during the season, and aims to provide a forum for reader-driven discussion at a time of day when there isn’t much NFL news being published. Feel free to introduce topics that interest you in the comments below.
Concussion numbers down in the preseason from 91 last season to 79 this preseason. Zero concussions on kickoffs with new kickoff rule, down from 3 last preseason.— Judy Battista (@judybattista) October 16, 2018
.@Stephania_ESPN filed this behind-the-scenes look at the NFL's game-day concussion protocol. ICYMI, a very good piece. https://t.co/WCloxLkDs4— bill hofheimer (@bhofheimer_espn) October 16, 2018
In recent years, the term “concussion protocol” has become such a part of the NFL lexicon that everyone refers to it -- from players to coaches to those of us who cover the league to all the fans who watch. But how many of us could actually describe the different elements of the protocol? Or identify the roughly 30 medical personnel present at every game?
(1) Activity in the spotter’s booth
While there are two spotters (both certified athletic trainers) in the booth, there are actually five people with distinct responsibilities who are tasked with looking for injuries throughout the game. All five are NFL-hired, independent of the teams playing.
The two athletic trainers are flanked by two video technicians, who are available to show various angles of video and zoom in on that video to enhance the view of a particular play and/or player(s).
The spotters are not sitting down, casually looking through binoculars and watching the game. Rather, they are standing, moving constantly, pivoting and turning, alternating between binocular-enhanced views of the field and technician-enabled cuts of video. There is constant communication between the spotters and their respective assigned technicians, between the spotters themselves, between the spotters and team personnel, between the video technicians in the booth and those on the field at the sideline video monitor, and between the spotters and the game officials in the case of a medical timeout.
The fifth individual in the booth is an unaffiliated neurotrauma consultant (UNC), who is responsible for monitoring broadcast video to help ensure that there is at least one pair of eyes on all possible video angles. The addition of this booth UNC is the result of an update to the 2018 game-day concussion protocol.
(2) Number of replay video offerings
The multiple angles available to the medical personnel tasked with reviewing video are far more comprehensive than I imagined them to be. Not only are there multiple view options, including an expanded field view, but the presence of video technicians to fast forward/rewind/freeze/zoom as necessary to help the medical provider optimally view the personnel involved in an injury-related play, as well as the circumstances of injury itself, is an incredible asset. The spotters have the authority to stop the game by calling a medical timeout so a player can receive medical attention.
The NFL’s concussion protocol has become increasingly scrutinized in recent years. Shanna Lockwood/USA Today Sports
To be clear, just as with football plays, video review is not 100 percent definitive and should never stand alone as a means of diagnosing injury. But to have this tool available for medical personnel to complement their player evaluation is a bonus. The video clips are logged and are also available to the medical staff after the game, something helpful for reviewing head injuries, as well as all orthopedic injuries that occur during a game. It is also a tool medical providers can use with the athletes after the game to help explain how an injury occurred, something players are often not aware of in the moment.
(3) Depth of medical personnel staff
During the “60-minute meeting” (so named because it takes place 60 minutes prior to kickoff), all medical providers for the game gather in the officials’ locker room to meet face-to-face (for purposes of easier identification, because the officials want to know who will be potentially running out onto the field or speaking in their ears) and to review the emergency action plan: What happens if a player needs to go to the hospital? Where are the ambulances and paramedics stationed? What is the path in this particular stadium to the X-ray unit?
Roughly 30 individuals with some type of medical responsibility are stationed at various points around the stadium and must be able to recognize one another in an urgent situation. They also need to be able to communicate effectively yet confidentially at all times, which is why the radio channels they will be using during the game are confirmed and tested in advance of kickoff. The 60-minute meeting might last only six minutes in its entirety, but it struck me as perhaps the most important pregame meeting taking place in the stadium.
Dr. Allen Sills, Chief Medical Officer of the NFL joins Stephania to discuss the NFL’s gameday concussion protocol. Their conversation is far-reaching and includes details ranging from which medical personnel are on-site, components of the protocol including what happens in the spotter’s booth and in the blue tent, video review, player evaluation and how the ongoing evaluation of the protocol keeps it a fluid process. Click to listen
The early returns are promising on the NFL's last-ditch attempt to save the kickoff from elimination... https://t.co/sZbX7otX4n— MarkMaske (@MarkMaske) October 18, 2018
Encouraging results so far
Six weeks into a season for which the NFL made significant modifications to kickoffs in an effort to make the play safer, league leaders say their early data about the number of concussions suffered by players on kickoffs has been promising. That is significant, given that the final injury numbers for the 2018 season likely will determine whether potential alternatives to the kickoff are contemplated in the offseason.
The league said at this week’s owners’ meeting in New York that there were zero concussions suffered by players on kickoffs during this year’s preseason games — three fewer than during the 2017 preseason.
The NFL will not release its injury data for the regular season until after the season concludes. But Atlanta Falcons President Rich McKay, the chairman of the league’s competition committee, said this week the preliminary indication is that the reduction of concussions on kickoffs has continued into the early stages of the regular season.
Trying to stay true to the spirit of the game
“One thing we have really tried to do is keep working with the framers, the way they framed the game, and then make adjustments, as opposed to saying we’re going to start over,” McKay said. “So I think the kickoff’s been a part of our game. Special teams have been an integral part of our game. And we need to keep them in the game if we can.
NFL leaders have called the kickoff the sport’s most hazardous play. When the kickoff was discussed at a player-safety summit held in May at the NFL’s offices, Green Bay Packers President Mark Murphy said the data showed that a player was five times more likely to suffer a concussion on a kickoff than on a play from the line of scrimmage.
“We also realize it’s part of the fabric of the game,” Murphy said in May. “It’s exciting. One of the best things about our game is that you can catch up with the onside kick. To completely lose some of those things would be a big change to the game. But when you’re staring at injury data, you’ve got to do something.”
Lots of changes to make the play safer, but maintain the excitement
The changes were designed to make the kickoff more like a punt, with blockers turning and running downfield alongside prospective tacklers rather than meeting them head-on in jarring collisions. Members of the kicking team were prohibited from getting a running start before the kick. A no-blocking zone between the two teams was instituted. All forms of “wedge” blocking, with multiple players lining up shoulder to shoulder, were banned. The hope was that teams would use smaller, swifter players on kickoffs.
“To me,” McKay said, “it shouldn’t be about elimination of plays. It should be about trying to find ways to keep them competitive and make them safer. And I think we can do that with kickoffs.”
Is it too easy for players to fool the doctors tasked with protecting them?
Washington Post: Athletes can easily trick popular concussion test, study finds
The researchers found that half of test takers who “sandbagged,” or purposefully underperformed, on the Immediate Post-Concussion Assessment and Cognitive Test, known as ImPACT, went undetected. That means those test takers were able to fool the exam, and thus might have returned to physical activity sooner than medically appropriate.
Athletes generally take ImPACT before the start of their sports season to record a baseline score.
If an athlete “sandbags” on the original baseline assessment, he or she would only have to match that lower threshold to possibly return to action after a head injury. Nearly a third of athletes reported to researchers in a separate 2017 study that they didn’t provide “maximal effort” on computerized neurocognitive tests, such as ImPACT.
“Anyone who works with the concussed clinically knows there are a lot of people who purposefully sandbag the baseline test and a lot of people don’t get caught,” said Amy Peak, one of the study’s authors and director of undergraduate health science programs at Butler. “I would hear in the community and hear all these athletes tell me, ‘I sandbagged mine, everybody sandbags it.’ ”
Some NFL concussion settlements are shockingly low. https://t.co/rFY7T0dIrf— USA TODAY Sports (@usatodaysports) October 23, 2018
Are the concussion protocols and rule changes to promote safety actually making the game safer for players?
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Are the concussion protocols and rule changes to promote safety good for the NFL?
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Yes, they are good for the game
No, they are hurting the game