NFL Injury Report: A Week of Concussions

Each week, will analyze one NFL player’s injury.  Sports Medicine doctor, Dr. Mandy Huggins (Twitter:  @HugginsMD), will provide medical analysis of the injury.  Alicia Jessop will then break down some of the contract ramifications of the injury.

Dr. Mandy Huggins’ Medical Analysis

Concussion is the name of the game for this week’s injury round-up. The following players were reported as having concussion as a result of play in week 10 of the NFL: Michael Vick, Jay Cutler, Alex Smith, Fred Jackson, Brandon Myers, Cliff Avril, and Shea McClellin.

As has been discussed previously, a concussion is defined as “a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces” by the International Conference on Concussion in Sport. A concussion is a functional disturbance, not a structural injury. Concussions are common in contact sports such as football, and we are seeing the results of increased awareness and better recognition, as is evidenced in this week’s NFL injury reports. When a player has been diagnosed with a concussion, the first step in management is rest – both mental and physical rest. Once the athlete’s symptoms have resolved, he or she begins a graduated return to play protocol. If the player can advance through steps involving cardio work, strengthening, drills, etc. then he or she will be cleared to return to sport. These steps are critical to avoid long-term and chronic symptoms (such as headache or cognitive difficulties) that can occur if the athlete returns to play too early. In the case of Alex Smith, it was reported that he stayed in the game for several more plays while having symptoms instead of taking himself out after suffering the concussion. It is unclear how many concussions Smith has sustained in the past, which could prolong his recovery, but continuing to play with a concussion is definitely one way to complicate matters.

The important thing to remember is that although we have algorithms and protocols to get an athlete back to sport, each concussion is different and each player should have an individualized treatment plan. Michael Vick’s symptoms will not be the same as Jay Cutler’s symptoms. Alex Smith’s symptoms may take longer to resolve than Fred Jackson’s, or vice versa. And so on. So when a coach or other representative of a team suggests that the concussed player will be back the next week, we should all be suspicious, as the time period for recovery cannot be predetermined. We should also raise an eyebrow when the terms “mild concussion” or “got his bell rung” are used.  A concussion is a concussion and should be treated as such, no matter one’s opinion of severity. Despite the recent increase in awareness in regards to concussions, the NFL still has a long way to go.

Alicia Jessop’s Commentary

I think I speak for every NFL fan, when I say that what I will remember for the last week of football, is the number of concussions players sustained.  Over the last year, fans, players and team personnel have arguably heard the word “concussion” more than in any other year of the NFL’s history.  The expansive litigation pending against the NFL is the impetus for this.

While we are likely years away from any resolution of the NFL concussion litigation, it is important that the NFL continue to seek ways to protect its players from head injuries.  Players must also work to incorporate plays that protect their heads into their arsenal of tools.

Today, NFL commissioner Roger Goodell is presenting a speech at the Harvard School of Public Health entitled, “Leadership on the Road to a Safer Game.”  This speech is one initiative that the NFL has taken on since concussions have come to the forefront of the league.  The speech will be available for the public’s viewing beginning this evening here.

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