Let me get this out of the way: I’m no doctor. Quite frankly, I can’t stand the site of blood and I may be one of the worst people in the world when it comes to getting a shot. That said, I am qualified to analyze one of the most troublesome, and unfortunately, common injuries in the NFL today: concussions.
Now don’t get me wrong; I am not here to delve deep into medical specifics regarding the injury or even analyze the long-term consequences of being hit in the head too many times (though I think we can all agree that the consequences are not good). I’ll leave that to our good friend at RotoWire, injury expert Jeff Stotts. What I can do in this space is equally as vital to fantasy owners, particularly as we enter the fantasy playoffs in most leagues: That is, arm owners with knowledge detailing the ins and outs of the NFL’s concussion policy and what barriers a player must overcome to suit up after sustaining a concussion.
A concussion is the most common type of brain injury, frequently defined as a head injury with a temporary loss of brain function. It is most often caused by a sudden blow to the head, which can cause the brain to shake inside the skull. There are three grades of concussion, determined by severity. Several systems exist in defining those grades, but most are concerned with the length of symptoms and whether the sufferer loses consciousness. There is no set treatment for a concussion, as the symptoms usually go away without treatment, but most victims are told to get a good night’s sleep and rest during the day until they can return to normal activities without experiencing any symptoms. At times, medication can be prescribed for symptoms such as dizziness or nausea, though it is not always necessary. Occasionally a person who has suffered from a concussion can develop post-concussive syndrome, when the symptoms continue long after the original injury was suffered.
In recent years (or even farther back than that, depending on who you believe), the NFL concluded that one’s brain shaking inside their skull has extremely serious consequences, both in the short-term and the long-term. As a result, in 2007 the NFL enacted its first regulations limiting a player’s ability to return to a game if he suffered from any concussion-related symptoms. Despite the league’s efforts, NFL executives were heavily criticized by the House Judiciary Committee for their minimalist response to growing concerns regarding the health and safety of players in an inherently violent sport. In December of 2009, the league responded, implementing strict guidelines regulating when a player would be eligible to return to the playing field after suffering concussion-related symptoms. The NFL continues to adapt to regulate the issue and the current guidelines are as follows:
· As an initial matter, any player who suffers from symptoms of a concussion, including loss of consciousness, amnesia, confusion or disorientation, persistent headaches (particularly if accompanied by photosensitivity, nausea, vomiting or dizziness), is prohibited from returning to the field that day. This also holds true for any player whose neurological examination is deemed abnormal by a trainer independent of the team. In a nutshell, if your player takes a blow to the head and suffers from any of the above symptoms, don’t expect to see him back on the field again that day.
· Once a player has been diagnosed with a concussion, he must clear four stages of post-concussion testing, a process that can take days, weeks or even months, before being allowed to return to the field. First, a player must pass a baseline cognitive test (most teams use the ImPACT Test, which is short for Immediate Post-Concussion Assessment and Cognitive Testing). Each player is given a baseline brain test before the season starts. He will not clear this stage until his post-concussion baseline test is close enough to the results of his preseason exam.
· Stage Two, “Rehab,” is a time consuming one. Within Stage Two, there are five phases. In each phase, a player engages in an activity where his heart rate is increased each time. The kicker: usually, 24 hours of recovery is given between each phase, and the players must emerge asymptomatic (symptom-free) from each one. The 24-hour time period generally required between each phase in Stage Two is the reason why so many players are labeled “Questionable” come Wednesdays before a game and often little is known as to their availability until the weekend.
· Stage Three also can take at least a few days as a team physician will meet with the concussed player on a handful of occasions and said player must show “improvement” with each subsequent visit.
· Finally, a player reaches Stage Four. Yet, Stage Four might be the toughest hurdle of all. Fearful that team doctors will simply wave players on through the process, succumbing to internal team pressure to clear an impacted player in a hurry, the NFL now requires a league-approved independent neurologist to sign off that a player is fully asymptomatic before being returned to the field. Given the league’s stated interest in erring on the side of caution when it comes to head injuries, it can be expected that a player will have to be completely symptom-free before we can expect him to suit up.
According to Eagles concussion specialist Dr. Gary Dorshimer, it’s impossible to predict a player’s progress through the various stages of concussion recovery, since every concussion is different and heals at a different, and unpredictable, rate. Guessing which stages of the NFL policy will trip up a given player is akin to guessing which Saints’ running back will carry the load on given day. However, understanding the barriers a player has to overcome in order to be deemed mentally and physically capable of participating in an NFL game can provide fantasy owners a huge edge when making critical roster decisions, particularly in the fantasy playoffs. Take Lesean McCoy for example. Owners who understood the substantial obstacles that he would have to overcome in order to take the field were likely the same ones who had out-of-nowhere star Bryce Brown pegged as their number one waiver priority. Ditto those who tabbed Colin Kaepernick when Alex Smith took the dreaded blow to the head. So for those lucky enough to remain alive in their fantasy playoffs, buckle up that chin strap and keep your head on a swivel for headhunting safeties.
Justin Fielkow is an attorney at the Franklin Law Group in Northfield, Illinois, a Chicago suburb. Justin attended Tulane University Law School and obtained a Certificate in Sports Law. He has been writing for Rotowire since 2008, first while at the University of Wisconsin, then and still as the beat writer for the New Orleans Saints, and now as a featured columnist providing insight twice a month into the legal side of sport with a fantasy spin.