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Injury Analysis: NFL Revises Concussion Protocol

Jeff Stotts

Jeff Stotts works as a Certified Athletic Trainer (MAT, ATC, PES, CES). He won the 2011 Best Fantasy Football Article in Print from the Fantasy Sports Trade Association.

With the season just nine days away and Andrew Luck's top target suffering from symptoms related to a concussion, now is the perfect time to review the league's mandated protocol for a player diagnosed with the head injury.

Concussions obviously are a serious issue in a violent sport like the NFL. Last year, the NFL reported 123 concussions throughout the season, just 36 fewer than the NBA has reported in the last 10 years. However, since 2007 the league has been more proactive in its approach, continually writing and rewriting concussion guidelines as needed. This offseason, a new rule, Resolution G-2 or "the Julian Edelman Rule," was added to allow a concussion spotter in the press box to stop game play to insure a player with a possible concussion is properly evaluated.

If a concussion is officially diagnosed, the affected player is directly entered into the league's concussion protocol. Medical staffs will begin immediate care of the injured player's symptoms, monitoring and managing them as best they can. Once the player no longer reports symptoms at rest, they can sit for a neurocognitive test.

All teams utilize the ImPACT Test ((Immediate Post-Concussion Assessment and Cognitive Testing). The computerized test is not a diagnostic tool but used to examine how an injured player's brain is reacting and recovering. Since each athlete reacts to a concussion in their own way, ImPACT testing allows for individuals to be properly screened.

The ImPACT test evaluates the individual's current mental status by utilizing a variety of neuropsychological tests including memory recall, shape and color recognition, as well as simple matching. The post-injury results are compared to a baseline scores collected prior to the start of the season. Before an athlete can resume progress in the protocol, his most recent IMPACT score must return to or be better than his original baseline score.

If the test is passed, the concussed player can return to activity but must remain symptom-free as the medical team gradually increases its amount of exertional activity. If the player remains symptom-free at rest and with activity AND is cleared by a team physician, his information is sent to an independent neurologist that examines the data before making the final decision regarding the player's clearance status.

T.Y. Hilton

Hilton has already begun the concussion program after reporting a headache following Saturday's preseason game at St. Louis. The Pro Bowl wideout has nearly two weeks to complete the protocol in time to be ready for Week 1 at Buffalo. Hilton does not have a history of concussions, which could play in his favor, though, as mentioned, every player reacts differently.

Randall Cobb

The Packers can ill-afford to lose another receiver with Jordy Nelson out for the season with a torn ACL. Unfortunately, Cobb was removed from the preseason loss to the Eagles following a hard hit along the sideline. X-rays ruled out a suspected clavicle fracture and further images revealed a minor sprain of the acromioclavicular (AC) joint. Injuries to the AC joint are often referred to as "separated shoulder," though Cobb's injury received the lowest degree of severity. Cobb will not participate in the team's final preseason game against the Saints and will spend the next nine days rehabbing the area and the surrounding musculature. The Green Bay medical staff will be able to brace the area if he remains less than 100 percent, and Cobb should be available for the Week 1 matchup against the Bears.

Turf Burns

Dez Bryant, Emmanuel Sanders:
Both receivers returned to practice this week after suffering hamstring strains a few weeks back. Neither plans on playing in his respective team's preseason finale, but both remain on track to play in Week 1.

Tevin Coleman, Devonta Freeman:
Injuries may be the deciding factor in who starts at running back for the Falcons. While it's been a neck-and-neck competition, Coleman appears to have a leg up on Freeman as he has progressed quicker in his return from a hamstring strain. Coleman was a participant in the team's preseason game against the Dolphins while Freeman was sidelined with a hamstring strain of his own. Things could easily change between now and Week 1, but Coleman should be the first off the board.

Victor Cruz:
Cruz's attempt to comeback from a devastating patellar tendon rupture has hit its first snag as the New York receiver is dealing with inflammation in his left calf. While the injury is on the opposite leg of his knee injury, he can ill afford to have any kind of limitation in his lower extremities. An injury to either side could easily create a muscle imbalance and put undue stress on the surgically repaired area. He isn't expected to practice this week, and his availability for Week 1 is in doubt.

Brandon LaFell:
The Patriots remain tight-lipped regarding specifics of LaFell's foot injury. He remains on the preseason PUP list after spending much of the summer with a boot on his left foot for an undisclosed reason. However, fantasy owners may soon get a better idea of the severity of the issue. If LaFell remains on the PUP on Saturday, when the final roster cuts are made, then he will be ineligible to play through the first six weeks of the season. Roster moves up to this point, including the signing of veteran Reggie Wayne, suggest this is a possibility and LaFell shouldn't be counted on for Week 1. Drop him down your draft boards accordingly.

Julius Thomas:
The 27-year-old tight end fractured his middle finger on his left hand two weeks ago, but it has now been revealed he also ruptured a tendon in the digit. Surgery could be necessary, though Thomas plans on examining all his options before going under the knife. Surgery would keep Thomas sidelined for at least four weeks, threatening his availability through Week 3 of the regular season. It sounds like the Jaguars are expecting to miss Thomas for a stretch, making him a TE2 at best in all formats.

Jameis Winston:
Tampa Bay's rookie quarterback is managing a minor ankle sprain, but the team fully expects him to be ready for Week 1 against the Titans. An ankle injury could limit Winston's ability to scramble and pick up yards, but the injury appears minor and should be a non-issue barring a setback.