The Debate of When To Pull A Player

This past week there were some prime examples of concussions, including mechanism of injury and how they are currently handled – some say mishandled – in the National Football League.  Now the debate rages on about when exactly a player should be pulled for evaluation.

In many cases this is absolutely obvious, for example Johnathan Baldwin of the Kansas City Chiefs last night in Pittsburgh.  As he laid out for a catch his head bounced off the ground and he immediately showed a fencing response and was “limp” on the field in a semi-prone position.  He “came to” and tried to get to his feet, key word being “tried”, as he was wobbly and needed help from a teammate and the official to stand.  The official then summoned the athletic trainers to aid in getting him off the field; it was obvious that Baldwin needed to be evaluated for a concussion (side note: the Chiefs are calling his injury a “neck”, which he could have hurt on that play but once again its an attempt to muddy the water, IMO).

To the credit of the NFL medical staffs these types of situations are rarely missed anymore, especially with the observer in the press box helping with the identification of potential head injuries.  I would dare say that these type of situations are missed more often at college, high school and youth level football games than the professional level; which is way more disturbing.

However, the debate remains about those players that don’t show overt signs of Continue reading

Cutler Follow Up

This is a GREAT video blog and investigation of the Jay Cutler injury.  Roy of sportsfansnetwork does make a good case for Cutler’s toughness, and even gives relevance to the “hypothetical” situation we posted about.  Take a look at his footwork after where Roy says the injury occurred.

Cutler Injury and Athletic Trainers

There was no hotter topic across the nation yesterday than Jay Cutler, particularly here in Illinois.  A lot was made of a very simple issue, and it didn’t take an MRI to figure it out, it took an athletic trainer.

The simple fact is that football players, by definition, are warriors and would give anything to play the game.  We see that with the concussion issue.  And even though this injury was not a concussion, it was an injury and the athletic trainer and medical staff did the best they could to allow Cutler to play.  Forget for a moment your fandom, remove your emotions, and understand what in all likelihood occurred at Solider Field this past Sunday.

BELOW IS AN EDUCATED GUESS AS TO WHAT HAPPENED, this is to better clarify what we do as professionals…  I hope that I am certainly not “assassinating” anyone’s character.

Cutler most likely reported to the athletic trainer that he hurt his knee, at which point an interview was conducted and very little was done at the time.  The fact that he was upright and not in obvious distress warranted the staff to look closely at him during play.  After they noticed that he was not performing up to par, they most likely went to a sideline evaluation, which occurred just prior to halftime.  During that evaluation the athletic trainer tested the stability of the knee ligaments (four major), ACL, MCL, PCL, LCL and if the evaluation was thorough, it would have included a screen for a meniscus issue as well.

After that initial evaluation, it warranted the staff to take Cutler to the locker room early, most likely for a more in-depth evaluation, in a “relaxed” setting, as well as allowing the doctors to do the same tests as the athletic trainer.  What was most likely found on the Continue reading

Cutler Coming Back

It is being reported the Jay Cutler, quarterback for the Chicago Bears, is cleared to return after his concussion on Monday Night Football against the Giants over 10 days ago.  However, they are now reporting that this is his 5th known concussion which leads us to a good point.

The old grading scale used to have limits to playing contact sports if you had sustained multiple concussions.  The thought process has changed, and no longer is a certain number a disqualification for the athlete.  Every person reacts differently to a concussion, therefore there is not an all encompassing number that would be “too many” for someone.

As long as the individual has FULLY recovered from the concussion and can pass the graded return to play criteria they would be allowed to play contact sports.  But, with each successive concussion it becomes harder to progress in a timely manner, as your brain has been compromised previously, it is now working harder to do the same work.  Once you have had a concussion you are more susceptible for another concussion.

What we need to understand and be aware for is the multiple concussions in the adolescent, in particular getting concussed before all brain function and symptoms have resolved.  It is of my professional opinion that if you have kids getting 3 or more concussions in a high school career, it is time to take a closer look at what they are doing.  And with each successive one it may be time to limit their actions, or make severe corrections in their actions.