Last week when the Chiefs played the Chargers running back Jamaal Charles scored a touchdown and was blasted in the end zone by Brandon Flowers.  A shot that Charles bounced up from and headed to the sideline while Flowers was slow to get to his feet.  The hit was helmet to face mask and the resulting forces were a classic case of what is typically needed to produce a concussion for one or both of the players.  Whether or not it actually did, we will never “officially know.”

The issue is not with the hit or the fact that Charles apparently cleared the screening done on the sideline after such a hit, the issue is with his comments a few days after on the Dan Le Batard show;

“It definitely hurt,” Charles said. “A couple plays later, I just [saw] this light buzz around my eyes and I was trying to catch ’em. But I was like, ‘Let’s get the ball and run again.'”

I am 100% confident that Head Athletic Trainer Rick Burkholder did his job on Sunday – screening Charles after the hit – it was evidenced on Tuesday/Wednesday when Burkholder placed Charles in the protocol as a precaution solely due to the comments Charles made.

Why you may ask?  Simple, by the absolute letter of the definition of concussion – disruption of normal brain function following a traumatic event – Charles admitted he was “not normal”.

Whether or not Charles had a concussion is up for debate among many people, not only externally – us blogging/media type – but likely internally – Charles and med staff.  Here in lies the problem with concussions and the issue of concussions.

As we tried to explain in the University of Michigan post, concussion is most often a subjective injury, we as medical professionals rely upon the athlete or injured to tell us what is going on.  If there are no overt or outward signs (loss of consciousness, wobbliness, gaze, vomiting, etc.) then all we can do is screen the athletes.  And by screening I mean simply asking the athlete if they are OK.

GAMING THE SYSTEM

I heard Mark Schlereth on Mike and Mike this morning saying something to the effect of; “there has to be more than just asking the player if they are ‘OK’?”.  The truth of the matter is that there is not really anything other than that; although just asking one question is not due diligence.  In my experience I ask more questions and even try to trick athletes into giving up any ruse they are trying to pull on me.  I have a to questions and line of questioning that has produced many responses that then warranted them to be fully examined with a sideline evaluation, even for the best “liars” (I won’t share them here because it can be used for people to study and then find a way around it).

The more complex yet simple reason we as athletic trainers feel confident with screening, even with limited questions, is that we know the athlete.  Their usual demeanor, behavior and general presentation.  People often ask me how long it takes me to know if someone has a concussion.  When they are my players, the ones I am around on a daily basis, usually it takes me Continue reading →