The Jets' hard-nosed possession receiver suffered his second concussion in 10 months Oct. 28 versus Buffalo, forcing him to miss the following Sunday's home game against the Redskins and ending his streaks of 104 starts and 107 straight games played.
It appears Coles will return to play the Steelers Nov. 18. It would be unfair to assume either Coles or the Jets' medical staff is making an unwise decision.
The Jets and all teams are under orders to follow the NFL's new guidelines on treating head trauma. Treating brain injuries, which concussions are, is a gray area.
"He's gotten some days of practice in, and with this injury, or really any injury, we're going to err on the side of caution," said head coach Eric Mangini when asked of Coles' possible return. "With this injury, we've gone through quite a bit of work in the offseason to improve the process of evaluating it to make sure that we're as cutting edge as possible in all of sports in terms of evaluating these types of injuries. It's very important to us. He's made good progress."
Let's hope the Jets are true to Mangini's word.
"Repeated, significant concussions, and you have to define significant, certainly can affect the function of the brain over many years," said Dr. Arno H. Fried, chairman of the Department of Neurosurgery at Hackensack University Medical Center in Bergen County, New Jersey in an interview with Jets Confidential.
"If you have a real concussion, I don't think there's convincing proof that you are more likely to have another concussion," said Dr. Fried, conceding that opinion is controversial.
However, Dr. Fried stressed what he believes is the more important issue.
"When you have another concussion, the effects can be much more severe than if it was an isolated concussion. In a second concussion, the effects can be magnified."
Just ask Al Toon or Wayne Chrebet. Toon, a three-time Pro Bowler still sleek and swift in what was his eighth season in 1992, suffered at least his ninth concussion after a seemingly routine tackle at Denver. It would be the last play of his career.
As the concussions had mounted for Toon, there'd been little, if any, discussion over whether he was jeopardizing his long-term health. The current discourse over Dolphins QB Trent Green's future is proof brain trauma awareness has grown in the NFL since Toon's days.
During the past offseason, new NFL Commissioner Roger Goodell took the unprecedented step of issuing a memorandum to all teams establishing guidelines to deal with concussions.
The NFL formed a concussion committee in 1994, headed by the current Jets medical department chief Dr. Elliott Pellman. In February, Pellman stepped down from his position. His tenure was marked by a series of news articles detailing his controversial opinions. And there was also the matter of Chrebet.
On Nov. 2, 2003, Chrebet returned to a game during which he had already been knocked out, according to published reports. As has been detailed in recent reports, Chrebet suffered a series of concussions during his illustrious college and pro careers. He would push it one too many.
In a 2005 home game against San Diego, Chrebet's head got blasted to the Meadowlands turf. It would be his last play, but it didn't have to end that way. Chrebet knew the possibilities when he decided to keep playing after missing the second half of the 2003 season with post-concussion syndrome. So did Dr. Pellman. Or did they?
Under Dr. Pellman's leadership, the NFL's concussion committee stated their work shows "no evidence of worsening injury or chronic cumulative effects of multiple [mild traumatic brain injury] in NFL players."
Dr. Fried disagrees. "Significant concussions that are repeated can cause neurocognitive effects. Severe concussions can cause even more severe effects, even in the acute period."
Now back to Coles. As mentioned, the Jets and all NFL teams have been given the league's new guidelines on allowing a players who've suffered brain trauma to return to competition. But according to Dr. Fried and other experts in the field, Coles' next concussion could result in even more severe effects. And that's the tricky, dangerous part. He might bounce back quickly, he might not. And how far should any player, not just Coles, push their luck in a sport that allows them to make millions of dollars per year, more money than they've ever made or may make for the rest of their lives?
In part two of this series, we'll examine that question as well as the Academy of Neurology's guidelines on sports concussions.
Martin DiCaro is an award-winning reporter for New Jersey 101.5.