Sunday slant: Concussions are ‘no joke'

The NFL has stepped up its procedures on how teams have to deal with concussions, as it should. Concussions are a mysterious injury about which science is still learning, meaning players and the league should err on the side of caution.

NFL games present plenty of ways to view the matchups – a physical back against a great defense, an opportunistic defense pitted against a masterful quarterback, or any other combination of talent vs. talent.

It's proven time and again that teams favored at the beginning of seasons aren't always the champions at the end. Along the journey from starting training camp at the end of July to hoisting of the Lombardi Trophy in February, there can be close to a thousand opportunities for players to get hurt in a game and several thousand practice snaps where that can happen.

When the Minnesota Vikings take the field against the Chicago Bears Sunday at noon, it will feature two of the more fortunate teams on the healthometer. After 10 games, the Vikings have only four players on injured reserve and only one of those is a starter – Chris Cook, who anticipates a return to the field in a month (as the player on IR designated for return, a new rule this year). The Bears have been in even better shape, with only two non-starters on injured reserve.

However, along the way, there have been a few injuries that caused concern for both teams. Fortunately, they didn't end the season for any of the players involved, and even better is that the NFL is coming out of the shadows and promoting awareness of concussions rather than trying to sweep their effects under the carpet while gridiron greats of yesteryear languish in a fog.

When Bears QB Jay Cutler suffered a concussion two weeks ago, he was one of three NFL quarterbacks to suffer the perplexing head injury in one day. He didn't play Monday night against the San Francisco 49ers and his status against the Vikings was up in the air most of the week. He was cleared to play on Saturday, but if the NFL has learned anything about concussions in the last five years, it's that players shouldn't be rushed back into action. No two concussions are alike, as Vikings linebacker Erin Henderson pointed out repeatedly.

Henderson, who missed two games with a concussion earlier this year, said some players are nauseous while others aren't after suffering a blow to the head. The different side effects make it hard for Henderson to put into words what it was like.

"You can't. I feel like I've already tried and you can't really explain. You just don't really feel like yourself. You feel like a shell of yourself," he said, admitting that the feeling of being in a fog is an appropriate descriptor.

Fortunately for Henderson, John Carlson and Jay Cutler – among the many players that have been diagnosed with concussions this year – the NFL stepped up its post-concussion protocol in 2009. Although it's far from an exact science and symptoms can still be missed, NFL personnel are placed at every game to look for signs of a possible concussion. If a player is suspected of possibly suffering one, he is to be pulled from the game and receive examination. If a concussion is the diagnosised, he can't return to the game (or practice) until after he has cleared a battery of tests.

The NFL statement to teams dealing with concussions reads, in part:

"Once removed for the duration of a practice or game, the player should not be considered for return-to-football activities until he is fully asymptomatic, both at rest and after exertion, has a normal neurological examination, normal neuropsychological testing, and has been cleared to return by both his team physician(s) and the independent neurological consultant. A critical element of managing concussions is candid reporting by players of their symptoms following an injury. Accordingly, players are to be encouraged to be candid with team medical staffs and fully disclose any signs or symptoms that may be associated with a concussion."

That last part allows for a wide variety of attitudes, even today, when players know much more about the potential long-term effects. Henderson confirmed, however, that awareness among players has increased in recent years.

"I would say for everybody it had to be. You had to take a different approach to it. You had to take it in a different light. If not, then you would be a disservice to yourself and to others and people who come and play the game in the future. It's not a joke," Henderson said. "It's nothing to play with. It's nothing to be laughed at and nothing to be thought of lightly or taken lightly. I think as we progress as a whole we start to learn more about it and start to educate ourselves more, I think we understand the importance of taking your time with that more and making sure that you are 100 percent before you step out there on the field and begin to start doing more damage to your head. It's a scary thing, but that's what we do."

In Henderson's case, the perplexing nature of concussions was pronounced. He suffered the concussion on Sept. 16, but the team didn't realize it until he returned to practice three days later and didn't feel normal.

"There were no indications after the game, Monday, Tuesday, and then Wednesday came after practice and (he) just didn't feel right," Vikings coach Leslie Frazier said at the time. "That's when they decided to take him through protocols for concussions."

He missed the next two games before passing the NFL-mandated post-concussion tests. Those involve being tested cognitively – all players are given baseline tests before the season – before and after they return to practice. Some players return to practice without issue, others pass the initial tests and then still aren't cleared after suffering symptoms following initial exertion.

Teams are instructed to look for numerous signs, including:

  • Loss of consciousness

  • Confusion as evidenced by disorientation to person, time or place; inability to respond appropriately to questions, or inability to remember assignments or plays

  • Amnesia as evidenced by a gap in memory for events occurring just prior to the injury; inability to learn and retain new information; or a gap in memory for events that occurred after the injury

  • Abnormal neurological examination, such as abnormal pupillary response, persistent dizziness or vertigo, or abnormal balance on sideline testing

  • New and persistent headache, particularly if accompanied by photosensitivity, nausea, vomiting or dizziness

  • Any other persistent signs or symptoms of concussion

    As Cutler attempts to come back from his more recent concussion behind a suspect offensive line, he needs to heed the statement from Henderson that concussions are "no joke."

    NFL tough guys will always want to "play through" injuries, but quality of long-term life has to be put before the competitive desire to win at all costs. The cost is too big – just ask those who played when they weren't considered tough enough if they sat out because of anything less than a broken bone or torn ligament. Or ask their wives, who are dealing with the effects that go beyond normal aging in their husbands.

    "I understand the antsy-ness and the anticipation and some of the pressure of people around you to try to get you back out there on the field, as well as the pressure you're putting on yourself and that want-to and that desire to get back out there," Henderson said when asked about Cutler's situation. "I know if he's medically and physically able to he'll get out there."

    At least these days, there are safeguards in place. Now it's a matter of better understanding proper recovery from a concussion and learning when to say enough is enough.


    Tim Yotter is the publisher of Viking Update. Follow Viking Update on Twitter and discuss this story on our subscriber message board.



  • Packer Report Top Stories

    \r\n\r\n","mobileBody":"NFL games present plenty of ways to view the matchups – a physical back against a great defense, an opportunistic defense pitted against a masterful quarterback, or any other combination of talent vs. talent. It's proven time and again that teams favored at the beginning of seasons aren't always the champions at the end. Along the journey from starting training camp at the end of July to hoisting of the Lombardi Trophy in February, there can be close to a thousand opportunities for players to get hurt in a game and several thousand practice snaps where that can happen. When the Minnesota Vikings take the field against the Chicago Bears Sunday at noon, it will feature two of the more fortunate teams on the healthometer. After 10 games, the Vikings have only four players on injured reserve and only one of those is a starter – Chris Cook, who anticipates a return to the field in a month (as the player on IR designated for return, a new rule this year). The Bears have been in even better shape, with only two non-starters on injured reserve. However, along the way, there have been a few injuries that caused concern for both teams. Fortunately, they didn't end the season for any of the players involved, and even better is that the NFL is coming out of the shadows and promoting awareness of concussions rather than trying to sweep their effects under the carpet while gridiron greats of yesteryear languish in a fog. When Bears QB Jay Cutler suffered a concussion two weeks ago, he was one of three NFL quarterbacks to suffer the perplexing head injury in one day. He didn't play Monday night against the San Francisco 49ers and his status against the Vikings was up in the air most of the week. He was cleared to play on Saturday, but if the NFL has learned anything about concussions in the last five years, it's that players shouldn't be rushed back into action. No two concussions are alike, as Vikings linebacker Erin Henderson pointed out repeatedly. Henderson, who missed two games with a concussion earlier this year, said some players are nauseous while others aren't after suffering a blow to the head. The different side effects make it hard for Henderson to put into words what it was like. \"You can't. I feel like I've already tried and you can't really explain. You just don't really feel like yourself. You feel like a shell of yourself,\" he said, admitting that the feeling of being in a fog is an appropriate descriptor. Fortunately for Henderson, John Carlson and Jay Cutler – among the many players that have been diagnosed with concussions this year – the NFL stepped up its post-concussion protocol in 2009. Although it's far from an exact science and symptoms can still be missed, NFL personnel are placed at every game to look for signs of a possible concussion. If a player is suspected of possibly suffering one, he is to be pulled from the game and receive examination. If a concussion is the diagnosised, he can't return to the game (or practice) until after he has cleared a battery of tests. The NFL statement to teams dealing with concussions reads, in part: \"Once removed for the duration of a practice or game, the player should not be considered for return-to-football activities until he is fully asymptomatic, both at rest and after exertion, has a normal neurological examination, normal neuropsychological testing, and has been cleared to return by both his team physician(s) and the independent neurological consultant. A critical element of managing concussions is candid reporting by players of their symptoms following an injury. Accordingly, players are to be encouraged to be candid with team medical staffs and fully disclose any signs or symptoms that may be associated with a concussion.\" That last part allows for a wide variety of attitudes, even today, when players know much more about the potential long-term effects. Henderson confirmed, however, that awareness among players has increased in recent years. \"I would say for everybody it had to be. You had to take a different approach to it. You had to take it in a different light. If not, then you would be a disservice to yourself and to others and people who come and play the game in the future. It's not a joke,\" Henderson said. \"It's nothing to play with. It's nothing to be laughed at and nothing to be thought of lightly or taken lightly. I think as we progress as a whole we start to learn more about it and start to educate ourselves more, I think we understand the importance of taking your time with that more and making sure that you are 100 percent before you step out there on the field and begin to start doing more damage to your head. It's a scary thing, but that's what we do.\" In Henderson's case, the perplexing nature of concussions was pronounced. He suffered the concussion on Sept. 16, but the team didn't realize it until he returned to practice three days later and didn't feel normal. \"There were no indications after the game, Monday, Tuesday, and then Wednesday came after practice and (he) just didn't feel right,\" Vikings coach Leslie Frazier said at the time. \"That's when they decided to take him through protocols for concussions.\" He missed the next two games before passing the NFL-mandated post-concussion tests. Those involve being tested cognitively – all players are given baseline tests before the season – before and after they return to practice. Some players return to practice without issue, others pass the initial tests and then still aren't cleared after suffering symptoms following initial exertion. Teams are instructed to look for numerous signs, including:
  • Loss of consciousness
  • Confusion as evidenced by disorientation to person, time or place; inability to respond appropriately to questions, or inability to remember assignments or plays
  • Amnesia as evidenced by a gap in memory for events occurring just prior to the injury; inability to learn and retain new information; or a gap in memory for events that occurred after the injury
  • Abnormal neurological examination, such as abnormal pupillary response, persistent dizziness or vertigo, or abnormal balance on sideline testing
  • New and persistent headache, particularly if accompanied by photosensitivity, nausea, vomiting or dizziness
  • Any other persistent signs or symptoms of concussion As Cutler attempts to come back from his more recent concussion behind a suspect offensive line, he needs to heed the statement from Henderson that concussions are \"no joke.\" NFL tough guys will always want to \"play through\" injuries, but quality of long-term life has to be put before the competitive desire to win at all costs. The cost is too big – just ask those who played when they weren't considered tough enough if they sat out because of anything less than a broken bone or torn ligament. Or ask their wives, who are dealing with the effects that go beyond normal aging in their husbands. \"I understand the antsy-ness and the anticipation and some of the pressure of people around you to try to get you back out there on the field, as well as the pressure you're putting on yourself and that want-to and that desire to get back out there,\" Henderson said when asked about Cutler's situation. \"I know if he's medically and physically able to he'll get out there.\" At least these days, there are safeguards in place. Now it's a matter of better understanding proper recovery from a concussion and learning when to say enough is enough.
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