Over the years, the NFL has made a lot of changes to its concussion protocol to better protect players from the dangers of head injuries. The league’s protocol now focuses on careful evaluation, thorough testing, and a step-by-step recovery plan for any player who may have a concussion. Here’s a clear look at how the NFL handles concussion concerns, from the initial sideline check to the return-to-play steps.
When a player takes a strong hit, many people on and off the field are watching for signs of a concussion. Team doctors, independent neurotrauma experts (people trained to check for brain injuries), and sideline spotters can all decide to evaluate a player. If a player shows signs like dizziness, confusion, or trouble moving steadily, the medical staff immediately removes them from the game and examines them on the sideline.
The sideline exam checks important functions such as speech, balance, and eye movement. There are also specific “no-go” symptoms that automatically mean the player cannot return to the game. These include:
- Loss of consciousness (passing out)
- Obvious trouble with balance or coordination
- Confusion
- Memory loss (amnesia)
- Ataxia (difficulty with motor skills or speech)
If a player doesn’t show any of these automatic “no-go” symptoms, they continue with more tests from an independent neurotrauma consultant. This includes watching a video replay of the hit, asking questions to make sure the player is aware of their surroundings (like where they are and who they’re playing against), and doing a deeper neurological exam. This thorough exam helps determine if the player can return to the game or if they need to start the full concussion protocol.
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The Return-to-Play Protocol: Five Phases
Once a player enters the concussion protocol, they must go through a structured five-phase plan to safely return to play. Here’s what each phase involves:
- Symptom-Limited Activity: In this first phase, the player is advised to rest as much as possible. They limit physical and mental activities that could make symptoms worse. Slowly, light stretching and balance exercises are added.
- Aerobic Exercise: In this phase, players begin light cardiovascular workouts, like riding a stationary bike or walking on a treadmill. They may also do stretching and balance training, all with supervision from the team’s medical staff.
- Football-Specific Exercise: Now, players start to do workouts that are more like football movements. They might do drills that mimic football actions while doctors carefully monitor them.
- Non-Contact Training Drills: At this point, the player can begin activities specific to their football position, but without any physical contact. This phase includes more cardio and strength exercises, and the player is tested again for balance and cognitive (mental) skills.
- Full Football Activity/Clearance: In the final phase, the player must be cleared by both the team doctor and an independent neurological consultant. If both agree that the player has fully recovered, they can return to full practice and games.
Each of these five phases takes as much time as needed for the player’s symptoms to improve. The goal is to give the player a safe recovery, with no set timeline. The medical team also considers the player’s history of concussions and future risks to ensure they protect their health.
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New Equipment, Rules, And The Evolution Of The NFL’s Concussion Protocol For Long-Term Safety
The NFL is constantly changing its rules and equipment to make the game safer for players. The league has banned helmet-to-helmet hits and head-first tackles, and it now allows players to wear Guardian Caps—soft covers over helmets that help reduce impact during practices and games. Additionally, some players are now using a device called the Q-Collar. This collar applies gentle pressure on the sides of the neck to reduce movement of the brain inside the skull. The Q-Collar stabilizes blood flow and may help prevent some head injuries, making it the only FDA-cleared neck device for this purpose.
The NFL has been working on concussion safety since the 1990s, but the concussion protocol itself officially began in 2011. Since then, the NFL has continued to improve its protocol with more research and new technology. For example, the league added independent neurotrauma consultants on the sidelines to make evaluations more thorough and fair, and it has expanded its list of “no-go” symptoms over time.
With the knowledge that concussions can have serious long-term effects, the NFL’s concussion protocol is a critical safety measure to help protect players’ health. As research and technology advance, the NFL will keep updating this protocol to keep players safe, with the ultimate goal of making football safer for everyone.
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