The State of the NFL & Concussions

By: Brian DeAlmeida

Before I start this piece I want to make one thing very clear to the readers of my article. Yes I attend Boston University’s Sargent College, and I am studying to be an certified Athletic Trainer but that means that I am just a student and the knowledge I will pull forward in this essay comes from my studies and what I have learned thus far. I am not a professional by any means but as a future ATC I could not let an opportunity like this go by the way side.

I must admit, unlike most football fans, I spent my Sunday afternoon at the pool working for the BU swimming and diving team. So I did not see the play live but oh have I watched it over and over again.

So let me set up the situation for you. There is less than 2 minutes remaining in the Ravens-Rams game with the game tied. The Rams are driving when starting quarterback Case Keenum drops back to pass. Baltimore’s defensive tackle Timmy Jernigan gets to Keenum and throws him down hard to the turf. Unfortunately, the first thing that hit the ground was Keenum’s head. He attempts to stand but stumbles over himself with a very apparent head injury that even the untrained medical professional can see. But yet, the next play Keenum is back on the field continuing to play while so obviously concussed. After the game, reports came out the Keenum had suffered a concussion.

What an absolute disgrace.

Most of the negativity has fallen on the NFL and rightfully so. Yet, many others need to be held accountable as well. In 2011, the NFL implemented a new policy to have an ATC spotter in the booth of each game. His/her function is to alert the on-field medical staff (the head ATC, team physician, etc.) of any obvious injuries, such as the one suffered by Keenum. But there are flaws in this system.

One of the major ones being that the ATC spotter cannot make a diagnosis on the condition of the player. They must phone down to the bench and recommend that the on-field medical staff tend to the player. The on-field staff may not have seen the play or the exact mechanism of injury unlike the ATC spotter yet they are in charge of the immediate intervention. While performing an evaluation on an injured athlete, the mechanism of injury is always one of the most important pieces of information an ATC can gather. The mechanism, or the way the injury occurred, can factor into how a treatment plan can be set and what will be factored into your immediate differential diagnosis.

Another problem with this system is that the ATC spotter may not stop the game if they believe an injury such as a concussion has occurred. I don’t think I need to explain this much further but really? The NFL would rather keep the pace of the game and have teams save their timeouts than protect their players? It is absolutely absurd to me that a league cares more about the flow of the game than the safety of their players.

Yet, at the end of the day the blame doesn’t fully fall on the NFL but rather the medical professionals on the sideline. In watching the sequence of events over and over again it struck me that Keenum actually spoke to the Rams’ head ATC after the play yet he was still allowed back into the game. As an up and coming AT who has been taught basic emergency management skills including determining the signs of a concussion, how could the ATC not see the obvious signs? Not only is it negligent, but how in the world can you live with yourself knowing that you allowed him to continue playing?

Many still question the validity of our profession and if it is necessary and incidents like this shine so poorly upon us.

As a child who played football from the time I could walk until my senior year of high school, I have seen teammates, my friends, suffer concussions first hand. I had a friend suffer a concussion during a game and instead of following us off the field to our sideline, he followed the opposing team to the opposite sideline. Concussions are not a joke especially among the youth and the utter disregard of the NFL and the Rams’ medical personal is a very scary thought. So many children emulate their favorite players and for them to see a quarterback suffer a concussion and continue to play shows them that it is the “tough” thing to do. The NFL has done everything they can to sweep traumatic brain injuries under the rug but they don’t understand the influence they have on the youth of America. Concussions and brain injuries are a serious problem and the NFL must do a better job in showing the youth the dangers behind it.

At Boston University we have the very unique opportunity to be the nation’s leading researcher in chronic traumatic encephalopathy or CTE. In fact, I had a graduate assistant who has researched the topic for sometime come and speak to my class just last week. Throughout his presentation, he hammered home how detrimental and important the disease is. We have seen how it affects people every time we turn on the news yet the NFL has refused to accept the research that backs the real dangers of such a detrimental disease.

Unfortunately, despite all the cutting edge research, there is only one day to diagnosis somebody with CTE and that is postmortem. But if there is one thing we know is that there is a positive correlation behind the number of incidents of trauma to the head and the likely hood of developing CTE. But going back to Keenum, the immediate implications of such an injury can become deadly. Not only could he have suffered a concussion but there is always a possibility for brain hemorrhaging which will result in death unless diagnosed immediately.

But sadly in today’s world, an event like this is needed to foster change. Not only in how this situation should be handled differently but also how we can prevent such injuries from occurring in the future. And no, some new high-tech helmet will not solve the problem. Rather it will be new breakthroughs in diagnostic techniques or structured rules to protect the players because yes we enjoy football for the grueling nature of the game, but that doesn’t mean we should subject these athletes to lives of pain and suffering just for our enjoyment. This is not the Roman Empire, we are beyond watching gladiators fight to the death for our enjoyment, or at least I hope so.

But as a future ATC, I am hopeful. I am hopeful that the newest generation of ATCs are being taught the most current protocols and procedures to keep our athletes safe. I am hopeful that this black mark on our profession will become a lesson for us in the future. I am hopeful that we will come up with new advances to protect our athletes. I am confident that we will make a difference and hopefully never let something like this occur under our watch ever again.

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