The NFL has made significant strides this past year with following their new Concussion Protocols and Guidelines. However, athletes with possible concussions may still go untreated if they are not identified.
Browns Quarterback Colt McCoy suffered what appeared to be a concussion Thursday night, December 5,. 2011 during a game against Pittsburgh (cbssports.com, December 20, 2011). However, he was allowed to return to the field and resume competing two plays later because no one on the medical staff observed the hit to his helmet.
As of December 20, 2011, McCoy has still not been cleared to practice due to a diagnosed concussion sustained during the game on December 5, 2011 (espn.go.com). On a positive note, the Browns are currently following the NFL Concussion Management Protocol with McCoy and he has yet to be allowed to practice.
Goodell Quick to Support Concussion Protocol Changes
According to Brinson, W. (cbssports.com, December 20, 2011), NFL Commissioner Roger Goodell supported a new concussion protocol that would include the hiring of an additional Certified Athletic Trainer (ATC) positioned in the press box during games for the sole purpose of keeping a permanent visual on the field at all times to identify any injuries that may be missed by the sideline medical staff.
The sideline of a football game for the medical staff is like no other sports. This is due to several factors including the sheer number of athletes competing on the field at one time, the quick pace at which athletes are substituted on and off of the field, and the potential for multiple injuries to occur at one time.
Medical Coverage Protocol During Football Games
Typically, the head athletic trainer is positioned on the sideline at the line of scrimmage during a game for the best vantage point of the entire field. Additional assistant certified athletic trainers are assigned to each of the defensive and offensive teams. There may also be certified athletic trainers stationed by the benches to handle any minor medical problems that may arise. Theoretically, this protocol was designed for maximum visual coverage and quick response time for all athletes.
For example, if a defensive player is injured and limps towards the sideline, the ATC assigned to the defensive athletes will move to assist the athlete as he moves towards the sideline. This protocol allows for the treatment of the injured athlete leaving the head athletic trainer and one assistant ATC watching the field.
The head athletic trainer is the ATC who usually responds on the field when a football player is injured and remains down. Depending on the size of the medical staff, the head athletic trainer may also identify one ATC to follow him/her onto the field to assist with the provision of medical care if needed.
However, the problem arises if a sidelined-injured athlete requires the expertise of the Head Athletic Trainer. This involves moving the head ATC off of the sideline to a position where his/her back is to the field. This can potentially place other injured athletes at risk for not being identified. This is apparently what happened to Colt McCoy during the game on December 5, 2011.
The medical staff were attending to other injured athletes leaving no one on the field to see the hit to McCoy's helmet. Unfortunately, this left McCoy's head injury missed by the medical staff.
To the credit of Goodell and the NFL, this hole in the current NFL Concussion Protocol was identified quickly and a new concussion protocol has been put into place to prevent this from happening in the future. Effective Christmas Eve 2011, an additional Certified Athletic Trainer will be required to be positioned in the Press Box for the sole purpose of having a permanent set of eyes on the field.
Lessons Learned by the NFL Should Carry Over to College/High School/Youth Sports
While the NFL is continuing to take important strides in improving the identification and management of concussed athletes, these lessons need to be carried over to other sports organizations including university, college, high school, and youth sports. The problem is that the amount of medical coverage varies significantly from the best that money can buy (NFL - multiple Team Physicians and Certified Athletic Trainers) to no coverage at all (most youth sports).
The NFL can lead the way through advocating legislation that would require the provision of certified athletic trainers at all levels of sports. If the NFL (an organization with the best medical staff in the country) feels the need to hire an additional ATC to ensure that all of their athletes are carefully monitored for injuries during games, how much more important is it for youth sports organizations with no medical coverage to have at least one ATC on the sideline to protect their athletes?
References
Cbssports.com, "NFL Sends Concussion-Monitoring Trainers to Games", (accessed December 20, 2011).
Espn.go.com, "Colt McCoy Still Not Practicing", (accessed December 21, 2011).
Terry Zeigler - Educating through writing with over twenty-five years of experience as a Kinesiology Professor and Certified Athletic Trainer.
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