The NFL Needs Better Tools to Detect Concussions
Even with almost 30 medical professionals being at every NFL game, concussions can be missed. After being hit in the head twice earlier in the season and a third time last week, Tua Tagovailoa continued to play in the game. After falling back and hitting his head, he did not show a loss of motor skills or other symptoms like loss of consciousness, trouble standing, or involuntary hand movements. He did throw multiple interceptions and the next day reported symptoms to team staff. They then put him under mandated observation and out of play, but this is too late.
The NFL and the players union both reviewed the game footage of Tagovailoa and say they did not think there was any evidence that would have required Tagovailoa to be removed from the game. He did not exhibit any symptoms and then reported symptoms the next day. There is an NFL mandate that there needs to be nearly 30 medical professionals at each game. This includes athletic trainers and neurotrauma experts on the field and medical experts up in the boxes scanning the field to detect any head injuries occurring in the game. Concussions can be problematic though because they can have mild symptoms like headaches, sluggishness, and difficulty sleeping, which are not always seen immediately after an injury. Updated tools need to be adopted so concussions can be found with a better degree of specificity.
Concussions are dangerous because they can disrupt anything that the brain controls. In the recent weeks of the season, players have been self-reporting concussion symptoms. A player for the Patriots stopped play so his teammate could be examined before resuming play. The teammate was later diagnosed with a concussion. Examples like this show there are promising changes in the NFL because players are willing to speak up about symptoms they are experiencing. Around 40 percent of diagnosed concussions were from self-reporting. Players today have grown up with concussion protocols, so they are more willing and able to self-report. Reporting an injury is super important, but players may not do this because of the culture of the team, or they may worry about loss of compensation since they do not have guaranteed contracts.
The NFL uses physical and cognitive exams to detect concussions, but the athletes operate at such a high level and can pass these tests easily, making it almost impossible to detect a head injury. Despite there being a lot of technology in medicine, there is no test, x-ray, or MRI scan that can detect a concussion. Teams rely on self-reporting, which is not a good standard because players may be afraid to report an injury. New tools are gaining traction outside of football though. CT scans and the Banyan Brain Trauma Indicator test are both becoming more common. The blood test looks for two proteins that occur in patients with brain bleeding.
The NFL is partnered with the CFL on testing and funds research on concussions but has not adopted any new tools from the research. The players’ union and the NFL both have to agree on concussion protocol changes, which can slow down progress. The union has helped with adding independent neurological evaluators on the sidelines and in booths and has advocated for better helmets in past years.
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Elena Bergeron, “Without Updated Tools, N.F.L. Is Still Finding Concussions Too Late” The New York Times (December 31, 2022). [Link]