What is the Impact?
A Reflection on the New NFL Concussion Guidelines
By: Nirav K. Shah, M.D.
December 17, 2009
Last week I had an opportunity to talk with Merrill Reese, the sports radio announcer with the Philadelphia Eagles, on his weekly radio show. The experience gave me the chance to share my thoughts on the new concussion regulations issued by the NFL (National Football League).
It is always interesting for me to talk to the players about what they see as relevant issues. On the show I was joined by Jordan Norwood, a member of the Eagles organization and a former Penn State football star. As a fellow Penn State alumnus, it was exciting to speak with a player who I had followed since his success on the collegiate level. Jordan made it clear that the new concussion regulations are definitely at the forefront of the players’ concerns.
This year, several marquis players in the NFL have sustained concussions, more than any other season in recent memory. These injuries result in time off, money lost, and a threat to their football futures. Now more than ever, these players need reliable research, analysis, and accurate return-to-play regulations. Their athletic career and quality of life demands it.
The new NFL regulations dictate that when a player sustains any type of concussion, with or without loss of consciousness, he is to remain out of the game for its entirety and abstain from football activities until completely asymptomatic both at rest and after exertion. The regulations further mandate the athlete must be evaluated by an independent medical examiner, preferably a neurologist of neurosurgeon, who is qualified to accurately assess the injury and develop a safe and effective treatment plan.
Unfortunately, many players in the past have been evaluated and treated by non-neurologic specialists, who lack the adequate education and experience to best facilitate care. Although these physicians may be trained in a variety of sports-related injuries, it is clear that a neurologist or neurosurgeon, who sees these types of cases in their training and day-to-day practices, are more capable of providing thorough and accurate diagnosis and treatment.
Another key component of the new NFL regulations is the requirement for an athlete to take time off to allow for healing. In the past, players were not adequately resting post-injury. Instead, they would continue to play through symptoms, such as nausea, vomiting, and dizziness. This is in line with a machismo sport where playing through an injury is expected. However, concussions are not simply another injury to play through. Without the time off for healing, further injury can perpetuate and profoundly impact an athlete’s ability to fully recover or return to the sport.
During the time off, consistent monitoring and rehabilitation, at rest and during exertion, is important in determining whether or not symptoms are still present. Reflexology, memory testing and vestibular or balance training are fundamental tools in post-concussion treatment. The cooperation and collaboration of all professionals involved – such as the neurosurgeon, physical therapist, athletic trainer, coach, and athletic director – is vital to ensure the athlete returns in a safe and optimal condition.
Talking with Merrill Reese was quite an honor, and the broadcast provided an amazing opportunity for me to bring this concussion discussion into the spotlight for our community. I hope that the new NFL regulations, and the publicity surrounding them, generate a shift in the way we think about head injury on the youth and high school level. At Princeton Brain & Spine Care, we are committed to protecting our children and enhancing our sports.
Read the official National Football league press release announcing stricter concussion guidelines, issued December 2, 2009 here:
http://blogs.nfl.com/2009/12/02/league-announces-stricter-concussion-guidelines/
Nirav K. Shah, M.D., FACS, is a neurosurgeon with Princeton Brain and Spine Care.
