NFL to require sideline test after head blows
February 25th, 2011
09:47 AM ET

NFL to require sideline test after head blows

Dr. Richard Ellenbogen and Dr. Hunt Batjer talk to CNN Chief Medical Correspondent Dr. Sanjay Gupta about the league’s concussion policy, part of a special “Sanjay Gupta, MD – Head Games: The Truth About Concussions,”  Saturday at  7:30 a.m. and 2:30 p.m. ET and Sunday at 7:30 a.m.

Under increasing pressure from players, medical professionals and even fans, on Friday the National Football League took a step towards clearing up its policy on treating head injuries. Starting this fall, every team will be required to use the same neurologic test to determine – on the field – whether an injured player may return to the game.

"It's simple, 'go or no-go,' says Dr. Richard Ellenbogen, co-chair of the NFL's Head, Neck and Spine Medical Committee, who adds that the exam was developed in response to a direct request from NFL commissioner Roger Goodell.

NFL committee co-chairs: "In doubt, take the player out"

"The NFL Sidelines Concussion Exam" is a battery of simple tests evaluating concentration, basic thinking skills and balance. It also includes a questionnaire that asks about concussion symptoms. It's designed to be given on the field, within a 6-to-8 minute window. “The individual pieces have all been validated through research, but they’ve never been used together like this,” says Ellenbogen.

All players will be tested before the season to determine a baseline – how they perform on the test when healthy. If the player suffers a suspected head injury, those results would be matched against an on-field test. If the performance dropoff exceeds a certain threshold, the player will automatically be held out of the game.

While most teams already perform some version of a sideline exam for injured players, they handle it differently. The inconsistency has led to complaints that the culture of professional football is prone to shrugging off concussions as part of the game. Worse, in recent years several former players have attributed health problems – ranging from headaches, to loss of thinking skills, to deep depression – to hits they took on the field, even years earlier. The most recent example: former Chicago Bear safety David Duerson, who killed himself this month after leaving a message asking that his brain be studied for signs of damage.

Ellenbogen and his committee co-chair, Dr. Hunt Batjer, spent the week briefing league employees and executives, who are gathered in Indianapolis for meetings and the NFL draft combine, its annual testing ground for college prospects. “If you’re in doubt, take the player out. Sit 'em down and let them recover,’” explains Ellenbogen, a neurosurgeon at the University of Washington School of Medicine. “If you let them recover, they have a much better chance of recovering [long-term] and have better long-term prognosis.”

Ellenbogen and Batjer, a neurosurgeon at Northwestern, say the response was enthusiastic – from team doctors, who were briefed Thursday, to trainers briefed the day before, to the influential Competition Committee, which saw the presentation on Tuesday.

“Clearly the tolerance for not handling this properly is zero,” Batjer tells CNN.

“Everyone we talk to, instead of pushing back, they are pushing us to be more aggressive,” adds Ellenbogen. “It’s beyond a neurosurgeon’s dream.”

soundoff (129 Responses)
  1. Steve

    New helmets aren't the answer. NOCSAE officials confirm. Dave Halstead suggests mouthguard use. A corrective oral appliance goes one better. No standard tooth protecting mouth guard has ever been proven to help in cases where a history of concussion exists. Boxers with "Glass Jaw" have benefited from a corrective medical protocol now used in the NFL and NHL. Better standards of oversight of the evaluation of oral appliances must become part of the discussion. http://www.mahercor.com has published data peer reviewed by a Harvard temporal mandibular joint specialist.

    March 7, 2011 at 17:01 | Report abuse | Reply
  2. Steve

    Cantu confirms, in some cases the end of the jawbone can be a factor in concussion. The question needs to be examined further. Does this force trauma delivered by the jawbone on the skull base result in a different form of mtbi. Different from the brain shaking like jello off the inside of the skull. The tmjiont exists right next to the medial temporal lobe, exactly were CTE is found in boxers, hockey and football players.

    March 7, 2011 at 19:57 | Report abuse | Reply
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