Concussion protocol 101 (3 players out)

[Gumby]

With 3 key players out (Henderson, Boutte, Wilson) for concussion protocol, I was wondering what the timeline might be. Doesn’t sound good for any for Jesters, although Wilson might be fastest (just cause no specific play was identified -could be ? not that bad ? )

Sharing some reading here, FYI if curious too …

Key Points on NFL Return-to-Play (RTP):

• No Fixed Time: There's no set minimum number of days; it's based on symptom resolution and medical clearance.
• Median vs. Fastest: While the median is 9 days, some players return in under a week, while others take much longer.
• Brock Purdy Example: In late 2023, Brock Purdy returned in about 4-5 days, a very quick turnaround.
• Protocol Stages: Players must complete a multi-phase return-to-participation protocol, with each step taking at least 24 hours and requiring symptom-free progression.
• Factors Influencing Speed: Severity of the initial injury, presence of ataxia (balance issues), and individual player factors affect the timeline.

Why It Varies:

• Symptom-Based: The protocol is designed to ensure players are symptom-free and clear of cognitive deficits before returning to contact.
• Medical Pressure: There's ongoing debate about competitive pressure potentially influencing faster clearances, as seen in past controversies.

In essence, while some players beat the odds and return in under a week, the typical experience is closer to 9 days, with the goal being complete symptom resolution, not just speed.

 

[Gumby]

Five phases of Protocol:

Phase 1: Symptom-Limited Activity: The player rests and avoids physical and cognitive activities that worsen symptoms, gradually introducing light daily activities like walking and stretching as tolerated.

1. Phase 2: Aerobic Exercise: Introduction of moderate exercise, like jogging or cycling, focusing on cardiovascular fitness while monitoring for symptom increase.
2. Phase 3: Football-Specific Exercise: The player starts drills that mimic game-specific movements, such as running, cutting, and throwing, but still without contact.
3. Phase 4: Club-Based Non-Contact Training Drills: Participation in all non-contact team practices, including drills, while continuing other exercises.
4. Phase 5: Full Football Activity/Clearance: Full practice participation, followed by clearance from the team physician and an Independent Neurological Consultant (INC) before returning to games.

A player must progress through these stages without any symptom recurrence to be cleared for full contact and game play.

 

[n1997y]

I expect both Henderson and Boutte to take awhile, Wilson maybe not so long.

I’m concerned that Boutte in particular seemed to have tonic posturing of his arms after hitting the ground, that’s why he lost the ball.

Henderson may also have had that reflexive reaction but it was harder to see what was going on with him. He definitely took longer to get off the field, and needed assistance before he could do so. So both of those two seemed like greater severity.

OTOH Wilson didn’t show anything that was noticed during the game, suggesting his is lesser severity.

Wilson might be back next week but I’d think he’s more likely out until the Phins game. The other two might be out until the playoffs. I hope they are all managed cautiously.

 

[Gumby]

I expect both Henderson and Boutte to take awhile, Wilson maybe not so long.

I’m concerned that Boutte in particular seemed to have tonic posturing of his arms after hitting the ground, that’s why he lost the ball.

Henderson may also have had that reflexive reaction but it was harder to see what was going on with him. He definitely took longer to get off the field, and needed assistance before he could do so. So both of those two seemed like greater severity.

OTOH Wilson didn’t show anything that was noticed during the game, suggesting his is lesser severity.

Wilson might be back next week but I’d think he’s more likely out until the Phins game. The other two might be out until the playoffs. I hope they are all managed cautiously.

I thought something I read kind of implied Wilson first reported symptoms on plane ride (did they fly? ) home.

So, could some of these CTE type things be aggravated by undergoing air pressure changes too soon after the game?
It was a late game so they probably tried to beat feet and get going. Maybe flying next day would be better for some guys ???

 

[WhatJustHappened]

I guess it isn't ALWAYS obvious that something is wrong, I've heard of that before.

 

[DoubleDeluxe]

Henderson practised today and I believe yesterday in a non-contact jersey, so he would be in stage 4.
That said, good chance he plays this week.

 

[ctpatsfan77]

I thought something I read kind of implied Wilson first reported symptoms on plane ride (did they fly? ) home.

So, could some of these CTE type things be aggravated by undergoing air pressure changes too soon after the game?
It was a late game so they probably tried to beat feet and get going. Maybe flying next day would be better for somebguys ???

A little Googling turned up a study comparing athletes in Florida and Colorado. It found "High altitude was associated with increased suspected concussions and prolonged recovery but less severe initial injury." So I don't think the flight had anything to do with it per se.

https://concussionmanagementofny.com/wp-content/uploads/2022/06/High-Altitude-Modulates-Concussion-Incidence-Severity-And-Recovery-In-Young-Athletes.pdf

 

[Gumby]

Henderson practised today and I believe yesterday in a non-contact jersey, so he would be in stage 4.
That said, good chance he plays this week.

Yeah, he made it into Stage 5. so just a matter of showing no symptoms and Vrabes wanting to „risk it“.

I’m a little surprised that Wilson isn’t showing up at one of the Stages yet.

 

[n1997y]

Yeah, he made it into Stage 5. so just a matter of showing no symptoms and Vrabes wanting to „risk it“.

I’m a little surprised that Wilson isn’t showing up at one of the Stages yet.

I think anything before Stage 4 is not participating in team practices. Looks to me like Stage 3 is individual activities that would be reported as DNP. So Wilson could be close to finishing Stage 3 and there would still be nothing said about it. Or he could still be in Stage 1. That’s why the team says as little as possible.

The questions about Henderson are how Vrabes sees the risk, and his appetite for taking that risk. I think he is likely to hold Henderson out even if he clears the protocol. Of course if he doesn’t clear protocol there’s no decision for Vrabes to make about it.

I won’t be surprised if Pop is also held out. Hamstring injuries are too prone to linger if they get aggravated for it to be a good risk to take going into the playoffs. Vrabel talking up Chism sounds like he’s signaling that decision is already made.