Week 2 Recap- Panthers

Analyzing Buffalo Bills injuries coming off Week 2 loss against the Panthers.

Well, that game is over. That was a tough one to watch from an offensive standpoint. LeSean McCoy ran for 9 yards and the offense scored 3 points. Not the kind of football that I want to watch nor root for. While the defense kept the Panthers to 9 points in their own house, there are no moral victories. Only upside is that the Bills continue to stay relatively healthy, once again, not sustaining any significant injuries.

Today’s post will consist of any Bills players who sustained any sort injury and breakdown potential ramifications for future games. First up, Marcell Dareus sustained an ankle injury early in the 1st quarter and sat out for some time. Watching the game, there was no injury timeout or replays showing the injury. Considering that Dareus returned to the game, it does not appear to be anything concerning. Best case scenario is that Dareus suffered a mild lateral sprain which was taped up on the sidelines, giving him stability to finish the game. Expect for Dareus to be limited in the next several practices as he recovers and be a full participant next week against Denver.

Next up is CB E.J. Gaines who was down momentarily with a shoulder injury. If you recall, Gaines suffered a shoulder injury that knocked him out of last week’s contest against the Jets. While not confirmed, it appeared to be the same shoulder, believed to the left side. This injury was sustained during a tackle near the end of the 1st quarter. While it was initially reported that his shoulder was not concerning last week, re-injuring the same shoulder now makes it concerning. Considering that it was a direct hit to the area, he may have suffered an AC sprain or possible SC sprain which would limit arm elevation, vital for tackling and batting passes down. Expect to see Gaines be listed on the injury report, too early to tell if he misses next game.

Cordy Glenn was next with an ankle injury sustained in the 2nd half. No video or injury timeout occurred leading to further review, but the fact that Glenn continues to be hampered with foot and ankle injuries is concerning. No updated reports indicate that this may be a multi week injury, but expect Glenn to be out of practice the next several days. It does help that McDermott has been rotating his lineman out to keep them fresh which has allowed Dion Dawkins to get vital playing time in cases such as this. I still believe that Glenn may be dealing with some sort of ankle instability which could lead to further sprains if not conservatively managed.

Two injuries that are not concerning are Kyle Williams going down with an eye injury and Andre Holmes with a chest injury. Both returned to the game quickly indicating that no damage occurred. Williams appeared to suffer a cut above his right eye during a tackle and Holmes appeared to have the wind knocked out of him briefly. Williams is too tough to let an eye laceration slow him down and Holmes still made plays towards the end of the game which allows these injuries to become afterthoughts.

Finally, LeSean McCoy went down with a right wrist injury during a tackle at the end of the 3rd quarter but was able to return. Last week, McCoy reported that his hand went numb during a similar play last week and pulled himself out briefly. Despite his hand going numb and then returning to the game tells me professionally that no structural damage has occurred. What is most likely happening is when McCoy goes down, he may be striking the field with his elbow and hitting his funny bone. When someone hits their funny bone, they are actually directly striking their ulnar nerve which is slightly exposed on the inside part of the elbow. This can cause immediate numbness along with the pins and needles feeling as though the hand fell asleep. McCoy could reduce the incidence by wearing elbow pads, but may be a comfort issue or may limit the ability to cradle the football.

A final note, earlier today, it was reported that Shaq Lawson suffered a nerve contusion during yesterday’s game and has begun to recover. Once again, no injury timeout or detailed video indicating when this occurred. Reports also do not identify the area that the nerve contusion occurred. Until further reports are made, I will have to assume that this is a similar injury that occurred with McCoy mentioned above.

Updates will be made once the official injury report comes out and more information is released. None of these injuries except Glenn’s ankle concern me. I expect players to get injured, miss plays/time, and not always be at 100%. While the results are not what us as fans want, I would rather have a close loss with everyone coming back to play next week than a win with a major player going down with a season ending injury. Expect further articles to briefly analyze Week 2 injuries around the league and updates on any Bills injuries once more information becomes available. As always, willing to answer questions, break down injuries, and educate my fellow fans on injuries occurring with the Buffalo Bills and in the NFL.

Week 2 Injury Breakdown- Panthers

Breaking down the Bills injury report for Week 2 against the Panthers.

Going into Week 2, the Bills continue to look healthy as they travel down to North Carolina to battle McDermott/Beane’s former employer, the Carolina Panthers. While the Bills are not immune to injuries, they still continue to look better than other teams around the league injury wise, losing no big pieces such as the Chiefs and Jaguars did last week.

Breaking down the injury report, DT Jerel Worthy is still out with a concussion from the preseason game against the Lions on 8/31. As he is not practicing, he is still most likely in the early stages of the concussion protocol, most likely on Level 2-3 at best. To refresh, he may be cleared to begin light aerobic activity with watching game film and participating in team meetings. He may also be cleared for lifting and increasing intensity with aerobic activity. Considering he has not been moved to IR with designation to return, it appears as though he is continuing to recover and may be ready by Week 3-4. The fact that he has not recovered as quickly as Tyrod Taylor did indicates that it may be a more severe concussion; also consider positional demands. Though he is not a starting player, he is crucial for depth and can continue to provide effective play in place of the starters.

Those limited in practice are as follows: S Colt Anderson (foot), CB Leonard Johnson (quad) and LB Tanner Vallejo (knee). Thankfully, none of these players are starters, but for a team to be successful, they must have depth. Colt Anderson has rarely seen the field since joining the Bills last year. He has been described as a special teams ace, but has yet to show his array of skills so far. Considering that he has not been outright waived yet, this indicates that the team will continue to wait for his recovery. As for what is ailing him, professionally, I have been unable to truly assess as there is no film or detailed description of injury on him. Leonard Johnson is listed with a quad; due to the position and demands, possibly could be a quad contusion, which is typically known as a deep bruise. This would limit running forward/backwards and prevent planting effectively to perform coverage duties in the secondary. Finally, Tanner Vallejo is listed as a knee and continues to be limited. Early in the preseason, Vallejo sustained a shoulder injury which knocked him out for several preseason games. It is unknown when Vallejo sustained his knee injury, but it was reported that he had a knee scope which indicates that he may have had fraying of the meniscus or a loose body, causing pain and discomfort. As a knee scope is a surgical procedure, as minimal as it is, will still require rehab and rest. He will have to ensure that his knee does not swell up frequently and can adjust to game time activity. Regardless, this is not a good start to Vallejo’s rookie campaign.

Those cleared for full practice were as follows: TE Charles Clay (shoulder), CB E.J. Gaines (shoulder), OT Cordy Glenn (foot), RB LeSean McCoy (wrist/groin), and FB Mike Tolbert (knee). In my previous article, Gaines and McCoy sustained injuries in the win over the Jets that knocked McCoy out briefly and knocked Gaines out for the game. Gaines’ injury was not reported to be serious and does not appear to have any long lasting effects. McCoy is worrisome as he is the force that drives the offense. McCoy stated after the game that he did not injure his wrist severely, but that it went numb briefly during the previous run into the end zone. It has also been reported later that he is dealing with a groin injury that was most likely sustained in practice. While he is a full participant, this is still something that must be watched due to requiring the groin to be ready for bursts and cutting, moves especially crucial to any running back.

Other injuries including Glenn, Tolbert, and Clay do not appear to be serious. While Glenn continues to have issues with his foot, it appears to now be different from the ankle injuries he dealt with at the beginning of training camp. There is not much information regarding the exact ailment; he is able to play, splitting time with Dion Dawkins to keep both lineman fresh and healthy. Clay and Tolbert did not appear to be removed from the Jets game for injury, possibly indicating that they are banged up due to the physical nature of the game. As practice is important, rest is more important. Teams under the current CBA are allowed 14 padded practices during the first 11 weeks of the season and coaches are not required to use all of them. I believe that McDermott will limit padded practices and provide maintenance days for veterans, focusing on proper play calling, technique, and keeping everyone healthy to maintain depth.

The Bills certainly have a winnable game later today. Cam Newton is coming off a rotator cuff tear repair which should not limit him physically, but the rust was evident in Week 1. Add in the fact that McDermott knows the nuances of the Carolina defense and personnel, expect to see the Bills to exploit those weaknesses. Continue to look for updates after the game with injury review, analysis around the league of significant injuries, and any other big news. Thank you for your time and Go Bills!

Week One Recap-Jets

Breaking down the Week One Bills victory over the New York Jets and Bills injuries sustained during today’s contest.

Football is back and Week 1 is in the books! With a solid 21-12 win over the NY Jets, the Bills sit atop of the AFC East due to the Patriots loss Thursday night and Miami not playing due to Hurricane Irma. While it may be short lived, we must enjoy it while we can. The Bills running game looked solid, gaining nearly 200 yards on the ground and moving the ball well throughout the game. As this is an injury blog, I will be reporting the injuries sustained to the Bills during today’s win.

Prior to the game, inactives were Khari Lee, Vladmir Ducasse, Kaelin Clay, Tanner Vallejo, Greg Mabin, Jerel Worthy, and Conor McDermott. Worthy is still in the concussion protocol following the 4th preseason game and Vallejo is out with a knee injury that not much is known about.

During today’s game, only two Bills went down with injury that are worth noting. Early in the 4th quarter, LeSean McCoy dove for the end zone and came up appearing to injure his left wrist. He initially looked to be in significant pain and was assessed in the trainer’s tent. McCoy eventually came out 15 minutes later and appeared to not harbor any ill effects from the injury. More may be known over the next several days, but considering that he reentered the game so quickly signifies that this shouldn’t cause any long term problems.

Shortly after McCoy went down, E.J. Gaines went down with 11 minutes left with a shoulder injury. While there is no video that is available to truly assess what happened, it appeared that it shook up Gaines as he walked on the sidelines with trainers. It appeared that a trainer was assisting in supporting the left shoulder which may indicate instability. Without seeing video, my initial diagnosis may be a sprained shoulder due to direct impact. I expect to have a more concrete diagnosis in the coming days as more information becomes available.

While this is not an injury that occurred during today’s game, I would like to note that rookie Dion Dawkins shared reps with Cordy Glenn throughout today’s game. This was most likely done to expose Dawkins to the pro game along with limiting stress on Glenn’s ankle/foot, which has been well documented, including one of my first posts. I expect to continue to see Glenn dealing with this injury throughout the season and share time with Dawkins in order to keep both lineman healthy.

Buffalo continues to minimize the injuries and keep starters healthy on the field. As expected, there were other injuries around the league including: Jaguars Allen Robinson (Knee), Ravens Danny Woodhead (Hamstring), Cardinals David Johnson (Wrist), and former Bill, now Eagles Ronald Darby (Ankle) all exiting the game. Add in Chiefs Eric Berry (Torn Achilles) and Patriots Danny Amendola (Concussion) from Thursday’s game and there is already a sizable injury list with the afternoon games yet to be played.

Overall, it was a great day for the Bills getting their first win and minimizing injury. This allows them to bring a healthy roster into their Week 2 match up against Cam Newton and the Panthers. While this was a great start to the season over a hapless Jets team, I expect a much tougher test against McDermott and Beane’s former employer. I will continue to provide updates and detail E.J. Gaines injury once more information is know. Thank you for reading and continue to check back for further updates!

Retrospective: Kevin Everett

Looking back on the 10 year anniversary of TE Kevin Everett sustaining a nearly fatal spinal cord injury and his miraculous recovery

Ten years ago today, September 9th, 2007 was going to be a day just like any other in Buffalo Bills history. It was the season opener for the Bills against the Denver Broncos. It was the first games for Marshawn Lynch and Paul Posluszny and a slow start into the 2nd season of the Dick Jauron era. The Drought was 7, going on 8 years after that season and still to this point hasn’t stopped. But on this date in 2007, TE Kevin Everett of the Buffalo Bills nearly died on the field of Ralph Wilson Stadium.

At the beginning of the 2nd half kickoff, Everett was running downfield during kick coverage, attempting to tackle kick returner Domenik Hixon when Hixon collided with Everett’s head and Everett collapsed to the ground. There is video here to recount that moment. Up to that point, Everett was a 3rd year backup TE and special teams player, having only recorded 2 receptions for 4 years in his career.

Upon impact, Everett sustained direct compression to the cervical spinal cord, initially paralyzing him and at that moment, nearly killing him. Upon falling to the turf motionless, Everett sustained a dislocation of the cervical vertebrae at C3-C4. As the spinal cord travels through the cervical vertebrae, the dislocation compressed directly on his spinal cord, which if left untreated, could have killed him. To educate how severe this injury could have been, the phrenic nerve is the nerve that innervates into the diaphragm which assists in breathing. The phrenic nerve is comprised of C3, C4, C5 within the cervical spine. This is right where the injury occurred, f that nerve were to be severely damaged or severed, the body would lose the ability to breath.

The cervical vertebrae that were damaged assist in maintaining neck posture, supporting the weight of the head, and bend forward/backward, and sidebend the neck. Since the vertebrae dislocated over the vertebrae below it, this placed a significant pressure on the spinal cord, leading to immediate disruption to the functions below the area and without quick action, could cause lasting injury. The only reason this injury was not worse was the fact that there was not a severance of the spinal cord, leading to irreparable damage.

In another era, Kevin Everett probably would have died, at worst, been a paraplegic, due to the damage sustained. Thankfully, he sustained the injury where he did and was able to get the assistance he needed right away. Dr. Andrew Cappuccino assisted in stabilizing the injury and applying cold therapy to the body. This is very similar to placing ice on a sprained ankle after injury. The idea was that if cold was applied to the spinal cord, this would reduce the chances of immediate swelling to the injured area, leading to reduced long term damage.

Cappuccino’s theory appeared to work as while Everett’s prognosis was initially grim, it rapidly improved once surgery was completed to stabilize the cervical region. On December 23rd, he was able to eventually walk at the end of the season when the Bills played the NY Giants at Ralph Wilson Stadium. With quick thinking by the right doctors, the lack of spinal cord severing, and determination, Everett was able to regain walking and a significant portion of his mobility. Many other people in his situation may have died or been paralyzed for life.

It is hard to believe that it is 10 years since Kevin Everett sustained his neck injury. There is not many articles regarding life for Everett following his injury. Most articles state that he has begun raising his family with his wife and participated in speaking engagements. The Buffalo News did an article on Everett and his family several years ago, detailing the long term effects of the injury.

As we get further away from that moment in time, it slowly becomes a footnote in history. My goal with today’s post was to bring it to the forefront, even just for a brief moment. While as a professional and fan, I pray this never happens to any player again. As fans, we know that football is a violent sport, there are risks both short and long term. It is important that we recognize that a player’s career and possibly even life, could end in a moment on the field. As we all sit down to watch the Bills home opener against the Jets on Sunday, remember Kevin Everett and the events of 10 years ago.

2017 NFL Preseason Injury Breakdown

Final analysis of the 2017 NFL Preseason Injury Breakdown. Looking at the injuries that occurred, how many service years, position, and by team.

As promised, the long awaited preseason breakdown! This article has been difficult to write due to accuracy and constant changes. As the first game of the NFL season has already been played by the time of this publication, I can say these are the final numbers. At the end of the day, the NFL is a business, players are looking for jobs, and something as simple as an injury can derail those prospects. The intended purpose of this article is to identify types of injuries, breakdowns involving teams, years played, and when the injury occurred. At the beginning of training camp, at least 2,880 players vie to make an NFL roster. Of those 2,880 players, only 1,696 reach their goal. That’s only 59% of the players that make it. This doesn’t account for all those who were unfortunate enough to be injured, cutting short their chances even before they had a shot.

As of 9/8/17, 328 players have sustained some sort of injury during the preseason that has sidelined them to either miss significant time or season ending. Of those that had sustained significant injury, 211 went to IR, 117 went to IR with an injury settlement which meant that once healthy they could sign with another team. Out of those 117, 3 players have already resigned with different teams. To understand what an injury settlement means, please check out this article.

Out of the reported injuries, the knee was the most common body area for injuries. 66 players sustained injuries which includes 29 ACL tears with a scattering of general knee injuries and meniscus, other ligament damage, or patellar tendon tears. This was followed by 31 ankle injures, 29 thigh injuries mostly consisting of hamstring strains, and 23 shoulders consisting of generalized shoulder injuries. Following up the breakdown of injuries, 21 arm injuries consisting of arm, elbow, wrist, hand, finger; 15 head injuries consisting of concussions, 13 back injuries consisting of disc issues; 12 hip injuries consisting of groins, and finally 8 lower leg injuries with mostly fractures. The remaining injuries were 32 undisclosed and 59 unknown.

Some of the teams were hit harder than others with the injury bug. Leading the way with injuries was the Colts with 17. Following close behind with 16 was the Jaguars and with 15 was the 49ers and Ravens. Tied for 14 are the Texans and Panthers. This was followed by the Giants with 13; Titans, Jets, Chargers, and Bears with 12. The teams with the least amount of injuries were the Broncos, Vikings, and Raiders with 5 and Packers with 6. As this is a Bills blog, the Bills finished with 8 players injured. Most Bills players were waived with injury settlements which meant that had they not gotten injured, they may have been cut.

During this analysis of player injuries, the highest number of injuries by position was at WR with 60. This was followed by LB at 49, CB at 40, followed up by TE at 28, and S at 26. The least hurt position was K with 0 and P with 1. Considering that the highest injuries involved positions with a wide variety of high impact movements, this is not surprising. Overall, 162 Defensive players were injured, 162 Offensive players were injured, and 4 special teams injured.

It was found that if a player was new to the league, the chances of injury were drastically higher. Out of the years of service, 100 rookies were injured, 70 2nd yr players. 58 3rd yr players, and 37 4th year players. According to ESPN, the average NFL career is about 3.3 years. Out of the 328 players injured, 265 fell in that time frame which accounted for nearly 81% of injuries.

Finally, while there is little information on when the injuries occurred, I was able to find that as the preseason wore on, injures increased. Preseason game 1 brought 19 injuries. Game 2 brought 12, Game 3 brought 24, and Game 4 brought 31. There has been talks to reduce preseason games, reducing the last 2 games alone would reduce 54 injuries or 16.7% of injuries in the preseason. Many more occurred in practice or in an unknown, but NFL setting.

Going down the rabbit hole, out of the 29 ACL tears, 11 were rookies. Looking at other injuries, no other trends stood out that was alarming; a variety of hamstring, foot, ankle, and concussions. Out of 2nd year players, 6 had ACL tears, but no one other group of injuries lead the way. Looking at 3rd year players, 4 ACL tears occurred with no other significant injuries noted. So to recap, 21 of the 29 ACL injuries were sustained by players 3 years or younger in the league. This brings up the question, are these players coming into the league not physically prepared? Are they not adapting to the increased speed of game play? What is the root cause? I do not have the answers at this time.

Finally, out of the ACL tears, the 49ers and Patriots were hit hardest with 3 players lost for the season with ACL tears. There were several other teams with 2 which included the Bears, Dolphins, Ravens, Seahawks, and Texans. For 29 tears over the course of the preseason between 32 teams, 7 teams accounted for 18 of the 29 ACL tears which comes out to 62% of the tears this preseason alone. Once again, what are the factors behind this? Coaching? Field surface? Luck? Many different factors at play.

I know that this breakdown only scratches the surface of the injuries during the preseason. I know that further analysis can be inferred from the raw data. At the end of the article, the raw data will be available for you to analyze and process at your own leisure. If there are any questions, comments, or concerns, please message me and I will get back to you. Thank you for reading and please continue to come back for further information! Future articles will consist of revisiting the Kevin Everett cervical injury 10 years ago and injury breakdown following Bills-Jets game.

NFL Training Camp Injuries 2017

That’s A Wrap!

Assessing the injuries coming out of the 4th preseason game against the Detroit Lions. Breaking down the IR, how it compares to past seasons, and upcoming posts.

The Buffalo Bills won over the Detroit Lions on Thursday night 27-17 behind a strong showing behind Nathan Peterman and company. With that win, Buffalo finishes the preseason 1-3 on a high note and ready for the home opener against the Jets in Week 1. Overall, the Bills continue this preseason by avoiding major injury, allowing them to have some depth going into the regular season. Injuries to note are Jerel Worthy’s concussion at the end of the first quarter which sent him into the concussion protocol for the foreseeable future. Michael Ola sustained an ankle injury in the first half and was unable to return. Besides the previously two mentioned, the rest of the game consisted of bubble players getting final chances at securing their roster spots.

As it was relatively a quiet preseason injury wise for the Bills, there are still some injuries to report. Right after the Lions game, the Bills had to make some hard decisions regarding their roster. As previously mentioned, TE Keith Towbridge was placed on IR with a foot injury back on 8/3/17 and TE Jason Croom was waived with an ankle injury and settlement on 8/18/17. Right now, there are no locks for IR as Michael Ola has been waived/injured, which means he may revert to IR and then released with an injury settlement in several days. I believe this to be the case as Ola had his ankle taped up after his Thursday night injury, possibly attempting to go back in. This would suggest his ankle was sprained and cost him a roster spot as the Bills had what they thought to be enough depth at the position.

Those released with injury settlement were as follows: WR Rod Streater (Toe), S Shamiel Gary (Unknown), WR Jeremy Butler (Concussion), and LB Sam Barrington (Unknown). As previously mentioned, Streater sustained what I believed to be a turf toe injury back against the Eagles. While I still believe it was a Grade II sprain, it may have been too injured to warrant holding a roster spot. Up to that point, Streater was having a solid preseason. He could be eligible to come back later in the season if the Bills run into depth issues, but it is too early to tell.

Butler was a long shot to make the roster, but he sustained what now appears to be a fairly serious concussion back on 8/8/17 and hasn’t fully recovered. Losing reps while recovering most likely cost him a roster spot. It is unknown what stage he is at in the league concussion protocol, but considering he has not been medically cleared yet, he may be still in Phase 1-2. There was little to no information on the nature of Barrington’s or Gary’s injury or when they sustained the injury. I have only been able to find that Gary came out of the Eagles game early but no description of the issue.

As the Bills are still dealing with injuries such as Taylor, Yates, and Worthy in the concussion protocol, along with Dareus’ hip and Glenn’s foot, these should not prevent these players from missing extended time. As the front office continues to shake things up releasing RB Jonathan Williams, LB Gerald Hodges, and WR Philly Brown yesterday, I am pleased to see that they are not having to replace players out of desperation.

These injuries this preseason are a stark contrast to the past several years in which multiple, big name players found their way onto IR or had significant injuries coming into the season. Going back the past several training camps, 2016 saw 10 players start the season on IR with Shaq Lawson designated to return. 2015 saw 3 players on IR and Marquis Goodwin missing most of the season with significant issues. 2014 saw 4 players out including Kiko Alonso already out due to an off season ACL tear. Looking back further, most seasons start off with 3-4 players on IR or missing large chunks of time. I had to go back to 2011 in where only one player started on IR and the noteworthy IR placements came with Kyle Williams and Eric Wood later in the season. That team if you remember, finished 6-10.

This wraps up the preseason for the Buffalo Bills with depth appearing to finally be where it needs to be at to have a realistic shot at staying in games when a starter goes down. In the next several posts, look for a final analysis of all the preseason injuries in the NFL, dissecting the severity of injury, trends, and what this means for the upcoming season. For the dedicated Bills fan, I will be doing a post on the 10 year anniversary of TE Kevin Everett’s neck injury with a retrospective look at what occurred and the outcomes afterward. I look forward to further educating my fellow Bills fans, other football fans, and growing this endeavor! Go Bills!

Bills Concussion Woes

Reviewing the NFL concussion protocol including return to play criteria and how this affects the Bills QB situation.

It’s been well known that being a Bills fan is hard. Losing Super Bowls, long extended playoff droughts, ill-timed injuries, the list goes on and on. Right now, that trend appears to be continuing with the 2017 preseason. After the loss to the Ravens by a score of 13-9, the Bills are now 0-3, heading into a show down at New Era Field tonight against the Lions. As mentioned last post, the Bills continue to demonstrate some luck by missing all the ACL tears, sprains, and injuries that can derail a season even before it starts. Unfortunately, the Bills don’t escape totally free. Tyrod Taylor and T.J. Yates both went down with concussions, leading Nathan Peterman to play most of the game. After Taylor and Yates entered the concussion protocol, the Bills signed Keith Wenning to fill in until both QB’s are medically cleared.

After a player sustains a concussion, the player enters the NFL concussion protocol. Most of the time, that’s all we hear until the player is cleared to return to play and contribute. But what does the NFL concussion protocol consist of? What is classified as a concussion? I will break down what classifies a concussion, what the protocol looks like, and the general timeline to return. Hopefully, this will give a clearer indication of what to expect.

A concussion is defined as a violent blow to the head which can disrupt brain function temporarily. Some concussions cause loss of consciousness, but not always necessary for a official concussion diagnosis. The brain is surrounded by cerebrospinal fluid which helps bring nutrients to the brain along with providing some protection during light trauma. However, the brain does not have air bags to protect from larger impacts. In the case of a more significant blow, the brain will strike against the inside of the skull, and then possibly strike the other side of the skull. This is known as a coup-contrecoup injury. This does not always happen in every concussion, but may intensify the symptoms if more areas of the brain are affected.

Upon striking the brain, immediate changes occur with physical symptoms including headaches, confusion, amnesia, dizziness, nausea, vomiting, fatigue, and delayed response time. Further symptoms include sleep disturbances, light and noise sensitivities, irritability, and difficulty with concentration, among other symptoms.

The NFL Head, Neck, and Spine Committee came up with a comprehensive protocol to identify and effectively treat a concussion. To keep it brief, the criteria are: a direct blow to the head or a force that translates towards impact to the head; rapid onset of transient impairment of neurological function, changes in neuropathological changes, and clinical symptoms that may or may not involve a loss of consciousness.

Down on the field, the NFL uses the SCAT2 which is the Standardized Concussion Assessment Tool to assess the player. This protocol has been modified for the NFL and is consistent with the SCAT3 released in 2013. The advantage is that this test can be administered multiple times with valid results to determine a concussion immediately or if symptoms are delayed. This is a test to assess for a concussion but a more formal screening process is done during the preseason and after suspected concussion to fully diagnose.

Each NFL team has a plan in place consisting of an unaffiliated neurotrauma consultant and ATC spotter to indicate whether the player may have a concussion. The player must have been removed from the field, video replay must have occurred of the injury, and an assessment must be performed. If there is any doubt of whether a concussion has been sustained, then the full evaluation must be performed. No more will there be a player being waved back into games or being rushed back in. Numerous players have stated they went back into games and they don’t remember being a part of those games when asked later.

Players will continue to be checked periodically to ensure they do not develop symptoms later and incur further damage. These results will be checked against their baseline assessment to determine the severity. Players could exceed the baseline score but still have a diagnosis of a concussion. This prevents a physician from looking at the diagnosis of a yes/no and look at the entire situation rather than a score.

If the player has sustained a concussion, there are 5 levels of recovery that must be performed in order to return to the game. These must be achieved in order to be medically cleared to return to playing. They are as follows:

  1. Rest and recovery: Players should avoid or limit meetings, social media, electronics to allow the brain to rest and minimize symptoms until player returns to baseline function. The player may engage in stretching and balance activities that allow them to lightly stress the body and being the process to improve. During this time, neurocognitive testing will be performed to assess for clearance towards normal activities.
  2. Light Aerobic Activity: A graduated exercise program consisting of cardiovascular exercise which may include a stationary bicycle or treadmill along with stretching and balance activities. This will be gradually increased as the player remains symptom free and begin to return to team meetings, film study, etc.
  3. Continued Aerobic Exercise and Introducing Strength Training: Cardiovascular exercise will continued to increase intensity and simulate the sport specific activities, progressing to supervised strength training. Once again, if the player is symptom free, they can proceed.
  4. Football specific activity: All activities continue to increase in intensity and duration and resume football activities. These activities must remain non-contact to ensure no recurrence of symptoms.
  5. Full football activity/clearance: Once the player has achieved the first 4 steps, contact may be re-initiated and determine that they have no recurrence of symptoms. The player will be reevaluated by a team physician and if cleared, resume normal activity. If at anytime the player experiences symptoms, they are placed back in the concussion protocol and restart the process until they are symptom free.

If you would like to review the actual documents in greater detail, please click here & here.

While this is a fairly comprehensive protocol, this should continue to improve as we learn more about concussions. Unfortunately, this protocol does not give a specific timeline for return as each concussion is different. Observing the hit on Taylor showed him getting his bell rung may keep him out for an extended period of time. Yates concussion was not as clear as when it occurred which may indicate a better prognosis. While it is not guaranteed that Taylor will be ready to start, CBS Sports reports that Taylor should be ready by Week 1 and has not had any setbacks. Recent reports on Twitter that he is out signing autographs before tonight’s game, tolerating lights and music which could signify he is already on Level 2-3. I believe Taylor will be cleared to start Week 1 and lead the offense to several touchdowns. Continue to follow for updates following cut down day, full recap of preseason injuries, and analysis of the Bills going into Week 1.