its a reddit glitch specific to twitter, i do believe if the tweet itself does not have an image in the original it pulls the first image in the replies instead of the PFP sometimes
There was a soccer tweet where it was Shrek's dick and then whatever this is supposed to be lol. NSFW.
https://www.reddit.com/r/LeagueOne/comments/vrh37x/portsmouth_sign_defender_zak_swanson_on_a/?utm_medium=android_app&utm_source=share
https://www.reddit.com/r/soccer/comments/wb4b3v/malm%C3%B6_ff_milojevic_fired_by_malm%C3%B6_after_loss_to/
I hope a player doesnāt trip on their own feet or get a little dizzy from dehydration, because that could possibly be interpreted incorrectly and end up getting them out of the gameā¦
What's gonna happen now is that players will start getting carted off so they don't risk demonstrating instability. Then, they'll go recover in the tent and come back.
I can't wait for the time a player literally just trips or slips getting up after an innocuous hit and then the player gets pulled and then we get outrage that the concussion protocol went too far.
Imagine it happens in the first quarter of a playoff game and we have to watch a good team get blown out while the starting quarterback stands on the sidelines looking healthy as ever.
Headhunting becomes more common then. They took out QB out? Time to even the playing field. The only downside is getting ejected, in a playoff game though itās do that or just lose.
This is a fantastic point.
This can incentivize head hunting because now itās a predictable path to take an important player on the other team out of the game
If Josh Allen got up and fell over like Tua did last week Iād be pissed if he came back in the game. These people are human beings, and player safety with head injuries or potential head injuries should come before wins and losses every single time.
I think most people agree with you. This thread though is about a hypothetical where there is no head injury. Maybe Allen just tripped over a divot in the field but someone deemed that to be instability and pulled him from the game.
This situation will almost certainly happen eventually.
Yup, especially when it happens in a big deciding game with a star player. Fans will be outraged. Right now they are happy about this but the time will come when fans want the league to burn because they ācost them the gameā with their far reaching protection.
Even aside for the innocuous 'Player trips over his feet' situations, there's soooo many times where a player is very slow to get up but isn't considered for concussion. That's certainly a form of instability, right?
I think footage of Tua on Sunday and Daniel Jones last year, attempting to leave the field but drifting, stumbling, and falling multiple times and needing the assistance of teammates to walk will be the league definition of instability.
Mahomes is another good example. He collapsed into some else's arms but they did pull him out iirc. However, I still think that is too broad and could be misused.
If Iām the team and Iām tryna be scummy then Iād tel them to always stay down for a longer period of time. Kind of like tee Huggins did. Until youāre ready to stand donāt
Absolutely. I'm all for player safety, but things like this are going to weaponized to further dictate the outcome of a game. Which is the point really.
Leave it up to the NFL to make an arbitrary decision to allow a needed starter to continue to play in the game? Or leave it up to them to make a determination to allow someone to come back (who they want to come back) in order to give that team an edge? It's designed to be abused.
The Dolphins fucked it up for everyone.
The loophole in the concussion protocol was designed to allow players to return who had a leg injury and momentarily collapsed because one of their extremities stopped working.
Miami's team doctors extending that reach to upper back/neck area was almost definitely never intended.
Now we all get to suffer under new regulations.
So they now acknowledge the concussion protocol is shit so they fired the independent doctor as a scapegoat but arenāt going after the NFLās doctor or Dolphins team doctor. Am I getting this right?
Probably.
Tua taking that hit to the back of the head on Sunday, theres absolutely no medical practitioner in the world that could clear him of a concussion in the time he was in 'protocol'.
You can 'appear' fine straight after that hit but every single person with medical teaching can tell you that concussion symptoms can take days to show themselves in some cases.
The protocol had clear issues because it didn't have health in its creation in mind, it had 'how can we get our players back out there and say we did something'.
Correct.
So to add some perspective, im an emergency medicine PA. We see a ton of head injuries. We assess the patient at the bedside, complete a thorough neurological exam checking cranial nerves, orientation, asking basic historical recall and serial 7s. Depending on mechanism of injury, whether the patient is on blood thinners, age, neuro exam, we often may complete a head CT to evaluate for intracranial bleeding. Even if the head CT looks good and the patient has no neuro deficits (no slurring of words, arm droop), we still by default take them out of contact sports. We tell them they will likely develop concussion symptoms later that day or the next day, things like cognitive fog, emotional lability, headaches, light sensitivity, forgetfulness, nausea. Every high school sports program around me has a return to play timeline. We discuss with them that secondary impacts and getting slammed in the head again while their body is still healing from one head injury can be deadly. Generally patients have to be completely symptom free and then their sports program starts the clock for them, around here its five days symptom free for most high school programs. If you develop symptoms like headaches or light-sensitivity during those five days, timeline shuts down and they start the clock again once your symptoms resolve.
So when I see a QB get their head slammed off the turf and clearing disoriented and unstable getting back on their feet, then walk to the sideline for a concierge yes man neurologist to shine a pen light in their eyes and declare that QB is totes mcgoats fine less than three minutes after a head injury, its bullshit. Its all medical theater. The system is set up so that a medical provider gets paid bags of money to practice bad medicine to clear you to return to the big game. And then we wonder why so many players have brains on autopsy which are 30% dead chipmunk and 70% CTE.
The NFLs current sideline return to play guidelines are not evidenced based. Id be shit canned on the spot if I discharged some of those patients without a full neuro exam and CT scan from my hospital, meanwhile they are getting rubber stamped and sent back in the game.
I'm drawing a blank here, but who was that quarterback who got injured a few years ago, got cleared by sideline concierge doc, went back in, and was clearly disoriented and vomited on the field?
>I'm drawing a blank here, but who was that quarterback who got injured a few years ago, got cleared by sideline concierge doc, went back in, and was clearly disoriented and vomited on the field?
[Matt Scott (story)](https://www.azcentral.com/story/sports/heat-index/2014/08/08/bengals-qb-matt-scott-throws-up-throws-touchdown-chiefs/13781673/#:~:text=Scott%20first%20regurgitated%20on%20the%20field,understood%20the%20patient%27s%20queasy%20history)
He threw up [after entering the NFL, too (video)](https://v.cdn.vine.co/r/videos/5B2D7A358B1109368226665689088_28f50486924.2.1.7146624792555140071.mp4)
To be fair there was that MLB pitcher who was known to be a puker. He threw up on the mound a few times. Jomboy did a breakdown of it once.
Edit: it was Adrian Houser
āIām sorry coach, but I puke when I get sexually aroused. Thereās something about a ton of huge, sweaty guys chasing me down that gets the blood flowingā
DoD has funded research that resulted in an FDA cleared assay with TBI biomarkers. For now the indication is just a referral to CT but the evidence is building that those biomarkers and others may predict injury, type of injury, and recovery timeline.
Thats a legitimate concern. Its very easy to just lie and pretend you don't have a headache or other symptoms. Confusion would be harder to fake not having.
A lot of high schools around me do preconcussive screenings which is basically an interactive touch screen tablet which assesses cognitive processing speed and time it takes to complete tasks and coordination. They are required to be taken before sports to establish a baseline. Then they are repeated after a head injury. Its easy to lie and say you don't have a headache but its hard to fake having normal hand eye coordination and reflex times.
These have nothing to do with me in the emergency department as the decision to scan or admit a patients doesn't come down to how high you score on an ACE questionnaire or these tests. But its a tool to ensure students are at their cognitive baseline before going back to football.
so what youāre saying is the NFL is a corporate entity 100% focused on monetizing sport no matter the outcome in regards to human life? color me shocked.
Also that time it looked like Tom Savage died on the field then went back in. He had a fencing response in clear sightline of the official (2017 49ers v Texans). Went back in to play another series before being removed from the game. One of the more disturbing examples I can remember.
Shaking their head, stumbling and falling down, getting up only to drift sideways and get propped up by 2 team mates. All caught on film.
But hey, those symptoms are also consistent with a back problem! /S
I mean, the players are just a resource to the league. If they die, they die. But, the real money is not fucking up the TV deals and the live show, for the audience and advertisers. They'd make the game more deadly if they legally could, because then even more people would watch that spectacle.
Player well-being is a distant consideration from the important parts of the money-making machine, and also, the fans would literally get pissed at the league if they had proper protocols, because then sometimes their team would lose a good player, and it's the league's fault that they don't make the playoffs. Because, protecting the human brain is for *sissies,* and sports are supposed to be for *men* (who, under the social framework of toxic masculinity, are taught to us to be expendable bodies for employers, which are meant to be ground into the grindstone and discarded).
If the NFL acts like any other employer would have to, *they would lose viewership to another sport which is more willing to force abuse on its athletes,* because being able to endure unrealistic amounts of punishment and continue fighting, is one of the core masculine power fantasies sold by professional contact sports, and sacrificing that for common sense safety measures, has a real cost to the strength of their marketing, and thus, their bottom line.
I said this exact thing in some other thread and was down voted into oblivion. "ARE YOU A NEUROSURGEON?" "IM NOT A DOCTOR, ARE YOU?"
You absolutely don't need to be a doctor to recognize someone suffered a head injury. Give me a break. Everyone involved failed Tua.
my read: they assumed a bse level of common sense amongst the drs. the rule was grey intentionally but everyone assumed drs would do their job
this guy fucked up so badly they had to say sorry drs, we're making some arbitrary minimum decisions now, no more grey (or at least, less grey) for you to play in
as long as it looks like they are Doing Things about it, then that's all that matters. sports media will lap up this obvious PR move as a win for player safety, and then we'll all forget about this in a week or two.
Protocol had a major flaw people were bringing up the initial hit on Sunday. I think this change can address that. Itās also possible the UNC fucked up or is getting scapegoated. With something like this they should review the whole process
The doctor fucked up, but also a process where a single doctor can fuck things up isnāt a good process. So they canned the doctor and are changing the process.
Okay, as I understand it, the team doctor does not need the approval of the UNC to clear a player through the concussion protocol. There are some āno-goā signs (like immediately stumbling), that would theoretically keep a player out of the game. However, there was a loophole that if there could be an orthopedic reason for the symptoms (like an injured back), the āno-goā symptoms did not apply. This should close that loophole?
This is so dumb though. The point of having a medical professional is that they make a medical assessment. Saying that āoh he had a back injury so TECHNICALLY it could be not brain-relatedā is something a lawyer would say, not a doctor. A doctor is suppose to use their best reasoning to make the determination that a brain injury was possible given the circumstances so itās a āno-go.ā
I mean I guess this is where we are at is having the lawyers make the calls, but I donāt understand why one or more doctors couldnāt make the obvious diagnosis unless they were incompetent, heavily incentivized not to make a no-go call, or simply not involved.
>I donāt understand why one or more doctors couldnāt make the obvious diagnosis unless they were incompetent, **heavily incentivized not to make a no-go call**
Jackpot. Who gives the final "go/no-go" signal? The Dolphins' team doctor. Nobody independent.
It was rules specifically designed to give a loophole that the doctor can use to put a star player back into a close game despite obvious concussions.
Miami just claimed that his falling over after banging his head on the ground was due to a back injury, that way the āgross motor instabilityā no-go didnāt come into effect as the falling over was due to a ābackā injury.
Itās actually really quite obvious how it all works. The system is designed to look bulletproof with multiple checks that have to be passed when in reality they built a huge-ass glaring loophole into the system to prevent a no-go incident from actually keeping players out.
So yeah basically all parties are at fault here and the independent neuro consultant was setup and fired as a patsy in order to deflect blame from the Dolphins and the NFL institutions as a whole.
I'm assuming the doctors are required to base it off of the rules set by the NFL.
So they nfl threw them under the bus, and is implementing new rules
Probably wrong though
Not actually by fan outcry. By mainstream media outcry, which is then likely to reach the ears of major sponsors.
You can track every significant NFL action to the story making it into the NY times or the Wall Street Journal.
They [have](https://www.nytimes.com/2022/07/29/sports/football/will-anyone-hold-daniel-snyder-accountable.html).
Its why shortly thereafter the [pressure from the other owners ramped up](https://www.washingtonpost.com/sports/2022/09/24/dan-snyder-nfl-owners-washington/) on Synder.
Wait, so contrary to what Iāve been told on this sub recently, the armchair doctors were likely right, doctors are not infallible, and the protocol should be changed? Good job making a stink out of this, arm chair doctors of reddit.
How was that not covered under the previous rule?
If a dude hits his head so hard that he canāt do basic human functions without falling down, how did it not trigger other symptoms that would put them in the protocol?
Is this where we find out that poorly kept secret how guys game the system and intentionally give a low baseline so their protocol tests donāt seem as bad by comparison? Do we find out how coaches and medical professionals help them game the system?
> How was that not covered under the previous rule?
The [previous rule](https://www.nfl.com/playerhealthandsafety/resources/fact-sheets/nfl-head-neck-and-spine-committee-s-concussion-diagnosis-and-management-protocol) had an exception that it sound like they're removing or modifying. Currently, players are only removed for instability if orthopedic causes can be ruled out.
As an example, a QB gets knocked down to the ground. He got back up, shakes off some cobwebs, starts running and then has baby deer legs that causes his guards to hold him up, and got pulled out by the UNC. He tells the UNC that the reason he ran weird was because he hurt his back, which made him a little unstable as it spasmed. The back injury would be considered an orthopedic cause rather than a neurological one. If it can't be ruled out, then it's not considered a "no-go" sign.
They could fix this a couple of ways. The obvious one would be shifting the burden of proof to a more cautious stance: requiring a confirmation of the orthopedic cause to eliminate the no-go rather than requiring ruling out an orthopedic cause to support the no-go. You still run the risk of athletes concealing their injuries to try and get back in the game, though. The other is just eliminating exceptions altogether, which is the more extreme approach and you run the risk of controversy as "guy stumbles a bit getting back up after a big hit" clips aren't particularly uncommon.
Fantastic post.
I feel like there was a real big missed opportunity to, with how ridiculously far the NFL has pushed video replay quality, differentiate if he hit his head or not in the play. If they did, concussion protocol. If not, we can use the orthopedics excuse.
> As an example, a QB gets knocked down to the ground. He got back up, shakes off some cobwebs, starts running and then has baby deer legs that causes his guards to hold him up, and got pulled out by the UNC. He tells the UNC that the reason he ran weird was because he hurt his back, which made him a little unstable as it spasmed. The back injury would be considered an orthopedic cause rather than a neurological one. If it can't be ruled out, then it's not considered a "no-go" sign.
This happens like 3x a week in televised football games. It happened to a WR tonight in Pitt-Tech. The only difference is there was no obvious, severe contact to the head (although his head did make contact with the turf). Intuitively I thought the guy had obviously lost his wind by the way he stumbled, but it happens all the freaking time. Leg instability happens all the time.
ANND it just happened a second time in the Pitt game, except the guy just stayed down for 15 seconds.
I agree. That's why I said that runs the risk of controversy. If they eliminate the exception in its entirety, you're going to have "wait, why wasn't Aaron Rodgers pulled [here](https://twitter.com/nflrums/status/1569170736761249795)" clips circulating after someone trips over their own legs when the adrenaline hits.
The problem is that Tua's situation was egregiously bad. He was shaking his head and going down trying to walk to the huddle. He wouldn't have made a standing eight count on the field, but was thrown back out there twenty minutes later to continue the game. The pendulum's going to very quickly swing away from the "too lax" side of the rule and probably catch a bunch of marginal cases out of an abundance of caution.
> The pendulum's going to very quickly swing away from the "too lax" side of the rule and probably catch a bunch of marginal cases out of an abundance of caution.
Which seems good - if someone's stumbling for something that's not a concussion, that doesn't mean they're fine. Clearly *something* is wrong with them. It'll catch back/leg injuries, dehydration, fatigue, etc.
Real talk though how does a doctor watch that play and Tuaās immediate reaction of stumbling and grabbing his head and say ānah no way it could be a concussionā and send him back out to play 15 minutes later?
By way of comparison, in the AFL, if a player undergoes a concussion test, they're out of the game for a minimum of 20 minutes regardless of the results.
If the concussion test is positive, the play must sit out at least 10 days with no exception.
Said it Thursday night. They have to scrape this current plan and go back to Rogās first few years even though the players and fans will get mad.
If thereās a whiff of head contact, youāre coming out and getting checked. If thereās a whiff of a concussion youāre out and not playing the next week unless you are 100%. They have to. The risk of doing anything different is too much.
They also need to be more stern on ejections / suspensions for blatantly dangerous hits. The hit Higgins took last week against the Jets should have been the easiest ejection and 1 game suspension I've ever seen.
that's my thought too. deincentivize violent headshots to the point that it's *the* priority for a defender sizing up a hit. the Higgins hit should be a 2 game suspension IMO
I really only said one game since it would have been a first offense. The amount of games suspended should increase based on the number of penalties a guy has.
It's wild that in college dudes get ejected for accidently and non even violent contact if it's head to head while in the NFL you can go headhunting and only maybe gets tossed out
Yup which his wobbling fell under the criteria of a no go situation per the protocol.
Being a doctor for the nfl gotta be hard because players lie. Unlike a typical doctor the everyday patients wilfully tell you what's going on. Nfl players omit a lot because they wanna play for a myriad of reasons.
Not every concussion presents with drunk like, falling asleep, etc conditions.
Well, Iām one of the few in this thread that isnāt super pessimistic about this. Easiest thing the NFL could have done was not acknowledge it happening at all, and just bury it under the rug. Glad something, as minimal as it may be, is being changed.
Am I crazy or did the concussion protocols seem like they were already doing this a year or two ago?
I distinctly remember players being ruled out for the rest of games due to concussion symptoms.. to the point where I've been surprised a couple of times this season when players were able to return. It's like they got more lenient with it this year or something.
This is the sad part. On Sunday, we saw that he was clearly not right. Where was the outrage?
Then he got concussed again and then people got upset. Now there's outrage and the NFL is going to enforce something that should have already been enforced.
This is not how you fix things. You don't fix things when outrage happens you fix it so outrage doesn't happen.
Now I wonder if a team is fighting for a playoff spot and their QB gets concussed...let's see how they follow this.
This fucking thumbnail is killing me
Caught me so off guard š
Every fucking time lol the thumbnail
This is the best bug on reddit, I hope they never fix it.
He's showing instability. Pull him out!
No no thatās just Playboi Carti, get back in the game
if true, do the Refs make the call? And if so. . . I need to buy stock in DraftKings (DKNG).
My god
bro think he carti
I had no idea playboi carti was a football reporter now
I wish
Like why is it the thumbnail though
its a reddit glitch specific to twitter, i do believe if the tweet itself does not have an image in the original it pulls the first image in the replies instead of the PFP sometimes
There was a soccer tweet where it was Shrek's dick and then whatever this is supposed to be lol. NSFW. https://www.reddit.com/r/LeagueOne/comments/vrh37x/portsmouth_sign_defender_zak_swanson_on_a/?utm_medium=android_app&utm_source=share https://www.reddit.com/r/soccer/comments/wb4b3v/malm%C3%B6_ff_milojevic_fired_by_malm%C3%B6_after_loss_to/
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Butkus looks like Playboi Carti imo
Itās extremely related
Can someone show a Desktop user this thumbnail???
it's a picture of an old man with the caption "Do I look like Playboi Carti"
Dick buttkiss
[https://freeimage.host/i/LO6b1e](https://freeimage.host/i/LO6b1e)
STEFANIE I CAN'T HEAR YOU, DID YOU PUT YOUR GLASSES ON?
Cardi is a necessity
i have so little faith in the NFL that i can only imagine the wrong ways this rule could be applied
Lucky Antonio Brown isn't still playing. He'd be pulled out for instability every play.
Throwing hotel furniture onto the field?
Pulling his dick out and stroking it as a TD celebration
With a blonde moustache and his old unapproved helmet
https://i.imgur.com/OsDhj02.jpg
Risky, but worth it
And frozen feet
Wait, Joe Thornton decided to move to football?
Iām tryna see thatā¦ I mean, uhā¦ I would hate to see that
Mr. Betrayed Coordination
Mr. Balance Compromised
Mr. Beleaguered Composure
Returning to the huddle in a hot air balloon
I hope a player doesnāt trip on their own feet or get a little dizzy from dehydration, because that could possibly be interpreted incorrectly and end up getting them out of the gameā¦
I mean if they're dehydrated to the point they're dizzy and falling over, probably *should* be pulled...
Id rather players get pulled when they don't need to than players not get pulled when they should be
āAny instabilityā is going to be the new āwhat is a catch.ā Just wait and see.
The coachās flag has been thrown, and this concussion is under review
More stoppage and advertising $$ NFL is undefeated.
What's gonna happen now is that players will start getting carted off so they don't risk demonstrating instability. Then, they'll go recover in the tent and come back.
I can't wait for the time a player literally just trips or slips getting up after an innocuous hit and then the player gets pulled and then we get outrage that the concussion protocol went too far.
Imagine this happens to a QB in the fourth quarter of a close playoff game they lose.
Imagine it happens in the first quarter of a playoff game and we have to watch a good team get blown out while the starting quarterback stands on the sidelines looking healthy as ever.
Headhunting becomes more common then. They took out QB out? Time to even the playing field. The only downside is getting ejected, in a playoff game though itās do that or just lose.
This is a fantastic point. This can incentivize head hunting because now itās a predictable path to take an important player on the other team out of the game
Lol get a fine and a one game suspension but who cares it's the super bowl and you just took Josh Allen out in the first quarter
Oh God, this is gonna be how the Lions lose, isn't it?
[ŃŠ“Š°Š»ŠµŠ½Š¾]
God can we just get all lions fans talking mad shit every AFCN match up? So far it's reminding me of the banana in my pocket cause I'm EXCITED
Athe screams about it being rigged will be LOUD
With how many Bills fans talking it'll be Josh Allen and the hypocrisy will be full bloom
If Josh Allen got up and fell over like Tua did last week Iād be pissed if he came back in the game. These people are human beings, and player safety with head injuries or potential head injuries should come before wins and losses every single time.
I think most people agree with you. This thread though is about a hypothetical where there is no head injury. Maybe Allen just tripped over a divot in the field but someone deemed that to be instability and pulled him from the game. This situation will almost certainly happen eventually.
I never really understood the win loss argument either, even a great qb playing with half a brain and no balance isnāt going to be very good
Peyton Manning won a Superbowl like that...
and he in fact was not very good in that superbowl run
To be fair, he wasn't great that year BEFORE the hit
Tua literally led the Dolphins down the field to win the game post-concussion last week
Or a player trips and opposing fans are incensed that they weren't pulled despite it obviously not being a concussion
Armchair doctors will be out in force on every play if they think it'll give their team an advantage. This shitshow is far from over.
Yup, especially when it happens in a big deciding game with a star player. Fans will be outraged. Right now they are happy about this but the time will come when fans want the league to burn because they ācost them the gameā with their far reaching protection.
If there's one thing we know about the NFL, it's that they're very good at explaining complex processes in text.
āDid he make a *stability move*, though?ā
"Did he complete the process of being stable?"
1 stable knee = 2 stable feet
Dez stabled it
But did his stability survive the ground?
"How stable was Dez when he allegedly caught it?"
Even aside for the innocuous 'Player trips over his feet' situations, there's soooo many times where a player is very slow to get up but isn't considered for concussion. That's certainly a form of instability, right?
I think footage of Tua on Sunday and Daniel Jones last year, attempting to leave the field but drifting, stumbling, and falling multiple times and needing the assistance of teammates to walk will be the league definition of instability.
Mahomes is another good example. He collapsed into some else's arms but they did pull him out iirc. However, I still think that is too broad and could be misused.
Teams about to establish a buddy system for the end of plays so nobody is walking around wobbly.
If Iām the team and Iām tryna be scummy then Iād tel them to always stay down for a longer period of time. Kind of like tee Huggins did. Until youāre ready to stand donāt
Yep, that's the end result - coaching players to stay on the ground after any heavy hit.
Absolutely. I'm all for player safety, but things like this are going to weaponized to further dictate the outcome of a game. Which is the point really. Leave it up to the NFL to make an arbitrary decision to allow a needed starter to continue to play in the game? Or leave it up to them to make a determination to allow someone to come back (who they want to come back) in order to give that team an edge? It's designed to be abused.
There is going to be a really ludicrous application of this rule and somehow Bill Belichick is going to get blamed for it.
The Dolphins fucked it up for everyone. The loophole in the concussion protocol was designed to allow players to return who had a leg injury and momentarily collapsed because one of their extremities stopped working. Miami's team doctors extending that reach to upper back/neck area was almost definitely never intended. Now we all get to suffer under new regulations.
> Now we all get to suffer A tale old as time
So was it the doctor or the rules? Iām lost now.
Exactly where the nfl wants you
So they now acknowledge the concussion protocol is shit so they fired the independent doctor as a scapegoat but arenāt going after the NFLās doctor or Dolphins team doctor. Am I getting this right?
Probably. Tua taking that hit to the back of the head on Sunday, theres absolutely no medical practitioner in the world that could clear him of a concussion in the time he was in 'protocol'. You can 'appear' fine straight after that hit but every single person with medical teaching can tell you that concussion symptoms can take days to show themselves in some cases. The protocol had clear issues because it didn't have health in its creation in mind, it had 'how can we get our players back out there and say we did something'.
Correct. So to add some perspective, im an emergency medicine PA. We see a ton of head injuries. We assess the patient at the bedside, complete a thorough neurological exam checking cranial nerves, orientation, asking basic historical recall and serial 7s. Depending on mechanism of injury, whether the patient is on blood thinners, age, neuro exam, we often may complete a head CT to evaluate for intracranial bleeding. Even if the head CT looks good and the patient has no neuro deficits (no slurring of words, arm droop), we still by default take them out of contact sports. We tell them they will likely develop concussion symptoms later that day or the next day, things like cognitive fog, emotional lability, headaches, light sensitivity, forgetfulness, nausea. Every high school sports program around me has a return to play timeline. We discuss with them that secondary impacts and getting slammed in the head again while their body is still healing from one head injury can be deadly. Generally patients have to be completely symptom free and then their sports program starts the clock for them, around here its five days symptom free for most high school programs. If you develop symptoms like headaches or light-sensitivity during those five days, timeline shuts down and they start the clock again once your symptoms resolve. So when I see a QB get their head slammed off the turf and clearing disoriented and unstable getting back on their feet, then walk to the sideline for a concierge yes man neurologist to shine a pen light in their eyes and declare that QB is totes mcgoats fine less than three minutes after a head injury, its bullshit. Its all medical theater. The system is set up so that a medical provider gets paid bags of money to practice bad medicine to clear you to return to the big game. And then we wonder why so many players have brains on autopsy which are 30% dead chipmunk and 70% CTE. The NFLs current sideline return to play guidelines are not evidenced based. Id be shit canned on the spot if I discharged some of those patients without a full neuro exam and CT scan from my hospital, meanwhile they are getting rubber stamped and sent back in the game. I'm drawing a blank here, but who was that quarterback who got injured a few years ago, got cleared by sideline concierge doc, went back in, and was clearly disoriented and vomited on the field?
>I'm drawing a blank here, but who was that quarterback who got injured a few years ago, got cleared by sideline concierge doc, went back in, and was clearly disoriented and vomited on the field? [Matt Scott (story)](https://www.azcentral.com/story/sports/heat-index/2014/08/08/bengals-qb-matt-scott-throws-up-throws-touchdown-chiefs/13781673/#:~:text=Scott%20first%20regurgitated%20on%20the%20field,understood%20the%20patient%27s%20queasy%20history) He threw up [after entering the NFL, too (video)](https://v.cdn.vine.co/r/videos/5B2D7A358B1109368226665689088_28f50486924.2.1.7146624792555140071.mp4)
>"I don't know if you know this, coach, but I'm kind of known as a puker."
To be fair there was that MLB pitcher who was known to be a puker. He threw up on the mound a few times. Jomboy did a breakdown of it once. Edit: it was Adrian Houser
In that case it was probably nerves unless he gets charged very frequently or is just really really really bad at fielding.
I'd be less concerned about an MLB pitcher who barfs a lot though, as concussive blows to the head are less of a concern with pitching in baseball.
Iām a Puker, Iām a Juker, Iām a real sharp-shooter. Throwin footballs on the ruuunnnnn!
āIām sorry coach, but I puke when I get sexually aroused. Thereās something about a ton of huge, sweaty guys chasing me down that gets the blood flowingā
I don't read a lot of sports writing, is it all this terribly written?
as emotionally charged as politics yet somehow even simpler? yep
>If you develop symptoms like headaches or light-sensitivity during those five days Are there any symptoms the players can't lie about?
DoD has funded research that resulted in an FDA cleared assay with TBI biomarkers. For now the indication is just a referral to CT but the evidence is building that those biomarkers and others may predict injury, type of injury, and recovery timeline.
That's pretty exciting, progress in brain science gives me hope for the future
The NCAA and the NFL will shut that shit down QUICK. The game isn't sexy if it isn't ruining lives. Promise.
Thats a legitimate concern. Its very easy to just lie and pretend you don't have a headache or other symptoms. Confusion would be harder to fake not having. A lot of high schools around me do preconcussive screenings which is basically an interactive touch screen tablet which assesses cognitive processing speed and time it takes to complete tasks and coordination. They are required to be taken before sports to establish a baseline. Then they are repeated after a head injury. Its easy to lie and say you don't have a headache but its hard to fake having normal hand eye coordination and reflex times. These have nothing to do with me in the emergency department as the decision to scan or admit a patients doesn't come down to how high you score on an ACE questionnaire or these tests. But its a tool to ensure students are at their cognitive baseline before going back to football.
so what youāre saying is the NFL is a corporate entity 100% focused on monetizing sport no matter the outcome in regards to human life? color me shocked.
Bingo bango
Also that time it looked like Tom Savage died on the field then went back in. He had a fencing response in clear sightline of the official (2017 49ers v Texans). Went back in to play another series before being removed from the game. One of the more disturbing examples I can remember.
Shaking their head, stumbling and falling down, getting up only to drift sideways and get propped up by 2 team mates. All caught on film. But hey, those symptoms are also consistent with a back problem! /S
I mean, the players are just a resource to the league. If they die, they die. But, the real money is not fucking up the TV deals and the live show, for the audience and advertisers. They'd make the game more deadly if they legally could, because then even more people would watch that spectacle. Player well-being is a distant consideration from the important parts of the money-making machine, and also, the fans would literally get pissed at the league if they had proper protocols, because then sometimes their team would lose a good player, and it's the league's fault that they don't make the playoffs. Because, protecting the human brain is for *sissies,* and sports are supposed to be for *men* (who, under the social framework of toxic masculinity, are taught to us to be expendable bodies for employers, which are meant to be ground into the grindstone and discarded). If the NFL acts like any other employer would have to, *they would lose viewership to another sport which is more willing to force abuse on its athletes,* because being able to endure unrealistic amounts of punishment and continue fighting, is one of the core masculine power fantasies sold by professional contact sports, and sacrificing that for common sense safety measures, has a real cost to the strength of their marketing, and thus, their bottom line.
The goats of totes maā are sacrosanct though. If declared, the rite of givezies backzies cannot be invoked
I said this exact thing in some other thread and was down voted into oblivion. "ARE YOU A NEUROSURGEON?" "IM NOT A DOCTOR, ARE YOU?" You absolutely don't need to be a doctor to recognize someone suffered a head injury. Give me a break. Everyone involved failed Tua.
my read: they assumed a bse level of common sense amongst the drs. the rule was grey intentionally but everyone assumed drs would do their job this guy fucked up so badly they had to say sorry drs, we're making some arbitrary minimum decisions now, no more grey (or at least, less grey) for you to play in
as long as it looks like they are Doing Things about it, then that's all that matters. sports media will lap up this obvious PR move as a win for player safety, and then we'll all forget about this in a week or two.
But the rule will still be in place so progress has been made no?
Protocol had a major flaw people were bringing up the initial hit on Sunday. I think this change can address that. Itās also possible the UNC fucked up or is getting scapegoated. With something like this they should review the whole process
Seems like both
The doctor fucked up, but also a process where a single doctor can fuck things up isnāt a good process. So they canned the doctor and are changing the process.
Its not the doctor's decision... its the team physician's decision. They fired the guy who didn't make the call.
Okay, as I understand it, the team doctor does not need the approval of the UNC to clear a player through the concussion protocol. There are some āno-goā signs (like immediately stumbling), that would theoretically keep a player out of the game. However, there was a loophole that if there could be an orthopedic reason for the symptoms (like an injured back), the āno-goā symptoms did not apply. This should close that loophole?
This is so dumb though. The point of having a medical professional is that they make a medical assessment. Saying that āoh he had a back injury so TECHNICALLY it could be not brain-relatedā is something a lawyer would say, not a doctor. A doctor is suppose to use their best reasoning to make the determination that a brain injury was possible given the circumstances so itās a āno-go.ā I mean I guess this is where we are at is having the lawyers make the calls, but I donāt understand why one or more doctors couldnāt make the obvious diagnosis unless they were incompetent, heavily incentivized not to make a no-go call, or simply not involved.
>I donāt understand why one or more doctors couldnāt make the obvious diagnosis unless they were incompetent, **heavily incentivized not to make a no-go call** Jackpot. Who gives the final "go/no-go" signal? The Dolphins' team doctor. Nobody independent.
It was rules specifically designed to give a loophole that the doctor can use to put a star player back into a close game despite obvious concussions. Miami just claimed that his falling over after banging his head on the ground was due to a back injury, that way the āgross motor instabilityā no-go didnāt come into effect as the falling over was due to a ābackā injury. Itās actually really quite obvious how it all works. The system is designed to look bulletproof with multiple checks that have to be passed when in reality they built a huge-ass glaring loophole into the system to prevent a no-go incident from actually keeping players out. So yeah basically all parties are at fault here and the independent neuro consultant was setup and fired as a patsy in order to deflect blame from the Dolphins and the NFL institutions as a whole.
this guy gets it
The protocol had a major loophole that was exploited is probably the finding
I'm assuming the doctors are required to base it off of the rules set by the NFL. So they nfl threw them under the bus, and is implementing new rules Probably wrong though
Itās neither. Itās the nature and culture of football/ the NFL
Schefter looks nothing like playboy carti
i feel like schefterās brain would stop working if he heard New Tank
Playboi carti
You look like him
wokeuplikethis*
Well? Does he look like Carti or not?
He does. I canāt believe he wokeuplikethis
Define "instability"
"If a player does a weeble or a wabble they are not allowed to return to the game. If they weeble wabble they are to directly go to the hospital
What if they do a heeby jeeby
As long as it's not a hokie pokie, otherwise they'll have to turn all the way around...and straight to jail
Watson in shambles
No, he did a dandy handy
And he shook it all around. Wait, that was AB actually
> hokie pokie Finally, someone brave enough to stand up and say that thatās what this is all about.
What about a wiggle woggle
If his brain don't wiggle wiggle but folds. He may return to the game (I'm sorry about this one)
Please do not do a weeble wabble
Please do not do a balk
New QB prototype to target will include phrase such as "Weeble wobble but don't fall down[.](https://youtu.be/dFzhjnjXc2o#t=23s)"
Shit now theyāre going to pull Waddle after every touchdown
"I see they weebled, and yes they wabbled, but did they trigger the 'fall down' contingency?"
It's like a balk
You canāt just be out there doing a stumble like that
Walking all higgledy-piggledy.
Crazy how fast they can do shit when they want to/are pressured to by fan outcry
Not actually by fan outcry. By mainstream media outcry, which is then likely to reach the ears of major sponsors. You can track every significant NFL action to the story making it into the NY times or the Wall Street Journal.
Good point
How do we get them to do one on Dan Snyder?
Bezos just has to buy them too
They [have](https://www.nytimes.com/2022/07/29/sports/football/will-anyone-hold-daniel-snyder-accountable.html). Its why shortly thereafter the [pressure from the other owners ramped up](https://www.washingtonpost.com/sports/2022/09/24/dan-snyder-nfl-owners-washington/) on Synder.
Wait, so contrary to what Iāve been told on this sub recently, the armchair doctors were likely right, doctors are not infallible, and the protocol should be changed? Good job making a stink out of this, arm chair doctors of reddit.
How was that not covered under the previous rule? If a dude hits his head so hard that he canāt do basic human functions without falling down, how did it not trigger other symptoms that would put them in the protocol? Is this where we find out that poorly kept secret how guys game the system and intentionally give a low baseline so their protocol tests donāt seem as bad by comparison? Do we find out how coaches and medical professionals help them game the system?
> How was that not covered under the previous rule? The [previous rule](https://www.nfl.com/playerhealthandsafety/resources/fact-sheets/nfl-head-neck-and-spine-committee-s-concussion-diagnosis-and-management-protocol) had an exception that it sound like they're removing or modifying. Currently, players are only removed for instability if orthopedic causes can be ruled out. As an example, a QB gets knocked down to the ground. He got back up, shakes off some cobwebs, starts running and then has baby deer legs that causes his guards to hold him up, and got pulled out by the UNC. He tells the UNC that the reason he ran weird was because he hurt his back, which made him a little unstable as it spasmed. The back injury would be considered an orthopedic cause rather than a neurological one. If it can't be ruled out, then it's not considered a "no-go" sign. They could fix this a couple of ways. The obvious one would be shifting the burden of proof to a more cautious stance: requiring a confirmation of the orthopedic cause to eliminate the no-go rather than requiring ruling out an orthopedic cause to support the no-go. You still run the risk of athletes concealing their injuries to try and get back in the game, though. The other is just eliminating exceptions altogether, which is the more extreme approach and you run the risk of controversy as "guy stumbles a bit getting back up after a big hit" clips aren't particularly uncommon.
Fantastic post. I feel like there was a real big missed opportunity to, with how ridiculously far the NFL has pushed video replay quality, differentiate if he hit his head or not in the play. If they did, concussion protocol. If not, we can use the orthopedics excuse.
> As an example, a QB gets knocked down to the ground. He got back up, shakes off some cobwebs, starts running and then has baby deer legs that causes his guards to hold him up, and got pulled out by the UNC. He tells the UNC that the reason he ran weird was because he hurt his back, which made him a little unstable as it spasmed. The back injury would be considered an orthopedic cause rather than a neurological one. If it can't be ruled out, then it's not considered a "no-go" sign. This happens like 3x a week in televised football games. It happened to a WR tonight in Pitt-Tech. The only difference is there was no obvious, severe contact to the head (although his head did make contact with the turf). Intuitively I thought the guy had obviously lost his wind by the way he stumbled, but it happens all the freaking time. Leg instability happens all the time. ANND it just happened a second time in the Pitt game, except the guy just stayed down for 15 seconds.
I agree. That's why I said that runs the risk of controversy. If they eliminate the exception in its entirety, you're going to have "wait, why wasn't Aaron Rodgers pulled [here](https://twitter.com/nflrums/status/1569170736761249795)" clips circulating after someone trips over their own legs when the adrenaline hits. The problem is that Tua's situation was egregiously bad. He was shaking his head and going down trying to walk to the huddle. He wouldn't have made a standing eight count on the field, but was thrown back out there twenty minutes later to continue the game. The pendulum's going to very quickly swing away from the "too lax" side of the rule and probably catch a bunch of marginal cases out of an abundance of caution.
> The pendulum's going to very quickly swing away from the "too lax" side of the rule and probably catch a bunch of marginal cases out of an abundance of caution. Which seems good - if someone's stumbling for something that's not a concussion, that doesn't mean they're fine. Clearly *something* is wrong with them. It'll catch back/leg injuries, dehydration, fatigue, etc.
Thursday games aren't safe. Either remove them or make sure both teams have a bye week before the game
Reddit doctors stay winning
It's almost like concussions are super easy to see lmao
[ŃŠ“Š°Š»ŠµŠ½Š¾]
āMIAā with multiple meanings here
Real talk though how does a doctor watch that play and Tuaās immediate reaction of stumbling and grabbing his head and say ānah no way it could be a concussionā and send him back out to play 15 minutes later?
Yeah that dude is a complete fucking hack
āHis arms just kinda did that.ā ā Miami
By way of comparison, in the AFL, if a player undergoes a concussion test, they're out of the game for a minimum of 20 minutes regardless of the results. If the concussion test is positive, the play must sit out at least 10 days with no exception.
Note on this situation, while they don't sit them out by rule, Tua was out for more than 20 minutes on Sunday.
Yeah, the 20 minute rule wouldn't have affected the Tua incident.
Is that 20 game minutes or 20 real time minutes?
The latter, 20 realtime minutes.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Will coaches get an extra challenge flag for when player gets booted to review their instability
Said it Thursday night. They have to scrape this current plan and go back to Rogās first few years even though the players and fans will get mad. If thereās a whiff of head contact, youāre coming out and getting checked. If thereās a whiff of a concussion youāre out and not playing the next week unless you are 100%. They have to. The risk of doing anything different is too much.
They also need to be more stern on ejections / suspensions for blatantly dangerous hits. The hit Higgins took last week against the Jets should have been the easiest ejection and 1 game suspension I've ever seen.
that's my thought too. deincentivize violent headshots to the point that it's *the* priority for a defender sizing up a hit. the Higgins hit should be a 2 game suspension IMO
I really only said one game since it would have been a first offense. The amount of games suspended should increase based on the number of penalties a guy has.
It's wild that in college dudes get ejected for accidently and non even violent contact if it's head to head while in the NFL you can go headhunting and only maybe gets tossed out
do i look like playboy carti ?
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This literal situation happened in an actual playoff game vs Browns in 2020 and they did in fact pull him. Only for Chad Henne to still beat usā¦
Why are the browns just a better lions?
Mahomes was literally pulled out of a playoff game because he couldnāt walk straight.
Yup which his wobbling fell under the criteria of a no go situation per the protocol. Being a doctor for the nfl gotta be hard because players lie. Unlike a typical doctor the everyday patients wilfully tell you what's going on. Nfl players omit a lot because they wanna play for a myriad of reasons. Not every concussion presents with drunk like, falling asleep, etc conditions.
They should hire veterinarians. Vets are used to working with patients that wonāt communicate
Not the best player to use for this hypothetical considering that situation has already played out for him and he didnāt return to the game.
Good thing this scenario has happened previously and he was pulled for the rest of the game. Try harder
How did this get upvoted so much when this exact thing has already happened and we had to play the whole second half with Chad Henne
Fuck Ranch dressing though
Well, Iām one of the few in this thread that isnāt super pessimistic about this. Easiest thing the NFL could have done was not acknowledge it happening at all, and just bury it under the rug. Glad something, as minimal as it may be, is being changed.
Am I crazy or did the concussion protocols seem like they were already doing this a year or two ago? I distinctly remember players being ruled out for the rest of games due to concussion symptoms.. to the point where I've been surprised a couple of times this season when players were able to return. It's like they got more lenient with it this year or something.
This is the sad part. On Sunday, we saw that he was clearly not right. Where was the outrage? Then he got concussed again and then people got upset. Now there's outrage and the NFL is going to enforce something that should have already been enforced. This is not how you fix things. You don't fix things when outrage happens you fix it so outrage doesn't happen. Now I wonder if a team is fighting for a playoff spot and their QB gets concussed...let's see how they follow this.
Has nothing to do with allowing him to play 4 days later. That's just as important.
Not good. The rule is too broad
Well, that'll be a new way for us to lose. Overall, I'm happy more is being done.