Concussions Protocol in Professional Sports

Concussions in professional sports have received more attention in the media in recent years, causing heightened awareness of the issue. A number of instances of head injuries with permanent effects have led to questions about what protocols professional sports teams follow, and should follow, when dealing with concussions.

During the 2015 National Basketball Association (NBA) playoffs, countless viewers watched as Stephen Curry tumbled to the court, his head striking the floor. He was removed from play and tested for symptoms of a concussion, but returned later in the game. In the following game, Curry’s teammate, Klay Thompson, also suffered a head injury. While Thompson also passed the required tests and it was reported that he had been cleared to return to the game, he stayed on the bench for the remainder of the contest. He began exhibiting concussion-like symptoms after the game’s end, but was not diagnosed with the condition until more than a day later.[1]

In Thompson’s case, the protocols in place failed to identify the concussion. Was this the fault of the medical staff administering the tests? Are the testing requirements thorough enough? Were other factors involved?  As it turns out, concussions, by their nature, can cause these tests to be ineffective.

A concussion is a type of traumatic brain injury that results from a force severely jarring the head and brain. This movement can cause the brain to impact or twist within the skull, damaging and stretching brain cells and even causing chemical changes in the brain.[2] While doctors know what causes concussions, determining whether a person has suffered from one is difficult because there is no definitive scan or examination for the condition. Doctors must simply look for the symptoms. This diagnosis is made more complicated because symptoms sometimes do not appear until a day or more after the injury occurs. A person who passes the tests at one point in time may fail the same test hours later.[3]

If a player is suspected of having a concussion, the NBA requires that he be immediately removed from the game for testing. This process requires team doctors to check each player’s short-term memory and recall with cognitive tests, test the player’s balance and coordination, and make other observations based on the injury and the mannerisms of the player. If the player fails the tests, protocol mandates he cannot return until he works through a number of steps that show he is completely healed. If the player passes the tests, he is observed and re-tested. Only then can he be cleared to return to the game.[4]

While this method would seem to be adequate for diagnosing concussions, as noted it clearly failed in Thompson’s case.  The problem, however, may not be the tests themselves, but the timetable in which they are administered. Thompson initially passed his tests when they were administered, but he failed the same tests hours later when his symptoms appeared.

The National Football League (NFL) uses a similar protocol to the NBA, but with expanded baselines for improved accuracy of the concussion tests. Both leagues create baselines for each player at the beginning of each season; however, the NFL does follow-up testing throughout the season to increase the reliability of the baselines. While this clearly helps the doctors identify any differences in the player’s responses, it could still fail to identify a concussion if the symptoms emerge after the tests are administered.[5]

The study of sports-related concussions is an ever-growing field, but the threat of injury is much better understood now than ever before. Even so, the tests and protocols for treating concussions are far from perfect and amount to a work-in-progress. Some players, like the NFL’s Chris Borland, have cited concern for their mental health as a reason to retire from the game.[6] While not playing is obviously the best way to avoid the injury, steps are being taken to protect the players who decide to play and put themselves at risk. At least the heightened awareness and focus on the risk is raising interest in making the players safer.

About the Author: Jack Berry is the managing partner and personal injury lawyer of Allen & Allen’s Charlottesville, VA office. He has practiced law as a trial attorney in Central Virginia for almost 30 years. He is dedicated to protecting the rights of his clients in all areas of personal injury law including car crashes, truck accidents, defective products, wrongful death and brain injury cases.