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Kansas City Chiefs quarterback Patrick Mahomes is in NFL concussion protocol, and that’s really all we can say about his status six days before the AFC Championship game.
We don’t know how long he will be sidelined. We do not know if he will be able to play on Sunday. We don’t even know for sure if he suffered a concussion.
What we do know is that brain health was one of the main storylines in the NFL divisional playoff round. Mahomes was pulled out of the Chiefs’ win over the Cleveland Browns on Sunday after a run-end hit left him staggering. A day earlier, Baltimore Ravens quarterback Lamar Jackson was ruled out of a loss to the Buffalo Bills after his head hit the ground.
What’s next for Mahomes this week? Let’s take a closer look.
How could Mahomes be in the concussion protocol if he didn’t have a concussion?
First of all, we somehow don’t know what Mahomes was diagnosed with. Most importantly, a player does not have to be immediately diagnosed with a concussion to be enrolled in the protocol. All the chiefs confirmed was that he was in protocol. Coach Andy Reid stopped by on Monday before saying Mahomes had suffered a concussion.
Why would the NFL do this?
In 2018, the NFL adjusted its protocol to require in-game assessments for “all players demonstrating gross motor instability (for example, tripping or falling to the ground while attempting to stand) to determine the cause of the instability. “. This roughly matches what happened to Mahomes on Sunday. The protocol goes on to say that if a doctor “determines that the instability is neurologically caused, the player is designated ‘No-Go’ and cannot return to play.”
The change was in response to the frightening injury suffered in December 2017 by Houston Texans quarterback Tom Savage, who could be seen shaking on the ground after a hit but was allowed to stay in the game. He was subsequently ruled out and diagnosed with a concussion. This adjustment allowed medics to exclude players from matches after examining them for these symptoms.
Mahomes, in fact, was ruled out even though he was running through the stadium tunnel after the injury, Reid said.
Does it matter that Mahomes actually suffered a concussion?
Of course. But whether or not he did, he has to go through the same five-step process to be allowed to return.
What are these steps?
The first thing you need to know is that before the season, every NFL player takes neurological and balancing tests while in an uninjured state to provide a “normal” score. These results can then be used to help diagnose a concussion and to determine when a player’s neurological activity and balance has returned to their previous state after a brain injury. The five stages are:
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Step 1: Depending on the symptoms, the player may practice light stretching, balance training, and optionally switch to light aerobic exercise.
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2nd step: The player can move on to cardiovascular exercise and dynamic stretching, followed by neurological and balance tests. He can go through this step once these test results match his baseline scores.
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Step 3: The player can progress to a limited amount of football specific drills. This includes up to 30 minutes of practice, under the supervision of a sports trainer.
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Step 4: Football activities can shift to non-contact exercises such as throwing and running. Another set of tests should again show the basic results.
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Step 5: This requires the team medic to allow the player to make contact. Once this occurs, the player should be examined by an independent neurological consultant (INC). If the “INC” confirms the decision of the team doctor, the player is allowed to fully train and play in the team’s next game.
How long will it take?
Protocols intentionally have no time requirements. They don’t require a player to be absent from a game, in large part because concussion science shows that brain damage heals at unpredictable rates. Players could potentially get back to the baseline quickly, without missing a game, or they could miss multiple games or even the rest of a season.
So there is no data on that?
This is not entirely true. According to the NFL, using data from the 2015-19 seasons, the median length of shifts to get out of the concussion protocol is seven days.
The AFC Championship is a really important game. Don’t players get injured all the time?
It is and they do, but the NFL has built this protocol to make sure it doesn’t happen with brain and neurological damage. By demanding a return to baseline test results, the NFL’s implicit policy is that a player with a brain or neurological injury cannot return until he is fully healed. Contact with football after only partial recovery can make the injury worse.
Mahomes is not supposed to be able to ‘get back’ on the pitch or ‘suck it off’. And the Chiefs aren’t even supposed to have the opportunity to take the kind of calculated risk they do when they allow a player to get back on the pitch with, say, a slight sprained knee.
How does the NFL prevent this?
The biggest distinction of the concussion protocol is that it requires an independent physician to confirm return. This doctor is not affiliated with the team or the player but has been jointly approved by the league and the NFL Players Association. The final step of getting permission from the independent doctor is designed as a safety solution for the player or team acting too aggressively.
On Monday, Reid told reporters: “There was a chance the day Patrick returned [the game]. You saw him go up the tunnel. By the time he got to this point, he was feeling pretty good. But there is a certain protocol that you have to follow that takes it out of the hand of the coach, the hand of the player, and the hand of the doctor. “
So when will we know more?
It will be a story for the whole week. We may know when (and if) Mahomes made it to Stage 3, based on the Chiefs injury participation report for training. Otherwise, we may not know if Mahomes will be able to play until the weekend. The Bills-Chiefs game kicks off at 6:40 p.m. ET on Sunday.
Mahomes himself suffered a concussion during his career, during the 2014 college season at Texas Tech. He returned to play in the team’s next game, which was two weeks later due to a scheduled time off.
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