NanceUSMC added a topic in Carolina PanthersNFL Concussion Protocol and Return to Practice ProcessSo after the game this weekend, I started to wonder what exactly it takes to move from stage to stage in the NFL Concussion Protocol... Don't know if it's been posted before, but I figured I'd share my findings...
NFL Head, Neck and Spine Committee's Protocols Regarding Diagnosis and Management of Concussion (PDF)
Includes: Definition, Signs, Symptoms, Emergency Action Plan, Practice and Game Day Management, and Return to Practice Process
NFL Sideline Test (PDF)
Includes: In-Depth screening questions used to diagnose potential concussion, scoring system, player self-assessment
ON THE FIELD
To assist the medical teams on game day, there is now an "eye in the sky" a certified athletic trainer sitting in a stadium box who watches the game and television replays to scan the field and look for players with a potential head injury who may require assessment by the medical staff.
Players who are suspected of suffering a concussion are assessed by their teams medical staff. The team physician first reviews a six-item checklist outlining findings that necessitate a player's immediate removal from the game. This checklist includes the more obvious symptoms of concussion: loss of consciousness, unresponsiveness, confusion, amnesia and other concerning symptoms. The team doctor then administers the rest of the sideline concussion assessment tool in order to further assess for concussion. This sideline test includes the same tests performed as part of the pre-season baseline concussion assessment, as well as some additional questions. Like the preseason evaluation, the test measures, memory, concentration and balance. as well as measuring how quickly and thoroughly the player recalls words given to them at least five minutes earlier. As in the preseason examination, the team doctor asks players to name the month, date, day of week, year and time. The additional questions include specific sideline orientation questions that ask players to identify the venue, quarter of game, who scored most recently, the team's previous opponent and whether the team won or lost its most recent game. This process takes about 8-12 minutes.
Beginning this year, a neuro-trauma expert physician unaffiliated with an NFL team will be available on the sideline as an extra set of eyes. He can be consulted by the NFL medical team or NFL player.
NFL regulations require a player diagnosed with a possible concussion to leave the field for the locker room. Medical personnel remain with the player for the remainder of the game. Team physicians determine whether the player's condition is stable enough to send him home -- with instructions that include physical and cognitive rest, avoiding certain medications and alcohol, and a plan for follow up care including phone numbers to call if there are any questions or concerns.
DAYS FOLLOWING THE CONCUSSION
The initial treatment is rest, and the team doctors and athletic trainers begin monitoring to see when a player appears to have returned to baseline functioning. Do symptoms return when a player watches practice or when he watches film? Is there return of symptoms with physical activity?
Once symptoms have completely subsided, the player again performs more comprehensive neuropsychological tests interpreted by the team neuropsychologist. There are no pass-fail grades, only additional data for physicians to consider.
If the player is progressing, he would be become eligible for increased physical activity. The workouts would ramp up over a few days if no symptoms occur.
A player feeling normal one day after the game might pass cognitive testing Tuesday and begin a light exercise program, intensify their exercise routine Wednesday, participate in non-contact aspects of practice on Thursday and return to full practice Friday. But if a player has a history of concussions or isn't progressing as quickly as planned, the process moves accordingly.
The medical team increases the exercise regimen to full speed as the player proves he can handle the escalation without incident. Some teams stage controlled contact drills featuring, for example, one lineman blocking another the way they would in an unpadded practice.
"The thing that I think is important here is you don't manage concussions by a calendar," Dr. Herring said. "Some guys may come back in a week. Some guys may come back in six weeks. These steps don't have an expiration date on them. The player's history of injury and other issues come into play."
Once a team doctor signs off on a player's return, the player is evaluated in person by an unaffiliated concussion expert physician approved by both the NFL and NFL Players Association. This unaffiliated expert also must sign off on the player's health before he is allowed to return to play.
"The thinking is that we have done our best work, but an automatic second opinion is built in," Herring said. "We've never had a disagreement, but I would welcome it if we did because we could learn from it. This is a trust issue. We need assurances there is no rush to return to play for any reason."
Return to Practice Process
After a concussion has occurred in practice or play, the concussed player must be examined and monitored in the training room on a daily basis or as decided by the medical staff. Components of the NFL Sideline Concussion Assessment can be utilized to check for symptoms as well as continue to monitor the other aspects of the examination. The following measures must occur in order for a
player to return to play:
a. A player returns to baseline status of symptoms and neurologic exam, including cognitive and balance functions.
i. Repeat neuropsychological evaluation is performed before return to practice or play with interpretation of the data by the team neuropsychology consultant. The team neuropsychology consultant reports the findings back to the team physician.b. A graduated exercise challenge, followed by a gradual return to practice and play, is initiated when the player returns to baseline status. The RTP protocol following a concussion follows a stepwise process to be outlined in the NFL Head, Neck and Spine Committee’s Return to Participation Protocol.
c. Prior to return to practice or play, not only must the team physician clear the player, but the Independent Neurological Consultant with expertise in concussion must also evaluate and clear the player for return to practice and play.
d. A player may be considered for return to practice and play only after the player has returned to baseline status with rest and exertion, has repeat neuropsychological testing which is interpreted by the team neuropsychology consultant as back to baseline levels of functioning, and has completed the Return to Participation Protocol referenced above and is cleared by the Team Physician and the Independent Neurological Consultant.
For those seeking a better understanding of what the NFL concussion protocol requires, here’s a look at its five steps:
Rest and recovery. Players may stretch and work on their balance, but they don’t work out beyond that. In addition, they’re advised against spending time on computers, any electronic device and social media. They don’t take part in team meetings.
Light aerobic exercise. Under supervision of the team’s medical staff, the player can start cardiovascular exercise, such as riding a stationary bike and using a treadmill, and work on more dynamic stretching and balancing. The workload is increased gradually and halted entirely if concussion-related symptoms recur. Players can attend team meetings and study film.
Continued aerobic exercise, introduction of strength training.Building gradually on the work of step 2, the player can start weight training.
Football-specific work. The player adds non-contact football drills, such as throwing, catching and running to his repertoire of exercise. No contact allowed with other players, tackling dummies or sleds.
Full football activity, full clearance. The player resumes practicing with the team, with no limitations. Once the team physician clears him to complete, the player is examined by the independent neurological consultant, who also reviews any relevant neurological tests.
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NanceUSMC added a article in Carolina PanthersTwas the Night Before Christmas, Panther Style - Merry Christmas Panther NationTwas the night before Christmas and all through the land,
The playoffs were coming, for each Panther fan.
However unlikely they said this would be,
The Panthers delivered, for you and for me.
The journey was long, and not without struggle,
There were plenty of doubters, over at Carolina Huddle.
But the team was determined, and promised to fight,
So that fans could rejoice, on this Christmas Eve night.
But just how we got to this wonderful place,
Is a story that puts a huge smile on my face.
The NFC South, we were expected to lose,
Good thing we don't care, about those point of views.
It's the year of the Saints, said the man on TV
They've got too much talent, who else could it be?
Coach Payton was back, that's what they were lackin',
But the experts forgot, Coach Ron has The Kraken.
The showdown was set, for a little past noon,
What they didn't expect? The Carolina monsoon.
The torrential downpour was a nice surprise,
And certainly helped with the Saintly demise.
The Saints kicked the ball, and the Panthers received,
The offense came out, and we all believed.
DWill off tackle, that was the call.
The crowd was electric, 'Get Smitty the ball!'
But the offense soon stalled, this wasn't the plan.
Not that it mattered, cause Kuechly's the man!
He dashed and he darted, it was quite a sight
And showed that this team, could put up a fight.
The Saints tried to run, and they didn't get far.
Thanks partly because of a big man named Star.
So Brees dropped back to pass, but had little success,
Cause the first half, you see, was a Panther sack-fest.
The Saints managed to put three points on the board
It didn't change much, fans continued to roar.
Saint coaches decided to win would take tricks
Then decided to try a surprise on-side kick.
They recovered the ball, and put up three more points.
The Panther response? Let's make some more noise!
The defense was solid, and TD is a beast,
He wasn't afraid of Drew Brees, in the least.
Brees dropped back to pass, he had Graham in his sights
But just about then, Thomas Davis took flight.
TD hauled it in, an incredible pick!
Then Deangelo rushed, for a really quick six!
Halftime had come, with the Panthers ahead
Twas the first time all day, that the Panthers had led.
It was just about now, that the rain came to town,
And man let me tell you, it really came down!
But Brees is fantastic, and a tough one to spook
But in this downpour, he threw it to Luke!
The rain made it tough, to move or to score
But despite all this mess, we were still up by four.
The Panthers had given, as good as they'd got
For rivals like this, predictions mean squat.
But the Saints they weren't done, they had more in the tank
That's when Brees tossed the ball, to Graham on the flank.
The Saints took the lead, at thirteen to ten
I hadn't been worried, up until then.
It was late in the game, and the offense had stalled
But just about then, Cam got the call.
He dropped back to pass, and hit Teddy in stride
And that quick young man, took the Saints for a ride.
Hurry up Cats, only seconds are left!
Don't worry my friends, cause Greg Olsen is deft!
He pulled in the pass, and fell to the ground
Cam rushed to the line, to spike the ball down.
And that's when it happened, the crowd started to rock
The next play, you see, put the Saints fans in shock.
Dom on the left, ran a simple out-route
And cradled the ball as he fell to the ground.
The crowd exploded, in spite of the rain
Cause we revel, you see, in Saintly disdain.
The review was upheld, as we knew it would be
That play right there, put the Cats up by three.
Extra point on the board, and time winding down
It was joyous to see, Sean Payton's frown.
The Panthers had won, on this wet winter day
And don't really care, what the 'experts' might say.
Now we're back in the playoffs, and man is it grand
There's room on our bandwagon, for everyone to stand.
We're gonna play tough, and we will make some noise
That's just how it is, for these Carolina boys!
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NanceUSMC added a article in Carolina PanthersWhat Was Marty Hurney Thinking?What on earth was Hurney thinking?
Well, let's think about that question for a moment... His job is to put the best available players possible on the field, and surround them with solid role players and a capable bench, thus giving the team the best possible chance to compete on a week in, week out basis...
So what goes into a draft selection?
First and foremost (and what many draftniks, both amature and professional (yes, I'm pointing at you Melvin Kiper)) it's absolutely imperative that you remember one rule: Need is a terrible evaluator. Take a moment and read that again... Need is a terrible evaluator. What does that mean exactly? It's simply that if you draft, based on your team's specific needs, you end up ignoring better players, and typically reaching just to fill that specific position with someone who either may have been available later, or may be a marginal player... Again, draft the best football players available for your team, and let you coaching staff figure out how to best get them on the field... Then fill the holes with role players via free agency... Not every position needs an all pro... Analysts inconsistently grade drafts based on whether or not specific needs were met or addressed... This is only part of a team's offseason storyline, and just because a team doesn't get that 'needed' position, it's often ignored that they added solid or above prospects that can upgrade underproducing veterans, or push them into better production... Drafts should be graded on an evaluation of the talent selected...
Second, you have to trust your scouts and advisors... This is their job... It's what they do 8 or 10 or 12 hours a day, 5 or 6 or 7 days a week... While you and I are sitting at work, answering phones, resolving issues, attending mindless meetings, these are individuals who are out watching football, evaluating players and taking notes... The draft process for an NFL franchise is a never ending cycle, and one that each GM (including Hurney) live daily... It's imperative that you trust your team's big board, and take the players that you feel offer you the best talent available... It's also imperative that you not cave to pressure from analysts, media or fans... Just because someone is selected that you've never heard of (as a fan) doesn't mean it isn't a solid talent... There are thousands of players participating at the collegiate level, most of which we have never heard of... The knee jerk reaction when someone is selected that we are unfamiliar with is to reject the selection... Instead, take more time to specifically research that player, and make a more educated fan judgement...
Third, keep in mind that the draft is an exercise in failure... If you 'hit' on 50% of your selections, you've have a fantastic draft... Hitting on a third of your picks (2 players that come in and start, or heavily contribute), you have had an average and respectable draft... Nothing stellar, nothing horrible... Anything more is gravy, anything less is potential disaster...
Finally, trust your instincts... We as fans are allowed to let our emotion dictate what we believe the team should do... But emotion is a dangerous thing... Emotion led the Saints to trade an entire draft for Ricky Williams... Emotion will get you fired... Trust your instincts, and not your heart...
So that is what's going through the minds of Hurney, and the other GM's participating in this draft...
We've got a couple good football players so far in this draft, and as a fan I'm happy about that... Certainly, I don't know what kind of careers they will have, but I'm excited to see how they can make our team better, and how they will be used...
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