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Texans rookie C.J. Stroud in NFL concussion protocol: Here’s what that means

EAST RUTHERFORD, NEW JERSEY - DECEMBER 10: C.J. Stroud #7 of the Houston Texans on the field with an injury during the fourth quarter in the game against the New York Jets at MetLife Stadium on December 10, 2023 in East Rutherford, New Jersey. (Photo by Al Bello/Getty Images) (Al Bello, 2023 Getty Images)

HOUSTON – Texans rookie quarterback C.J. Stroud was placed under the NFL’s concussion protocol after hitting his head on the turf during Sunday’s game against the New York Jets.

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Although it’s not confirmed Stroud suffered a concussion during the game, the NFL’s protocol says when a play receives an impact to the head, they must be placed on concussion protocol, which means the player must be immediately removed to the sideline or stabilized on the field to undergo the concussion assessment, which includes:

  • No-Go
  • History of Event
  • Concussion Signs/Symptoms
  • Maddock’s Questions
  • Video Review
  • Focused Neurological Exam: – Cervical Spine Exam (including range of motion- pain)
  • Evaluation of Speech
  • Observation of Gait
  • Eye Movements and Pupillary Exam

If any elements are positive, inconclusive or suspicious of concussion, the player is escorted to the locker room.

In the locker room, the player will undergo a complete NFL SCAT and complete neurological exam.

To return to the game or practice, the NFL says the player has to go through a five-step process and be cleared by the team’s physician and separately cleared by an Independent Neurological Consultant (INC), jointly approved by the NFL and NFLPA, who is not affiliated with any NFL club.

5-step participation protocol:

  • Phase 1: Symptom Limited Activity
  • Phase 2: Aerobic Exercise
  • Phase 3: Football-Specific Exercise
  • Phase 4: Club-Based Non-Contact Training Drills
  • Phase 5: Full Football Activity/Clearance

As some of you may know, concussions are a big problem in contact sports like football.

This past weekend, medical experts gathered in Massachusetts to discuss traumatic brain injuries and ways to prevent them in sports.

Researchers, doctors, and the NFL weighed in with their guidance, which included eliminating unnecessary contact with the head and neck area and penalizing players who continue to make unnecessary contact.

The NFL’s guidance on its concussion protocols:

  • Added a third UNC who will monitor the broadcast video and audio feeds of each game from the spotters’ booth, and notify on-field UNCs of possible head, neck or spine injuries.
  • Defined impact seizure and fencing responses as independent signs of potential loss of consciousness, representing “No-Go” criteria under the current Protocol. Players who display either of these signs at any time shall be removed from play and may not return to the game.
  • Required an evaluation for all players demonstrating ataxia (abnormality of balance/stability, motor coordination, or dysfunctional speech) to determine the cause of the instability. If the team physician, in consultation with the sideline UNC, determines the instability to be neurologically caused, the player is designated a “No-Go” and may not return to play.
  • Officials, teammates, and coaching staff have been instructed to take an injured player directly to a member of the medical team for appropriate evaluation, including a concussion assessment, if warranted.
  • Required all players who undergo any concussion evaluation on game day to have a follow-up evaluation conducted the following day by a member of the medical staff.

Amid concussion injuries, there has also been a lot of attention surrounding traumatic brain injury and chronic traumatic encephalopathy or CTE in sports.

CTE has been associated with memory loss, confusion, aggression, depression and suicidal behavior. CTE has only been formally diagnosed with an autopsy in brain donors who were suspected of having the condition. Now, medical professionals are working to determine how to diagnose CTE in people who are alive.


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