If we’ve heard it once, we’ve heard it a million times in the previous two weeks: 𝙘𝙤𝙣𝙘𝙪𝙨𝙨𝙞𝙤𝙣 𝙥𝙧𝙤𝙩𝙤𝙘𝙤𝙡 . 

When Patrick Mahomes left the division playoff against the Browns with a concussion (a form of mild traumatic brain injury), the media entered a frenzy regarding his status for the following week’s AFC championship. 

“He has entered the NFL’s concussion protocol”

“He must clear the concussion protocol”

And with the number of concussions reported in sports, this was not our first experience with this terminology. 

So what is a concussion protocol?

A protocol is an official procedure or a set of rules, typically agreed to by a group of people or organization. That means a concussion protocol is a set of rules or procedure a concussed patient/athlete will follow, that has been agreed upon by a group of health professionals. 

Concussion protocols may vary between one organization/group and another, but they should be based on the best available evidence. A concussion protocol will almost always include:

• monitoring the patient’s signs & symptoms, and
• slowly progressing physical and mental activities once the patient’s symptoms have subsided.  

Goals of Concussion Protocols

The ultimate goal of the protocol is progressing the patient back to full activity as efficiently and safely as possible. This is often referred to as return-to-play (RTP) or return-to-learn. A physical progression should look like light cardiovascular activity ➡️non-contact sport drills in isolation ➡️ non-contact sport drills involving others, or resistance training ➡️ unrestricted training ➡️ physician clearance. 

While it’s easy to focus on how a concussion impacts an athlete’s ability to compete physically, research tells us that a concussion can have significant impacts on mood, memory, focus, and cognition. 

In the case of Patrick Mahomes, there was undoubtedly immense pressure to “clear protocol” in time for the next game. But whether you are an athletic trainer working in the NFL or a parent of a kiddo who sustains a concussion on the playground, it is important to understand that healing has its own timeline. As much as we hope that healing aligns with personal or team deadlines, each brain may respond differently. 

Things you can do to advocate for your patient:

• Listen to the body and look for signs of lingering injury. 
• Progress through the protocol as long as the patient remains asymptomatic. 
• Eliminate as much internal and external pressure as possible. 

Is there more you would like to know on this topic? Let’s talk about it! 

Resources

Visit https://www.nata.org/sites/default/files/Concussion_Management_Position_Statement.pdf to read the NATA’s position statement on the management of sport concussion, and https://www.nfl.com/playerhealthandsafety/resources/fact-sheets/nfl-head-neck-and-spine-committee-s-concussion-diagnosis-and-management-protocol to view the NFL’s  concussion protocol 🧠