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Armour: How Long is the NFL Concussion Protocol?

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Kansas City Chiefs quarterback Patrick Mahomes (15) is brought down by Cleveland Browns outside linebacker Mack Wilson (51). Jay Biggerstaff-USA TODAY Sports

By Nancy Armour |

Encouraging as it was to hear Patrick Mahomes was “doing good” after suffering a concussion in the divisional round of the NFL playoffs, a lot more needs to happen before he is cleared to play in the AFC championship game this Sunday.

The NFL does not have a set timetable for when players with concussions can return. Rather, players must complete a five-step, return-to-participation protocol, and there is no skipping steps or doing them halfway. Players advance to the next progression only when they are symptom free, and it will be an independent neurologist who makes the ultimate call on when someone can practice or play again.

“This is a way of protecting, I think, the player most of all,” Chiefs coach Andy Reid said Monday. “Also protecting the trainer and the doctors who are making the decision. I think it’s a plus all the way around.”

The first phase involves rest, and avoidance of any activities that could increase or aggravate symptoms. If Mahomes is symptom-free after an evaluation Monday, he will be allowed to do some light stretching and what the NFL calls “light aerobic exercise.”

If he has no symptoms – including but not limited to headaches, sensitivity to light, nausea, double vision and dizziness – Mahomes will move onto the second phase, which is “aerobic exercise.” Riding a stationary bike or running on a treadmill are two of the more common options. He also will be allowed to do dynamic stretching and balance exercises.

All of this has to be done under the direct supervision of the Kansas City Chiefs’ medical staff.

Next comes “football-specific exercises,” which could involve weight training and conditioning work. A player in this phase is allowed to work with his teammates for 30 minutes or less under “careful monitoring” by medical staff. If Mahomes can do that without any setbacks, he’ll be allowed to do non-contact football drills, which the NFL describes as “throwing, catching, running and other position-specific activities.”

While Mahomes is in the “football-specific exercise” and “non-contact training drill” phases, he will undergo another battery of neurocognitive and balance tests. His results will have to match the baseline each player establishes in pre-season testing.

If – and only if – all this occurs, the Chiefs team physician will clear him to return to full contact. But to ensure there is no pressure or temptation to return the NFL’s brightest young star too early, an independent neurological consultant who has been pre-assigned to the team will have to agree Mahomes has recovered.

Then, and only then, can he play against Buffalo.

“It’s a no-brainer from the coach’s standpoint. You don’t have to think about it,” Reid said. “It’s (the independent neurologist’s) decision. I just follow it.” 

This article was republished with permission from the original author and 2015 Ronald Reagan Media Award recipient, Nancy Armour, and the original publisher, USA Today. Follow columnist Nancy Armour on Twitter @nrarmour.

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