Removal of Mahomes, Jackson shows severity of NFL’s concussion protocol

Whew. Patrick Mahomes is cleared to play football on Sunday. The announcement made Chiefs’ fans exhale, television executives celebrate and cynics roll their eyes. Was there ever a doubt?

Technically, yes.

For all its greed and ruthless ambition, the NFL should be commended for its commitment to concussion protocol. In the divisional round of the NFL playoffs, two-star quarterbacks — Mahomes and Baltimore’s Lamar Jackson — were pulled from a game for concussion testing and never returned to the field.

Not that long ago, they wouldn’t have missed a play.

It’s not a joke anymore.

“Personally, I was quite pleased when I saw over the weekend two star quarterbacks who were evaluated and then removed from the game,” said Dr. Javier Cardenas, neurologist and director of the Barrow Concussion and Brain Injury Center in Arizona. “Without question. Without resistance. Without anything that would raise an eyebrow.”

Football is experiencing real culture change in the realm of concussions. Players understand the health implications for faking their way back on the field. Teams are not throwing temper tantrums when a player is deemed medically unfit to continue. Fans seem empathetic. Tackling techniques are finally starting to change. That’s real progress.

Cardenas was there at the very beginning, when the NFL began assigning concussion specialists to each NFL sideline in 2013. Two years later, he was working Super Bowl XLIX at State Farm Stadium in Glendale, compelled to examine Seahawks star Cliff Avril following an interception return. And then he pulled the veteran player from the biggest stage in sports.

Years later, Avril told Seattle media he was grateful for the care he received, even though he missed most of the second half and the Seahawks lost the Super Bowl.

“Of course, I wish I could’ve played out there, but my health is more important,” Avril said.

“For me, that was an important teaching point in this game,” Cardenas said. “And the message I try to give to parents and young athletes is that, in the biggest game in the world, we are removing an athlete from play for that athlete’s health and safety.”

You’ve seen the concussion tents that have popped up on NFL sidelines in the past two years. If you enter, you will be asked five questions:  What venue are we at? What quarter is it? Who scored last? Who did you play last week? Who won?

There are also three different “no go” signs that trigger concussion protocol: an observed loss of consciousness; post-traumatic seizure or posturing; or gross motor instability, creating an imbalance in somebody. The latter is what triggered the examination of Mahomes, and once doctors confirmed it was a neurological issue and not an ankle/knee/foot injury, he was ruled out for the game.

The final phase is post-game protocol. A player must rest until symptoms pass. Then he must pass a series of tests in order to be cleared for action by an independent neurologist.

In recent years, helmet technology has helped the NFL limit brain trauma. So have fortified rules regarding late hits and leading with one’s helmet. But adherence to concussion protocol without old-school protest is yet another victory for the league, especially when it involves star performers in playoff games.

Once, the NFL’s biggest health issue was the concussion epidemic. Now it’s a pandemic. That’s a big shift for a sport where brain trauma is no longer a minor injury, where getting your bell rung is no longer an excuse to keep playing.

Just ask the doctor brave enough to pull a player from the Super Bowl.

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