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Percy Harvin's Concussion: What's Standing in the Way of His Return from Injury?

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Percy Harvin's Concussion: What's Standing in the Way of His Return from Injury?
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As the NFC Championship Game approaches, the status of Seattle Seahawks wide receiver Percy Harvin remains in doubt as he attempts to return from a concussion.

Harvin suffered his injury last weekend during a playoff matchup with the New Orleans Saints. According to the official Seahawks injury report, he remains sidelined, missing practice on both Wednesday and Thursday.

At this point, all is not lost. However, as each hour passes, the star wideout's outlook for Sunday looks more and more bleak, and he may still have a number of obstacles to safely overcome before lining up on the line of scrimmage once again.

Following a concussion, NFL players begin a standardized return-to-play protocol that at least partially mirrors rules set forth by the medical literature. Such protocols generally consist of sequential steps of increasingly strenuous physical activity, among other checkpoints. If concussion symptoms recur at any point, the athlete must rest until they resolve before he or she resumes the process.

All told, the exercise steps cover the entire range of physical activity levels, from complete rest to 100 percent exertion. Often, doctors and athletic trainers use a full-contact practice as a final test before clearing an athlete to return to the field. NFL players also need the blessing of an independent neurological consultant.

What does that mean for Harvin in terms of his availability this Sunday?

Unfortunately, it seems he may still have a ways to go.

A "did not participate" tag for Thursday's practice may not only mean that Harvin is likely still progressing through the protocol, but also that he may not even be on its final steps. Many times, the penultimate phase of a concussion-recovery sequence consists of light practice, and media reports do not yet suggest he is completing any such activities.

It's possible Harvin is progressing on his own under close medical supervision. That said, it's also plausible he remains in the very early stages of his return and isn't anywhere near setting foot on the practice field. Only the Seahawks medical circle truly knows.

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Either way, multiple NFL physicians have told this author that the magnitude or importance of a game does not play into the decision to clear a player. Rather, health and safety reign above all else.

Furthermore, even if Harvin practices on Friday, nothing is a guarantee.

As the case of Washington Redskins tight end Jordan Reed showed earlier this year, concussion symptoms can return at any time.

A pregame headache held Reed out of a Week 13 matchup with the New York Giants—and eventually the rest of the 2013 season—after multiple reports stated doctors cleared him to play. Nothing suggests the Redskins medical staff did anything wrong. Sometimes concussions can proceed with a somewhat unpredictable course.

With that in mind, Seahawks fans should still hold out hope. But at the same time, the possibility of a Harvin-less NFC Championship Game remains a very real one.

After all, missing two straight practices is a neutral prognostic sign at best—and quite possibly a very poor one.

 

Dr. Dave Siebert is a resident physician at the University of Washington. He plans to pursue fellowship training in Primary Care (non-operative) Sports Medicine. He is not privileged to any of Percy Harvin's confidential medical information.

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