Welker's Helmet and Harvin's Return: The NFL's Next Concussion Challenge

Will Carroll@injuryexpertSports Injuries Lead WriterJanuary 14, 2014

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There was a collective reaction when Wes Welker came out of the Denver Broncos tunnel with his new Riddell helmet: "Ha ha!"

The Twitterati fell all over themselves, trying to get the best Nelson Muntz laugh, the best punch line or Dark Helmet meme. It all echoed what happened when David Wright of the Mets first wore his larger, but more effective, batting helmet a few years ago.

Despite the cyberbullying and more than a few jokes he probably received at practice, Welker was successful with the helmet. He made it through the game without any new injury. He also had a productive game (six receptions, 38 yards, one touchdown) to help the Broncos win and move on.

Do we know if the helmet worked in preventing another concussion? No, but it will be interesting to go back through the tape and see whether Welker took any hits to the head.

Many asked me on Sunday why more players don't wear the helmets if Welker's helmet was better? The type of jokes you saw are one reason, but other reasons are comfort and inertia. NFL players have mostly worn the same helmet—often literally—for their entire careers. Brett Favre finished his career with the same helmet that he used in college.

The other question is whether the helmet is indeed "better." Riddell's 360 helmet is the top of the line for the company. It's not new or customized for Welker. It's been available for two years and has had little uptake. The Riddell website doesn't offer much in the way of details about why the helmet is better, though its reasonable to assume that a newer product like this will be better than their previous versions.

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Dustin Fink, an Illinois athletic trainer who monitors concussions on his website, The Concussion Blog, told me Monday that Welker is also wearing a special insert that may have included sensors. Riddell has a system called Insite that would fit natively into the 360 helmet, though it is unknown whether the Broncos were monitoring from the sidelines.

Welker is not the only player wearing the specialized helmet. His teammate, Knowshon Moreno, also switched to the 360 after concussion issues. The helmet is used more by defensive players, largely because of the helmet's weight, Fink explained. 

Jan 11, 2014; Seattle, WA, USA; Seattle Seahawks wide receiver Percy Harvin (11) is helped off the field by medical staff members against the New Orleans Saints during the first half of the 2013 NFC divisional playoff football game at CenturyLink Field. M
Joe Nicholson-USA TODAY Sports

Harvin Returns?

Earlier in the weekend, another player's return was derailed by concussion when Percy Harvin of the Seattle Seahawks came back from his hip injury only to take a couple of shots to the head.

The perception of how he was handled was questioned, after Harvin was initially hit, medically checked, returned and then took another hit against the New Orleans Saints that forced him out of the game. While it appears the Seahawks staff followed policy and returned Harvin after an appropriate check, it didn't look right to many watching. That was not on the Seattle medical sideline staff. Its job is to execute, not explain.

Speculation that Harvin asked teammates to help him up quickly so he wouldn't be checked and that he tried to avoid testing hasn't been confirmed by anyone, but it fits a pattern. Players don't seem to understand or accept the policy as being helpful. To them, it's still something that takes them off the field. It takes money out of their pockets and blocks them from their dream. The inertia of the football culture is strongly in place.

Part of the issue is the culture, but part of the question is also the policy itself. The NFL has iterated the policy quickly in response to its deficiencies, but its also made the process deliberately opaque. The black box of testing is creating speculation that only leads to confusion.

Why was Harvin allowed to return after his first test? Simple. He passed the NFL's concussion test, period. That doesn't mean he was not concussed. It means that he passed a test and that the doctors did not rule him out on their own.

Yes, they can do that. The test is only necessary for confirmation. A player lying unconscious on the field needs absolutely no testing, but doctors have become slaves to the process. 

The Policy in Question

The NFL's concussion policy has been shown to be inconsistent, or at least poorly understood. Dr. Jene Bramel of FootballGuys.com exposed the fact that the NFL's PR did not match its policy in a series of articles last fall. I detailed those changes and their effects in a previous B/R article.

In total, the changes that the NFL has made over the last couple of years have been ineffective despite its best intentions. The "independent doctor" on the sidelines has little or no power. The concussion observer program is so opaque that we can't tell, though anecdotally, it seems to miss concussions that are seen by myself and others.

We've learned that in the playoffs, the pressures get even tougher. Despite the fact that the medical staffs and league have policies in place, the competitive nature of the players—those who the policy is designed to protect—pushed through.

GREEN BAY, WI - DECEMBER 22:  David Bakhtiari #69 of the Green Bay Packers blocks Troy Polamalu #43 of the Pittsburgh Steelers at Lambeau Field on December 22, 2013 in Green Bay, Wisconsin.  The Steelers defeated the Packers 38-31.  (Photo by Jonathan Dan
Jonathan Daniel/Getty Images

Bakhtiari's Risk

During Green Bay's playoff game last weekend, Packers offensive tackle David Bakhtiari returned to the field even after being diagnosed with a concussion. It's unclear why Bakhtiari wasn't taken back to the locker room, but if he was diagnosed quickly and ruled out, it had to be a very clear concussion, which means Bakhtiari may not have been fully aware of what he was doing. 

At this point, the medical staff should be doing everything it can to remove the player from the field. A player is, by the policy, supposed to be taken to the locker room for observation. Getting him away from the lights and noise helps as well, but it's also for his own safety. In many cases, an athletic trainer will take away a player's helmet. That said, I've seen players at the collegiate level grab another helmet and try to go back out.

Bakhtiari's case is just one issue. He was properly diagnosed, but then went off on his own. The NFL found no fault on the medical staff, so who was at fault?

Bakhtiari may have still been altered. Did his coaches not know he had been concussed? Did the observer not know that he had been tested and ruled out? Why had the Packers not announced he had been ruled out at that point?

The situation was similar with Saints cornerback Keenan Lewis, but not quite as dangerous. Lewis was diagnosed with a game concussion on the sideline but refused to go to the locker room. Lewis' situation appears to be simple disappointment and frustration.

He wanted to play, argued with the medical staff and, in the end, didn't get his way. It was hardly an ideal situation, but it seems to have been handled as effectively as possible. The worry is that a situation like that of Lewis could more easily become one like that of Bakhtiari. 

Lewis' situation shows how strongly these athletic trainers and doctors must stand by their sideline diagnosis and why it's so important to have an independent voice. In a playoff game, with so much at stake, a team physician has more pressure on him from fans, coaches and the owner, who ultimately signs his paycheck. The mere question in the minds of fans and players would be easily solved by a truly independent physician on the sidelines. 

Independence Day

Over and over, I've called for the final call on concussions and other return-to-play (RTP) questions to be given over to an independent doctor. It would be easy to get qualified doctors and send them out as part of officiating crews. The team would still have a team doctor and medical staff who would be in charge of care and treatment, but not given the final game-day RTP decision. 

The NFL has decisions to make this offseason. Once the concussion settlement is finalized, the legal concerns are pushed aside and the NFL can do more to address the real problems. The rule changes the league has made have not reduced the number or severity of concussions in any meaningful way. The next steps are critical if the NFL is to avoid the Gladwellian predictions and loss of youth participation.

Independent game-day physicians would be a good first step. A focus on improving equipment, especially helmets, would also be an easy change. A team could easily add incentives for the use of better helmets, rib protectors and other devices. 

The NFL should also immediately bring in sensors. The league has conducted some tests, but using this data to help detect unnoticed concussions and require tests would also give insight into the kind of hits that players are taking and which hits are the most dangerous. The costs per helmet would be negligible—a couple hundred dollars per helmet plus the monitoring equipment. 

Dec 15, 2013; East Rutherford, NJ, USA;  NFL commissioner Roger S. Goodell prior to game between the New York Giants and the Seattle Seahawks at MetLife Stadium. Mandatory Credit: Jim O'Connor-USA TODAY Sports
Jim O'Connor-USA TODAY Sports

Accelerate the Change

The NFL has shown it can improve and is willing to make changes. The programs and policies the league has in place now are better than what it had five years ago, but cases like the ones we've seen over the last two playoff weekends show that the NFL can't stop now. Programs like Heads Up Football will take a decade or more to show real results, meaning what the league does now is even more key.

What we've seen in the last couple of weeksfrom not understanding Harvin's return to the jokes about Welker's helmets and their unconscious effect on players upgrading their own safety equipmentshows just how much further the league has to go. Bakhtiari and Lewis show that the culture inside the lines and on the sidelines isn't changing quickly enough to let the other changes work. 

The NFL is nowhere near its goal and, in fact, has made very little progress despite its best efforts. The window is closing for the league to make effective changes. The NFL not only has to change, but it has to accelerate the pace that it iterates if it hopes to advance. The entire sport is at stake. 

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