College Football Lacks Concussion Policy, Could Lead to Tragedy

The video is tough to watch. Shane Morris staggers after taking a direct hit to his helmet. He collapses, reaching for his teammate to keep him upright. Immediately, his teammates begin waving to the sidelines. Instead of an athletic trainer, Morris, a QB for Michigan, is met by Brady Hoke, the head coach. 

Morris was sent back into the game moments later, despite appearing woozy and blinking slowly. Hoke was close enough to notice this, and he sent Morris back out anyway. Hoke's job is not to diagnose, but he appeared unaware of the issue even as late as Monday. That speaks to a systemic failure of communication, top to bottom.

When Morris finally came off the field, he was met by Hoke, a position coach and walked into a group of players. It's unclear if a doctor saw him at this point, but it appears that Morris is speaking to Paul Schmidt, the longtime head athletic trainer at Michigan, in a brief shot. 

Less than a minute later, after the replacement's helmet came off, Morris was put back into the game. Schmidt is seen again and pats Morris on the back as he goes back into the game. While it is impossible to know what Schmidt saw or evaluated, he had only a minute to do so. That is not enough time for even a cursory concussion evaluation, nor even time to treat his ankle. 

Hoke insisted on Monday that Morris did not have a concussion and that he was complaining of pain in his ankle. While Morris did clearly have an ankle injury and could be seen hobbling on the plays in between that injury and his head injury, Hoke and offensive coordinator Doug Nussmeier did not appear to have noticed that either, calling for a rollout for Morris on one play.

It is that ankle injury that was noted by athletic director Dave Brandon in a statement. Brandon said in the statement that Morris had been treated for a sprained ankle earlier in the game, and medical staff on the sideline believed that was why he stumbled while trying to walk around after being hit by Cockran.

"The team neurologist, watching from further down the field, also did not see the hit. However, the neurologist, with expertise in detecting signs of concussion, saw Shane stumble and determined he needed to head down the sideline to evaluate Shane," Brandon stated, via USA Today. It does not appear to have happened before Morris was sent back out.

At no point did Hoke, Nussmaier or Schmidt appear to question whether Morris should be put back in the game. It's unclear whether Hoke or Nussmaier called for Morris' reinsertion, but no one protested, including Morris. 

Gregg Doyel at CBS summarizes the situation well: "Hoke says he never saw the hit to the head. Same goes for everyone else on his staff—on the sideline and in the press box, including some with access to replays—and everyone on the medical staff as well. So when all of these trained professionals saw Shane Morris reeling his way off the field, and when they saw teammates gesturing to the sideline for help, they all thought it was because of the ankle."

This situation recalls one in the NFL two seasons ago when Colt McCoy, then with the Cleveland Browns, was hit in the head and clearly concussed. He also injured his hand on the play, and when asked by the medical staff, McCoy complained of hand pain. He was not evaluated for a concussion and was sent back out by the coaching staff. 

That incident led to several changes in NFL policy, including the use of a "concussion observer" who is supposed to have the ability to call down to the sidelines and request a concussion evaluation on any player. The efficacy of that program is in doubt, but it was nonetheless a quick and positive response to a clear problem.

With collegiate football, the question is not whether this is a problem or whether this could recur, but who is in position to do something about it? The NCAA, the conference authority or the school itself could all be in position to make changes, but aside from very few instances, there is no clear policy to prevent this kind of incident.

While the NCAA does offer guidelines for concussion management that appear very specific, there's a loophole in there that goes to this very case. For any of the policy to matter, a concussion must first be diagnosed. Morris' situation shows just how difficult this can be and how easy it is to miss. 

Let's assume that all the parties involved have good intentions. While you don't have to like or even agree with this assumption, I find it easier to believe that a long-tenured athletic trainer is both competent and well-intentioned. Schmidt was seen with the player, and reports are that he checked Morris' ankle, much in the same way that McCoy's hand, the immediate painful issue, is the primary complaint.

Of course, to assume this, we have to also assume that Schmidt saw no symptoms. In asking about Morris' ankle, Schmidt must not have seen any signs of concussion such as an unfocused gaze, slurred or altered speech, or the same kind of balance problems he appeared to show on the field. The assumption is that Schmidt, a trained and respected medical professional, missed the signs that Morris' teammates saw just a few moments prior.

(Speaking of which, I wonder if anyone will ask Ben Barden, the offensive lineman who helped hold Morris up, what he saw and thought at that time. What did he see and who did he tell? The answers could clear up a lot of issues. Michigan should make Barden and Schmidt available immediately.) 

It's harder with Brady Hoke, who refuses to wear a headset and has a history of diminishing injuries. A few years ago, Hoke told a player to stop limping. Devin Gardner was later found to have a broken foot. At Ball State, Hoke insisted on a practice in sub-freezing conditions, leading to frostbite for several players.

Hoke's greatest sin is not missing the injury—that can be very difficult to see from his position on the sidelines—but in failing to have someone see it and getting him the information. We still don't know if someone in the press box might have seen by eyes or replay what had happened to Morris, but we do know that by Monday, no one had clarified the situation for Hoke.

On B/R Radio Tuesday, Drew Sharpe of the Detroit Free Press told us that Hoke still appeared to have the facts of the situation confused. Sharpe also said that Nussmeier may have been signaling at one point for Morris to stay down. Michigan would not confirm this or make Nussmeier available for questions.

Indeed, Congress is now getting involved. Rep. Bill Pascrell of New Jersey and co-chair of the Congressional Brain Injury Task Force has asked the Big Ten to investigate. We'll have to see if this kind of attention forces changes. 

A simple solution would be to put an athletic trainer or other qualified observer in the press box, as the NFL does. The NFL's system hasn't been very successful, but it is an improvement that the NCAA or conferences could immediately put into place without significant extra cost. Even at the smaller schools or lower levels, this is doable by this weekend, if athletic departments call for it. 

Michigan may have other problems, but they're not alone with this important issue. The NCAA, conferences and individual schools need to address this issue now before the "student-athletes" they claim to care about end up with the same kind of brain and long-term issues that the NFL is struggling to deal with.