Vick's latest helmet blow raises questions about concussion policy

Sunday afternoon in Washington brought the football world the latest talking point in the concussion debate.

In the third quarter of the Redskins-Eagles game, Philly's Michael Vick scrambled, spinning out of a near-sack, and ran down the field. As he was tackled, he fell into the path of Redskins safety LaRon Landry's helmet. It was a clear helmet to helmet hit, as you can see on this video (1:05 mark for the slow motion of the hit.) Vick lay on the turf for a moment, limp, before standing up under his own power. "They're holding him up like a punch drunk boxer," said Brian Billick, calling the game for Fox. Washington linebacker London Fletcher stood next to Vick with his arm around him and waved for the trainers, as did Eagles receiver DeSean Jackson, a guy who knows the dangers of concussions first-hand. After the game, Fletcher told the Washington Post that Vick was "groggy, like he was about to fall down."

Vick walked to the sidelines under his own power, where he could be seen talking to several on the medical staff, including head athletic trainer Rick Burkholder and head coach Andy Reid. A Vince Young intercepted drive later, Vick returned to the field to lead the Philly offense. With commercials, the time from Vick walking off the field to his return was 5:02.

After the incident, the Eagles reported both that Vick had dirt in his eye (despite having a visor and him showing no irritation as he walked off the field. In fact, he was smiling) and that he had the wind knocked out of him (though Vick again showed no distress or signs of this having happened.)

Gamesmanship with injuries is understandable, up to a level. The real question is whether or not, with clear signs of possible concussion, was Vick ever evaluated?

The NFL's Concussion Policy is clear. A player that exhibits "certain signs or symptoms" of a possible concussion must be evaluated using the "NFL Sidelines Concussion Exam." According to this article by CNN's Dr. Sanjay Gupta, the exam consists of "simple tests evaluating concentration, basic thinking skills and balance. It also includes a questionnaire that asks about concussion symptoms. It's designed to be given on the field, within a 6-to-8 minute window." Vick likely said he was fine and wished to return, but players who are concussed are in no position to be making this kind of decision, which is why medical professionals should be making the "go or no go" decision, as per the NFL's policy.

In fact, Burkholder is one of two athletic trainers on the league's committee that determines and sets the policy. Yet, this isn't the first time his evaluations have been called into question. The league's policy requires that any player that is diagnosed with a concussion be removed from play and not returned until cleared by an independent doctor. The path most teams take is to not diagnose a player as concussed, such as the Eagles did with Vick, claiming he left a game earlier this season with a neck injury before later confirming that he was concussed and following league protocol for his return.

Whether it's a star like Vick or any other player in the league, the current policy raises practical questions about whether it can realistically be followed and does it do enough to protect players?

Asking a team employee, even a highly regarded medical professional like Burkholder, to make a "go/no go" decision that could greatly affect his team's chances is hard. It would be very difficult for Burkholder to look at Andy Reid, a coach already under fire for his team's underperformance and say "No, your star QB can't go. Given that the NFL understands the need for an independent doctor to clear players, it's difficult to grasp why they would allow this to be short-circuited at the most crucial time.

The easiest solution would be to add a couple of doctors to the sidelines, rotated in like the officiating crew (perhaps as a part of it.) They would be independent arbiters on concussions and other injuries, making sure that the evaluations were done properly or even done at all. Perhaps the replay official could see Vick laying on the turf and buzz down to ask the sideline doctor to make him aware, allowing him to make a decision on whether the player should be removed from the game and evaluated.

The NFL has had no response to this or several other incidents like this one. The policy is clear, but the results are not. If the players on the field and the announcer in the stands all thought that Vick had symptoms of a concussion, it has to make one wonder what the medical staff saw that took it the other way. Perhaps it was dirt in Vick's eyes, but it's more likely that they were just blowing smoke in ours.