I was asked about concussion spotters on a radio show recently. My initial reaction was that these plans were good ideas. I still agree with that general assumption. For my latest newspaper column, I explored the idea in more detail. I offer insight into making these plans better and the likelihood that we see similar efforts in other sports.Brain MRI doctor reading

Julian Edelman’s performance in Super Bowl XLIX appears to have had longer lasting effects than just bringing the New England Patriots a fourth championship. And it might have influenced a sport other than football.

Julian Edelman’s injury

With about 11 minutes left in the fourth quarter, Edelman took a helmet-to-helmet hit from Seattle Seahawks safety Kam Chancellor. Fans watching on TV watched the receiver stumble after the hit, but he stayed in the game. Edelman ultimately caught a 3-yard touchdown pass that ended the drive.

According to Ben Volin of The Boston Globe, reporters heard the concussion spotter call down to the Patriots’ sideline, but due to the team’s hurry-up offense, Edelman remained on the field.

NFL adopts athletic trainers as concussion spotters

Shortly after another scary incident involving Cleveland Browns quarterback Colt McCoy in 2011, the NFL appointed independent athletic trainers to serve as “spotters” during games. They watch the action on the field and monitor video to identify players who might have sustained concussions. They can call down to the sideline and speak to the doctor or athletic trainer, provide information about the incident and even send video to the medical staff.

Also read:
Recognize that concussions occur in sports other than football
How can we encourage athletes to report concussions?
Does fear of getting benched keep players from reporting concussions?

The medical time out for possibly concussed players

In what many have nicknamed “the Julian Edelman rule,” these spotters can now use a medical time out to remove a player from the game so that doctors can perform a neurological assessment. A spotter can stop play if he sees signs that a player is unstable or disoriented and if the player avoids attention from the team’s medical staff.

The spotter can contact the game official with the concussed player’s jersey number as well as notify the doctor or athletic trainer to have the player evaluated.Ice hockey players

Requirements to serve as a concussion spotter in the NFL

The NFL requires that the spotter has at least 10 years experience as an athletic trainer with current board certification by the National Athletic Trainers’ Association in addition to experience in professional or collegiate sports. He or she must also never have served as an NFL team’s head athletic trainer or have worked for an NFL team in the past 20 years.

The NHL facing similar head injury battles

The NFL recently settled a lawsuit over concussions filed by former players. The National Hockey League also faces a similar lawsuit filed by former players who claim to have long-term issues resulting from concussions they suffered in their pro hockey careers. Like the NFL suit, the players allege that the NHL didn’t do enough to protect the athletes and inform them of the long-term neurological consequences of these brain injuries.

Also read:
Don’t depend on a helmet to prevent concussions
Look for emotional side effects from concussions
Do parents understand concussions and their importance?

Steps to improve safety for hockey players

The NHL has taken steps to improve safety, including implementing a Department of Player Safety, restricting contact to a player’s head, and adopting a concussion protocol in 2011. This season, the league will place independent spotters at every game in the 30 arenas.

Possible flaws in the NHL concussion spotter plan

The plan differs from the NFL’s in several ways. First, the home team doesn’t have to use them. They can hire their own spotters who can communicate with the athletic trainer for the team. If so, the independent spotters then only log the injuries they see. Plus, a spotter will only work in one arena. The NHL team in that city will pay the spotter.

The NHL spotters also might not have medical experience. According to NHL Deputy Commissioner Bill Daly, “They aren’t evaluating the players or diagnosing whether or not they have a concussion. That’s the job of the doctors and trainers. All they are doing is alerting team medical staff where they witness or identify an incident where there is a visible sign of concussion. Those signs aren’t ‘medical’ – they are objectively observable and they have already been precisely defined in the protocol.”Hockey injury

A step in the right direction

Generally I think that the NFL’s plan, and to a lesser extent the NHL’s, are steps in the right direction. The action is often too fast and there is too much going on for an athletic trainer and doctor to see every player and every possible injury. Plus we know many players will hide or deny symptoms to stay the game.

The future of concussion spotters in professional sports

The spotters need to be independent, though. In theory, officials paid by the home team could call for a player from the visiting team to be pulled out and examined at key moments of the game. That might be a far-fetched conspiracy theory unlikely to actually occur, but fans and the media might rally against the potential conflict of interest.

The spotters also need to have medical experience. While I agree that they aren’t making the diagnosis but instead looking for signs of an injury and relaying information, certified athletic trainers and doctors can better recognize injuries. They have years of training and hands-on experience covering games and evaluating athletes with head injuries. If safety of the athletes is the goal, we should put qualified personnel in place to watch and protect them.

Also read:
High school athletes’ perceptions of concussions
Player-to-player contact and concussions in high school football

Again, these are still worthwhile moves. We will soon see what kind of impact they have on injuries and the flow of the games. Expect to see some version of these concussion spotters in every professional collision sport in the near future.

Do you think these concussion spotters will increase the diagnosis of concussions in football and hockey? What can we do to further protect the athletes? Please share your ideas below!

Note: This article appears in a modified format as my sports medicine column in the September 16, 2015 issue of The Post and Courier.

NHL adds concussion spotters, controversial ‘Julian Edelman Rule.’ By Greg Wyshynski. Yahoo! Sports. September 14, 2015.

NHL to use concussion spotters at all games this season. By Frank Seravalli. TSN. September 14, 2015.

Rumblings: League instituting independent concussion spotters for all 30 arenas. By – Pierre LeBrun. ESPN.com. September 14, 2015.

Sunday Football Notes: NFL has hit on something with ‘Julian Edelman Rule’ and concussion spotters. By Ben Volin. The Boston Globe. August 9, 2015.

NHL ordered to hand over documents in concussion lawsuit. By Katie Strang. ESPN.com. August 5, 2015.

ATC Spotters. NFL Football Operations.