Josh Allen in concussion protocol: Update cleared 10/5

[The Dean]

3 minutes ago, NoSaint said:

 

Nope - turns out even fans can fly to Nashville for the game 

 

 

[Augie]

On 9/29/2019 at 4:28 PM, clayboy54 said:

Let me check my Magic 8-ball.

 

I’m starting to wonder if you can trust those things! 

[Augie]

13 minutes ago, NoSaint said:

 

 

Nope - turns out even fans can fly to Nashville for the game 

 

I’ll take it a step further! Even @plenzmd1 was allowed to fly in. Of course, if he misses his his return cheapo flight he has to wait a week for the next one. Bargains can come at a price....and teach promptness! 

[VW82]

1 hour ago, 3rdand12 said:

I will validate your opinion.
it is just that.

 i would not freak out if they sat him as an active player. get a different viewpoint and support Barkley.
But i suppose no forward thinking NFL team would do that to be honest with you.
if he is good to go? They play him. He is the Bills Franchise QB and gives them the best chance to win. But anyone that trusts the NFL to look out for the player's long term health is placing trust in the wrong place. as far as concussion protocol and anything else really

 I will Trust McBeanes. they are solid.

 

I trust them too which given the history with Bills coaches and GMs since Levy/Polian is a strange feeling. Have to give the Pegulas props on both those hires.

 

I also agree with the bolded for most players/positions but I think even the poorly run franchises treat franchise QBs differently.

 

There are two issues at play here: the concussion and Josh's confidence. If he's completely free of concussion symptoms already and participates in all the meetings and practices leading up to the game then great. If he'd performed admirably prior to the hit on Sunday then there'd be no question about him starting, but that performance raised questions IMO. Not everyone learns the same way. Maybe what's best for Josh's development is to get right back in the ring, so to speak. Maybe he'd be better off watching Barkley and regrouping over the bye. Miami is a much easier opponent to come back against and should help restore that confidence of his which is arguably his best quality. The worst outcome is he comes back, performs poorly again vs. a tough Titans defense -- Baker is still having nightmares over that pass rush -- or gets concussed again, and actually starts to doubt his abilities. 

 

Maybe I'm overthinking it but we have too much invested in this kid to be putting him in positions to fail. This might be the last time we get to use an injury as an excuse for a teaching moment. All I'm saying is that McD might be wise to use it or at least consider it. If he doesn't I'm sure he'll have good reasons. Like I said, I actually trust those guys.    

Edited October 3, 2019 by VW82

[reddogblitz]

If he's 100%, he plays. Anything less than 80-85% he sits.  We're trying win more than any thing else  .he's not to the point where him at 70% is better than the back up ... Yet.

[Ol Dirty B]

2 hours ago, YoloinOhio said:

I think he would need to be on the 53 to travel - could be wrong 

 

I don't believe this is the case in the nfl. I believe often times it seems like a waste to bring PS, or players out with an injury on a trip.

 

I'm pretty sure it's just what the organization wants to pay for.

 

Melvin Gordon played, but I believe Anthony Lynn first said he'd make be the trip but not suit up. I don't believe their is any nfl or cba rule that prevents teams from brining inactives on a trip. It's just a waste to some if a guy is definitely not playing.

 

At least that's my understanding.

[GaryPinC]

Wow, so glad to hear Allen is practicing.  Given the two headshots he took, he must not be too susceptible to concussion/post concussion syndrome.

[YoloinOhio]

20 minutes ago, Ol Dirty B said:

 

I don't believe this is the case in the nfl. I believe often times it seems like a waste to bring PS, or players out with an injury on a trip.

 

I'm pretty sure it's just what the organization wants to pay for.

 

Melvin Gordon played, but I believe Anthony Lynn first said he'd make be the trip but not suit up. I don't believe their is any nfl or cba rule that prevents teams from brining inactives on a trip. It's just a waste to some if a guy is definitely not playing.

 

At least that's my understanding.

Right but Gordon was on the 53. I’m not saying I know that guys who aren’t signed to the  roster can’t travel with the team, maybe they can, just figured they would sign him before they left since normally the PS QB isn’t traveling  to away games. Either way he needs to be signed by 4pm Sat to be eligible to play. 

Edited October 3, 2019 by YoloinOhio

[DefenseWins]

If Allen clears the concussion protocols and is ready to play then he starts. As others have said, he is the starter and the "franchise QB" and gives this team the best chance to win. But if he is less than 100% he sits and Barkley starts/plays.

Edited October 3, 2019 by DefenseWins

[Ol Dirty B]

3 minutes ago, YoloinOhio said:

Right but Gordon was on the 53. I’m not saying I know that guys who aren’t signed to the  roster can’t travel with the team, maybe they can, just figured they would sign him before they left since normally the PS QB isn’t traveling  to away games. Either way he needs to be signed by 4pm Sat to be eligible to play. 

 

I'm sorry I misunderstood you, my bad. I thought you were referring to Allen not Webb.

 

I'd assume you're right.

[Paulus]

https://www.wbur.org/news/2018/01/30/nfl-concussion-protocol-gronkowski

 

5 stages... I'd say stage 4. Josh is too smart to be stuck in concussion protocol for long. I sincerely hope he never has to see it again. 

[Hapless Bills Fan]

55 minutes ago, reddogblitz said:

If he's 100%, he plays. Anything less than 80-85% he sits.  We're trying win more than any thing else  .he's not to the point where him at 70% is better than the back up ... Yet.

 

Unstated and unmentioned in the 5-stages of concussion protocol is the role played by baseline mental testing.

 

As I understand it, the NFL (like all the high school and college sports I know of) makes all their athletes take a reasonably lengthy test that includes math and logic problems.  The point is to see where the unconcussed athlete's personal baseline is.

 

Then, along with the progression of physical activity, the concussed athlete has to repeat the test and return to baseline before playing again.

 

John Urshel, the Ravens guard turned MIT PhD candidate, said "I must have been having a good day when I did the initial test because it took me a long time to return to baseline".   This may have been what kept Mitch Morse out so long, as well - good NFL centers are noted for being among the smartest guys on the team.

 

Point being, it's not just can Allen run around and throw the ball.  He has to be able to understand and retain the game plan at a very high level and process what he sees quickly.  When I had my concussion it took me 2 months to return to being able to drive because I wasn't processing quickly enough.  I also had memory deficits and struggled with logic puzzles. 

9 minutes ago, Paulus said:

https://www.wbur.org/news/2018/01/30/nfl-concussion-protocol-gronkowski

 

5 stages... I'd say stage 4. Josh is too smart to be stuck in concussion protocol for long. I sincerely hope he never has to see it again. 

 

Being "stuck in concussion protocol for a long time" has nothing to do with being smart and everything to do with documentable changes in mental abilities and processing.  If your brain is damaged and won't let you remember 10 numbers and recall them accurately 10 minutes later, it won't.  You can work back to it, but it takes time.

 

[Stank_Nasty]

3 minutes ago, Hapless Bills Fan said:

 

Unstated and unmentioned in the 5-stages of concussion protocol is the role played by baseline mental testing.

 

As I understand it, the NFL (like all the high school and college sports I know of) makes all their athletes take a reasonably lengthy test that includes math and logic problems.  The point is to see where the unconcussed athlete's personal baseline is.

 

Then, along with the progression of physical activity, the concussed athlete has to repeat the test and return to baseline before playing again.

 

John Urshel, the Ravens guard turned MIT PhD candidate, said "I must have been having a good day when I did the initial test because it took me a long time to return to baseline".   This may have been what kept Mitch Morse out so long, as well - good NFL centers are noted for being among the smartest guys on the team.

 

Point being, it's not just can Allen run around and throw the ball.  He has to be able to understand and retain the game plan at a very high level and process what he sees quickly.  When I had my concussion it took me 2 months to return to being able to drive because I wasn't processing quickly enough.  I also had memory deficits and struggled with logic puzzles. 

Am I the only one thinking there may be athletes that have some faked stupidity on these initial tests? 

 

I’ve had one concussion in my life from a massive car accident and I honestly can’t say that I noticed any difference at all.... scary right? Lol. 

Edited October 3, 2019 by Stank_Nasty

[Hapless Bills Fan]

1 minute ago, Stank_Nasty said:

Am I the only one thinking there may be athletes that have some faked stupidity on these initial tests? 

 

I thought that myself - that there might be some locker room talk floating about "don't try too hard on the baseline".  The thing is, at least the one my daughter took as a varsity HS player is a long damn test - 1 or 2 hrs, done at a computer - and it's actually harder than people think to fake dumb consistently.

 

1 minute ago, Stank_Nasty said:

I’ve had one concussion in my life from a massive car accident and I honestly can’t say that I noticed any difference at all.... scary right? Lol. 

 

Well, that's why they say all concussions are different.  It probably also matters what you do for a living and for hobbies.

[Gugny]

6 minutes ago, Stank_Nasty said:

I’ve had one concussion in my life from a massive car accident and I honestly can’t say that I noticed any difference at all.... scary right? Lol. 

 

1 minute ago, Hapless Bills Fan said:

 

Well, that's why they say all concussions are different.  It probably also matters what you do for a living and for hobbies.

 

Hey, this isn't match.com over here!

[Paulus]

10 minutes ago, Hapless Bills Fan said:

 

Unstated and unmentioned in the 5-stages of concussion protocol is the role played by baseline mental testing.

 

As I understand it, the NFL (like all the high school and college sports I know of) makes all their athletes take a reasonably lengthy test that includes math and logic problems.  The point is to see where the unconcussed athlete's personal baseline is.

 

Then, along with the progression of physical activity, the concussed athlete has to repeat the test and return to baseline before playing again.

 

John Urshel, the Ravens guard turned MIT PhD candidate, said "I must have been having a good day when I did the initial test because it took me a long time to return to baseline".   This may have been what kept Mitch Morse out so long, as well - good NFL centers are noted for being among the smartest guys on the team.

 

Point being, it's not just can Allen run around and throw the ball.  He has to be able to understand and retain the game plan at a very high level and process what he sees quickly.  When I had my concussion it took me 2 months to return to being able to drive because I wasn't processing quickly enough.  I also had memory deficits and struggled with logic puzzles. 

 

Being "stuck in concussion protocol for a long time" has nothing to do with being smart and everything to do with documentable changes in mental abilities and processing.  If your brain is damaged and won't let you remember 10 numbers and recall them accurately 10 minutes later, it won't.  You can work back to it, but it takes time.

 

Do you really think smarter people are less capable of gaming the protocol? I disagree.

[Stank_Nasty]

14 minutes ago, Hapless Bills Fan said:

 

 

 

Well, that's why they say all concussions are different.  It probably also matters what you do for a living and for hobbies.

Right. Attention to detail or thinking, in general, wasn’t real high on the list in my mid 20’s! 

[Hapless Bills Fan]

9 hours ago, badassgixxer05 said:

Agreed. If he was throwing to Mike Evans on all those throws there probably isn't an interception. Hes either catching it or making sure the db doesn't catch it. Worst case hes drawing a flag cuz the db is scared shitless and hanging on him like big brother..

 

I had similar thoughts about throwing to someone like Diggs or Theilen

 

[transplantbillsfan]

2 hours ago, VW82 said:

 

I trust them too which given the history with Bills coaches and GMs since Levy/Polian is a strange feeling. Have to give the Pegulas props on both those hires.

 

I also agree with the bolded for most players/positions but I think even the poorly run franchises treat franchise QBs differently.

 

There are two issues at play here: the concussion and Josh's confidence. If he's completely free of concussion symptoms already and participates in all the meetings and practices leading up to the game then great. If he'd performed admirably prior to the hit on Sunday then there'd be no question about him starting, but that performance raised questions IMO. Not everyone learns the same way. Maybe what's best for Josh's development is to get right back in the ring, so to speak. Maybe he'd be better off watching Barkley and regrouping over the bye. Miami is a much easier opponent to come back against and should help restore that confidence of his which is arguably his best quality. The worst outcome is he comes back, performs poorly again vs. a tough Titans defense -- Baker is still having nightmares over that pass rush -- or gets concussed again, and actually starts to doubt his abilities. 

 

Maybe I'm overthinking it but we have too much invested in this kid to be putting him in positions to fail. This might be the last time we get to use an injury as an excuse for a teaching moment. All I'm saying is that McD might be wise to use it or at least consider it. If he doesn't I'm sure he'll have good reasons. Like I said, I actually trust those guys.    

 

Josh's ability to play will hinge purely on whether he clears protocol or not.

 

If you try playing that game you're talking about because of his confidence and poor play last week, I would argue it has the opposite effect.

 

He's a competitor. If he's healthy and kept off the field, that's more of a shot to his confidence FOR SURE than him MAAAAAAAYBE playing poorly.

[DrPJax]

https://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097506SCAT5.full.pdf

 

Public service post.  Hey guys with all the concern over Josh, I thought it might be a good opportunity to post a couple of links to help us all be in the same page with concussions.  The link above is to the SCAT5 ( sport concussion assessment tool 5) and I like it because while it is for a clinician  to use on field / immediately  post injury, it’s pretty basic and has good info on what symptoms are looked for , what are worrisome or red flag things or observations, and it talks about the things for clearing ( the protocol for increasing activity ) for sports and even for returning to school and studying. It has a good explanation on its last two pages. This information is collected prior to injury and then after for comparison. This is used quickly to determine need for transport to hospital, need for cat scans etc. I am sure Josh was examined by trainers or docs quickly after the injury. Note in red print about player not returning to action on day or injury and this is mandated in all 50 states for high schools. Just wanted you to see the various symptoms and also the protocol for returning defined. Josh is in stage 4 on wed which is good but all that means is he is progressing. So if he is symptom free after practicing Thursday, he MIGHT progress thru stage 5 which means he is ok after full practice (I doubt they allow anyone to have “ contact “ with their qb). That still doesn’t mean he will play. There is a known buffer zone where clinical symptoms ( patient feels better ) improve before physiological complete healing. A big study of around 3000 college athletes with concussion showed the biggest risk for further injury or second impact syndrome was within the first 7-10 days of the initial injury. About 1 in 15 had another concussion within the same year, most within that 7-10 day period.  If someone had 3 concussions their risk for more was 3x that of someone with no concussions, so you can see the associate worry surrounding CTE. 

https://scipol.duke.edu/track/immediate-post-concussion-assessment-and-cognitive-testing-impact
 The second link is about “ impact”., immediate post-concussion assessment and cognitive testing.  This is the computer testing that is the only FDA approve program I know of for managing concussion and returning to participation and one that the NFL , Olympics, FIFA and others use. Also your your high school students do this. It is done prior to injury for baseline and then post injury for management. After a concussion the test would be done 24 hours later by using a computer online portal with a certified trainer present. So I would think Josh is doing this daily. This test has to do with memory, impulse control , reaction time, processing etc.   This is important as these things are objectively measured so a competitor athlete can’t underreport symptoms just to be able to play. Also , as some of you have addressed, this is hard to fudge initially by underperforming because if an athlete attempts that, red flags stand out showing statistical things that trained observers catch and make the person perform the test again. This does happen about 10% as self reported on the website, and apparently they have a good success rate catching this. So to be clearer to play the athlete has to return to baseline at a minimum to be cleared. Even doing that tho does not guarantee they will be cleared to play. These tests are all still just clinical “ guides” and it still comes down to the clinical judgment of the independent neurologist to give the full go ahead. That is just a legal way to protect the testing comapny and it does out the onus on a seasoned real life dr and I think that’ s good as these computerized tests are still building data and there is much ongoing research about brain injury. 
 https://impactconcussion.com.     BTW, this is the link to the actual company website where the computer testing was developed and marketed. You can actually even purchase a baseline test for your son/ daughter if you wish to have that data.  I think the cost was around 20$ or so. Most high schools should be doing this already but I put the link there just for you to see the actual site and place the NFL does use. ( guys I couldn’t test the links prior to posting ,,just a doc and not an IT guy .  All the links are public tho so I am sure you can google the info if links don’t work for some reason. ). 
 

So , it looks good that Josh is progressing and I expected that for a young healthy guy. He looked good in the video I saw of practice. Will probably know more on Friday if he fully practices Thursday and has no recurrence of symptoms. The one thing I am a little concerned about regarding him playing ( from my fanboy standpoint) is that Mcd is very conservative ( this is obviously a good thing ).  He doesn’t even commit to Knox getting more plays when listening to him At the presser almost saying they won’t overload expectations on young guys. Mcd still emphasizes Josh being young and inexperienced. So that makes me LEAN, imho, to a position where I am thinking regardless of protocol, Josh may be sitting until after the bye. I just think Mcd errs on being conservative and just passing a protocol , while that would justify Mcd allowing josh to start, won’t be the only factor in his decision. I know it’s a huge game, yet I am ok with Barkley (sp) with a week of full reps.  I would love watching Josh get a chance to “ redeem” himself, but maybe it’s best to believe you have Barkley on the roster just for this purpose and better to give Josh no pressure to recover so quickly. Don’t shoot me, it’s just an opinion and I have no idea what actually will happen. Hope the links provide some basic info so we don’t have to rely on opinion regarding how a concussion is evaluated and followed. ?

 

Edited October 3, 2019 by DrPJax