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Josh Allen in concussion protocol: Update cleared 10/5


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4 hours ago, Stank_Nasty said:

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. 

 

Maybe concussions are like drinking alcohol... everyone knows it's bad for you, but it's affects some people significantly worse long term than others. 

 

I drink every day and hit my head randomly rather frequently, but I'm still all right...

 

 

 

 

despite what my wife says :flirt:

Edited by transplantbillsfan
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29 minutes ago, GaryPinC said:

Awesome post with great links.  Thanks!

Thanks !  Hope it was useful with all the talk about the concussion protocol.  It also points out despite the objective tests it still comes down to individual clinician judgement approval for final clearance. ?

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21 minutes ago, DrPJax said:

Thanks !  Hope it was useful with all the talk about the concussion protocol.  It also points out despite the objective tests it still comes down to individual clinician judgement approval for final clearance. ?

Both my kids have sustained concussions and my son will start high school next year.  It's great info as I don't know how long it would take for me to track all that down.

As a researcher, the BU work is a great wake up call but heavily biased data.  There's a lot of blind panic about concussions and it's good to know what the current tests/protocols are.

One of the interesting things about my kids' concussions is that after feeling normal and being cleared to play they experienced very mild, transient symptoms one to two weeks after.

In the case of my daughter it was over a month after initial injury.  Curious how it relates to the 7-10 days in adults.

So much science still to be done here.

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7 hours ago, Paulus said:

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

'He has to be able to understand and retain the game plan at a very high level and process what he sees quickly. '

 

Allen wasn't doing this ANYWAY, maybe he'll start to do this now

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3 minutes ago, GaryPinC said:

Both my kids have sustained concussions and my son will start high school next year.  It's great info as I don't know how long it would take for me to track all that down.

As a researcher, the BU work is a great wake up call but heavily biased data.  There's a lot of blind panic about concussions and it's good to know what the current tests/protocols are.

One of the interesting things about my kids' concussions is that after feeling normal and being cleared to play they experienced very mild, transient symptoms one to two weeks after.

In the case of my daughter it was over a month after initial injury.  Curious how it relates to the 7-10 days in adults.

So much science still to be done here.

Wow , sorry to hear your kids have had those issues but imo sports are such a vital part of growing up and learning life lessons. I did tons of presports exams / clearance exams and we rarely try to disqualify anyone if there is a sound medical way around it. That one website , the impactconcussion.com, would be really useful for you I think. You can sign your kids up for baseline testing and they also have an app listed on the website for your phone that allows you to keep tract of all the testing related to your kids done on their site ( perhaps more as I haven’t downloaded the app yet.). They also have links to providers in your area tans have been certified by them in concussion protocol testing and interpretation. For someone with family in sports I believe it’s really important knowing the providers your kids are seeing have appropriate credentials. I think the fact that the olympics , NFL, FIFA, Imternational hockey association, etc have all contributed to their research and use the exact testing that is available to you thru the site. Also all the thousands of high school associations and colleges also use that site. BYW, I have NO affiliation financially with the site but thru my clinical research I believe they are currently state of the art for concussion management etc.  Thanks for the feedback and wish you and you kids great health. Protect their health because without that nothing else matters much. If I can help with anything like Questions, just let me know, I am not a concussion expert but am a general clinician and have enough credentials that I am used for malpractice cases in family practice and urgent care as an expert to determine the merit of cases.   Go bills !   

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7 hours ago, Paulus said:

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

 

In other words, by "smart" you mean "put his personal long term well being at risk by cheating on his baseline test"?

 

That's not my definition of "smart" but I'll accept that it's yours

 

The thing is, QB of all positions on the team really needs to be 100% "with it" mentally with quick processing.  I'm not sure cheating on his baseline would benefit the team.

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23 hours ago, No_Matter_What said:

 

Uhm what? It is kinda hard to orchestrate any comeback while sitting on the bench ?

 

Other than that I agree with your post.

 

OK . .probably wrong data point  .. how about this one .. Tyrod Bill's starts 46 ... Josh 15 .. same # of 4th Quarter comebacks - 4

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27 minutes ago, london_bills said:

'He has to be able to understand and retain the game plan at a very high level and process what he sees quickly. '

 

Allen wasn't doing this ANYWAY, maybe he'll start to do this now

 

*sigh*

 

Except that in the three previous games, it was pretty clear Allen had made a significant step forward in executing the game plan, processing what he sees, and taking what the D gave him.  He also made some boneheaded careless plays, but that's different.

 

Even in the Pats game, Allen ran a very good drive in the 2nd half and was driving again when he got knocked out.

 

I swear, there's a collection of bipolar fans here.

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8 minutes ago, Hapless Bills Fan said:

 

*sigh*

 

Except that in the three previous games, it was pretty clear Allen had made a significant step forward in executing the game plan, processing what he sees, and taking what the D gave him.  He also made some boneheaded careless plays, but that's different.

 

Even in the Pats game, Allen ran a very good drive in the 2nd half and was driving again when he got knocked out.

 

I swear, there's a collection of bipolar fans here.

 

Either that, or they're unipolar in the wrong direction.

 

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On 9/29/2019 at 5:25 PM, RiotAct said:

true.  Overall he was much, much smarter with the ball than Allen was today.  (No real surprise, but still...)

 

I'm really not sure how you can say that.  Played less than 1Q, 2 INT (one correctly overturned, but could have been), one fumble.

Yeah, he 100% played better than Allen did in the first half, not as well as Allen did to start the 2nd half.  I guess I'd give him "smarter" but I don't see the "much, much"

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36 minutes ago, Hapless Bills Fan said:

 

In other words, by "smart" you mean "put his personal long term well being at risk by cheating on his baseline test"?

 

That's not my definition of "smart" but I'll accept that it's yours

 

The thing is, QB of all positions on the team really needs to be 100% "with it" mentally with quick processing.  I'm not sure cheating on his baseline would benefit the team.

 

Smart for a QB is sliding when you are in the middle of the field. The sideline 50/50.  

Cheating on his baseline, not so much.

 

without the Ref seeing the QB on the ground, it may not be clear to people on the sideline if or when a QB gets hit hard and "the competitors" will want to  keep playing. 

 

I've seen it with Tyrod in Buffalo.   What about the concussion that Giselle mentioned but Tom denies?   I've often said to myself, they can't be helping the team if their head is spinning.   

 

just adding my 2 cents 

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12 minutes ago, Hapless Bills Fan said:

 

I'm really not sure how you can say that.  Played less than 1Q, 2 INT (one correctly overturned, but could have been), one fumble.

Yeah, he 100% played better than Allen did in the first half, not as well as Allen did to start the 2nd half.  I guess I'd give him "smarter" but I don't see the "much, much"

I was referring to Brady, not Barkley.

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24 minutes ago, Hapless Bills Fan said:

 

*sigh*

 

Except that in the three previous games, it was pretty clear Allen had made a significant step forward in executing the game plan, processing what he sees, and taking what the D gave him.  He also made some boneheaded careless plays, but that's different.

 

Even in the Pats game, Allen ran a very good drive in the 2nd half and was driving again when he got knocked out.

 

I swear, there's a collection of bipolar fans here.

Sure, that's fair.

 

My comment was a little sarcastic yes but 

Allen's playing in a 'bipolar' way as we know. Good and bad.

 

Perhaps the Pats game has concerned ME more than others.

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42 minutes ago, WideRightRevenge said:

 

OK . .probably wrong data point  .. how about this one .. Tyrod Bill's starts 46 ... Josh 15 .. same # of 4th Quarter comebacks - 4

 

Now that is completely fine. I didn't want to argue that Tyrod is better or anything, just said that I didn't find your numbers fair.

 

I agree that you can't even compare Allen to Taylor in 4th quarter play.

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On 9/29/2019 at 5:51 PM, Chris66 said:

If Allen would have slid instead of trying to pick up that yard he would have been available for thebend of the game.

 

Perhaps.  Or perhaps he would have been clubbed in the head like Gronk did to Tre White (after the whistle) or like Kiko Alonso tried to do to him in the MIA game last year.  The bottom line is that if the NFL wants to stop this helmet to helmet hit crap, these hits have to have real-time in-game consequences or they'll keep happening.

 

An offsetting penalty for holding is not a significant consequence, more like a free ticket.

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Pretty obvious.  No differant than how Brady has beat us the last 4 games or so.  With the defense there is no reason to play as risky as Allen has.  Really, if he removes the late roll right and throw it in a crowd his interceptions are cut in half.  The other ones are the price of doing business and taking aggressive shot down the feild.  

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On 9/29/2019 at 6:18 PM, USCGBILLSFAN said:

Can one of the mods ban the pats fans, they are just trying to pull us all down, neither one is giving any kind of intellectiual argument.  They need to stay on their fan sites and away from ours

 

From our site's TOS:

Special note to fans of other teams: This message board is provided for the enjoyment of Bills fans and you should recognize that as such. We welcome fans from any team that come here in the spirit of good sportsmanship and with the intent to exchange good dialog with Bills fans. However, inappropriate trash talk and other inappropriate methods of disruption are grounds for message removal and possible restricted board access to violators. TBD does not allow mischievous activity from disruptive posters that would result in decreased readership or a devaluation of the product.

 

So, No.  They can and will get warned for trash-talking or being disruptive - f they start an account 10 minutes after the game to trash talk out the airlock they go - but we look at the posting history and  if there seems to be an attempt at dialog and football convo intermixed with the trash, they're allowed.

 

5 hours ago, DrPJax said:

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 car 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 improvement ( patient feels better ) improves 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 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 god 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 him 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. ?

 

 

This post is the kind of info that keeps me here.  Great stuff and Thank you.

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On 9/29/2019 at 11:51 PM, Chris66 said:

If Allen would have slid instead of trying to pick up that yard he would have been available for thebend of the game.

I admire Allen's courage and character. I think he deserves the benefit of the doubt once.

 

McDermott HAS to have said to him 'slide we need you to stay on the field'

 

But If Allen plays the Titans game and runs head first I just think theres a BIGGER problem that will never go away.

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