Robert Griffin III’s return to the practice field–and next week’s game–is partly under the control of an independent neurologist hired by the Washington Redskins, according to the NFL’s post-concussion return-to-play procedures.
Griffin must pass a neuropsychological evaluation, must be cleared by the Redskins’ team physician and by the independent neurological consultant, and must demonstrate that he can exercise at game-level exertion without a recurrence of concussion symptoms before he can be cleared to practice or play, Thom Mayer, the medical director of the NFL Players Association, said Monday.
Mayer said he spoke to Anthony Casolaro, the Redskins’ physician, and was satisfied that the team followed all medical procedures properly when Griffin was injured Sunday. Under NFL rules, any player with concussion symptoms must be removed from the game and leave the field. Griffin left the field, then walked behind the Redskins’ bench on his way back off the field to the tunnel that leads to the team’s locker room.
“They did a sideline medical exam,” Mayer said. “The results were not dramatic. But there was enough there, in terms of him having a problem knowing what quarter it was, that it was appropriate that they did the exam and removed him from the game. They did the right thing in protecting their player.”
“They did all the right things from a medical standpoint,” Mayer said in a telephone interview.
The members of the Redskins’ medical staff saw the hit absorbed by Griffin, Mayer said, and also observed physiological signs of a concussion. Teams use queries known as “Maddocks questions,” Mayer said, as part of their evaluation process for diagnosing a concussion. Those questions include basic issues such as which quarter is being played.
“Technically he failed a part of the exam and by protocol he was removed from play,” Mayer said. “The fact he was confused about what quarter it was tells you there were physiological signs. In this case they saw the hit and the physiology was off.”
The neuropsychological evaluation that Griffin must pass typically includes elements that measure reaction time and shape recognition, Mayer said. Many NFL teams use the computerized ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) test, Mayer said. To pass, Griffin would have to achieve results comparable to his baseline results from previous testing.
According to the ImPACT web site, the test measures “verbal and visual memory, processing speed and reaction time.” Reaction time is measured to a hundredth of a second. The test, which takes approximately 20 minutes to complete, according to the web site, measures aspects of cognitive functioning that include attention span, working memory, sustained and selective attention time, response variability, non-verbal problem-solving and reaction time.
Griffin must be cleared by Casolaro and the independent neurologist used by the Redskins in such matters.
An example of exercising symptom-free would be having a player run the stadium steps without a recurrence of symptoms, Mayer said.