With Super Bowl madness winding down, the issue of concussion is coming up. And once again, we’re talking about the NFL.

I’m a great fan of football, and Sunday found me like it did 111.5 million other viewers – sitting in front of the TV watching the match-up between Seattle and New England. There were great plays and it was a great game. But as a physician certified in concussion management, I watched closely as the Patriot’s receiver, Julian Edelman, took a hard hit helmet-to-helmet in the fourth quarter. It was clear he was slow getting back on his feet. My concussion alarm went off. And then, despite the NFL’s big focus on reducing brain injuries, we saw Edelman go back into the game, finishing with the winning touchdown that gave the Patriot’s players a Super Bowl ring.

Edelman was checked on the sideline by the team medical staff and an independent neurologist after that series of plays. He was cleared to return to play at that time.

But it got worse. Edelman’s slow-motion reaction after being hit wasn’t the only thing I noticed. In an after-game interview, he referred to Seattle as St. Louis. Granted, he corrected himself, and I misspeak all the time. But my concussion alarm was rattling again; memory loss or confusion is another symptom of concussion.

We have been told he did not sustain a concussion. But some concussions do not become clinically apparent for a few hours; I hope he was reexamined later that day or the following day. But we do know that there continues to be a lack of awareness about the serious nature of brain injury. Since the game, there’s been much praise for Edelman’s performance, with players and broadcasters alike applauding him for the “inspiration” he showed by staying and playing – despite the hit to the head.

At the risk of annoying some of my readership I am a Patriots fan, I have been since the 70’s when the word dynasty was the antithesis of New England football. So I am happy with the outcome. The Super Bowl is THE biggest football event of the year. And it’s as much about opportunity as it is the game. Companies spend millions on advertising during the game, to the point that “Super Bowl commercials” are a big part of the event. The incident with Edelman was a golden opportunity for the NFL to walk the walk. If only the announcers and reporters pointed out that it was a high risk hit, that Edelman needed to be evaluated then and there, that a players health is more important than a game outcome. How great would it have been if the NFL had a brief public service announcement available to run for that inevitable “ooh that’s gotta hurt” moment. And it may have sent an unfortunate message to young football players everywhere. Studies show that as many as 6 out of 7 players with documented concussions do not report any symptoms to the examiners. What they learned is that there is glory in “playing through the pain.” What they could have learned is that we value both the game and the players, and as such, we take head injuries seriously and deal with them immediately.

We clearly have a ways to go in changing our culture and awareness.

Concussion is a brain injury. It is serious. Pats on the back need to be doled out for more than performance; they should also be given to players and coaches who take immediate steps to determine whether a hit to the head has resulted in concussion.

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