What Is The NFL Concussion Protocol And Why Isn’t C.J. Stroud Out Of It Yet

What Is The NFL Concussion Protocol And Why Isn’t C.J. Stroud Out Of It Yet

If you are coming here in November of 2025, you’re likely concerned about CJ Stout or at the very least curious about him. Maybe you’re a Colts fan and uh and you and you’re not concerned about him whatsoever. Uh it’s understandable. The concussion protocol that the NFL has been using uh for many years now, but has continued to refine still is a little bit of a mystery to a lot of people. And there’s a lot of misconceptions about exactly what happens. And it it leads to responses like this from Demo Ryan when asked about CJ Strad’s availability this week. Hey, do um will CJ start this week? Yeah. So, uh for us right now, CJ and Jaylen are still in the concussion protocol. So, whenever CJ is back, ready to roll, he’s been our starter. He will be our starter whenever he’s back ready to go. Yeah, look, it’s a it’s a perfectly fair question. I think the frustration from coaches sometimes comes from the fact that the NFL has appropriately tried to remove coaches as much as possible from a player and how how he’s treated when he’s within the concussion protocol. I look I played through however many concussions I played through back in the day. We didn’t know any better. We just thought that’s what you did. We didn’t even know we had concussions most of the time. Um but things have changed and obviously they’ve they’ve had to make it safer. from every level of the sport. All 50 states in high school football have a concussion protocol of some sort. College certainly in the NFL and all of them share some similarities. But just to give you a quick rundown, if we look at there’s there’s really two main stages. And first is just the identification of the concussion. Um and what they’ve done is okay on game day it can be triggered by a report from a game official, a coach, a teammate, a team or unaffiliated medical personnel and athletic trainer spotters or the booth unaffiliated neurot trauma consultant. So that UNC the unaffiliated neurot trauma consultant uh he makes a few appear or she he or she makes a few appearances uh throughout this process. The other the next step in the concussion protocol in the identification stage is they remove the player to the sideline medical tent. They run their tests for a sideline medical survey. If it’s inconclusive, suspicious of concussion um or positive, then the player is escorted to the locker room for further evaluation. When we talk about removing coaches from this process, this is why Brian Dball was fined $100,000 a few weeks ago, a couple weeks before he was fired because his quarterback goes into the tent to be evaluated for concussion and then all of a sudden Brian Dball’s antsy, wants to get him back, wants to get Jackson Dart back out there. Cam Scataboo follows him into the tent, too. The NFL does not want any interference or influence from the coach at all in that scenario. They find Dave $100,000. They find uh Cam Scatteroo, I think, $25 $25,000, which he’s a look, he’s a rookie. He’s he’s basically a popper. At that stage, if he ends up in the concussion protocol, that’s where we get the five-step concussion return to participation protocol. And we’ll go through these step by step. Right now, for those of you curious, CJ Stroud and Jaylen Petri for the Texans are in phase five, the full football uh activity clearance. But stage one is simple enough. This is basically just hey settle the hell down bro you got to relax a little bit rest limiting or if necessary avoiding activities both physical and cognitive which increase or aggravate symptoms under athletic training staff supervision limited stretching and balance training can be introduced progressing to light aerobic exercise as tolerated. So, first dark room, no screens, anything like that. Then they monitor you and they bring you along slowly to some really mild um exertion and they monitor you for symptoms that whole time. Some of it self-reported. Some of it through these five steps is physical and mental tests that they’ll use and compare it to a baseline that players took during the preseason. And one of the questions people always ask about that is, well, can a player just can a player just tank his baseline? Theoretically, yes. And perhaps it’s happened. I think most players these days do genuinely take the concussion protocol pretty seriously. They’ve had it driven into their head, not literally because we’re trying to avoid concussions. They have it they’ve had it driven into their head. Um, just the seriousness of the situation. I was skeptical of this myself when they started doing all this 10 years ago or so. The first indication to me that players were really taking it seriously was when Brian Cushing self-reported uh a head issue in a game. And like Brian Cushing is a guy who play through anything. He he got dinged in the head once on a tough collision and pointed to his head and came out of the game. And like so if you doubt that any guys or most guys take it seriously. I think most do. Is there a way to tank it? Perhaps. Possibly. Um but that’s where some of the testing that they do is it’s physical in nature. They’re doing balance tests. Um they’re doing cognitive tests. And all of this is under the direction or at least observation of the unaffiliated neurotrum consultant. He doesn’t he doesn’t work for the team, doesn’t work for the league. He’s supposed to be unaffiliated. There’s there’s potential for, you know, malfcence there, but the it’s never going to be perfect. Step two, phase two. Under direct oversight of the team’s medical staff, players should begin graduated cardiovascular exercise and may also engage in dynamic stretching and balance training. Neurocognitive and balance testing can be administered after completion of phase 2 and the results should be interpreted as back to baseline. So without a whole lot of strenuous physical activity, they’re back to their baseline. So, if it was just like a normal relatively sedentary individual or somebody that just walked around during the day or anything, they’re not showing signs of concussion. One interesting little tidbit here in high school, I’m not so sure about college, but in a lot of the high school uh protocols, you actually have to return to full academic load before you can return before you can pass the physical side of it. Uh, which makes sense, you know, because that’s that’s an extra level of mental fatigue and testing and strain that NFL players don’t necessarily have other than quarterbacks, which we’ll get to because it gets interesting with quarterbacks. Uh, phase three, the player continues with supervised cardiovascular exercises that are increased and may mimic sports specific activities and supervised strength training is introduced. The player’s allowed to practice with the team in sports specific exercise for 30 minutes or less with ongoing and careful monitoring. So I think sometimes when you see a player return to practice but he’s limited. He might be in stage three. He might also be in stage four because that’s still in the limited phase of things. The player continues cardiovascular strength and balance training, team-based sports specific exercise, and participates in non-cont football activities, throwing, catching, running, and other position specific activities. Neurocognitive and balance testing should be completed no later than the end of phase 4 with the results interpreted as back to baseline. So again, the balance testing, the neurocognitive testing, this is after you’ve increased your level of activity. You might be throwing a football. You might be doing agility drills or something like that, but certainly no contact. Stage five is where it gets interesting. And this is the final test. Upon clearance by the club physician for full football activity involving contact, the player must be examined by the independent neurological consultant. They use these in the concussion protocol. I it’s it’s a little bit confusing. I think the indep independent neurological consultant can be the same guy as the unaffiliated neurological consultant, but I’m not 100% certain. If the INC concurs with a club physician that the players concussion has resolved, he may participate in his club’s next practice or game. So, if you think about in our particular situation here with the Houston Texans, CJ Stout and Jaylen Petri both practiced last week, but it was immediately before that Thursday night game. They really I mean and I’ll explain where it gets complicated. They didn’t have enough team practices to actually get all of that done. When it comes to quarterbacks especially or other players in a phase of the year when there aren’t full contact practices going on, there are ways to simulate full contact and you can return to play. So late in the season especially when a lot of teams are just having glorified walkthroughs, what they’ll do with quarterbacks is simulated contact. they’ll maybe just hit him with blocking dummies as he’s maneuvering around in the pocket. Um, some teams or and a lot of this is up to the discretion of the independent neurological consultant. They might, you know, push him with a bag down onto a mat or, you know, something like they do in the if you’ve ever been out to practice and you watch them practicing blocking kicks, they’ll be diving onto a mat like Hollywood stuntmen or something. So, things that simulate somewhat exactly what a quarterback might go through. Obviously, you’re not going to line up CJ Stout and have him take 10 hits from Denil Hunter or anything. You can’t you can and that’s not a full Nobody does that in a full contact NFL practice anyway. They also have the quarterbacks uh go through drills where they’re they have to jerk their head around because a lot of things that can be uh troublesome with people recovering from concussions, uh you know, jostling of the head and whatnot. They’ll have them go through calling out coverages or doing mental exercises as they’re doing their drills. this is all of what they’re doing with CJ Stout is I believe Aaron Wilson reported that they expect him to come back. Um the I I’ll be surprised if he doesn’t come back this week. The average time that a player spends in the concussion protocol is about 9 days. Now that stat is a couple years old, so it may have changed in that time. Missing three games is above average obviously. Um the whether you start talking about median or mean, it gets tricky because guys are in the concussion protocol and then the timing of when they fully exit it might involve a little bit of gamesmanship. You know, like they, hey, let’s really take our time. If CJ wasn’t going to be available for the Thursday night game, we don’t need to do a simulated practice on Saturday or Sunday of this past week to get him out there as soon as possible because he’s not going to be missing anything in terms of meetings or limited onfield activity, walkthroughs, corrections, and everything like that. Uh, so whatever gamesmanship there might be involved in it, I don’t I don’t think they fault the coaches if they say, “Hey, bro, stay in the concussion protocol longer.” What they’re worried about is rushing guys out of the concussion protocol. So that’s where we are with it right now. And uh for our intents and purposes right now, I think CJ Stout is probably going to clear. He missed three games, which is more than normal, but if the if it hadn’t been a Thursday night game, I think there’s a very good chance that he would have played in that Bills game. Suck it up, princess. Yeah, that’s the the biggest and I know you’re joking, Brandon. I think that’s the biggest misconception I’ve seen from people either asking questions or making comments is that it’s up to the toughness of the player or something. They just um they really and there are certain things that they could do that um you know you know like they could sabotage themselves in the preseason or whatever. This is uh I’m sorry Kayama Houston I read an interview with a neurologist assigned to the Steelers. You said the players are very responsible about it because they are worried about the long-term cognitive issues. I think the other side of it is this. When it comes to say a quarterback especially, but any position player on the field, but especially quarterbacks, it you almost have to be a little bit like a major league pitcher, you have to understand that, man, I my responsibility is to go out there and be as good as I can possibly be. Major League pitchers have to walk that fine line between being a tough guy, but then also reporting when they’ve got a little twinge in their elbow that doesn’t develop into the dreaded Astros elbow discomfort. So with quarterbacks likewise, if a guy comes back, if somehow he figured out a way to game the system and come back early, there’s a good chance he’s going to act he’s going to play like a dullard out there and that’s not helping. No, that’s as I almost said, that’s not helping nobody. I had a lot of concussions. You think proper English comes from this battered brain? God, no. I can barely remember my address on any given day. Um, you remember when Brian Hoyer really worked his butt off to come back and speed his way through the concussion protocol? He rented a hyperaric chamber, all did all that stuff. He came back and that first game back, man, he didn’t look so sharp. Like, I didn’t say whatever you want about Brian Hoarder. He was a pretty intelligent guy. He didn’t look like he was at his normal level of mental acuity. And that’s going on a decade ago or so, uh, before they’ve kind of refined some of these things. the uh Tuatunga Violoa incident from a couple years ago where he was cleared to play. They’ve taken measures to try to um avoid that. For one, oh, I don’t have it on here. Um basically, if there’s any sign at all, like um the fencing position, that’s when somebody has their arms straight out or one arm straight out immediately you’re in the concussion protocol. If you if you get up and show any dizziness or anything like that, boom, you’re in the concussion protocol after a blow to the head. Obviously, um they’ve they’ve taken a lot of the room for judgment out of it. And they’ve also increased the number of actual medical professionals who are observing. I can tell you from the early days of the concussion protocol, they had some just average jammokes up there as spotters. like they had people that weren’t necessarily trained and it was they improved it and refined it, but they just kind of threw a bunch of stuff at the wall early on there. So hopefully we see CJ Stout if you’ve come here after the CJ Strad scenario is over. Hopefully I helped shine a little light on this and I encourage you just to just to Google it. This stuff’s all publicly available information. Um I will uh we’ll chat a little bit about this Colts game here over the next couple days.

Former Houston Texans player Seth Payne discusses the steps of the NFL concussion protocol and explains why Texans QB C.J. Stroud remains in it.