Slowly, sometimes reluctantly, NFL teams are wising up to the dangers of head injuries. A league-mandated concussion protocol has removed much of the guesswork in evaluating players, opting for a more cautious, if imperfect, assessment process that removes players on suspicion of a concussion, only allowing them to return once they pass cognitive testing.
Somehow, that system failed Case Keenum. Against Baltimore on Sunday, the Rams quarterback suffered one of the most evident concussions you'll ever see on the football field -- every armchair doctor watching the game knew exactly what happened.
From the way the back of his head rebounded off the turf -- one of the most common ways in which quarterbacks are concussed -- to his disoriented flailing on the ground, to his inability to stand up, to the slowness and confusion he exhibited once back on his feet, his condition was apparent. No one needed to hear from a sideline assessment: Keenum had a concussion.
He should have been immediately yanked, replaced by Nick Foles. Instead, Keenum played two more snaps, eventually fumbling the ball away to Baltimore. The Ravens took over possession and won a game-winning field goal, but the events on the field are irrelevant. The Rams and the NFL failed Keenum and put his personal health at risk.
The NFL is first-in-line for blame because its designated ATC spotter -- a certified athletic trainer designated with identifying injuries on the field, and given the power to call medical timeouts in the event of concussions and other injuries -- failed to recognize the concussion.
But the Rams shouldn't have passed the buck, either. The whole stadium knew Keenum was injured -- Foles even got ready to take the field. ATC spotters aren't the only line of defense against concussions, and Rams coach Jeff Fisher -- or a coordinator watching Keenum's behavior -- should have recognized his condition and called for a change. You can't trust someone with an injured brain to make the prudent decision himself.
That's what the Rams did, though, leaving Keenum exposed to much more serious injury. It's fitting that the Rams lost because of that oversight, but it isn't an equitable punishment. Keenum's brain health is worth more than the result of a football game. The NFL is almost certain to bring additional heat against the team, issuing a strong statement Monday:
"Promptly after the conclusion of yesterday's game, we began a review to determine the facts of the injury to St. Louis quarterback Case Keenum and why he was not removed from the game for the necessary evaluation by a team physician or the unaffiliated neuro-trauma consultant as required by our concussion protocols. We are continuing that review today, which includes discussions with the Rams and their medical staff, the ATC spotter, the game officials, our medical advisors and the NFLPA. In the meantime, prior to this week’s games, we will reinforce with all involved the need to ensure that these injuries are properly identified and addressed in a manner consistent with our protocols."
The Rams could use some extra tutoring on the subject. This isn't the team's first blatant disregard of player health in the past month. On November 9, the team signed free-agent wide receiver Wes Welker to a contract through the rest of the season. Welker's abilities coming out of the slot are well-known, and even with diminished skills, he's clearly capable of contributing on the football field.
Welker's skills were never in question, though. One of the leading reasons he had remained unsigned into November was his lengthy concussion history -- at least six in the NFL, including three within a 10-month span. Welker's health was such a great concern that one of his former teammates, Champ Bailey, openly pleaded for Welker to retire rather than expose himself to greater risks.
"I already played a full season without a concussion, so I'm really not worried about it," said Welker upon signing with the Rams, according to ESPN.
His new coach attempted to wipe his hands of any wrongdoing.
"This is his decision," Fisher said. "He missed football. He loves football. He's fine. He hasn't had any issues. He just wants to play and help us win."[YIELDMO3
Fisher is right about one thing: It's Welker's decision to play, or at least to try and prolong his career. He's an adult, and he received medical clearance. Friends and family can plead otherwise, but Welker is free to do as he chooses.
But if the Rams want to pretend they aren't complicit, they've got another thing coming. The general consensus among NFL teams has been that most were uncomfortable playing Welker given his past concussions and risks that came with tacking on additional traumatic hits. Such blows to the head are an inherent risk of playing football, but the circumstances are much different for someone with half a dozen concussions under his belt.
There's a lot we don't know about concussions and football's affects on the brain, but among our infantile understanding is this: Multiple concussions pit players at an extremely high risk of cognitive injuries later in life. Likewise, we're starting to understand the significant role sub-concussive hits can play on that cognitive health.
Welker already faces very scary, if unknown, circumstances. For an NFL head coach to be so flippant about those risks -- and "He's fine" certainly qualifies -- has the opposite effect of passing the blame.
Fisher and the Rams are implicated by their ignorance to this very serious issue.
The Rams are likely facing a tough decision regarding the future of Fisher as their head coach. In his fourth season, the Rams are a disappointing 4-6, on a three-game losing streak and two games out of the playoffs with six games to play. When the Rams do sit down for an evaluation, they should also consider whether Fisher's Cro-Magnon methods of personnel management fit in this changing era of professional football.
In the meantime, the NFL has a lot of work to do in penalizing the guilty parties and preventing future instances of what happened to Case Keenum. The league had better come down hard.