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Concussions in NFL are up again after two seasons of declines

Dolphins quarterback Tua Tagovailoa leaves the field to be evaluated for a possible head injury during a September game against the Bills in Miami Gardens, Fla. (Wilfredo Lee/AP)
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The number of diagnosed concussions suffered by NFL players during the just-completed regular season was up 18 percent from the previous season, according to injury data released Friday by the league.

The increase — from 126 last season to 149 this season — came after modest declines in each of the previous two seasons. It also came after concussions were down during the preseason.

“It’s a number that I wish were zero, but medically speaking it’s unlikely to be zero,” Allen Sills, the NFL’s chief medical officer, said in a video conference with reporters Friday. “But I think, again, I go back to saying we want to drive these numbers down. We want to diagnose them with a high degree of fidelity. But we want to prevent them. … We want the numbers of concussions to go down. But more importantly, we want the number of head impacts to go down. Now that we can measure that, we’ll be tracking that and working very actively against it.”

The number perhaps was higher in part because the NFL’s regular season now is longer, with teams playing 17 games apiece for a second year since the league’s new schedule format was enacted. It’s unclear whether the increase was driven by an actual uptick in the number of head injuries suffered by players or by improvements in the detection and diagnosis of those injuries.

NFL, NFLPA change concussion protocols, complete Tua Tagovailoa review

According to Sills, medical staffs for NFL teams conducted more in-game concussion evaluations of players than in previous seasons and the number of medical timeouts taken during games to identify players in need of such evaluations was sharply higher.

“I think that there are a lot of factors that we’re looking into as to what could be driving that,” Sills said. “Obviously, I mentioned earlier that we’re doing more evaluations than ever. We did change the protocol to become even more conservative. We had the more medical timeouts that I mentioned. And certainly we know that we continue to emphasize the importance of player self-report.”

The evaluation and treatment of Miami Dolphins quarterback Tua Tagovailoa, who suffered two diagnosed concussions this season, drew intense public scrutiny. The league and the NFL Players Association modified their concussion protocols to eliminate an exception that allowed Tagovailoa to be cleared by doctors to reenter a September game after he stumbled following a hit.

“We’ll have a continued very major focus on getting the head out of the game because reducing the number of head impacts is going to be the main driver for reducing concussions,” Sills said.

About 60 percent of the increase in concussions was attributable to head injuries suffered by quarterbacks and players participating in special teams plays, according to Jeff Miller, the NFL’s executive vice president of communications, public affairs and policy.

“It’s something that obviously we’ll take away [and] talk to the competition committee about, both quarterback injuries as well as special teams,” Miller said.

These puffy helmet caps are the next big thing in NFL player safety

About 20 percent of the concussions that are suffered by players in games come on kickoffs and punt plays, Miller said. The NFL previously made rule changes to kickoffs to attempt to make them safer. The league tried to formulate rule changes for punts last offseason, without success. Miller said that will remain a priority this offseason.

“So [there’s] a lot of work to be done there,” Miller said. “I don’t think there are any easy solutions. But it’s something that we want to spend a fair amount of time focused on.”

League leaders have emphasized data gathering and analysis, education, equipment improvements, rule changes and modifications to players’ training schedules in their attempts to reduce head injuries.

“I think we are getting very close now to a quarterback-specific helmet,” Miller said Friday of one potential innovation.

The NFL’s medical leaders said Friday the league is likely to expand the use next summer of Guardian Caps by players during teams’ training camps. Last summer, the league required all offensive and defensive linemen, tight ends and linebackers to wear the pillowy, padded shells affixed to the outside of their helmets in practices through the second of teams’ three preseason games.

There was a 52 percent reduction in the number of concussions suffered by players at those position groups during that period from the three-year average, according to the NFL. The league and the NFLPA could expand the use of the caps to players at other positions and mandate their use for a longer period.

“I think our initial experience with the Guardian Cap was overwhelmingly positive,” Sills said.

NFL to consider ‘mechanics’ of tackle that injured Cowboys’ Tony Pollard

Overall injuries were down about 5.6 percent during the preseason and regular season, according to the injury data.

Sills confirmed there will be offseason discussions among the league and the competition committee about the “hip-drop” tackles — legal under the current rules — that resulted in ankle injuries suffered during the NFL playoffs by Dallas Cowboys running back Tony Pollard and Kansas City Chiefs quarterback Patrick Mahomes.

“I think it’ll be a very active offseason conversation to look at the mechanism,” Sills said. “Obviously the ‘hip-drop’ tackle is not the only cause of high-ankle sprains. There are certainly other factors. … We have noted that type of tackle that you mentioned. And I think it needs to be a very active discussion point, again, with the competition committee and others this season.”