A player in any sport being placed in concussion protocol has become as common as players dealing with ankle sprains. In contact sports -- even in non-contact sports -- concussions happen.
It's something the Steelers are dealing with this week as placekicker Chris Boswell works his way through the levels of protocol after suffering a concussion in last Sunday's 15-10 win over the Browns.
The idea of concussion protocol began back in 1990 in Pittsburgh because of a simple question asked by then-head coach Chuck Noll regarding the status of quarterback Bubby Brister.
Brister had suffered a concussion the previous week, but had returned to the team and was sitting in on meetings and doing everything he needed to do the following week to play. But Steelers team neurologist Dr. Joseph Maroon told Noll that Brister was not yet ready to play.
Concussions are graded as 1, 2 or 3, with one meaning the individual has mild symptoms -- dizziness, nausea, etc. -- and 3 meaning the individual had been knocked unconscious. And in those days, if you hadn't been knocked out, you didn't really have a concussion. You had had your bell rung.
Noll thought Brister was fine. But Maroon said he had to be held out another week.
"(Noll) came to me and said 'He knows his plays, he looks perfect, I don’t see any memory problems,' " Maroon recalled. "'If you want me to keep an athlete out of playing, I want objective data, not just guidelines that are not evidenced-based.'"
Maroon realized Noll was right. There was nothing in place to provide evidence of his mandate, just his opinion. So he and colleague Dr. Mark Lovell set about creating a neurological baseline test for athletes that the Steelers began using in 1991 with the approval of Noll and team president Dan Rooney.
That test -- then pencil and paper -- grew into the ImPACT test that is used across all levels of sports.
"We later found 90 percent of concussion occur without a loss of consciousness," said Maroon. "If you lost consciousness, you were really bad. But if you didn’t lose consciousness, you’re going to be OK. Don’t worry about it. Shake it off."
Obviously, things have changed since those days.
"In 1997 the NHL adopted the test for the entire NHL," Maroon said. "It was 10 years later that the NFL mandated neurological testing for the whole NFL as a baseline for return to play, one of the three things for returning to play. The other two were being completely asymptomatic, no headaches nausea, anything like that, a progressive return with anaerobic activity, stationary bike to running to light contact. Those are the criteria now."
And it all started with Noll's one question, why?
It wasn't that Noll wanted to rush Brister back into action. He wanted a reason why he was holding a player out if he was going to do so.
We still don't everything there is to know about concussions, but we know much more about them than we did 30 years ago.
"Thank Chuck Noll," Marooon said. "That’s the whole thing."
MORE STEELERS
• Boswell seems to be getting through concussion protocol fine. Thursday was a day of getting in some cardio work, the next-to-last stage for players in concussion protocol. Friday, the doctors will check him to make sure he didn't have any setbacks from the cardio work. If that happens, he'll likely be cleared Saturday by an independent neurologist. Though Mike Tomlin wouldn't bite on my question to him regarding the legality of the hit put on Boswell in last Sunday's game against the Browns, the Steelers definitely think a flag should have been thrown on the play. We'll see if the league agrees today when fines are handed out if Cleveland defensive lineman Jordan Elliott draws a fine. -- Lolley
• Ben Roethlisberger might be the Steelers' "emergency holder," but is he really? Roethlisberger has never really been the team's primary holder, not even as a rookie in 2004 when he opened the season as the team's backup to Tommy Maddox. Yes, Roethlisberger practiced taking snaps and setting the ball down at times in training camp, but there's no way you want your quarterback taking the chance of getting his hand kicked on a PAT or field goal. That's why the Steelers had cornerback Cam Sutton working with punter Pressley Harvin during the second half of last Sunday's win over the Browns after Boswell was declared out. "We were ready," Sutton declared Thursday. "Now, perhaps the Steelers should have had a better plan in place ahead of time, but how often are punters or placekickers injured? And coaches are loath to have two new guys doing something, which would have been the situation with both an untested placekicker and holder. They do have guys who work on those things on the side at times. But it doesn't mean they're good at it, as Mike Tomlin noted earlier this week. There are too many bad things that can go on during a field goal or PAT that can lead to the other team scoring points. So, Tomlin trusted his offense against the Browns rather than having two-thirds of the PAT or field goal specialists doing it in a game for the first time. -- Lolley
• For much the same reason, Zach Banner has been inactive the past two weeks, much to the chagrin, apparently, of many fans. Banner is strictly considered a right tackle. He never takes snaps on the left side, nor does he necessarily have the skillset needed to line up there in the NFL, even though he played left tackle in college. For Banner to be active over Joe Haeg, he would have to be capable of playing both sides. If, for example, left tackle Dan Moore were injured during a game and Banner were the only backup tackle, the Steelers would have to make to moves to replace him, shifting Chuks Okorafor from right to left tackle and putting Banner in on the right side. And coaches are loathe to change two things in-game to fix one. -- Lolley
PENGUINS
• The Penguins' farm team in Wilkes-Barre is off to a strong start, going 5-2-0-1 in its first eight games, but that won't necessarily translate to a promotion to the parent club for any players there in the near future, unless injuries and/or illnesses create a need, like the one that led to Taylor Fedun being summoned Thursday. "I wouldn't say anybody is beating down the door, where we have to create a spot for them (in the NHL)," Ron Hextall said. That doesn't mean that some guys haven't made a good impression with their play in the early weeks of the season, though, as Hextall readily acknowledged. " (Kasper) Bjorkqvist has been very good down there," he said. "(Valtteri) Puustinen has done some good things. (Sam) Poulin and (Nathan) Legare, they're starting to come around. Their games have started to evolve a little bit, but we believe they're going to need time. Both of our goaltenders down there (Filip Lindberg and Louis Domingue) have played well, so there certainly are some good signs." A few days before Fedun was recalled, Hextall described him as "someone we're confident could come up and at least give us some games." -- Dave Molinari
• The confluence of several factors, from pandemic-related issues to the absence of some of the Penguins' most prominent players, effectively doomed the franchise's sellout streak, which reached 633 games before it ended last month. What might concern team officials, though, is some pretty attractive games during the current eight-game home stand have played out before less-than-capacity crowds. Those include a Saturday night visit by Marc-Andre Fleury Oct. 16, a meeting with the two-time champion Lightning Oct. 26 and Sidney Crosby's return from wrist surgery lsat Saturday. It's hard been a return to, say, 1983-84, when there were plenty of good sections available as most games got underway, but it will be interesting to see if there is a significant decline in ticket revenue and it eventually prompts ownership to do things like stop giving the front office clearance to spend to the salary-cap ceiling every season. -- Molinari
• At least one guy who wasn't directly involved in the drawn-out Jack Eichel drama that finally ended when the Sabres traded him to Vegas Thursday: Mike Sullivan. The Golden Knights will allow Eichel to get the artificial disc replacement surgery Buffalo refused to approve, but the delay means he will still be recovering from the operation during the Beijing Olympics, where Sullivan will coach Team USA. Had Eichel been available, he might well have centered the top U.S. line. And to make things even worse for Sullivan, it's possible he'll have to deal with Eichel as an opponent shortly after the Games, since some projections are that Eichel could be healthy enough to resume playing by then. -- Molinari
• Penn State defenseman Clayton Phillips, the Penguins' third-round pick in 2017, is an under-the-radar prospect who should be worth watching this winter. The Penguins definitely will, because they have to decide whether to try to sign him or surrender his rights. "We'll certainly be on himAd this year, because it's his senior year," Hextall said. "We're certainly aware of him, and we're going to keep a close eye on him." Phillips, 22, is 6-foot, 195 pounds and is an exceptional skater whose puck management has ben cited as an area of his game that must be improved. He was named the Big Ten's first star of the week after scoring two goals and setting up another in the Nittany Lions' 6-4 upset of No. 6 North Dakota last Saturday in the U.S. Hockey Hall of Fame Game in Nashville. Phillips, who transferred to Penn State after beginning his college career at the University of Minnesota, and his teammates will open conference play with games at Ohio State Friday and Saturday. -- Molinari
PIRATES
• Adrian Florencio is not one of the Pirates’ top prospects, but he was named the club’s Bob Friend pitcher of the year. I got conflicting reports on him though. One, from a scout, was complimentary, focusing on his approach. The other was from an analyst, who was concerned his sinker didn’t get ground balls. The analyst thought the strikeouts Florencio relied on in Class Low A won’t translate to the upper levels, but his slider is good. All told, there’s a reason why he isn’t in the club’s top-30 prospects, but that obviously doesn’t mean you should write him off. -- Alex Stumpf
• It’s going to be a busy month for the Pirates when it comes to roster cuts. The first batch are due by Thursday to get the roster down to 40, with all players needing to be activated from the injured list. Prospects need to be protected by Nov. 19, so expect more moves then, and the final non-tender deadline is Dec. 2. The most notable cuts of arbitration-eligible players will come later, so don’t expect anything too surprising this week. But with the number of prospects the Pirates need to protect from the Rule 5 draft, there will be plenty of moves to come. -- Stumpf
• The Pirates are giving a long look internally for their third base and Indianapolis managerial openings first. Altoona Curve manager Miguel Pérez should be one of those candidates. He and his staff did a great job in Altoona this past year, and many of those top players he had will be either in Indy or the majors in 2022. Having someone with strong relationships with those players in either AAA or on the major league coaching staff would be very beneficial. -- Stumpf
