Why more NFL players are self-reporting concussion symptoms

The San Francisco 49ers had just completed a 22-yard pass, but the play cost Frank Gore dearly.

The running back suffered a concussion while running a block on Seattle Seahawks linebacker Bobby Wagner.

Gore lay on his back after the play, initially unable to get up. Several teammates ran to his side before Gore left the field without assistance.

It wouldn't take long for the gravity of the situation to sink in for the veteran, who was in his 10th season at the time in 2014. With two games left in the season, his first concern wasn't his health, but rather the impact his absence could have on his upcoming free agency.

“I knew I had to show people that I could still play,” Gore told ESPN. “I was 31. And I knew as you got older, how teams judged you.”

So in the days following his diagnosis, Gore made a decision he's not proud of: He lied about his ongoing symptoms. He even managed to pass an assessment later in the week which allowed him to play in the next match and the season finale a week later.

“You know, I actually never told anyone about it,” Gore said. “What happened was that all year long I was sharing photos with [Carlos Hyde]. But he was injured. So I said, “Man, this might be my last chance to really play.”

“I knew they were going to draft someone, and it was my last year with San Francisco. So, I just said, 'I have to find a way to play.'”

In telling the story, Gore made a distinction between attitudes toward concussions at the time and opinions today.

“We didn't even talk about it,” said Gore, now an advisor in the 49ers scouting department. “It’s not something we had thought about.”

Now, NFL executives are welcoming a trend: More players are alerting medical staff about their concussion symptoms. During the 2023 season, 43% of concussions “had a self-report component,” according to the league. As recently as 2016, this figure was 19%.

Yet even as self-reporting has increased, the number of diagnosed concussions has decreased, from 244 in 2016 to 219 last season. The league attributes the reduction to improvements to equipment and rules. Another change was implemented this week at the league's annual meetings in Orlando, Fla., as owners voted to revamp the kickoff format to, among other things, reduce concussions caused by high-speed collisions.

Experts and players say the rise in self-diagnosis is the result of players becoming more aware of concussions. Not only are they better informed, they say, but they are also more willing to act on that information. However, there are exceptions.

“We will never be able to spot every injury,” said NFL chief medical officer Dr. Allen Sills. “There will absolutely be injuries that can only be captured by a player speaking out.

“This is why self-reporting is so important.”

If anyone understands the potential impact of a concussion diagnosis, it's Indianapolis Colts center Ryan Kelly, who has had three diagnosed concussions.

In 2017, his second season in the NFL, Kelly suffered a concussion in Week 12 that caused symptoms that persisted so long that he missed the final five games and ended up on injured reserve. wounded. Kelly suffered two more concussions last season, including one in Week 2 when he alerted the team's coaches, who quickly removed him from the game.

“I can get my knee replaced,” Kelly said. “I can’t get a brain replacement.”

But Kelly acknowledged the conflicts players face when dealing with concussions. The kinds of things that crossed Gore's mind years ago are still relevant today.

“It’s tough,” said Kelly, a member of the NFL Players Association executive committee. “I can't show it to you on an MRI, I can't show it to you on an X-ray machine, but you stay there at night knowing that you're looking after your future and your family. I have children .I have a family that I want to take care of.

“But [teams] preach availability all the time. »

Still, Kelly played it safe. And he wasn't the only Colts player to suffer a concussion in the Week 2 game against the Houston Texans. Rookie quarterback Anthony Richardson, 21, grew up in an era of concussion awareness and took no chances.

“I noticed I wasn’t feeling like I should,” Richardson said. “I asked them to take me to [injury] try to check and see. I didn't want to hurt the team.”

Richardson missed the remainder of the game, as well as the following week.

The current concussion protocol – which was developed in partnership with the players' union – requires approval from an independent expert before a player returns to action. Unaffiliated neurotrauma consultants (UNC) are stationed on each sideline, and observers are in a skybox at each game to monitor players who may be exhibiting the effects of a concussion. UNC has the authority to remove these players from games.

During a late-season 2022 game, former Pittsburgh Steelers quarterback Kenny Pickett, who has since been traded to the Philadelphia Eagles, returned to action after being cleared by medical staff to following a concussion assessment. But he quickly developed symptoms, including changes in his vision. Pickett self-reported, was removed from the game and missed the following week.

New York Jets cornerback DJ Reed made a very different calculation during an October 1, 2023 game when he hid his concussion symptoms. Reed admitted that the opportunity to play in the nationally televised “Sunday Night Football” game against the Kansas City Chiefs influenced his decision. After the game, Reed's symptoms worsened and he missed the next two games.

“It didn’t feel right, but it was just the selfish part of me that just wanted to play,” Reed said. “Come to think of it, any time you get a concussion, you have to get through it.

“Talking to the doctors, it could have been bad. Something terrible could have happened, so it's definitely a lesson learned.”

The lessons the NFL has learned about concussions have resulted in new rules, but that's only part of the equation. Self-assessment also plays an important role.

“People have seen a lot [former players] I struggle later in life,” Kelly said. “I think players now think, 'If this is what it takes, and then at 60, this is what I look like , then no.' I want to be able to remember my children's names. I want to be able to play with my grandchildren.

“And that’s more important than playing with a concussion.”

Brooke Pryor and Rich Cimini contributed to this report.