QB losses rekindle concerns

San Francisco 49ers quarterback Alex Smith (11) is tackled by St. Louis Rams linebacker Jo-Lonn Dunbar during the first quarter of Sunday’s game in San Francisco. Smith suffered a concussion on the play.
San Francisco 49ers quarterback Alex Smith (11) is tackled by St. Louis Rams linebacker Jo-Lonn Dunbar during the first quarter of Sunday’s game in San Francisco. Smith suffered a concussion on the play.

— Next week’s big, nationally televised Monday Night Football showcase could feature a quarterback match up of journeyman Jason Campbell of the Chicago Bears vs. untested Colin Kaepernick of the San Francisco 49ers.

Why? Concussions, of course.

With so much attention paid to replacement refs and bounty ruling appeals this season, it’s an issue that’s slipped a bit under the radar lately. But 25 percent of Sunday’s NFL games saw a starting quarterback leave with a concussion.

Two were Chicago’s Jay Cutler and San Francisco’s Alex Smith, whose teams play each other next Monday. Both stayed in Sunday’s games for several plays after what appeared to be head rattling hits. Smith even threw a touchdown pass while playing with blurred vision before he departed, according to Coach Jim Harbaugh.

“It’s a reminder that you’ve got to err on the side of caution,” said Dr. Richard Ellenbogen, co-chairman of the NFL’s head, neck and spine committee, who was not familiar with the particulars of Sunday’s quarterback injuries. “The question that I would ask is: Why did Mr. Smith not report this to his team physician, and say, ‘Hey, I’ve got blurred vision, is that a problem?’ ... We have to educate the medical teams to be really conservative. And we still have to educate players to self-report. If they don’t feel 100 percent, they have to be willing to very strongly tell somebody.”

More than 3,500 former players - including at least 26 members of the Pro Football Hall of Fame - have sued the NFL, saying not enough was done to inform them about the dangers of concussions in the past, and not enough is being done today to take care of them.

The instructions now used for in-game sideline concussion assessments in the NFL include a box that reads: “Signs and symptoms of concussion may be delayed, and therefore it may be prudent to remove an athlete from play, not leave them alone, and serially monitor them over a period of time.” After that, in all capital letters, it reads: “When in doubt, take a ‘time out.’ ”

The NFL looked into the Cutler and Smith cases - and Philadelphia’s Michael Vick, the third quarterback who got a concussion this weekend - and came away satisfied that the proper protocol was followed. Players who exhibit any concussion symptoms are supposed to be removed from a game immediately and not be allowed to return to play or practice until fully without symptoms.

“Our medical advisers routinely review with team medical staffs all significant injuries,” league spokesman Greg Aiello wrote in an e-mail. “In these cases, we learned that the teams handled the injuries properly and removed the players from the game as soon as they displayed symptoms and were diagnosed with a concussion.”

Ellenbogen pointed out that concussion symptoms might take time to emerge. That’s apparently what happened with another noteworthy player, Buffalo Bills running back Fred Jackson, who took a late hit to the head in a loss at the New England Patriots on Sunday.

He was examined Monday - a day after showing what Coach Chan Gailey called “concussionlike symptoms” on the flight home. Gailey said Jackson will miss Thursday’s game against Miami.

After Cleveland Browns quarterback Colt McCoy returned to a game in December 2011 despite not being checked for a head injury following an against-the-rules hit to the helmet, the league put certified athletic trainers in booths above the field to watch for injuries and added video feeds on sidelines to make it easier to track dangerous hits immediately.

Aiello said that video was used by the Bears and 49ers to look at their quarterbacks’ injuries.

The league spokesman declined to comment on Harbaugh’s description of what happened with Smith.

Sports, Pages 15 on 11/13/2012

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