In the Choice Between Reducing Concussions and Roughing the Passer, There Is No Conflict

The NFL has a dual safety controversy, with concussions dominating headlines and roughing the passer penalties angering fans. There is no conflict.

The NFL finds itself in an unenviable position of being at the forefront of controversy over concussions while also seeing backlash from fans in their attempts to protect quarterbacks from the very hits that could create additional injuries.

With the rules protecting passers, it seems impossible for defenders to effectively sack the opposing quarterback.

NFL Week 5 Brought New Controversy to Light

This has long been a source of fan frustration, but Week 5 brought the new rules into harsh light with two seemingly clean sacks from Grady Jarrett and Chris Jones being taken away by roughing the passer penalties that would not have been called several years ago.

These are not one-to-one issues – though the first injury to Dolphins quarterback Tua Tagovailoa, described as a back injury by Dolphins training staff and a concussion by non-diagnostic observers, was flagged for roughing the passer — the new rules surrounding the penalty emerged because of a different injury to a different quarterback.

The now infamous “body weight” rule inhibiting pass-rushers is the direct result of Packers quarterback Aaron Rodgers’ collarbone injury following a sack from Vikings linebacker Anthony Barr and the emphasis on the rule is about protecting the quarterback’s body more than his brain.

Nevertheless, there is tension. The NFL is simultaneously being asked to do more to protect player safety while relaxing rules designed to make players safer. That does not mean that fans are talking out of both sides of their mouth or that analysts are being hypocritical when demanding more protection for quarterbacks potentially suffering neurological issues like Tagovailoa and less for quarterbacks being escorted to the ground like Derek Carr.

But it does mean that the NFL needs to be careful navigating those waters so that one move – to liberalize contact rules on quarterbacks – does not counteract another effort to protect players’ brains.

The NFL Can Reduce Roughing-the-Passer Penalties

There are a number of ways to resolve these concurrent problems. As Pro Football Network’s Aaron Wilson reports, the NFL will not be considering replay review for roughing the passer penalties – a suggestion made popular by Jones when he was asked after the game about his game-changing flag.

Given the fiasco surrounding reviews of pass interference – where New York would almost never overturn the ruling on the field and all fans saw were unnecessary delays in game action – it’s not surprising to see the NFL avoid this outcome, as frustrating as it may be.

Instead, the competition committee – which will be discussing the penalty next week and at the end of the season – could either change the wording of the rule back to its original wording, come up with new wording that emphasizes a judgment of intent or a higher threshold of contact, or change enforcement of the ruling without changing any of the wording.

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That last would come down through a memo to officials about how to call those penalties, in much the same way that officials were told to “emphasize” illegal contact rulings this year. There’s a good chance they choose this last option, as they have already done it once and it worked.

That’s an unusual thing to point out after all the furor over the penalty this weekend, but the NFL did ask officials to relax its enforcement of the penalty after the 2021 season. As a result, officials were reminded that the rule required “forcible” contact. Through five weeks, roughing the passer calls have decreased 45 percent when compared to last year and are down 32 percent when compared to 2020.

YearPenalties Per Game

If anything, it seems as if that “reminder” didn’t get through to referees Jerome Boger or Carl Cheffers, both of whom took a strict interpretation of the rule when penalizing Jarret and Jones.

In the postgame pool report, Boger said, “What I had was the defender grabbed the quarterback while he was still in the pocket and unnecessarily throwing him to the ground,” while Cheffers said, “[Carr] gets full protection of all aspects of what we give the quarterback in a passing posture. So when he was tackled, my ruling was the defender landed on him with full body weight. The quarterback is protected from being tackled with full body weight.”

Cheffers did not think any consideration needed to be made for the fact that the ball had popped out of Carr’s hands and was a live fumble.

While Jones was, in fact, bracing with one arm so as not to land his full body weight on Carr, Boger’s interpretation of Jarrett’s play is particularly egregious. There was no way Jarrett could finish the sack on Brady without violating the rule – either he had to land on Brady to complete the sack, or he had to spin Brady to the ground. That second choice was judged as throwing Brady down, even though the quarterback was pulling forward to get out of the sack.

And Jones’ postgame interview hit on a concern that players have had about this rule since its introduction – the NFL may be demanding play outside the realm of physics. In 2018, Star Tribune reporter Ben Goessling asked Vikings safety Harrison Smith about roughing the passer penalties. Smith said, “As defensive players, we’re not resistant to these [rule] changes. They just need to be … physically possible, I guess.”

Announcers in both games disagreed with officials, with Joe Buck saying, “I mean at some point you have to be realistic with where the defensive player – what’s he supposed to do, disappear? I mean, he’s there, the ball comes out, the ball’s in his gut and I don’t know where he’s supposed to go” in the Raiders-Chiefs game, and Troy Aikman echoing his disbelief, ultimately concluding that “it was a bad call.”

Daryl Johnston, watching Brady spin to the ground, said, “I don’t understand that one… He’s going to be down onto the hips of Tom Brady while he’s in pursuit, so he’s spinning around, too. There’s no intent to hurt the quarterback right there. I just don’t know how you call that. That is not in the spirit of the rule, the way it was created to protect quarterbacks going to the ground.”

Johnston hits on a key point critical to the nature of the rule – on these plays, there does not seem to be a present danger to the quarterback in a way that seems outside of the spirit of the game. Football is a violent sport, and that’s a major part of its appeal.

The NFL is not blind to this, and they used to sell highlight reels of big hits before it became clear that some of the celebrations of big hits might run counter to their public commitment to player safety. Any game where play is stopped by a player being taken to the ground will necessarily be violent, and removing that aspect of the game is neutering what makes it an exciting affair for players and fans.

The goal of the NFL and the NFLPA should be to maximize player safety while also preserving the essence of the game, and this type of rule enforcement does not do that.

This brings us back to the other controversy surrounding quarterbacks, one which led to Teddy Bridgewater leaving the Dolphins game without being diagnosed with a concussion, perhaps as an overreaction to Tagovailoa’s return after not having been diagnosed following the first major hit.

Player Rules Aren’t the Only Solution

The NFL cannot solve every problem with rules governing player behavior. It is entirely conceivable that the rules in place – already restrictive to defensive players bearing down on quarterbacks in the pocket – do as much as can be done to prevent concussions.

Instead, the NFL should continue to invest in technology that reduces concussion incidence and improve player safety following injuries. This time around, the concussion protocol did not appear to do that.

Tagovailoa took a nasty hit in the Dolphins’ Week 3 matchup against the Buffalo Bills and took some time getting up. When he did get up, he shook his head before falling back down to the ground. As he got up a second time, he showcased significant motor instability and was taken to the sideline for a concussion evaluation.

As we learned from the joint investigation from the NFL and NFLPA, the unaffiliated neurotrauma consultant (UNC) and team medical staff reviewed the video of the play, and each conducted an examination of Tagovailoa – one that would include Maddocks questions as well as diagnostic questions, an eye exam and an examination of motor instability – concluding that Tagovailoa did not exhibit any symptoms of a concussion aside from the initial motor instability found on video.

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There was an alternate explanation for that instability, as Tagovailoa suffered ankle and back injuries earlier in the game, something the quarterback himself brought up. They concluded that because Tagovailoa had suffered back injuries and did not demonstrate any other concussion symptoms that there was an alternate cause for his motor instability and that he could be cleared to return to the game.

There are several problems with this, however. The first is that concussion symptoms are not always immediately present, and concussions can often present with only one visible symptom in the moments following an injury.

The second is that Tagovailoa did not suffer just one symptom, he suffered several. As neurologist Chris Nowinski – who predicted that a second concussion was more likely for Tagovailoa in the Thursday Night Football matchup against the Bengals – pointed out, Tagovailoa exhibited multiple symptoms.

He grabbed his helmet following the hit (one), he was off-balance immediately after getting up (two), he “shook out the cobwebs” (three), then he fell (four) and fell again (five).

Nowinski, in particular, pointed out that there was not much reason for a player who is suffering from a back injury to shake his head side to side as if clearing his head.

The third problem compounds the second: the Dolphins did not conduct a secondary examination of Tagovailoa’s back or ankle after the hit to confirm that this was the proximate cause of his instability.

This is an issue with the protocol but also a worrying sign of the attitudes in the NFL – the Dolphins were looking for a way out, not looking out for the best interests of the player, who has an incentive to misdiagnose or misreport the causes of instability in order to return to the field.

Because the Dolphins ultimately make the final call in consultation with the UNC, it is on them to make the secondary examination of any alternate explanations for instability.

In this case, the UNC only conducted an examination with the tools available to him at the game. Those tools rely on player feedback. The UNC could not perform the secondary examination of Tagovailoa’s back, which was up to the team.

The reason this ignited into a scandal instead of a weeklong controversy is that Tagovailoa suffered a second hit to the head in the following game, just four days later. He suffered severe concussion symptoms, which is consistent with the increased likelihood and severity of traumatic brain injuries while still recovering from the initial concussion.

There is also the possibility of a rare condition known as Second Impact Syndrome, often fatal or disabling, to appear in this circumstance – though the condition is controversial, it should nevertheless be considered in the range of outcomes for players returning to play while not having recovered.

Concussions are notoriously difficult to diagnose and do not show up in CT scans or MRIs – only secondary symptoms, not always present, will show up in those scans – so it would have been difficult to confirm that Tagovailoa suffered a concussion after the game. But without confirmation that there was an alternate explanation for Tagovailoa’s symptoms, the Dolphins were questionable at best, irresponsible at worst, in their care of their star quarterback.

After all, a back injury severe enough to cause instability is itself a reason to take the quarterback out of the game, regardless. And a back injury that significant deserves a second examination.

These severe circumstances make it all the more likely that the NFL wants to be cautious about implementing a change in the rules that, in their eyes, could increase the likelihood of player injury.

Naturally, the NFL wants to reduce the incidence of concussions, not just make sure that players are prevented from exacerbating concussions they’ve already received. But there are limits to what players can be protected from before making the game unrecognizable.

The NFL Runs on Informed Consent

The key element that allows gladiatorial contests like the NFL to exist at all is informed consent. Players agree to the risk of injury when playing the game, and the reason the NFL was in hot water with regards to concussions was that they had information about the risks of a particular type of injury that they did not share with players – who therefore could not make an informed decision about the risks to play.

We know this impacts player decisions even before they are diagnosed with concussions. There are direct and explicit examples, like former 49ers linebacker Chris Borland retiring early despite playing well through his rookie contract, and direct implicit examples, like former Ravens guard John Urschel’s early retirement.

That doesn’t include players who suffered multiple or severe concussions throughout their career that retired early because of them, like former Carolina Panthers linebacker Luke Kuechly, who may have attempted to continue playing football in a world where information about the impact of concussions was unclear.

There are also an unknown number of players out of the spotlight who may have retired for similar reasons or moved up their retirement schedule out of concerns about potential neurological symptoms down the road.

Players want to avoid injuries of all types, but the nature of brain injuries versus other types of injuries forces players to consider the difference between an injury that can alter one’s career, like a torn ACL, and one that can alter one’s conception of the self.

Persistent memory loss, light sensitivity, and mood changes can be traumatic, and players looking down the road will make different decisions about injuries based on how important those concerns are.

In this case, the NFL cannot regulate away the risk and will find itself compromising its own game if it attempts to do so. Instead, the NFL needs to respect the covenant between player and doctor, and enable medical professionals to protect players once the game has started.

The NFL can eliminate or significantly curtail enforcement of the body-weight rule, which has frustrated defensive players, confused fans, and made for a worse game. They can also protect players from neurological damage, a different class of damage than ligament, bone, or muscle injury.

While these goals can appear to be in conflict, they aren’t. The risk is that the NFL uses one player safety controversy to mitigate their actions on another player safety controversy. They shouldn’t.

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