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Welker Forecast: Out

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Recent Blog Entries From Dr. Dave Hnida


Wide receiver Wes Welker

Wide receiver Wes Welker of the Denver Broncos hauls in a pass against the Tennessee Titans at Sports Authority Field Field at Mile High on Dec. 8, 2013. (Photo by Dustin Bradford/Getty Images)

Written by Dr. Dave Hnida, CBS4 Medical EditorWhen Wes Welker got scrunched early in yesterday’s game, my first thought was that he had suffered a neck injury — his head was bent absolutely sideways.

Well, the neck turned out to be a lesser issue — the major one, though, was another blow to the head … and another concussion. That’s two in less than a month. And one more out of too many in Welker’s career.

So how does it work from here? When is he ready to play? And how do you determine that?

Here’s how it is supposed to work out based on the NFL concussion protocols.

When Welker came to the sideline, he was immediately checked by team doctors who evaluated things such as balance, coordination, and memory. They then complete the Standardized Concussion Assessment Test — which goes into more detail, and takes a minimum of 8-12 minutes to complete.

Here’s a copy: nflevolution.com/….NFL-SIDELINE-TOOL-POST-INJURY-2-18-12.pdf

Players also are given a 65-point exam that includes repeating a list of numbers and words — they also need to know that day’s month, date and year, where they are playing, who scored the most recent touchdown, which team they played the week before, and the score of that game.

That testing can take place on the sideline, or in a quieter place within the stadium.

Get diagnosed with a concussion, and you are not allowed back on the sideline, let alone the field.

Then comes the week ahead, and the gradual road back to play. It is supposed to be a five phase process, with 24 hours between each phase — and the player is allowed to move onto the next phase only if there is clear-cut improvement in symptoms.

Day 1. Monday (for a Sunday game). Another medical checkup. Watch film, and be able to concentrate while watching film. A slightly different neuro test is done and compared to one done in training camp: nflevolution.com/…/NFL-SIDELINE-TOOL-BASELINE-2-18-12.pdf. This gives you a before and after snapshot.

The whole idea is to gradually increase activity as symptoms improve. If jogging or weight lifting is done, its is at about 40 percent of max. This can either take place Monday or Tuesday, so let’s assume Monday.

Day 2. Tuesday. Medical check up. If no worsening, again increase activity, this time to 60 percent of max.

Day 3. Wednesday. About 80 percent exertion.

Day 4. Thursday. Light practice. No contact.

Day 5. Friday. If all okay, regular practice, with clearance to play Sunday. Team doctors plus an independent expert must both give the go-ahead for this to happen.

Do the math on Welker, and even with the best case scenario — Thusday is, at best, a light practice day. So: No Chargers this week.

At least this is the way it is supposed to work. The NFL guidelines are filled with terms such as “may,” “might,” “could” and “maybe.”

No rules are hard and fast, but then again neither are concussions. Symtoms wax and wane. They show up late. The last concussion is different from this one, and this one is different than the last — so there is no predictability. And there is no one surefire diagnostic test that absolutely says all is okay –and you have no worries. Ever.

Bottom line. Welker should be out this week. He may be out next week, and even the next (remember, the guidelines we just outlined are for a one week recovery — which he already blew through before the New England game).

The bigger question I have is just how healthy is Wes Welker’s brain after these concussions — and all of the blows he’s taken during his career?

It’s like Vegas.

Roll the dice of health: Road to the Super Bowl or stop to protect the long-term ability to think clearly years down the line? Or is there a worry? What do you think? I know my opinion.

That’s a topic for another blog.

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