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With RGIII out, Redskins have to prepare Kirk Cousins for opener

BALTIMORE — With the NFL's independent neurologist recommending that Robert Griffin III be retested in one to two weeks before a decision is made on whether to clear him to compete, the Washington Redskins have no choice but to prepare backup quarterback Kirk Cousins for the Sept. 13 season opener.

That's the only possible course of action given a two-week window would place that re-test on Friday, Sept. 11, less than 48 hours before the Redskins host Miami at FedEx Field. It's also the view of former Redskins quarterback Joe Theismann, who has close ties to team's front office.

"Robert was named the starter. He was going to be the starter and in all likelihood would have been the starter," Theismann said in a telephone interview Saturday. "Now the Redskins have to move on the assumption that he may not be available for Miami. So now Kirk is going to start. So now Kirk and the coaches have a chance to see what he can do."

The last-minute reversal on whether Griffin, 25, had sufficiently recovered from concussion-like symptoms to play Saturday threw the Redskins' preparations for the regular season into chaos and raised numerous questions about the NFL's process for clearing concussed players to return to the field, as well as the Redskins' handling of Griffin's case.

After suffering what the Redskins' medical staff diagnosed as a concussion in the Aug. 20 game against Detroit, Griffin returned to practice three days later and continued practicing without limitation all week.

On Thursday night, the Redskins announced that an independent neurologist had cleared his return to competition, giving the green light to his participation in Saturday's game at Baltimore, where Griffin was to play the first half. Then, 24 hours before kickoff, the Redskins issued a statement reversing that decision, with Robert N. Kurtzke stating that he agreed with the Redskins' team physician and unspecified neuropsychologists, after "further scrutiny" of data, that Griffin should be withheld and retested in one to two weeks.

That reversal, combined with vague statements earlier in the week from Redskins Coach Jay Gruden and Griffin himself about when the quarterback suffered the concussive blow, spurred fevered speculation in print, broadcast and social media about conspiracies, incompetence and plain confusion.

Skepticism about the severity of Griffin's injury was compounded by Theismann's report during the live broadcast of the Detroit game that the quarterback had passed a concussion test. Theismann confirmed Saturday that the report, which Gruden debunked after the game, had been phoned up to the studio from the sideline. According to a source, former Redskins running back Clinton Portis, working his second game as a sideline reporter, was the source of the erroneous information.

Redskins spokesman Tony Wyllie offered no details Saturday when asked throughout the day to clarify the steps involved in the initial decision to clear Griffin, the reversal that followed and the number of neurologists and neuropsychologists involved.

Wyllie said simply that Gruden would address it after the game.

According to one person with knowledge of the events, "everything was fine" with the Redskins' application of the NFL's concussion protocol, which spells out the steps for clearing a concussed player to return to practice and games, and proper procedures were followed.

Griffin "passed the baseline tests" and was cleared for non-contact drills in practice, according to that person, who spoke on the condition of anonymity because of the sensitivity of the topic. The independent doctor later decided against clearing Griffin to play, according to the person, who said the doctor "had the right to do that."

Griffin "felt fine," the person said, calling the league "super cautious" in its current approach to concussion-related issues. "It isn't anything [the Redskins] did," the person said.

Another person familiar with the situation said the quarterback had no setback during the week that would have accounted for the doctor's reversal, at least as far as Griffin was aware, and that the quarterback only learned his clearance had been revoked when the Redskins informed the media Friday night. According to that person, Griffin has no idea what changed or what the timeline for his return is. Several Redskins players said privately that they were equally surprised by the reversal.

Griffin appeared in fine shape two hours before kickoff Saturday, when he took the M&T Bank Stadium field in Redskins shorts, a grey shirt and trademark sleeve to work on his throws.

In Theismann's view, Griffin's inability to complete the preseason is the worst possible development at this stage in his career, when he's trying to get comfortable as a drop-back passer.

"Two years ago, he hurt his knee in practice; last year he dislocated his ankle," Theismann said. "He really needs the work in the pocket, and he has missed so many opportunities to work under live fire with people around him. ... Of all the guys, he needed the most work."

The NFL declined to comment on the handling of Griffin's injury. And the NFL Players Association, which advocates for players' rights on a host of issues, did not respond to requests for comment.

Griffin has suffered two previous concussions — one at Baylor and one his rookie NFL season. That fact alone — that he has suffered repeated brain trauma — counsels a cautious, slow return to football, according to Chris Nowitzki, executive director of the Sports Legacy Institute and a highly regarded advocate for concussion research and awareness.

"It's always best to err toward a conservative return to play," Nowitzki said in a telephone interview. "Returning a top quarterback in one week in the preseason is aggressive and frankly unnecessary and risky. In this situation, the independent neurologist may have provided that check to say, 'Our tests aren't perfect. This player has had concussions previously. Let's give him that extra time to recover.' The more we study concussions, the more longer-term abnormalities we find. Any return to play within a week may be inappropriate."

Recovering from traumatic brain injury, which is what a concussion represents, is rarely a straight-line progression. Symptoms may not present themselves immediately, so an athlete who initially looks as if he avoided neurological damage may show symptoms days later.

Moreover, a concussed athlete may show signs of recovering only to take a step backward as he increases his workload. That's why the NFL concussion protocol, which spells out five steps an athlete must clear before returning to play, requires that athletes be evaluated by a doctor before progressing from one step to the next — to ensure the increased workload hasn't triggered a setback.

In returning to practice Sunday, Griffin raced through the first four steps of the concussion protocol in less than 72 hours. Asked about his remarkable bounce back, Gruden insisted doctors had followed the required steps in clearing his return.

But it's possible that practicing could have impaired Griffin's performance on the concussion test. More significantly, it could have triggered a setback in his recovery.

It's unclear which test neurologists put Griffin through in the process of evaluating his recovery. The most common post-concussion test is called the ImPACT test, which primarily measures cognition and reaction time. It includes tests and tasks designed to flag problems with memory, attention span, reaction time and impulse control, as well as other basic functions.

For example, a player might be asked to click a button when he is shown a green light and not click a button when shown a red light. Then, the instructions are reversed, and the player is asked to not click a button when a green light appears and click a button when shown a red light.


7 min read

Published

Updated

By Liz Clarke, Mike Jones, Mark Maske

Source: The Washington Post



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