Steven Adams: Concussion Protocol Testing Explanation

Steven Adams left the game versus the Sacramento Kings and was initially listed as having entered the concussion protocol program.

If in fact Steven Adams was deemed to have a concussion and has entered the NBA concussion protocol it’s unlikely he’ll be on the court for the Clippers match tonight.

Examining The Injury:

First let’s look at the incident that led to his injury. Steven Adams was positioned under the basket looking to rebound the ball. He was paired versus DeMarcus Cousins in the paint, who initially looked like the guilty party who threw Adams down.

Closer inspection however, shows both Garrett Temple and Rudy Gay contributed to Adams fall.  Cousins grabs at Adams shoulder and pushes him toward the ground which is the primary reason Adams loses his balance. Simultaneously, Temple is pushing on Adams left arm and pushing down. Completing the incident is the shove by Gay from the front.

Gay’s role in the fall is hard to decipher as being intentional, or if he was simply losing his own balance. When viewed from a different angle (under the basket looking out) it appears like Gay purposely pushes on Steven Adams, but this video shows Gay trying to stop Roberson and he isn’t looking at Adams until he himself loses his balance.

As you can see from the above vine the resulting effect is Adams falls backwards and his head snaps back hitting the court.

The Concussion Protocol:

I get asked about this quite often so figured this was a great opportunity to explain the testing.

First thing to note is the NBA stipulates following 24 hours after the incident the player can start the testing to return. This in itself makes Adams return to the court seem  unlikely since he was hurt at 10:24 of the third quarter in the Kings game. Given the game began at 9PM ET and the Clippers game tips off at 10:30 PM ET there would need to be some sort of agreement between the doctors and the NBA appointed concussion specialist for Adams to begin the testing.

When the NBA introduced the new concussion protocol it was 2011. Dr. Jeffrey Kutcher, an Associate Professor of Neurology from the University of Michigan was appointed the director of the program. I’m uncertain if he is still the Director of this program, but suffice to say there is someone of his capacity in place.

Step one – determine if there is a concussion:

First the team doctor and medical staff would have taken Adams to a quiet, distraction free site to gauge if a concussion occurred.

Step two – entered into concussion protocol:

News following the game said Adams was in the concussion protocol program. Therefore we can either deduce this was the medical staffs diagnosis or it was an assumption.

Step three -a period of time must pass with the player showing improvements, prior to administering physical tests:

When I first read about the protocol a period of 24 hours was stated. Given I can’t confirm that time frame, perhaps there isn’t an exact period, or it has been adjusted to some time within 24 hours of the concussion occurring.

The reason this is important is because of when Adams sustained the injury. That is to say, if he has to wait 24 hours he’s out for the game versus the Clippers regardless. If however, it’s simply some time the next day then if Adams shows no ill effects he can begin the testing.

Step four- series of tests administered each with observation immediately after as well as after a period of rest:

At this stage Adams would go through a series of physical tests each increasing in difficulty and involving a different physical requirement. The tests I’ve found included riding a stationary bike, jogging/running, agility tests/drills, non contact drills and finishing with some sort of contact (other players involved) drills.

At any point in the testing if the player feels ill, gets dizzy or shows signs of distress the test is stopped. If however the player gets through the test prior to beginning the next phase the player is checked to see how they measure up to their baseline testing (conducted at the beginning of each season). As the NBA describes it this would occur immediately after the test as well as after a small waiting period to make sure the symptoms don’t return. Although I could find no specific time frame, I’m assuming within an hour or half hour following each phase.

If the player positively progresses through each phase without demonstrating any ill effects the next phase of the test can be administered.

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Once the player has progressed through each level the medical staff compares the results to the players baselines.

Final Step: Medical staff compare to season starting benchmarks:

Assuming Adams passed each phase of tests, afterward the results are once more compared to the players benchmarks, shared with the NBA Concussion Protocol Director and then ultimately cleared to play by the player’s own team doctors.

Of note, if at any time the player showcases regression, feels poorly or doesn’t meet the benchmarks the testing is stopped. When the player restarts the testing they must do so from the first stage.

Other notes:

Based on the individual response to each level of tests, you can see how the testing period varies from a portion of a day, several days and in some cases can take weeks. If you recall earlier this season Al Horford was out for a substantial period of time following his concussion.

The best OKC Thunder fans can hope for is Steven Adams wakes up today and feels fine. The one thing Adams has always demonstrated is a propensity to heal quickly and deal with pain. Mind you a concussion is different given it’s neurological. Cross your fingers and hope it’s not as bad as it initially looked.