What's the protocol for Rob Gronkowski's return?

What's the protocol for Rob Gronkowski's return?

When Jaguars safety Barry Church connected on a helmet-to-helmet hit with Rob Gronkowski, it didn't just throw the Patriots' plan for the AFC title game out of whack. Once the Patriots won, the hit also cast some doubt on exactly how much Gronkowski would be able to do as the team prepares for Super Bowl LII.

Based on what happened in the game, it appears as though it was determined that Gronkowski showed "no-go" signs or symptoms soon after the hit. He was helped to his feet by receiver Chris Hogan, he met with Patriots medical personnel, and he was headed to the locker room less than a minute after hitting the sidelines.


According to the NFL's Head, Neck and Spine Committee's concussion management protocol, which we've quoted throughout this post, if a player exhibits or reports loss of consciousness, confusion or amnesia, "he must be removed immediately from the field of play and transported to the locker room." Players exhibiting those signs or symptoms are considered to have suffered a concussion and may not return to participation on the same day under any circumstances.

Inside the locker room, per the NFL's protocol, Gronkowski would have been evaluated by the team's medical staff and a designated unaffiliated neurotrauma consultant using the NFL Locker Room Comprehensive Concussion Assessment, which is based on the Standardized Concussion Assessment Tool, published by the International Concussion in Sport Group. In conjunction with preseason baseline testing, the assessment is meant to provide "a comprehensive and detailed picture of each athlete's injury and recovery course."

"The team physician shall be responsible for determining whether the player is diagnosed as having a concussion," according to the protocol, which may be the case even if a player can complete the locker room assessment "within normal limits" compared to their baseline because of the assessment's limitations.

"Such limitations underscore the importance of knowing the athlete," per the league's protocol, "and the subtle deficits in their personality and behaviors that can occur with concussive injury."


Once a player is diagnosed with a concussion, he then must pass through the return-to-participation protocol. Because recovery from concussions varies from player to player, there is no time-frame for return laid out by the league. The decision to return a player to participation "remains within the professional judgment of the head team physician or team physician designated for concussion evaluation and treatment," and all return to full participation decisions must be confirmed by an independent neurological consultant (INC). 

The return-to-participation protocol is a five-step process, and a player must demonstrate a tolerance of all activities in each step "without recurrence of signs or symptoms of concussion being observed or reported" before proceeding to the next step. 
1) Rest and Recovery: Players may take part in some stretching and balance activity. Once players reach their baseline level of signs and symptoms and neurological examination, he can proceed to Step 2. 


2) Light Aerobic Exercise: Players begin, under oversight of team medical staff, a graduated exercise program. Dynamic stretching and balance work is allowed, as is cardiovascular exercise, the duration and intensity of which may be gradually increased as long as players remain at baseline during and after activity. Players in Step 2 may attend team meetings and study film. Weight training is not permitted. 

3) Continued Aeobic Exercise and Introduction of Strength Training: The duration and intensity of aerobic exercise (for example, more intense or longer time on a stationary bike or treadmill) can be increased. Players can also begin to participate in supervised strength training and some sport-specific conditioning drills like change-of-direction drills and cone drills. 

4) Football Specific Activities: Players may participate in all non-contact activities -- throwing, catching, running and other position-specific activities -- for the typical duration of a full practice. Contact with players, tackling dummies or sleds is not permitted. 

5) Full Football Activity/Clearance: Players may participate in all aspects of practice without restrictions on contact. Upon clearance by the team physician, the player must then be examined by the INC assigned to the team. If the INC confirms the team doctor's conclusion, then the player is cleared and can fully participate in his team's next game or practice. 


Hightower’s presence at OTAs leads to a look at linebacker depth

Hightower’s presence at OTAs leads to a look at linebacker depth

FOXBORO - Dont'a Hightower was among the missing during Tuesday's OTA that was open to reporters. He was prominently featured on the team's website as a participant in Thursday's OTA, though.

It's a positive development for one of the Patriots best and most versatile defenders. Hightower tore his pectoral in October and missed the remainder of the 2017 season, leading to some shuffling of personnel both at the second level and on the edge. 

Hightower snagged one of the team's photos of his participation in Thursday's workout and slapped it on his Instagram page. 

Hightower's presence on the turf behind Gillette Stadium, even if he was limited in the practice, allows our minds to wander a bit and look ahead to what the Patriots depth chart might look like at linebacker with him in the fold. 

The Patriots are consistently altering their fronts and Hightower's adaptability allows his role to change with whatever scheme Bill Belichick deploys. 

Hightower can play on the line or off. He can be used as a "Sam" linebacker at the second level in a 4-3 or at the end of the line of scrimmage in 3-4 looks. He played on the left end early last season - a spot we identified yesterday as a potential landing spot for Derek Rivers. And if the Patriots needed Hightower to play as a "Mike" linebacker, he has the ability to do that as well. 

Sub packages, base packages . . . Hightower can line up in a variety of front-seven spots for the Patriots regardless of the situation, which is why when healthy he's been able to serve as an every-down player. (He played 92.4 percent of Patriots defensive snaps in 2014 and 83.1 percent of the snaps in 2016.)

How might the rest of the Patriots linebacker corps slot in if Hightower is a full go for training camp? Let's take a look . . . 


Kyle Van Noy is probably the closest approximation to Hightower that the Patriots have on their roster. When Hightower went out last season, it was Van Noy who moved around the front seven and handled a variety of responsibilities. He's probably best suited as a "Will" linebacker, someone who can use his athleticism to make plays in different areas depending on the situation, but Van Noy's ability to handle multiple responsibilities in New England's defense is part of the reason why the team likes him as much as they do. He was handed a two-year extension early last season. 


Elandon Roberts often handled the "Mike" responsibilities in the Patriots defense last season. The third-year player out of Houston might have the inside track on this role in 2018, but he could be pushed by rookie fifth-round selection Ja'Whaun Bentley out of Purdue. Both players seem like they're at their best against the run game, unafraid to fill their lanes as prideful "thumpers." What may separate this duo is which player can more consistently cover the correct gaps on first and second down, and which player more effectively communicates the defense to their teammates around them. Whether either player can contribute on special teams could also alter how the workload is distributed here. 


Van Noy would likely be the first choice here for the Patriots, but there are a few others who could be angling for time here. Marquis Flowers re-signed with the Patriots this offseason after an impressive end-of-the-season run where he showed up as a pass-rusher with enough athleticism to be trusted to run with backs in the passing game. Flowers was also a key contributor on special teams last season. Rookie sixth-round pick Christian Sam could also compete for "Will" reps. A defensive back in high school, Sam bulked up at Arizona State but remains a good athlete and could be a fit behind Van Noy. Special teamers Nicholas Grigsby and Brandon King work out with the linebackers and could be options here if they were ever called upon defensively.


NFL owners words not consistent with their actions with new anthem policy

NFL owners words not consistent with their actions with new anthem policy

Chris Gasper and Michael Holley talk about the inconsistent messaging from NFL owners to their teams' players after they unanimously voted to change the league's policy regarding the national anthem. Watch the video above.