S John Howell (45) did not shy away from contact during his first practice in a week on Wednesday
National Football League athletic trainers, like the Tampa Bay Buccaneers' Todd Toriscelli, have worked hard to make their field a more exact science, with precise diagnoses and predictable recovery times.
Player injuries are often divided into degrees, and most trainers know instantly what a certain degree of sprain or strain will lead to in terms of missed time.
For instance, a second-degree sprain of the medial collateral ligament in the knee, such as the one suffered by Bucs defensive tackle Anthony McFarland against Minnesota, is almost sure to require a two to three week recovery time. On the other hand, a more severe third-degree sprain, such as the one encountered last year by fullback Mike Alstott, needs four to six weeks to heal.
And then there are concussions, for which there are no neat charts.
A concussion can cause a player to yo-yo up and down the official injury report like the Dow Jones during an election year. While the symptoms may be somewhat predictable, when and how severely they strike can be difficult to gauge.
Just ask Bucs rookie safety John Howell, who recently went through the aftermath of his first concussion.
Howell sustained his concussion – literally, an injury to the brain that occurs when that organ strikes the inside of the skull with sufficient force – while playing free safety against Minnesota on October 28 in place of the injured Dexter Jackson. He was diagnosed as such after the game, but was relatively symptom-free by the following Tuesday and was not even included on the team's first official injury report for the next week.
However, a short stint at Wednesday's practice brought the post-concussion syndrome symptoms crashing back down on Howell. By the next day, he was 'questionable' on the team's injury report and, as the week progressed, it became clear that he would not play in Green Bay.
Howell learned quickly about the possible aftereffects of a concussion – persistent headaches, sensitivity to light and loud noises, dizziness (he had all of these) and sleep disturbances, confusion or forgetfulness (but not these). After the game on the 28th, he had not known exactly what to expect or how to handle it.
"That was the toughest part," said Howell. "Dealing with the post-concussion syndrome symptoms, the headaches and the dizziness, it kind of worries you. You get scared a little bit because you've never dealt with it before. I talked with guys who have had them before, and I realized what I was feeling was a normal part of it."
As another game week began this past Monday, trainers kept an eye on Howell but it was believed he was through the worst of it. Still, some effects lingered.
"I had a screaming headache again on Tuesday," said Howell. "It was starting to get frustrating. I was beginning to wonder, but I've had every test. They've sent me to see several doctors, and they've done MRIs and CAT scans and all kinds of stuff, and everything has checked out clean."
Concussions may be more unpredictable than a torn muscle or a dislocated joint, but that doesn't mean they are treated haphazardly. Perhaps because of this unpredictability – and certainly because it is an injury that involves the brain – the Bucs' training staff goes to great lengths to make sure a player with a concussion is not in any permanent danger. In fact, the issue is taken so seriously that some players have tests done before they're injured.
Each June, just before training camp begins, Bucs who play certain high-impact positions – and safety is clearly one of those – are given neuropsychological evaluations to set a base measure of their cognitive abilities. A psychologist from the local Moffitt Cancer Center performs these evaluations.
Then, if a player suffers a concussion, the test can be administered again and the results compared to the pre-injury base line. In Howell's case, he actually performed better on the test in November. These results, coupled with the visual evidence supplied by the MRIs and CAT scans can give both the trainer and the player confidence that it is okay to return to action.
Howell came to that conclusion on Tuesday, even though he still had that sharp, migraine-type headache on the top of his skull. He showed up on Wednesday with a clear head and was given clearance to join the team on the field.
"Finally, I just said, 'I want to get back to practice,'" said Howell. "I came over (on Wednesday) and my head felt great. I got in a couple of helmet-to-helmet contacts in practice and everything was fine.
"I've been injured before, and the best thing you can do is just block it out. I was just anxious to get out there and get in a couple of hits to see how it felt. I wasn't hesitant about it all. Afterwards, I started thinking, 'Hey, it feels good. I'm ready to go.'"
The hard-hitting Howell is no longer on the injury report and should be ready to play on Sunday, which could give a boost to the Bucs' special teams units. However, another Buccaneer, tight end Todd Yoder, is on the report with his own concussion, sustained in Green Bay on Sunday. While Howell's first week after the injury was a tough one, Yoder is faring better and was able to practice on Wednesday and Thursday, so he remains 'probable' on the team's injury report.
Perhaps Howell can now offer Yoder some pointers as to what to expect, though the two might have somewhat different experiences.
"It's not very fun at all, but it's part of the game," said Howell. "The more I talked to other guys, I realized that what I was feeling was normal."