FOXBOROUGH — Let’s start with the question Patriots fans are desperate to know: Will star tight end Rob Gronkowski play in Super Bowl LII in two weeks?
Gronkowski was not spotted in the Patriots’ locker room Monday, a day after absorbing a scary helmet-to-helmet hit in the team’s 24-20 victory over the Jaguars in the AFC Championship game.
Gronkowski was evaluated for a head injury after the hit and, according to multiple reports, entered the NFL’s concussion protocol. If that’s the case, the league has a five-step process that Gronkowski and the Patriots must follow in order to determine if he is healthy enough to play Feb. 4.
Coach Bill Belichick refuses to talk about injuries, a long-standing policy. But Patriots wide receiver Matthew Slater said Monday Gronkowski “was in good spirits when I spoke to him today.”
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That the tight end left the field under his own power after the blow is a “positive sign,” according to sports neurologist Vernon Williams, a consulting physician with the Los Angeles Rams.
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Gronkowski was crunched as he was trying to snag a Tom Brady pass and clearly was woozy as he got back on his feet with the help of teammate Chris Hogan. Gronkowski walked to the sideline and was immediately escorted to the locker room under his own power, stretching his neck and moving his head from side to side.
He was first listed as questionable while being examined before being declared out for the second half.
In explaining why concussions can be tricky to diagnose and treat, Williams noted “the majority of concussive episodes don’t involve loss of consciousness or the need to transport [a player] off the field or that kind of thing.
“We do know that things can evolve with concussive injuries and I mean that both ways,’’ said Williams, the director of the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles. “Sometimes people can seem to have had a more severe injury, with loss of consciousness, but the systems resolve pretty quickly and they do very well in short order with symptoms that don’t last a long time without complication.
“And sometimes the reverse is true. Sometimes people look good immediately and then over the course of several hours symptoms increase and by the next day they have pretty severe symptoms. Having said that, the fewer symptoms people have initially, the better, and generally, that bodes well for an uncomplicated recovery.’’
There is no timetable for returning from a head injury, although the two-week break before the Super Bowl is beneficial.
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“We know that probably 85 percent of the time with sports-related concussion, symptoms will resolve and people will be asymptomatic and back to normal in 10 days to two weeks,’’ Williams said. “And certainly there can be a range from person to person and even within an individual, but, the longer you have [to recover], the more likely it is that all of those symptoms resolve and that individual would be able to demonstrate that they’ve progressed through and passed all the tests required to return to play.’’
There are specific steps that must be taken to clear the NFL’s return-to-play protocols.
According to 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, performed in accordance with these protocols.’’
The return to participation protocol involves five steps: Rest and recovery; light aerobic exercise; continued aerobic exercise and introduction of strength training; football-specific activities; and full football activity/clearance.
For Step 1, the activity goal is “routine daily activities as tolerated.”
For Step 2, the player should be able to undergo “10-20 minutes on a stationary bike or treadmill with light to moderate resistance supervised by the team’s athletic trainer. No resistance training or weight training.”
For Step 3, the head trainer will supervise and “increase the duration and intensity of aerobic exercise,” which could include non-contact sport conditioning drills (i.e. running around cones) and some strength training.
Step 4, the player can participae in “non-contact activities for the typical duration of a full practice.’’
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For the last step, the player can have “full participation in practice and contact without restriction.”
Williams is a fan of the NFL’s concussion protocol.
“The NFL protocol provides safeguards to ensure that individuals return to play when they’re ready and when their brain has recovered and aren’t going to return too early,’’ he said. “So, yeah, I think it’s been effective and it’s been a very reasonable protocol.’’