Did Julian Edelman suffer a concussion in last season's Super Bowl? Did Case Keenum suffer one at the end of the Rams game three weeks ago?
We think we know the answers, based on the protocols being used to diagnose concussions, plus what we see with our eyes.
But the diagnosing of concussions is still wildly subjective. Under the NFL's concussion protocol, players are asked questions on the sideline — for example, "Can you count backward from 10? Who is the current president?" — and their ability to answer them cogently determines whether they have suffered a concussion and are allowed to return to the field.
But the testing has major flaws. For example, Eagles safety Malcolm Jenkins admitted last month that he played more than half of a game with a concussion after hiding it effectively from team doctors and teammates. He's certainly not the only player to have done this.
Doctors can diagnose a broken foot or torn ACL moments after it happens, and now a company based in the Boston area says it has the technology to do essentially the same for concussions with a simple finger prick. Within 20 minutes, a blood analysis could let the player know if he suffered a concussion and when he can return to play.
"We're kind of hoping to bring objectivity to the process," said Kevin Hrusovsky, CEO of Quanterix in Lexington. "Getting to a real objective point is what I think changes the game. It changes the science and the whole area of medicine for concussions."
The Department of Defense and National Institutes of Health conducted studies with Quanterix's technology over the last several years to better understand concussions and blast victims among soldiers, and discovered that tiny amounts of proteins are released from the brain and into the bloodstream after a concussion takes place.
Most current technology can't detect these protein amounts, but Hrusovsky said his company's machine does.
"It's like seeing a single grain of sand in 2,000 Olympic swimming pools, or picking a single blade of grass in a field the size of Alaska," he said. "They're such low concentrations of proteins that nobody understood that they were there. But the data is quite compelling, showing that if someone has a concussion, the level of these proteins go up in their blood."
The NFL has taken notice of Quanterix's work. NFL officials visited the company early in 2015 to view the results of its studies, then over the past year awarded the company a total of $800,000 in grants as part of its $10 million Head Health Challenge in a partnership with General Electric.
The NFL hasn't committed to further investing in the technology, but Hrusovsky hopes that by 2017 or 2018 the league will have one of Quanterix's machines at every game.
"The vision we have is the player may have suffered a concussion, he comes to the sideline, they do a finger prick, they put it into our machine, and it will take, we think, 20 minutes to get an answer," Hrusovsky said. "And they don't go back into the game until they get an answer."
Not only does the company's machine diagnose a concussion, Hrusovsky said, but by measuring protein levels against a baseline blood test, it can ideally determine the severity of the concussion and the athlete's history of concussions. The more concentrated the level of proteins found in the blood, the more severe the concussion.
The subconcussive hits — the minor "dings" that are common in contact sports — can be just as dangerous as the major concussions and lead to chronic traumatic encephalopathy, the brain disease discovered by Dr. Bennet Omalu and being portrayed in the new movie "Concussion," and second impact syndrome, in which athletes who return to the field too soon can suffer death or permanent brain damage.
"The brain is the only organ in the body that there's no blood test for," Hrusovsky said. "I would say that in 2016, the biggest questions we'll be answering are, 'Did he have a concussion, how severe was it, does it look like he's had a history of concussions, and when is it safe to return to play based on the results?' "
Quanterix hopes the NFL takes the lead in adopting this technology, but the real benefit is for athletes at lower levels. Hrusovsky cites a statistic that only 1 in 27 concussions at the NCAA level get diagnosed.
"I actually think the NFL might be one of the safest places to play, because there's a neurologist watching every play," he said. "But you don't get that at college and high school. I'm actually more worried about Pop Warner, high school soccer, cheerleading. If I'm a parent, I would want to know what my child's baselines are for all of these critical biomarkers."
And Hrusovsky believes that his company's technology can help in other areas of medicine — earlier detection of cancer, heart attacks, Parkinson's, and many neurological diseases.
"When people say they're in 'remission,' a lot of it is because the blood testing isn't sensitive like ours. We can see it much sooner — sometimes six to eight months sooner," Hrusovsky said. "It takes a billion cancer cells to be in a tumor before today's imaging picks it up. Our technology makes everything earlier."
And no longer will athletes be able to "fool" a concussion test, either.
"The blood test could make it much more objective — 'No matter what you think, you've had a concussion,' " Hrusovsky said. "There's nothing from a science standpoint preventing it [now]. We would like to see more studies done to further validate it and pinpoint more information, but there's enough promise here that it would be a shame if this weren't pushed really hard."
Relocation talks are not personal
The NFL constantly sells the concept of sentimentality to its fans, whether it's celebrating a new Hall of Fame class, honoring the previous 49 Super Bowl matchups this season, or teams wearing throwback uniforms.
But an NFL executive made it clear last week — there is no room for sentimentality in stadium negotiations.
The Chargers, Raiders, and Rams continue to jockey for the right to move to Los Angeles as soon as next season, yet the cities of San Diego, Oakland, and St. Louis have not given up hope of keeping their teams with new stadium deals.
Of the three cities, St. Louis is the only one that has come up with even a halfway viable plan, but is having trouble coming up with the $400 million in public funds needed to make a downtown stadium a reality.
NFL executive vice president Eric Grubman, the league's point man on the return to LA, appeared on 101 ESPN in St. Louis on Wednesday to discuss the latest with the Rams. Grubman was asked by host Bernie Miklasz why Rams owner Stan Kroenke, worth an estimated $7.7 billion, couldn't chip in a little bit more of his own money if St. Louis can't come up with the $400 million. Grubman responded that Kroenke's net worth doesn't matter. To keep an NFL team, it's either pay up or else.
"If your logic follows, then somebody worth [$]7.2 [billion], if it goes from [$]400 [million] to zero should feel the same way. It's the same thing," Gruman said. "Now what you're trying to do is make a business argument with emotion."
As a follow-up, Miklasz asked if the NFL has no room for loyalty or sentiment.
"That's not life," Grubman said. "Life is [Kroenke has] got options. Everyone has options. And they have to weigh those options against one another, and it's not fair for you to bring up that person's net worth to say that makes the difference between $400 million and $300 million."
Kroenke is a Missouri native, but badly wants to move the Rams back to LA. He owns land in Inglewood, Calif., and has a $1.7 billion stadium project lined up and ready to go, but needs the approval of 24 owners to move his team.
The Raiders and Chargers have a separate joint stadium project in nearby Carson, Calif., and both teams have declined overtures from Kroenke to join him in his project. It is believed that both projects have the necessary number of votes to block the other from happening, so there will be a lot of behind-the-scenes politicking from all three teams before a vote is held among the NFL owners Jan. 12-13 in Houston.
Three things remain clear: The NFL wants two teams in LA next year; most of this stuff won't get sorted out until right before or during the January owners' meetings, as deadlines spur action; and don't expect the NFL to get teary-eyed about leaving one or more of its current cities.
In the NFL, money talks.
Fans should give LaFell a break
Hey, Patriots fans: Ease off Brandon LaFell a bit, won't you?
LaFell hasn't had the most consistent season, catching 25 of 56 passes thrown his way for 369 yards and no touchdowns in seven games since returning from the physically unable to perform list. LaFell is the only Patriots receiver not to have caught at least 50 percent of his targets, and he hasn't done the best job filling in for Julian Edelman and Rob Gronkowski the last two weeks, catching four passes for 36 yards against the Broncos and four for 27 against the Eagles, seemingly giving up on a few routes.
Expectations were high for LaFell coming off a career year in 2014 — 74 catches for 953 yards and seven touchdowns, plus two touchdowns in three postseason games. Patriots fans have been riding him hard the last few weeks for not helping overcome the losses of Edelman and Gronkowski, but LaFell is not that type of receiver.
What is he? A solid No. 2 or No. 3, with a big 6-foot-3-inch frame, average NFL speed, and inconsistent hands. He feasted on single coverage last year thanks to Edelman, Gronkowski, and Shane Vereen drawing most of the defense's attention, but as the No. 1 option in Carolina, LaFell averaged just 42 catches per season in his four years. There's a reason Carolina let LaFell walk in free agency (signing a modest three-year, $9 million deal with the Patriots), and Panthers fans were shocked to see him perform so well last year in his first season in New England.
Now as the Patriots' top receiver, LaFell is reverting back to form. He's not a game-changer, but extrapolate his current stats over a 16-game season, and he'd have 57 catches for 843 yards — better numbers than he had in any season in Carolina.
On top of it, LaFell missed the offseason program, training camp, and the first six weeks of the regular season following foot surgery in February. Ask any current or former Patriots receiver receiver how easy it is to get on the same page as Tom Brady after missing that much practice time.
LaFell still gives the Patriots a big body in the red zone, is an excellent run blocker, and makes some difficult catches look easy. Expecting him to replace the production of Edelman and Gronkowski just isn't realistic.
Consider Goodell officially on case
Roger Goodell wants NFL officials to get the calls right and for the definition of a catch to become clearer. And both might happen sooner than you think.
Appearing on SiriusXM on Friday morning, Goodell suggested that the NFL is willing to introduce new technology during this year's playoffs to help officials get calls correct.
"We have to make sure our officials have access to that kind of technology in a way that's not overly disruptive to our game, so that they can get the same type of input when they're making decisions and avoid those critical errors," Goodell said. "And we're looking at that even in the context of this year's postseason. We're looking at how we can do that on a more regular basis."
Meanwhile, the NFL has established a six-member committee to make a recommendation to the Competition Committee about simplifying the catch rules at the league's annual meetings next spring. On the committee: Bill Polian, Ken Whisenhunt, Jim Schwartz, Joe Philbin, former receiver James Thrash, and former side judge Tom Finken.
The Patriots have a saying that the season doesn't begin until Thanksgiving, but for a quarter of the NFL, Turkey Day marks the beginning of the end. The Raiders and Browns began their offseason housekeeping by awarding contract extensions to receiver Michael Crabtree and tight end Gary Barnidge, respectively, while Titans players began counting down the number of full-padded practices remaining. Teams are allowed only 14 full-padded practices during the regular season — one per week for the first 11 weeks, and three over the final six weeks. The 3-9 Titans had their final padded practice of the season last week. "I didn't see any tears shed when they pulled [the pads] off," interim coach Mike Mularkey quipped . . . Saints cornerback Brandon Browner leads the NFL with 21 penalties, including 10 for holding. It's the most penalties against one player since NFLPenalties.com began tracking flags in 2009. Browner holds the top three spots, with 19 penalties in 2011 and 18 last year. Tampa Bay offensive tackle Gosder Cherilus is second this year with 14 penalties . . . Washington has lost nine straight on the road, including all five road games this year. A loss at Chicago on Sunday will set a franchise record at 10 . . . Kickers missed more extra points last week (nine) than they did all of last season (eight). There were three missed extra points in the Raiders-Chiefs game alone, and Saints linebacker Stephone Anthony became the first player under the new rules this year to return a blocked extra point to the other end zone for 2 points . . . Jaguars quarterback Blake Bortles has 27 touchdown passes this year, and is on the verge of becoming just the fourth player to throw 30-plus TD passes in a season before his 24th birthday, joining Dan Marino, Matthew Stafford, and Daunte Culpepper.
Serving his purpose
Stanford running back Christian McCaffrey broke Barry Sanders's single-season all-purpose yards record in the Pac-12 championship game. The sophomore had 461 all-purpose yards in the Cardinal's win over Southern Cal, pushing his season total to 3,496. Here's a breakdown of McCaffrey and Sanders's yardage splits: