The Eagles' secondary took a hit two weeks ago in Los Angeles when Darius Slay got up slowly and was taken into the medical tent, then another soon after against Baltimore when Reed Blankenship had trouble keeping his balance after a collision – he went straight to the tent, too.
Both ended up with concussions.
Slay missed the Ravens game, but returned to practice soon after and was back on the field for Sunday against the Carolina Panthers.
Blankenship was sidelined, though his practice schedule and the corresponding injury report over the next few days will paint a clearer picture of where he's at.
Concussions are tricky. The severity can vary, symptoms can be apparent immediately or not even visible until a few days later, and depending on a variety of factors, they can take anywhere from a couple of weeks to a couple of months to come back from.
To get a better insight into concussions, and how NFL players like Slay and Blankenship navigate and recover from them, Dr. James Scott, an orthopedic surgeon with the St. Mary's Orthopedics Group in Langhorne, offered his perspective.
A note before getting started…
The views and opinions expressed in this article are those of the author and guest authors and do not reflect any official policy or position of any NFL team or a team's athletic physicians.
"A concussion, by definition, is basically a mild traumatic injury," Dr. Scott said. "And typically, something like that happens either through a direct blow to the head or rapid deceleration, so flash injuries, a player gets slammed down to the turf, their head hits the ground, and what happens is the brain actually collides with the inside of the skull. That's what causes the trauma to the brain itself."
And that trauma, depending on how hard a hit might've been or the velocity of a collision with another player or fall down to the grass, can take varying degrees of severity, which factors into what kind of symptoms there could be.
In the cases of Slay and Blankenship, both got up from plays that left them woozy, which on-field spotters and team trainers picked up on and were able to walk them over to the blue medical tent on the sideline for an evaluation.
The more extreme end of the spectrum are the scenarios like the ones that have involved Miami Dolphins quarterback Tua Tagovailoa, where collisions have happened at a force and velocity to leave him unconscious.
The latter, obviously, looks scarier than the former, but they all have to be taken seriously.
"The important thing is that it's a traumatic brain injury," Dr. Scott said. "If you think of it that way, it gives you a little bit more context that, alright, this is a pretty serious event that you're dealing with, so the expectation is that you're going to be out of play – potentially out of play for a significant amount of time, at least missing a game if not more."
Slay missed the Ravens game and didn't practice at all in the days leading up to it. Blankenship was the same approaching the Panthers game until the Eagles could officially rule him out.
Neither likely sat totally inactive during that span, but the first 24-48 hours after a concussion diagnosis, Dr. Scott explained, is typically kept as light as possible. No strenuous activity, avoiding screens whenever possible, minimal reading, "just letting things kind of quiet down," he said.
Then it's a steady feeling-out process of ramping back up, with rest in between to see what a player can handle again.
That can be seen with Slay in this past week's injury report. He was limited in practice on Wednesday, then back to being a full participant on Thursday and Friday before getting cleared to play.
He was back within 14 days and a game missed, which is a typical timeline for most concussions, Dr. Scott said.
"If a player, has a documented concussion during a game, you can probably expect them to miss at least the following game," he explained. "Just with the baseline protocol as far as the amount of time that they would need to go through for rest and to progress through the different steps to be able to get back to full contact."
But that's the fastest scenario, which is hardly a guarantee. For a player to be ready to return, they have to be symptom-free and at the lowest possible risk of sustaining another concussion. No set amount of time can be put on those conditions.
"A lot of that depends on how they're progressing," Dr. Scott said. "So you move from some light jogging and do a little bit more strenuous physical activity, back on the weights, doing agility training, and if the symptoms are recurring, we're getting worse, you're having recurring headaches, blurry vision, memory problems, well, that locks you back down."
"There can be some variability in how long it takes a player to come back, depending on how their symptoms are responding with each stage," he continued. "The more severe the concussion, the greater the likelihood that they're going to be out for a longer period of time, because you can expect that there's a little bit more healing that would need to go on, and you want to give them more time. The risk of going back in too soon and experiencing another head injury shortly after could pose some pretty serious risk of long-term concussion symptoms, or even the risks that come with getting traumatic head injuries."
So it's crucial to get the recovery right, the initial detection, too.
The NFL has concussion spotters on the field during all games, plus video operators who are watching replays solely to detect any concerning hits to the head or neck area. If one gets picked up on, the player in question is pulled aside for evaluation, first in the blue medical tent on the sideline and then in the locker room for further testing if necessary.
If a concussion is sustained, the player is placed within the league's concussion protocol and won't be clear of it until testing proves them symptom-free and safe to play again.
Anything short of that is a major risk.
"Players have missed entire seasons or have even had their careers cut short prematurely because of persistent symptoms that prevented them from returning to play," Dr. Scott said. "So it's really important to ensure that they are basically asymptomatic and fully resolved before putting them back on the field."
Bringing it back to the Eagles, Slay, after Sunday, appears all clear. Blankenship's progress will show itself later this week.
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