Basketball might not be the collision sport that football is, but concussions are still prevalent in the NBA as a result of the physicality and speed with which the game is played. According to Spotrac, a total of 51 games were missed by a combined 16 players that displayed concussion-like symptoms during the 2021-22 NBA season.
In the NBA, concussions are treated on a case-by-case basis — the result of a new policy implemented by the league prior to the 2017-18 season. As such, a number of factors including the results of baseline testing and acute evaluation play a large role in how each player's injury is handled.
Here is more from the NBA Concussion Policy:
Understanding that concussions are diverse injuries that may have significant long-term consequences, the NBA Concussion Policy is designed to maximize the health and safety of NBA players by providing a framework of education and clinical management that best reflects the current scientific understanding of the injury. Prior concussion history, genetic predisposition, a history of learning disorder, ADHD, migraines, and mood disorder have all been suggested, among other things, to affect the risk of sustaining a concussion or having a more protracted or complicated course. The policy was created, therefore, under the core principle that each concussion, and each athlete, is unique.
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How NBA concussion protocol compares to the NFL
Steps needed for players to return from concussion in the NBA
The NBA Concussion Policy outlines the steps required for a player to return to participation. Within these steps is a return-to-participation exertion process of physical activity, which a player cannot begin until 24 hours after sustaining the concussion.
Per the policy, a player may not return to participation until these conditions are met:
- The player is without concussion-related symptoms at rest.
- The player has been evaluated by a physician.
- The player has successfully completed the NBA's return-to-participation exertion process.
- A team physician has discussed the return-to-participation process and decision with the director of the NBA Concussion Program. The final return-to-participation decision is made by the player's team physician.
NBA return-to-participation exertion process
- Several steps of increasing exertion — from a stationary bike to jogging, to agility work, to non-contact team drills.
- With each step, a focused neurological examination is performed. A player must be symptom-free to move to the next step. If a player is not symptom-free after a step, he stops until he is symptom-free and begins again at the last step he passed without any symptoms.
- There is no timeframe to complete the process.
Steps needed for players to return from concussion in the NFL
The NFL's concussion protocol began in 2011 when it was developed by the Head, Neck and Spine Committee. If there is concern that a player might have a concussion, the player undergoes an exam by a team doctor or an unaffiliated neurotrauma consultant or athletic trainer.
If it is determined that a player has a concussion, the protocol is initiated. This protocol includes a follow-up neurological exam and periodic evaluation by the medical team.
A player must complete several steps before leaving the NFL concussion protocol:
- Symptom-limited activity — included team-supervised limited stretching and light aerobic exercises
- Aerobic exercise — supervised cardio exercises along with stretching and training.
- Football-specific exercise — players can take part in football-specific exercises to start working with the team for up to 30 minutes under supervision.
- Club-based non-contact training drills — players can start throwing, catching and running, and engage in activities more specific to their position. By this phase's end, players have to have undergone neurocognitive and balance testing.
- Full football activity/clearance — a player has to be cleared by both the club physician and the independent neurological consultant to return to full activity.
How NBA concussion protocol compares to the NFL
The NBA and NFL protocols to return from a diagnosed concussion are similar in that they each involve multi-step processes, however, the NFL's process is a bit more rigid, which makes sense given the NFL's schedule and the nature of collisions in the sport.
With 17 games in a given season, the NFL's return-to-participation process is a bit more spaced out and involves input from independent consultants. There are five progressive steps that come after evaluations and clearance.
The NBA, which plays 82 games in a season and multiple games in a week, has to take a different approach given the ways in which practices and travel factor into the schedule. While they are listed together in the NBA's policy, it is important to note that the increases in exertion come separately and each is followed by a focused neurological examination.
The biggest similarities are that there are multiple steps, various neurological examinations and no timeframe is placed on the process with the goal of prioritizing the player's health.
