When Dolphins quarterback Matt Moore was laid out by a shot to the jaw against the Pittsburgh Steelers, it was easy to assume his day was done.
When Moore had his helmet back in his hands 3 1/2 minutes later, it was easy to question why.
Today, even the NFL is wondering.
Dr. Gillian Hotz can tell you how and why, but before outlining her expert opinion, it’s important to note the serious nature of the situation, beyond the obvious concern for Moore. Under the system agreed to by the NFL and NFL Players Association last July, clubs found in violation of concussion protocol can be fined and forced to forfeit draft picks.
Currently, no evidence has been made public that the Dolphins violated protocol, although the investigation is ongoing.
Moore’s agent, Lynn Lashbrook, told The Post he’s confident protocol was followed for what he believes was the hardest hit of Moore’s career. So does Hotz, co-director of the University of Miami’s Miller School of Medicine’s Concussion Program since 1995.
“I think in his case, they weren’t concerned at all about this kid having any concussive injury,” Hotz said. Although she did not treat Moore, as part of her job, she’s often on the sidelines on Saturdays, determining if injured Hurricanes may return to play.
In Moore’s case, his jaw took the full brunt of a blow by Steelers linebacker Bud Dupree that elicited gasps throughout Heinz Field. Dupree reportedly is being fined $18,231 by the league. As for the doctors, how it is possible they were not concerned “at all”?
“Every hit to the head is not a concussion,” Hotz said. “We just have to be careful about this. Yes, most of the time you see a kid sitting after a hit, they’re dazed, they have trouble getting up. OK, that’s a whole different story. But with this kid, he probably just took a hard hit to his jaw.”
Moore missed only one play. As he took his next snap, there was an outcry on social media mocking the NFL’s concussion protocol. This followed a regular season in which questions were raised about sideline treatment for quarterback Cam Newton.
How can doctors assess if there’s a problem in a minute or two? First, consider the circumstances.
“It’s hectic,” she said. “There’s a lot of noise, there’s a lot of commotion. It’s a tight sideline, so we do have a protocol where if they really suspect that there’s an injury, it’s best to take them downstairs, to the locker room. We have that protocol even with our Miami Hurricanes.”
Whether it’s on the sidelines, locker room or inside tents college teams quickly erect on sidelines, doctors check for symptoms. In the NFL, this process is done by doctors, some affiliated with the team, some not.
At this point, information is gathered in two ways — by observation and by interview.
“Just a quick orientation if he knows what’s going on,” Hotz said.
Questions can range from basic to involved. Where are you? What’s today’s date? What was the last play called? Or: Count backward. Perform a balance assessment test.
Visually? “Looking at his eyes,” Hotz said. “Looking at how he’s looking at you. Is he looking like he’s on a lost train?” Doctors also check for dilated pupils and eye movement. If red flags are raised, players should be taken to the locker room for “a full-blown” assessment, Hotz said.
Still, critics say loopholes exist. The Washington Post reported that “full-blown” tests take eight minutes, which puts pressure on doctors and spotters positioned overhead. Imagine the outcry if they pull a key player in a crucial situation and later learn that player was fine.
And although two “unaffiliated neutrotrauma consultants” are assigned to each NFL game, the league confirmed they are paid by the NFL, raising questions about the term “unaffiliated.”
Moore, evidently, passed the sideline tests.
“I know it was tough to watch,” Lashbrook said Tuesday. “I talked to Matt this morning. He’s very comfortable with the protocol he went through. He took his time to get up. He’s been through concussions before. But he knew he could play and he demonstrated that.”
Hotz said some of her colleagues at UHealth, UM’s medical system, serve as sideline neurotrauma experts at Dolphins games. She conceded that doctors are reluctant to criticize one another, especially when one is on scene and one is not.
“We can’t all be Monday morning quarterbacks,” Hotz said. “There were professionals there. One was working for the team. One was unaffiliated. These experts are saying, ‘Look, we don’t have an issue here.’ I think we have to be very careful not to point fingers.”
The hit itself, she said, reveals only part of the information. Not all brains are created equally. A player’s age and size affects how much impact it can safely absorb.
But, Hotz added, she welcomes scrutiny on traumatic brain injury including chronic traumatic encephalopathy (CTE), which has been blamed in the deaths of many former football players including Pahokee’s Andre Waters and former Dolphin Junior Seau. The more awareness, the better, Hotz said.
“I’m ecstatic that we’re hearing ‘concussion protocol’ in media reports,” Hotz said. “People like me have waited a long time to get this evaluation on the sideline. It’s a real start. It’s great people are questioning whether it’s a real hit or not.”