Steve Grech Brings CSUN Experience to NFL Concussion Protocol

by Geoffrey Herberg

NORTHRIDGE, Calif. – Over the past decade, an ailment that was once overlooked and misunderstood is front and center in the minds of athletic trainers and sports professionals everywhere: concussions. It was once as simple as giving a player some smelling salts (ammonium carbonate) and running them back onto the field for the next play. That is no longer the case.

Fortunately, science and safety caught up with the tactics and concussions have become a paramount focus of professional sports leagues throughout the world. In the National Football League, the possibility of a concussion exists on every play. With 22 players slamming into each other over 60 minutes, the frequency of the event can be terrifying.

The NFL has responded to this trend by implementing a series of rules and protocols for players experiencing concussion-like symptoms. Part of that expansion includes having an "Unaffiliated Neurotrauma Consultant" (UNC) on each sideline to monitor the action from the field and work alongside team medical staff on all neurological evaluations. Helping the team medical staffs and UNCs are independent certified Athletic Trainer (ATCs) spotters who monitor the action from the press box and identify potential injuries, especially to the head or neck.

In his 11th season as the Assistant Athletic Director for Sports Medicine/Head Athletic Trainer at CSUN, Steve Grech is currently serving as an ATC spotter for the NFL during Los Angeles Rams home games for the 2016 season. That includes the team's upcoming trip to London and he brings invaluable experience and professional knowledge to his role in monitoring player safety.

"I was quite fortunate that my previous work experience helped me become a candidate for the program. When the Rams moved to Los Angeles, the NFL office contacted me about the need for local specialists and I was happy to apply," said Grech.

Player safety and concussions hit a crescendo in the 2011 season. A quarterback for the Cleveland Browns was allowed to continue playing despite signs of neurotrauma because team athletic trainers and medical personnel were attending to another injury.

There are two independent certified athletic trainers (ATCs) in the press box at every stadium, who serve as spotters during the game. Before the contest, they meet with the officials and go over the protocol. During the game, they sit in the press box and have an unobstructed view of the action with a feed of the broadcast as well to help them identify possible injuries. The ATCs can call down to the sidelines of either team to help them identify any possible head trauma and players who may be in need of medical attention.

"The spotters have the ability to call a medical timeout if they see a player that has received some sort of head trauma and are showing signs and symptoms of a possible concussion," Grech noted. "If it looks they are not going to be removed from the game, we are able to contact the officials directly and remove that player from the contest for an evaluation." 8036

That decision is a tough one to make in the heat of the moment, but it is one Grech and the NFL take incredibly seriously and requires a great deal of instinct. Even if a player is identified as possibly having suffered head trauma and later cleared to return to action, it allows medical personnel the ability to fully evaluate their injury.

The full NFL concussion protocol reads as seriously as you would expect given the amount of attention devoted to the subject:

When a potential concussion is identified the player shall be removed immediately from the field
The NFL team physician and the unaffiliated neurotrauma consultant (UNC) will:
1. Review video of the play
2. Perform a focused neurological examination
Madden Rule: If there is suspicion of a concussion, the player will be escorted to the locker room for a full assessment
If the player is diagnosed with a concussion, there is no same-day return to play
If the player passes the exam, he will be monitored for symptoms throughout the game

Among the many symptoms Grech and medical personnel are looking for are: loss of consciousness, motor coordination/balance problems, blank or vacant look, disorientation and clutching of the head after contact.

As a kid attending Raiders games in the LA Coliseum, Grech watched George Anderson attend to players and that introduced him to the profession of athletic training.

From 1999 to 2002, Grech was an assistant athletic trainer at CSUN working primarily with men's basketball and football. He also served one year as the head football athletic trainer at the University of San Diego (1998-99) and gained NFL and NHL experience while working as a summer camp athletic training intern for the Oakland Raiders (1995-97) and the Los Angeles Kings (1995).

From 2002 to 2005, he was an assistant athletic trainer at the University of Southern California where he was a part of two consecutive National Championship football teams and two Heisman Trophy winners.

"We find out more and more about concussions as the years go by through the latest research. There is more sensitivity around concussions and head trauma. We are more aware of the situations that create the injuries now and how it affects the athlete not just in the moment, but also throughout the rest of their life," Grech said. "Student-athletes and professional athletes are better for all that we continue to learn about concussions."

Grech's NFL work is not just limited to neurotrauma incidents on the field. The video replay system allows ATCs to send team medical personnel replays of any injury, which then can be evaluated in real-time on the field.

In his role with the Matadors, Grech works with the CSUN ATCs to keep them prepared for any situation that may arise. That includes teaming with the CSUN Police Department to stage serious injuries or events that require additional medical care.

In fact, Grech is not the only Matador representing CSUN at Rams game as ATC Spotters. Dunford Rodill, an athletic trainer at USC, is the team's other ATC spotter and received both his undergraduate and graduate degrees from CSUN. Additionally, Ronda Lowry-Hyatt, who served as the head ATC at CSUN for 16 years including when Grech was a student, is also an ATC spotter, giving the Matadors three generations of ATCs involved in the NFL's expanding program.

The reality is simple: concussions and football are married to each other for the rest of eternity. The increased focus on the injury and the changes to the rules to protect players, especially those in defenseless positions, make concussions a topic that is on the minds of everyone within the myriad of organizations involved in all levels of football throughout the nation.

"Having this opportunity and going back to the Coliseum to help with this project is very fulfilling. It brings back a lot of great memories and I am really enjoying the chance to be involved with a game I grew up playing and still love," Grech concluded.

California State University Northridge Athletics

Steve Grech Brings CSUN Experience to NFL Concussion Protocol

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