The Doctor Is In: Brown Likely Closer To Playing Than You Think

UPDATE: Brown ruled out Friday morning by team.
I believe that Antonio Brown will play this weekend and play well.   And I think that will be evident later today, when the Pittsburgh Steelers practice report for Friday is released.

It’s no secret that as each day passes, Steeler Nation becomes more frantic with worry about whether the best wide receiver in the NFL will be ready to join the Steelers when they face the Denver Broncos in the Divisional round of the playoffs.  Ever since Antonio Brown was struck in the head by Vontaz Burfict in the final game-winning drive against the Cincinnati Bengals, he has been in the concussion protocol.  And contrary to what Adam “Pacman” Jones continues to insist, Brown was not faking this head injury.  Brown is a player who knows how to protect his body when he falls; it is a skill that appears to be natural in him but is more likely by design, and it has always impressed me.  After Burfict’s shoulder rammed AB’s helmet, Brown fell like a ragdoll with his arms flailing in the air.  If I had to guess, he probably awoke when his head struck the ground.

Speaking of guessing…SPOILER ALERT!!!  I will be making educated guesses (otherwise known as speculation) here.  If that’s a problem and you only want absolute facts, this is not the post you’re looking for.

When Bob Holtzman of ESPN reported on Monday that it was “not looking good” for Brown to play, many of us thought he had made a mistake and actually meant DeAngelo Williams, who is struggling with a foot injury.  It was an odd statement to make so early in the week, when Brown may not have been tested at all.  But it set off a rampage of news posts all reiterating this single comment, and the rumor was picked up by most media outlets until it seemed like it must be true.

The Steelers are usually tight-lipped about their players’ injuries, and that only escalates in the playoffs.  They have clearly circled the wagons here, and the only scrap of information available – other than that Brown remains in the concussion protocol – is the brief videos he posts on snapchat.  A feisty Coach Tomlin refused to answer any questions regarding his star WR’s progress in his weekly press conference on Tuesday.  Brown has not been available to the media, part of the league rules for players with concussions.  His teammates have offered no updates, other than the plan for punt return duties if AB is unable to go.  Martavis Bryant did confirm today that Brown took part in the team meetings.

Some fans suggested that the Steelers were moving Brown through the steps of the protocol slower than needed to counter Pacman’s accusation, which is absurd.  The team would not delay having their best offensive skill player’s return to practice, and they absolutely do not care what any player for the Bengals says or what anyone else thinks about it.  Nor are the Steelers engaging in gamesmanship with the Broncos (another conspiracy theory), who will certainly plan as if Brown is playing anyway.  The Steelers are, however, keeping any updates on Brown’s progress from the media and fans…simply because revealing these details would not benefit the team in any way.

So what are the steps in the concussion protocol?  Here are the basic concepts:

  • A player can only proceed to the next step if he can tolerate the activities of the current step without return of signs or symptoms of concussion
  • If the activities trigger recurrent symptoms, the player must return to the prior step in the protocol.
  • Neurocognitive testing (the ImPACT test) can be done any time after the player completes Step 1 or during Steps 2 or 3. The player just has to perform well on this testing before resuming contact activities.

Here is the full monty if you want to read it all.  And here is the Cliff notes version if you want some details or look down further for a chart that will take you 3 seconds to process:

  1. Step One: Rest and Recovery: This is the physical and relative cognitive rest step.  The player is prescribed rest, limiting or, if necessary, avoiding such activities as electronics, social media and team meetings until his signs and symptoms and neurologic examination, including cognitive and balance tests, return to baseline status.  Stretching and balance activity is allowed.
  2. Step Two: Light Aerobic Exercise: Under the direct oversight of the team’s medical staff, the player should begin graduated cardiovascular exercise (e.g., stationary bicycle, treadmill) and may also engage in dynamic stretching and balance training.  The duration and intensity of all activity may be gradually increased as long as the player’s symptoms don’t return.  He may attend regular team meetings and engage in film study.
  3. Step Three: Continued Aerobic Exercise & Introduction of Strength Training: This is pretty much a continuation of Step 2, but the increased activity can mimic sport specific activities, such as the strength and endurance drills that players do in practice.
  4. Step Four: Football Specific Activities: The player may participate in non-contact football activities such as throwing, catching, running and other position-specific activities.  All activities at this step remain non-contact.
  5. Step Five: Full Football Activity/Clearance: The player has to perform at his baseline on the cognitive test before getting to Step Five.  He also has to show he can participate in non-contact football activity including team meetings, conditioning and non-contact practice without recurrence of signs and symptoms.  At that point, the player is allowed to participate fully in practice.  If he does so without return of symptoms and then passes inspection by both the team physician and the independent neurological consultant, he is cleared to play in a game.


Sunday night in Cincinnati, Gerry Dulac of the Pittsburgh Post-Gazette tweeted that Antonio Brown “is fine and should be good to go in Denver”.  By all reports, he was in good form in the locker room after the game, and it is entirely possible that he was without symptoms by the following day, even after such a big hit.  Keep in mind that this was his first concussion.  Yes, it is also possible that he felt fine but still had a concussion, no question.

Monday was a quiet day for AB, as expected.  The players did not practice, and he likely rested at home.  He was already on social media, appearing in Snapchat stories, so he clearly had permission from the team physicians for that.  The following day, Tomlin confirmed that Brown would be at the South Side facility, per Pittsburgh Tribune beat reporter Mark Kaboly’s tweet:

Since the players did not practice on Tuesday, it is obvious that Brown was there for evaluation.  Therefore, we can assume that he was free of concussion symptoms at rest and had advanced to Step 2.  While at the training facility, he may have begun light exercise and even taken the ImPACT test.  Obviously, we don’t know how he spent his time there.

Brown was back there again the following morning by 7:26 am, as reported by Aditi Kinkhabwala.  A photo tweeted later that day showed a player in sweats with the report that Brown didn’t practice:

Unfortunately, the photo cuts off at the neck, so we cannot be sure that it is AB.  Then again, the only other players that didn’t practice were Cameron Heyward, DeAngelo Williams, Ben Roethlisberger, and Ryan Shazier.  Safe to say none of them have the slim build of the player in the photo.  So I am betting it’s Brown, and he is not laying on a couch.  It’s likely that he was in Step 3 or even 4.  My understanding is that the reporters present for the open part of the practice are not permitted to share what they see.  Brown could have been doing cone drills or catching footballs, but it wasn’t going to show up on twitter.

Our final piece of circumstantial evidence comes from Antonio himself.  Wednesday evening he posted a clip on Snapchat suggesting that he would practice the following morning, as reported on this site by Alex Kozora.  We know from Thursday’s practice report that he didn’t participate…with the team.  Again, Brown could have spent time on individual drills, even catching the ball and running routes on his own.  He would probably consider this “practice” even if it doesn’t meet the criteria as defined by the NFL rule book.

Many fans are concerned that Brown won’t clear the protocol based on time intervals that must be met between each step, but that is not the case.  The management of concussions was determined by a consensus statement derived at the 4th International Conference on Concussion in Sport.  This was the basis for the concussion protocol adapted by the NFL.  Several folks have tweeted this graph in the past few days, BUT IT IS NOT THE NFL PROTOCOL!!!!!!!!!!:

return to play protocol graph3_edited

The NFL concussion protocol for return to participation contains the following wording:

  • There is no set timeframe for return to participation or for the progression through the steps of the graduated exercise program.
  • Recovery time will vary from player to player.
  • What constitutes a reasonable amount of time (for remaining at baseline status following activity) shall be determined on a case-by-case basis.
  • Depending on the severity of the concussion and the time required to return to baseline, the progression through the steps may be accelerated.

Based on this, Brown could have gone through Step 1 on Sunday and passed through Steps 2-4 in 1 or 2 days.  He may already be cleared for full contact activity, and that is my guess.  If he were having recurrent symptoms, he would be at home resting, not hanging out at the training facility all day.

And for the conspiracy theorists that will immediately claim that the team physicians would push Brown through whether he was ready or not, think again.  This is the team that held Roethlisberger out of practice after the Seahawks game when he was symptom-free and didn’t even think that he had a concussion.

Obviously, I have no proof of Antonio Brown’s progress through the concussion protocol.  But I will be very surprised if he is not a full participant in practice for the Steelers today.  And we will know that very soon.

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