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The Doctor Is In: When Will Mason Rudolph Return?

You are all familiar with the expression of “adding insult to injury.”  In Sunday’s matchup between the Steelers and Ravens, it almost felt like adding injury to insult.  In the midst of a frustrating loss during a heated division battle, Steelers quarterback Mason Rudolph, who has taken over as the starter for an injured Ben Roethlisberger for the rest of the season, collapsed after a helmet to helmet hit by Ravens safety Earl Thomas.  The officials belatedly threw a flag for roughing the passer long after Rudolph hit the turf.

With the emergency cart not working properly (do not even get me started) Rudolph walked off the field with the support of team trainers.  Not stopping at the locker room, he was taken directly to the hospital for additional testing.  According to a tweet from Adam Schefter, Rudolph was discharged in stable condition and will be resting at home tonight.  Obviously, this is very good news and the best case scenario in this situation.

The biggest priority, of course, is Rudolph’s health, not just for his playing career but for his life.  But it’s perfectly natural for fans to want to know when he will return under center.  With a conference matchup against the Chargers on the west coast next Sunday night and the season on life support, the Steelers need all the help they can get.  Many would guess that with another loss, any hopes for even a Wildcard playoff berth would slip away.

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.

We know that Mason will be in concussion protocol this week.  There is a chance he will be cleared and start for the Steelers on SNF next weekend.  We’ll look at whether I think he will get a helmet but first, here’s a quick review of the process:

  • 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.  I would guess that means the strength and endurance drills that players do in practice.
  4. Step Four: Football Specific Activites: 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.

 

I’m not Mason Rudolph’s physician and I obviously have no access to his medical records.  Based on what I saw on video, however, I have real concerns about Mason making it through the protocol this week and here’s why.

When Thomas hit Rudolph, he fell to the ground limply, with no attempt to protect himself.  On landing, his helmet hit the ground.  That’s two helmet hits the QB absorbed.  The way he fell makes me think that he was already obtunded  (less than a full level of alertness, or an altered level of consciousness) before he fell.  Here’s the hit and the fall:

 

If that looks familiar, it should.  The last time a Steelers player fell like a rag doll, making all of us cringe in horror, was in Cincinnati for the Wildcard game on 1/6/16.  While Vontaz Burfict (currently appealing a yearlong suspension for his latest dirty hit) rammed Antonio Brown at a much higher velocity than Thomas hit Rudolph, the physical reaction is pretty similar:

As you all remember, Brown was unable to clear the concussion protocol and make it back to play in the Divisional round game in Denver the following week, where the Steelers season ended.  According to comments that Brown made in interviews during the offseason, he wasn’t even sure he could have played a week later had the Steelers advanced to the AFC Championship game.

With the bye week coming after the Chargers game, I can’t see the team taking any chances with Mason Rudolph’s health.  Unless he flies through his tests without a hitch, I would expect the team doctors to recommend that he skip the next game, which will give him plenty of time to recover before returning under center to face the Dolphins on Monday Night Football on 10/28/19.

It’s safe to assume the Steelers will make a roster move early this week to add another quarterback.  This may involve promoting the Paxton Lynch from the practice squad.  In the meantime, Devlin Hodges acquitted himself well, stepping in today to lead the team on a TD drive and giving the Steelers the lead and a chance to win.  Fortunately, I expect Mason Rudolph to make a full recovery.  Hopefully, when he returns the Steelers will still have a shot at the playoffs.

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