RGIII has a concussion, Matt Cassel goes down and more NFL Week 5 injury updates

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SB Nation's medical expert runs down the list of noteworthy injuries.

Head injuries, and specifically concussions, dominated the NFL injury front from Sunday's games, perhaps none with a bigger impact than the one suffered by Washington Redskins quarterback Robert Griffin III in his team's 24-17 loss to the Atlanta Falcons.

At least four players were removed from play due to head trauma, and in Griffin's case, the Redskins' handling of his injury drew the ire of the NFL officials as potentially violating the league's official concussion policy. Here are the details on RGIII's injury, some other key injuries from the week so far, and their potential impact:

More: NFL Week 5 scores | Sunday highlights


Robert Griffin III, Washington Redskins (concussion)

The entire Washington, DC, metropolitan area held its collective breath in the third quarter of the Redskins' loss to Atlanta Sunday when RGIII, the dynamic rookie quarterback, was laid out by Falcons linebacker Sean Weatherspoon on a scramble down the sideline. Griffin slumped to the ground after the hit -- which was a legal shot to the helmet (you can see it here) -- and according to head coach Mike Shanahan, he had trouble remembering details about the game when questioned after walking off the field under his own power. The team later announced the injury was a concussion, which raises the question of whether Griffin will be able to suit up for next Sunday's matchup against the Minnesota Vikings.

So what aspect of the NFL's concussion policy has the Redskins potentially in trouble with the league? Under league guidelines, teams must report all injuries sustained during the game in a timely and accurate fashion, and officials will consider whether the team's description given during the game, that Griffin was "shaken up" -- and whether they knew that he had been concussed -- breaks the spirit of this regulation.

How a team's medical staff determines whether a player who has suffered a head injury during a game can return to the field has long been a subject of confusion. To address this, the league has made several adjustments to its formal policy over the past several years, calling upon teams to diagnose concussions -- and remove them from play for the remainder of the game -- based on the presence of a number of cardinal signs and symptoms, including:

  • Loss of consciousness
  • Confusion
  • Amnesia
  • New and/or persistent symptoms (such a headache and nausea)
  • Abnormal neurological finding (such as balance issues)
  • And progressive, persistent or worsening symptoms

The team's medical staff can use these symptoms, or rely on its own clinical judgment, to remove players from the game. However, with the exception of loss of consciousness, many of these findings can be subtle, and to aid teams in more challenging cases, the NFL has suggested teams conduct the following tests on the sidelines to help determine whether players can return to action:

  • In the case of worsening symptoms, players will be screened for possible spinal injury or brain trauma more serious than concussions, such as a skull fracture or bleeding on the brain.
  • Orientation: "What month is it? "What year is it?"
  • Word recall: The five-word list they're asked to repeat.
  • Concentration: Repeating numbers backward. It's not just three numbers. It goes up to five, like 7-1-8-4-6.
  • Balance: In addition to the test with two feet together, there are others with one foot behind the other and standing on one leg.
  • Symptoms checklist: Such as headache, nausea and dizziness.

Beyond the short-term complications of concussions listed above, a major concern regarding their impact involves the potential long-term effects of repeated head trauma, and particularly those sustained before full healing of a preceding injury.

From listening to Shanahan's post-game press conference, RGIII's symptoms were not subtle, and therefore the team may not have needed to go through all of these tests to determine that he had suffered a concussion. Griffin himself said after the game that he expects to play in Week 6, although the Redskins' medical staff will have to monitor his progress and retest for concussion symptoms later this week before he can be clear. If he is unable to take the field against the Vikings, fellow rookie quarterback Kirk Cousins, who had his share of ups and downs after replacing Griffin Sunday, would take the helm of the Redskins' offense.


Matt Cassel, Kansas City Chiefs (head)

In perhaps the ugliest scene of Week 5, the much-maligned Chiefs quarterback lay flat on his back for several minutes after suffering a head injury on a hit by Ravens' Haloti Ngata, as some fans cheered Cassel's injury. Cassel was flattened by Ngata after releasing a pass in the direction of Jamaal Charles and did not return to the game. If Cassel does not pass neurological tests later this week, backup quarterback Brady Quinn, who finished the team's 9-6 loss to Baltimore Sunday, would get the start in Week 6 at Tampa Bay .

More: Eric Winston angry at Chiefs fans for cheering Cassel's injury

Running Backs

Andre Brown, New York Giants (concussion)

The Giants running back, a surprise star as a fill-in for Ahmad Bradshaw in Week 3, suffered a head injury while returning a kickoff in the first quarter of the team's 41-27 win over Cleveland Sunday and did not return. Brown violated an NFL rule of his own by tweeting during the game, telling fans that "Everything is OK" after leaving the field for further evaluation. Bradshaw (200 yards rushing) and third-string running back David Wilson (40-yard touchdown run) more than managed in Brown's absence, and it will likely not be until mid-week until the Giants know whether they have all three of their capable running backs available for next week's showdown at San Francisco.

Javon Ringer, Tennessee Titans (knee)

The Titans' second-string running back, filling in for Chris Johnson at the end of a 30-7 trouncing at Minnesota, injured his left knee after being tackled by Vikings' cornerback Josh Robinson and was carted off the field. While there has been no word out of Tennessee regarding the severity of the injury, with Ringer unable to bear weight on the leg, the prognosis for a quick return appears to be pessimistic.

Brace Hemmelgarn-US PRESSWIRE

Tight Ends

Jermichael Finley, Green Bay Packers (shoulder)

Adding injury to the sting of losing a 21-3 lead in Sunday's loss to Indianapolis, Finley left the game in the third quarter due to a right shoulder injury. For his part, Finley downplayed the significance of the injury after the game, telling the media that the team "didn't want to risk it going in and reinjuring it." After falling to a surprising 2-3 and facing arguable the league's best team in the Houston Texans next Sunday night, the Packers can ill afford to lose Finley, whose backups if he cannot take the field are Tom Crabtree and D.J. Williams.


D'Qwell Jackson, Cleveland Browns (concussion)

Joining the concussion parade from Week 5 was Jackson, the Browns' defensive leader, who left the game in the second quarter and did not return. Following Jackson's absence, the wheels fell off the Cleveland defense, with the team squandering a 17-7 lead against the New York Giants en route to a 41-27 loss. Rookie linebacker L.J. Fort took Jackson's place on the defense and would get the nod in Week 6 against AFC North rival Cincinnati next week.


Troy Polamalu, Pittsburgh Steelers (calf)

The Steelers' safety, who had missed the previous two games with a right calf strain, aggravated the injury in the first quarter of Sunday's thrilling 16-14 win over the Philadelphia Eagles and did not return to action. After Polamalu limped off the field, Ryan Mundy took over in his place, as he had done in the All-Pro safety's absence. With Pittsburgh facing a short week before a Thursday night matchup at Tennessee, it would not be a surprise if Mundy makes the start for the Steelers in Week 6.

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