Dr. Ken Podell, the co-director of the Houston Methodist Concussion Center and a neuropsychological ...

1. Concussions in baseball: the view from a neuropyschological
expert
Dr. Ken Podell, the co-director of the Houston Methodist Concussion Center and a
neuropsychological consultant for the Texans, Astros, Dynamo, Dash and Rice, discusses George
Springer's crash into the wall last night and MLB's concussion protocols:
What did you think when you saw the play? If you ask the sport fan side of me then I saw a great
catch (made ESPN Top 10). However, if you ask the clinician side of me I saw the potential for a
head injury including concussion and even neck or facial injury. All competitive sports, particularly
at the professional level, have inherent risks of injury. Many of these athletes risk injury to be highly
competitive, which seems to have been the case with George Springer's catch.
What kind of protocol is followed after a concussion is suspected? All of the professional leagues
such as NFL, NBA, NHL, MLS, and NASCAR all have concussion protocols in place that include how
to handle concussions on the field as well as return to play. Often these protocols are distinct and
are intended to work together. On-field protocols include an evaluation assessment by the team's
athletic trainer or team physician or designated health care provider to assess that concussion. At
that point in time if a diagnosis of concussion is made then the player must be pulled from the
competition and cannot return. If a concussion is diagnosed that immediately evokes the return to
play protocol. I most involved in the return to play portion of the concussion protocol for the
professionals. The different leagues have different requirements that determine the length of my
examination.

2. Many of the professional leagues will use a combination of symptoms, neurological exam,
neurocognitive testing, and balance assessment to make the initial diagnosis of concussion (on the
field). A common tool called the Sideline Concussion Assessment Tool-3 incorporates all of the
above. There are other additional tests that can be used by the healthcare staff to make the initial
diagnosis of concussion, if desired.
MLB's concussion policy seems like it's really focused on collisions at the plate or being hit by a
pitch/line drive. How does the policy handle situations like this? The leagues' concussion protocols
are not specific to the mechanism of injury. The two examples you gave are the most common
mechanisms causing concussions in baseball. However, the MLB concussion protocol is not specific
to the mechanism of injury. However, the concussion protocols are all treated the same regardless of
the mechanism of injury so whether a players hit by a ball, strikes her head on the ground, or strikes
an object the concussion protocol is exactly the same
At what point would you get involved in a case like Springer's? At the professional level the team
athletic trainer or team doctor is quite capable of evaluating for concussion at the game. I am
sometimes consulted by the athletic trainer after a player is pulled from the competition. I am most
involved after the diagnosis is made and in determining when the player has recovered and possible
treatment plan while still concussed.
What is Springer's condition? You must ask the Astros.

3. Compared to other sports, in your research and experience, how often do you deal with baseball
concussions? Statistically, baseball has a lower rate of concussion than other professional sports
such as football, ice hockey, or soccer. One study found 33 concussion from 2001-2010 (catchers
have the highest rate and so do umpires!!). However, I suspect that is low and that there will be a
higher rate when data from 2010-2014 is looked. This is what has been found in the NFL and NHL,
which we believe is due to the strict policies, better awareness, better diagnostic criteria and tools.
But it is still much lower than hockey and football.
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