Wes Welker—Should the Concussion Prone Player Retire from the NFL?

**UPDATE: The Broncos announced that Wes Welker will be suspended for the first four games of the season for violating the NFL’s policy on performance enhancing substances, specifically for use of amphetamines. Although he staunchly defends his innocence and claims he would never knowingly take any substance, Welker tested positive from a sample taken shortly after he attended the Kentucky Derby. He had earlier appealed to the NFL, claiming the sample was tainted. He has said he does wonder if someone put something in his drink at the Derby.

Is this four week suspension a ‘blessing in disguise’ in the form of an enforced rest for further recovery from Welker’s recent concussion? Although according to Dr. Arno Fried, who would not clear Welker to play at this point, while four weeks is better than the reported one week break he took following his previous concussion, it is far from the one year break that Dr. Fried ultimately recommends for Welker.

But Wes Welker’s issue is just the tip of the Titanic-like iceberg. As of today, there have been 67 reported concussions since the start of this year’s NFL preseason, according to @NFLConcussions on Twitter (not affiliated with the NFL).

Read more about Wes Welker’s latest news on ESPN.com

Neurosurgeon Dr. Arno Fried Details the Risks

football-helmetTo play or not to play—that is the question. After suffering three concussions in the past ten months, Denver Broncos wide receiver Wes Welker may be on the field for the season opener against Indianapolis on Sunday, a mere 15 days after suffering his latest concussion.

Many pundits are calling on Welker not only to forego playing, but to retire from the sport. It seems that in their analysis, enough is enough. But Dr. Arno Fried, an expert neurosurgeon and founding member of Advanced Neurosurgery Associates in New Jersey, has a slightly nuanced view.

“I am not a big believer in ‘absolutes,’ such as telling Wes Welker he should retire,” says Dr. Fried. “I would counsel him on the cognitive changes he may undergo in the long term with his concussion history, and that the odds of those changes will increase if he gets another concussion. I would give him informed consent and then let him decide.”

One problem, points out Dr. Fried, is that we don’t know what kind of concussions comprise Welker’s past history: was he merely dazed, did he suffer memory loss or did he black out?

Dr. Fried, however, has short-term advice on which he is definitive: “If Wes Welker were my patient, I would not clear him to play on Sunday.” In fact, Dr. Fried would advise him not to play for a year. And in terms of Welker’s return to practice this past Monday, Fried said, “I wouldn’t recommend it.” Fried counsels rest for at least two weeks following a concussion, and he is clear that rest means not only no practice, running or other exercise, but complete rest from computer screens, television, or other work.

It is important to clarify the meaning of medically recommended rest following a concussion. The recommendation is for cognitive rest. This means avoiding cognitive activity, which is defined as anything that taxes the brain. This would include anything from reading, to doing homework, to watching TV or going to a movie. It also includes texting, being on the phone, or being on the computer. Cognitive activity is resumed slowly, and depends on the presence or lack of concussion symptoms.

If Wes Welker remains symptom-free after Monday’s workout (non-contact practice drills) — Tuesday is an off day for the players — he could progress to the next stage, which would be full participation in all parts of practice on by Wednesday. This would set the stage for his potential participation in the game on Sunday.

To return to play, Welker, who is under the supervision and evaluation of team medical staff, would have to be cleared by an independent physician designated by both the NFL and NFL Players Association.