Saturday, November 14, 2026

Following Protocol: Inside NFL’s Player Safety Measures

  • From the spotters in the booth to doctors on the sidelines, 30 medical staffers work each NFL game.
  • NFL’s emergency action plan praised after responders save Damar Hamlin’s life.
NFL concussion protocol.
Photo by A.J. Perez.

Want more from Front Office Sports
in your search results?

Add Front Office Sports on Google

PHOENIX — Robb Rehberg showed off “the button” for player safety days before Sunday’s Super Bowl LVII at State Farm Stadium.

“What we are looking for is more than just a hard hit,” said Rehberg, NFL’s coordinator of gameday medical operations. “A hard hit is not just enough to call down to call down and initiate the concussion protocol and a medical timeout. It’s looking for the injury behavior that we are looking for.” 

The two ATCs  — one concentrating on each team — could stop play for a suspected concussion since the 2015 season by sending a signal that reaches the referee directly to initiate an injury timeout. 

“To my knowledge, it’s the only place that medical personnel can stop a professional game strictly for the purpose of health and safety,” NFL Chief Medical Officer Dr. Allen Sills said.

Concussions Up

From the start of the preseason through the conference championship games two weeks ago, spotters stopped play 33 times — nearly twice the rate as last season. Diagnosed concussions were up 18% in the regular season compared to the 2021 season.

“I think it’s because we’re getting better at identifying these things,” Rehberg said. 

The two-spotter system isn’t infallible. Most recently, the spotter assigned to the New England Patriots that game appeared to be slow to stop play when receiver DeVante Parker showed signs of distress. An NFL-NFLPA investigation found the spotter was about to halt play when the Cardinals threw the challenge flag.

The spotter system is just one way a player can be evaluated for a potential concussion. The others include: 

  • The player can self-report. 
  • One of his teammates or coaches can express concern to the team’s medical staff.
  • The team’s medical staff.
  • An unaffiliated neurotrauma consultant on each sideline with access to replays.

“When someone has been identified as possibly concussed, the first stop — if they don’t have no-go characteristics — usually is the blue tent where he gets a sideline concussion evaluation,” Sills said. “Every single player gets the same exact evaluation. We have a checklist that they go through.”

NFL concussions

NFL Says Regular Season Concussions Rose 18% as Protocol Evolves

The NFL said diagnosed concussions in the 2022 NFL regular season increased…
February 3, 2023

The NFL’s no-go list — which already included loss of consciousness and confusion — was amended to include ataxia. It is “defined as abnormality of balance/stability, motor coordination or dysfunctional speech.” Players with no-go symptoms are taken immediately to the locker room. 

That change came after a joint investigation into how Miami Dolphins quarterback Tua Tagovailoa’s initial concussion was mishandled in September. 

Preparation Keys

Sixty minutes before each game, the 30-person medical staff of both teams meets. It’s where plans are laid for various situations — like a player falling unconscious after a hit to the chest. 

Several medical workers who sat in on the meeting that reviewed the emergency action plan before the Bills played the Bengals saved the life of Damar Hamlin. That game’s medical staff and those from the University of Cincinnati Medical Center recognized Hamlin at Thursday’s “NFL Honors.”

“That plan was followed to a T,” said Dr. Jim Ellis, the NFL’s director of emergency preparedness. “The principal reason — in addition to the great medical response from everyone —  there was a good outcome was because we had planned for that, and we followed the plan.”

Inside the Protocols

Download the FOS App

The business of sports, in your pocket.

QR code to download the app

Scan the QR code to get the app now.

Linkedin
Whatsapp
Copy Link
Link Copied
Link Copied

What to Read

Sports World Swoops In on Sam Hartman’s ‘Bachelor’ Season

The Commanders’ practice squad quarterback will star in the show’s 30th season.
Exclusive

Dianna Russini Will Seek Credential for Super Bowl Radio Row

Some NFL teams cite her association with BetUS as an issue.

Bears Stadium Saga Draws Flurry of Unsolicited Bids

Local developers are touting a previously rejected stadium site.

NFL Viewership Climbs As ESPN, Amazon Deliver Double-Digit Gains

ESPN and Amazon have generated significant audience increases.
podcast thumbnail mobile
Front Office Sports Today

11/13/26 – NFL Ratings Records, Softball Players Unionize, Skubal Deal Looms

0:00

Featured Today

Soccer Football - Premier League - Aston Villa v Brentford - Villa Park, Birmingham, Britain - October 10, 2026 Aston Villa's Boubacar Kamara applauds fans after the match

English Soccer Still Inundated by Gambling Ads Despite Jersey Ban

The ban on front-of-shirt gambling ads looks strict, but it’s largely cosmetic.
West Wind Mahjong
November 11, 2026

Mahjong Mania Has Come for College Sports

Bespoke retailers are cashing in with officially licensed mahjong sets.
November 6, 2026

Can MLS Capitalize on Son-Mania?

Korea and Tottenham fans alike have flocked to LAFC’s away matches.
Pickering High School North
November 4, 2026

High School Athletic Directors Say They’re Running ‘Mini Colleges’

ADs are managing a growing list of demands from athletes and parents.
October 30, 2026

How Injuries Hit Pro Marathoners in the Wallet

Staying healthy can get expensive—quickly.
Jessica Pegula returns to Linda Noskova during their last round-robin group match at the WTA Finals in Indian Wells, Calif., on Thurs., Nov. 12, 2026.

WTA Chair Believes She Has Road Map Out of Financial Hole

The WTA’s fragile finances have prompted concerns from players.
November 12, 2026

Boras Sees Skubal Deal Coming Before Expected MLB Lockout

A potentially historic free agent deal runs up against economic uncertainty.
Tracy McGrady Fornt Office Sports
First at FOS
November 13, 2026

Tracy McGrady Says Magic Reached Out About Retiring His Jersey

McGrady played 4 of his 16 NBA seasons in Orlando.
Sponsored

How Jeremy Bloom Is Reinventing the X Games

Jeremy Bloom discusses transforming the X Games into a global brand.
November 12, 2026

Softball Players Reach Deal With Athletes Unlimited to Form Union

The league recognized the union a month after the group launched.
November 11, 2026

Mike Tomlin Knows Coaching Talk Is ‘Going to Come Up’ Soon

The ex-Steelers coach is “enjoying” his NBC Sports role.
Nov 10, 2026; Philadelphia, Pennsylvania, USA; Philadelphia 76ers guard Jaylen Brown (7) controls the ball against Boston Celtics forward Jayson Tatum (0) during the first quarter at Xfinity Mobile Arena. Mandatory Credit: Bill Streicher-Imagn Images
November 11, 2026

NBC Plays Up Tatum-Brown Rivalry With Netflix-Style Open

Tatum’s Celtics and Brown’s Sixers will meet three more times this season.
Nov 8, 2026; Madrid, ESP; A general overall view of the 2026 NFL Madrid Game at an empty Bernabeu Stadium. Mandatory Credit: Kirby Lee-Imagn Images
November 11, 2026

NFL Network’s Europe Games Average a Record 6.9M in First ESPN Season

NFL Network games this season also stream on the ESPN app.