Alex Smith details how he circumvented concussion protocol while playing for Chiefs

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The NFL’s concussion protocol is in the spotlight — again — following Dolphins quarterback Tua Tagovailoa’s dreadful injury in last week’s game against the Bengals.

Former Chiefs quarterback Alex Smith was asked Monday how the protocol works by Pablo Torres on the ESPN Daily podcast, and Smith delved into his own experiences with the Chiefs in 2016.

During an Oct. 30 game against the Colts at Lucas Oil Stadium, Smith twice hit his head on the turf. Twice he left the game and was evaluated for a concussion. And once he was allowed to return to the game.

The Chiefs later said Smith wasn’t ruled to have had a concussion. But on the podcast, Smith said he lost consciousness at one point and definitely had a concussion.

First quarter

Smith first left that game against the Colts after being hit while sliding. Smith tried to jump up, but was wobbly, much like Tagovailoa last week, he said.

After being removed from the game, Smith was asked basic questions on the sideline. He said those are simple queries such as, do you know where you are? Or what did you have for breakfast?

“You quickly can find out if somebody’s slow to respond, doesn’t know, that’s your first ticket to get into the protocol and once you’re in it, you’re obviously not going back into the game,” Smith said.

But in that 2016 game, Smith passed the test and was taken to the locker room for round two of testing with a trainer and neurologist.

“At the very beginning, (the neurologist) is going to ask you a bunch of questions, he’s going to give you some words, a bunch of words he’s going to ask you, then he’s going to distract you,” Smith said. “He’s going to (ask questions) ... geography questions, they can be simple math questions, he’s going to ask you a bunch of stuff.

“He’s giving you this kind of sobriety test. So he’s also asking you to perform kind of basic agility, balance standing on one leg, at the end of this 10 to 15 minutes, he’s going to come back to these words he gave you at the very beginning of the test. And if you do well on this entire thing, you’re not in the protocol if he deems you to not have a concussion at this point. You are not in the protocol, you cleared it.”

Smith was hyper-focused on passing the test because he had lost his starting job with the 49ers in 2012 when he left a game because of a concussion. Colin Kaepernick took over and Smith never started again for San Francisco.

So while in the Chiefs locker room, Smith withheld information about how he was feeling because he considered his concussion symptoms to be mild and he wanted to play again.

The doctor determined Smith had passed that test and he returned to the Chiefs sideline. Smith pressed coach Andy Reid to allow him to return to the game.

“Here’s a coach I have a ton of respect for. Has coached football as long as anybody, right? He was there but ... the experts cleared me. I passed,” Smith said. “I passed their metric of a concussion that I got through and similarly that Tua shouldn’t have (go through). And I went back in the game.”

Third quarter

Smith returned in the second quarter of that game against the Colts. But shortly after halftime, Smith again was hit while sliding and his head slammed into the turf.

“I’d kind of talked to Andy Reid into running some QB-driven run plays, read options and I loved them and I always told him I’d protect myself,” Smith recalled. ”And so I slid feet first on the first one. I slid kind of late (with a) defender coming over the top. When you slide feet first as a quarterback, you’re just so vulnerable. And sure enough, he kind of hits me in my head and same kind of thing as Tua, I bounced off the turf. And that was the first incident.

“Well, (on the) second incident, like here we go again. ... I slide again, I feel like I slide even earlier. Sure enough safety comes over the top clips my head. And it’s like, same thing. I hit my head on the ground. And yeah, it happened all over again.”

This time, Smith didn’t try to get up right away. That’s because he lost consciousness.

“I’m out on the field for a short period of time, a very small period of time and come to with a bunch of trainers and people all over around me,” Smith said. “And for me, at that point, a rush of emotion. You’re pissed at yourself, to be honest, that it happened, that I let it happen.”

There was no testing on the sideline this time. Smith went right back to the locker room.

”It’s the same protocol, though, right?” Smith said. “So you start with those first, same basic, generic, easy questions, you knock those out, and here we go again. And we go down this the second test, which is the same thing, this time, it’s a whole series of new words that you’ve got to remember and then you go down this whole sobriety test, again, agility, balance, answering all these kind of problem-solving questions, any kind of common sense things people would know.

“They’re trying to evaluate my response time, things like that, come back to those same questions at the end of it. Ten minutes later, I crushed it. I crush the second one better than the first one. I knock this one out. And Pablo, wouldn’t you know it? I’m out of the protocol.”

Smith didn’t return to the game this time as Nick Foles finished off the 30-14 victory.

After the game, there was confusion. Reid said Smith had a concussion, but the Chiefs’ head athletic trainer, Rick Burkholder, said the following day that wasn’t the case.


Despite having passed the tests during the game, Smith was put in the concussion protocol back in Kansas City and Foles played the following week’s game against Jacksonville.

Although Smith didn’t like the move at the time, he is grateful the Chiefs did it because he clearly had a concussion in Indianapolis.

“I even remember our head trainer like laughing about it like, ‘The concussion that you didn’t have.’ Like everybody knew it, like it happened,” Smith said. “Obviously the entrance into the protocol was imperfect, and still is, but I kind of slipped out this side door. ...

“I remember sitting down with Andy later that week and I didn’t have any symptoms. I had done really well and Andy, I think was very frustrated at himself that he had stuck me in the game the week prior, and obviously made the wise decision that, given the fact that I still had passed all the stuff (tests), that he wasn’t going to let me play.

“And I’m thankful for him for that, along with our trainer and doctors that all made great decisions. Again, for me at a point when I was still symptom-free, passing tests and moving along and feel like, ‘Hey, let’s go.” And so I sat a week and thankfully ..I’ve never had another incident the rest of my career. So, I’m sure if you look at my medical records, technically, I probably only had one official concussion in the eyes of the NFL.”