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UAGC Staff Member

by Tiffany Galvin, Sean Smith and Lasharee Esters


Damar Hamlin's frightening collapse last year reopened concern for how professional and college football leagues prevent and handle athletic injuries. The Buffalo Bills’ starting safety suffered a cardiac arrest after tackling Cincinnati Bengals' Tee Higgins in a January 2, 2023 game.  

Denny Kellington, the Bills Athletic Trainer, administered life-saving CPR to resuscitate Hamlin. He then spent one week in the ICU before being transferred to the Buffalo General Medical Center-Gates Vascular Institute in New York. Two days later he was released. He has since recovered and plans to return to playing. Many concerns arose following Hamlin’s ordeal, particularly why the NFL spent hours deciding whether to resume the game after Hamlin’s exit. In the months since, Hamlin has been medically cleared to return to football. In the current offseason he has returned to the field to practice with his teammates.  


Hamlin’s case was a rare and shocking one, but athletic injuries are not uncommon. Sports injuries are of special concern at the college level. How coaches, trainers and players prevent injuries and react to them is key to their future athletic careers. According to a study by the National Collegiate Athletic Association (NCAA) over a 5-year period, between 2004-2009, roughly 41,000 college football players experienced an injury. The most common, at 8% of all injuries, was a concussion. The level of care needed to deal with these injuries varies.  


In an interview with Denise Yoder, Director of Sports Medicine and Head Athletic Trainer for Augustana College, she discussed her role and the setbacks trainers and athletes face.  

“The public’s perception of who we are and what we do is a large hurdle,” she said. “People don’t realize how important we are until a medical emergency occurs. (The) best example of what we can do is Damar Hamlin. Things like this happen every day.” 


Yoder has been on the Augustana College athletic training staff for 25 years and took over as head Athletic Trainer in 2012. She oversees the care of over 700 NCAA athletes in 23 varsity sports. Augustana is a Division III college. 


Yoder said there are many people involved in keeping athletes safe and healthy. Field groundskeepers make sure playing surfaces are even. Nutritionists advise on proper diets for athletes. Equipment managers ensure that players’ padding and uniforms fit properly. Coaches monitor practices and player behavior daily. Athletic Trainers evaluate, diagnose and treat injuries. Physical and occupational therapists aid trainers in rehabilitation of athletes.  


According to Yoder, her job as an AT is great, but there are plenty of setbacks. She said that underfunding for trainers causes strain on athletic programs and athlete safety. “There never seems to be enough money to pay Athletic Trainers,” she said.  


Along with underfunding, Yoder said that there are roadblocks she hits with her athletes throughout the recovery process. Yoder’s top priorities are for the integrity of athletic departments and for the health and safety of student athletes. Student athletes face many safety risks during grueling schedules.  


These students face unique challenges because of their packed schedules. A typical day begins with 6 a.m. practice and classes from 8 a.m. to 3 p.m. Dinner is scheduled, then practice until 9 p.m. Down time consists of homework and sleep. Athletic trainers and directors play a large part in supporting them through these packed schedules.  


Athletic associations like the NCAA and NFL take concussions and brain injuries like chronic traumatic encephalopathy (CTE) seriously. According to Dr. Brian Hainline, Chief Medical Officer for the NCAA, a $30 million study was conducted in 2014 in conjunction with the Department of Defense. Their study set precedents for the way injuries are handled from youth sports to the professional level.  


Hagen Weaver, former quarterback for Iowa Wesleyan University, contends that the protocol becomes more advanced as you move up through the ranks. “I know if I’m in the NFL there’s like, a program for guys that shows the beginning CTE signs,” he said. However, there is no uniform policy in place by the NCAA for college-level athletes.  


The NFL’s official Concussion Protocol was established in 2011. It lays out a five-step return to play process that begins with the club physician okaying a concussed player. Approvals must be granted by unaffiliated physicians and neurological consultants. Once the process is completed, and only if all authorities clear the player, they can return to practice or game play. 


The policy also states that NFL teams who fail to follow the protocol will result in discipline in the form of fines and possible forfeiture of draft picks. For students at the college level, not following safety rules can lead to suspension or even removal from the team. This could result in the subsequent loss of scholarships and other opportunities. Following protocol and enacting safety procedures reduces injuries and increases longevity of player health. 




In 2012, over 4,500 individuals filed a lawsuit against the NFL. These players and their families claimed that the NFL was negligent regarding the dangers associated with repeated concussions and other head injuries. The league settled out of court for an estimated $1 billion 


In 2016, the NCAA settled a class-action lawsuit for nearly $75 million toward concussion research and monitoring of former college athletes. This fund will assist current and future athletes experiencing concussion-related injuries. Following the suit, six additional lawsuits were brought against the NCAA by May 2016.  

The NFL and NCAA have made updates to concussion protocols in the last decade that help reduce damage to players. In 2014, the NCAA began limiting contact (tackle) practices while in season to twice a week. This followed the NFL’s attempts to reduce player CTEs using the 2011 Concussion Protocol. 


Former NFL player Marvin Washington said in a piece for the New York Times, “football is safer than it has ever been, and is evolving into an even safer game.”  


Not all data supports the idea that contact sports, such as football, are safe, especially when it comes to the probability of concussions and CTEs. The NCAA reports that roughly 3,400 college football players suffered concussions over a 5-year period from 2009-2014. In February 2023, the NFL reported an 18% increase in player concussions in the previous season. The number grew from 126 concussions to 149 in a 271-game season. 


When injured, college and professional level athletes are under pressure to return to play. This tension may increase when coaches are eager to get players back in the game and physicians cannot give them the all-clear.  

In an interview with Jennie Sertterh, Director of Athletic Training for the University of Iowa, she discussed the importance of athletes maintaining balance.  


“Injuries are going to happen, but we Sertterh said. This life-saving work was seen by millions in the case of AT Kellington’s efforts on Hamlin earlier this year.  


“Being able to deliver care in emergency situations is not just important at sporting events, but in all walks of life,” NFL Commissioner Roger Goodell said in a public statement.  


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