What needs to happen for Rob Gronkowski to play in Super Bowl LII

Rob Gronkowski was a limited participant in the Patriots' pre-Super Bowl practice on Wednesday.

While he seemed to confirm he would play in Super Bowl LII, Rob Gronkowski’s official status for Sunday’s game remains uncertain.

Gronkowski, who suffered a concussion in the AFC Championship Game against the Jaguars, must pass through all five steps of the NFL’s “Return to Participation Protocol.” Based on Gronkowski’s limited participation in Patriots practice on Wednesday, it appears he is on the fourth step of the protocol.

In order to pass the fifth and final step and actually play in the Super Bowl, here’s what the NFL defines must happen:

After the player-patient has established his ability to participate in non-contact football activity including team meetings, conditioning and non-contact practice without recurrence of signs and symptoms and his neurocognitive testing is back to baseline, the team physician may clear him for full football activity involving contact.

Once cleared by the team physician, the player-patient may participate in all aspects of practice.  If the player-patient tolerates full participation practice and contact without signs or symptoms and the team physician concludes that the player-patient’s concussion has resolved, he may clear the player-patient to return to full participation.

Upon clearance by the team physician, the player must be examined by the INC (Independent Neurological Consultant) assigned to his Club.  The INC must be provided a copy of all relevant reports and tests, including the player-patient’s neurocognitive tests and interpretations.  If the INC confirms the team physician’s conclusion that the player-patient’s concussion has resolved, the player-patient is considered cleared and may participate in his Club’s next game or practice.

The independent neurological consultant is, by definition, a doctor who is unaffiliated in any way with the team. The NFL explains this in specific terms:

The Independent Neurological Consultant must be impartial and independent from the player’s club, and be board certified or board eligible in neurology, neurological surgery, emergency medicine, physical medicine and rehabilitation, or any primary care CAQ sports medicine certified physician and has documented competence and experience in the treatment of acute head injuries (as evidenced by no less than monthly treatment of such patients).  Each Club must designate one INC at the start of the league year, which must be approved by the NFL CMO and NFLPA Medical Director.  For the avoidance of doubt a UNC may serve as an INC.  Neither a UNC nor an INC may have any affiliation with an NFL team.

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As to when the Patriots (and fans) will know for sure about Gronkowski’s status, it might not happen until the end of the week. The team is enabled with some freedom as to when Gronkowski is sent through the examination by the INC:

Not every NFL player believes that the system of using independent neurologists is working. As noted in a video for The Players’ Tribune, Seahawks cornerback Richard Sherman explained his problem with it:

I think it’s an absolute joke. It’s for public opinion, for them to show the public that they care about the players, they care about player safety. In a show of good faith and good will they said we’re gonna have an independent trauma expert, an independent neurologist approve people, and the same things are happening that were happening before.

The Tom Savage play where he was looked at by the independent neurologist and they approved him to go back into the game, and now the team is being ridiculed. How about the league gets ridiculed for letting him go back in the game? Because they approved it. The independent neurologist, which is hired by the league, approved for him to go back in the game.

Gronkowski, in quotes from earlier in the week, said that he will play in Super Bowl LII.

The Patriots’ tight end missed Super Bowl LI a year ago after his season was ended due to a back injury.