The biggest change the policy brings is the creation of a seven-day disabled list for concussions, which is aimed to allow suitable time for concussions to clear and prevent players from returning too early. If a player spends more than 14 days on the seven-day disabled list, the player will be retroactively transferred to the 15-day disabled list. This will be implanted on a trial basis during the upcoming season.
"I like it," Yankees manager Joe Girardi said. "I like it because sometimes that two or three days where a guy can't play can really put you in a hole where you don't want to send him down for 15 days. So, I think it's great."
Rays manager Joe Maddon was similarly supportive of the implementation of the new seven-day DL.
"If it's a concussion, it'd normally take more than seven days, I would think, if you're truly going to pay attention to a head injury," said Maddon. "I would imagine, off the top of my head, no pun intended, that it's going to be a longer than a seven-day stint on the DL. I like the idea of the seven-day DL for that little thing that's bothering somebody that permits you to stay at full strength and not hurt somebody else in the process."
The procedure for clearing a player or umpire to return to activity includes a club-submitted "Return to Play" form to Major League Baseball's medical director. The submission of the form is required regardless of whether the player was placed on the disabled list.
The policy also includes mandatory baseline neuropsychological testing requirements for players and umpires during Spring Training, or when a player joins a new club during the season. This already has been common practice for most clubs.
New procedures will be implemented for evaluating players and umpires for possible concussions after such incidents as being hit in the head by a pitched, batted or thrown ball or bat; a collision with a player, umpire or fixed object; or any time the head or neck of a player or umpire is forcibly rotated.
"Obviously they're trying to take care of the players," said Red Sox manager Terry Francona. "It seems, at first blush, like a common sense decision, which, if you're trying to take care of the players, that's good."
The Commissioner's Office will conduct an orientation for club medical staffs regarding the new protocols, and each club will be required to have a mild traumatic brain injury specialist in its home city.
"The MLBPA is pleased to have worked with the Commissioner's Office, members of club training and medical staffs and some of today's leading experts in neurology to develop new protocols for the diagnosis and treatment of concussions," said MLBPA executive director Michael Weiner. "Player safety is a major concern of the collective bargaining parties, and these new protocols and procedures should enhance our ongoing efforts to protect the health of players and umpires."
The committee was chaired by Alex Valadka, MD, FACS, who is MLB's consultant on mild traumatic brain injury and chief of adult neurosciences and neuosurgery at the Seton Brain and Spine Institute in Austin, Texas. Other experts on the committee included Andy Jagoda, MD, FACEP, professor and chairman of the Department of Emergency Medicine at the Mount Sinai School of Medicine in New York; James Kelly, MA, MD, FAAN, a neurologist at the University of Colorado Neurosurgery, and professor of neurosurgery at the University of Colorado School of Medicine; Thomas McAllister, MD, a neuropsychiatrist at Dartmouth-Hitchcock Medical Center, and professor of psychiatry & neurology at Dartmouth Medical School; and John Golfinos, MD, chair of the Department of Neurosurgery at NYU Medical Center and a representative of the MLB Players Association.
Other committee members included:
Roger Caplinger: Head athletic trainer of the Milwaukee Brewers
Tony Clark: MLBPA director of player relations
Steven Erickson, MD: MLB's medical consultant to the Major League umpires
Gary Green, MD: Medical director of Major League Baseball
Rick McWane: Head athletic trainer of the Minnesota Twins
Mark Schickendantz, MD: Team physician of the Cleveland Indians and president of the MLB Team Physicians Association
Ed Snell, MD: Team physician of the Pittsburgh Pirates
Lonnie Soloff: Head athletic trainer of the Cleveland Indians
Joel Solomon, MD: Medical consultant to the MLBPA
Kathy Weber, MD: Team physician of the Chicago White Sox