Christian Gonzalez injury: NFL concussion protocol, explained

The New England Patriots’ win over the Los Angeles Chargers in the divisional round of the NFL playoffs came at a cost. In the early fourth quarter of the 16-3 victory, Pro Bowl cornerback Christian Gonzalez left the game after sustaining a head injury.

On Monday, head coach Mike Vrabel confirmed that Gonzalez had been placed in the NFL’s concussion protocol.

“How long that lasts I don’t know, but when you don’t return to the game — when they don’t let you go back in the game that would put you in the protocol,” Vrabel said. “So, wherever that goes, that goes.”

Gonzalez is not the first Patriot in the protocol this season, and it is also not his first career rodeo either. With the playoffs now underway and him one of the most important players on the team both in the short and the long term, however, we thought now would be a good time to refresh our knowledge of the protocol and its workings.

How the NFL concussion protocol works

Concussions are one of the biggest concerns for the NFL and the sport in general. The league recognizes this, implementing several measures over the years in order to increase player safety and limit the prevalence of head injuries. There is still plenty of work to be done, but the introduction of strict guidelines such as the concussion protocol has created a more sensible environment compared to 10 or 20 years ago.

The protocol itself kicks into action when a player is either displaying or self-reporting signs of head injury. Once that happens, the team’s medical staff as well as the league’s unaffiliated neurotrauma consultants — three are assigned to each game — take further steps.

In Gonzalez’s case, this process did not start immediately. He remained in the game for one more snap, an incomplete pass that prompted the Chargers to punt. During the ensuing break for the defense, he retreated to the blue medical tent and afterwards left for the locker room for further evaluation. It was at that point, that the “questionable” label was applied.

Shortly before the game concluded, Gonzalez was then downgraded to out. That designation happened in accordance with the medical experts.

As part of their evaluation, after all, they run through a series of tests including checks of the eyes, speech, spine and cognitive abilities. In addition, the play itself will also be reviewed to determine whether or not the player in question will be cleared to return to the game or not. Gonzalez was not.

He is therefore now entering the next phase of the protocol.

What this means for the Patriots and Christian Gonzalez

After being placed in the concussion protocol on Sunday, Gonzalez will have to be cleared by medical professionals before returning to practice or game action. Both the Patriots’ own staff, led by Dr. Scott Martin, as well as an independent neurological consultant will need to green-light a comeback.

A follow-up step was taken on Monday with the goal of finding out whether the symptoms displayed after exiting the game have worsened. The results of those tests as well as a player’s personal history — Gonzalez also suffered a concussion the last time the Patriots played the Chargers, in December 2024 — will be factored into the next steps and the resulting timeline to be cleared.

The NFL’s return-to-participation protocol outlines five of them that Gonzalez will have to go through.

Phase 1: Symptom-limited activity. Gonzalez will be prescribed rest as well as limiting and/or avoiding physical and cognitive activities which increase the risk of aggravating symptoms. Limited stretching and balance training can be introduced under supervision of the athletic training staff, progressing to light aerobic exercise. Gonzalez can attend meetings and film study, if permitted by the medical staff.

Phase 2: Aerobic exercise. In this phase, Gonzalez can graduate to doing cardiovascular exercise under supervision of the Patriots’ medical staff. This includes riding on a stationary bike or a treadmill, as well as some stretching and balance training.

Phase 3: Football-specific exercise. This phase includes cardiovascular exercises and sport-specific activities. Gonzalez may also do some strength training, all under supervision.

Phase 4: Non-contact training drills. Building on Phases 2 and 3, Gonzalez will be allowed to continue cardiovascular, strength and balance training while also introducing specific exercise and non-contact football activities.

Phase 5: Full football activity/clearance. At this point, Gonzalez will be fully cleared to resume all football activities including full contact. If both the team’s physician and the independent neurological consultant are in agreement, he will be allowed to participate in the next game or practice.

Despite that clear structure, there is no set timeline when it comes to a player returning from a concussion. As a result, every option from returning to practice as early as Wednesday to missing Sunday’s divisional round game against the Houston Texans, and possibly even more time, is on the table.

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