Should Josh Allen play football on Monday?

One leading neuroscientist, Chris Nowinski, tells us the Buffalo Bills quarterback should not play vs. the Jets. He makes a compelling case. Either way, the concussion discussion isn't going anywhere.

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One does not require a medical degree or a conspiratorial sixth sense to smell something fishy. We all saw Josh Allen bang his head against the turf at NRG Stadium with six minutes left in the Buffalo Bills’ loss to the Houston Texans last weekend. We all saw his arm go limp. The quarterback didn’t bother to catch his fall. We saw that pale gaze of concussed players past.

Allen missed only six minutes and six seconds of real time — a total of one offensive snap — before returning to game action. Buffalo trailed by three points at the time. And before jogging back onto the field, it appears Allen is handed smelling salts. A scene straight out of “Varsity Blues.”

All of this, after banging his head on a failed trick play vs. Baltimore one week prior.

Head coach Sean McDermott said afterward that his quarterback was cleared by the medical staff.

A guarded Allen said he went into the blue tent where he “can only control what I can control.” He added that the Bills “deemed” him clear to play and refused to delve any deeper.

Since the sport’s creation, of course, this has been the default impulse of all red-blooded competitors. Guys like Allen reach the pinnacle of their profession for a reason. They’re going to hurl themselves back into action. The onus is always on the NFL teams themselves. Two years ago, the Miami Dolphins received justified backlash for their handling of Tua Tagovailoa’s head trauma. Countless players — including ex-Bills QB Kevin Kolb here at Go Long — have shared their chilling concussion stories. Many, like Kolb, experience disturbing symptoms in real time. Many others suffer the effects of chronic traumatic encephalopathy (CTE) later in life.

We’ve been lectured repeatedly by NFL commissioner Roger Goodell that player safety is at an all-time high.

This scene in Houston isn’t quite a ringing endorsement.

By all accounts, the league would love for this storyline to float away with the autumn wind. Surely, they’re counting on consumers moving along to gambling apps, fantasy-football lineups, the next game. Always the next game. The NFL is a runaway freight train. Lest we forget, games were played just a few days after a player nearly died on the field two years ago. So, this week, I caught up with one leading voice on concussion awareness: Chris Nowinski, the co-founder of the Concussion Legacy Foundation, and a prominent figure in the most consequential football book of our lifetime, “League of Denial.”

Nowinski has dedicated his life to studying the effects of concussions and bringing needed sunlight to an uncomfortable topic the NFL wants buried in the shadows.

He’s blunt. He does not believe Allen should play on Monday Night Football against the New York Jets this week.

“If I’m the owner of that team,” Nowinski says, “and I see Josh Allen as my quarterback of the future, there is no way he is playing on Monday.”

His case is compelling. The more he explains, the more it’s clear the league’s concussion problem isn’t going away any time soon.

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When Nowinski first watched the replay of Allen hitting his head, this appeared to him like a hit that’d trigger delayed symptoms.

He couldn’t fathom why the Bills would even think about risking their franchise.

“Then, when I actually got the full video and sort of broke it down, I became confident that he was unconscious,” Nowinski says. “And then we realized it was a protocol issue, too. So it was a bad strategy and bad medical care in my opinion.”

He’s seen the same script play out in the public sphere before. He knows the Bills — like teams past — can claim they evaluated Allen and he was fine. They can say his arm going limp is not always a concussion and the fact that he didn't roll over himself is not always a concussion. After the game, Allen said that he absorbed a “big shot to the chest” and rolled his ankle. (“They flagged me for hitting my head, but felt good enough to go back in.”) Nobody’s clarified what this chest issue was exactly, and Nowinski didn’t see Allen struggling to breathe on tape.

Perhaps the Bills do have a firm grasp of Allen’s health.

On Friday, the NFL and NFLPA released a joint statement saying that proper protocol was followed.

Nowinski is skeptical, and he’s not alone. Former players such as Chase Daniel and Emmanuel Acho spoke out in the moment.

Bare minimum, he wishes the Bills would blame the “ankle” or “chest” and sideline Allen for one week to play it safe after back-to-back blows to the head.

“Because he’s taken two bad shots in which I would suspect both could have been symptomatic,” Nowinski says. “And the idea of getting a third in 16 days could be the kind of thing that turns you into discussions of being concussion-prone and retiring and that sort of thing. And then you just wonder, are teams actually prepared to make these difficult decisions in close games?

“You’re still early in the season. Your quarterback takes a gigantic hit that puts him into the tent. Considering what everybody knows about delayed symptoms — considering everyone knows the protocol is not perfect by any stretch of the imagination — the idea that you wouldn’t just say ‘First half of the season. Star quarterback takes a huge hit and he’s in the blue tent for a concussion evaluation. We’re not putting him back in. We’re going to be conservative,’ the fact that no one’s having those conversations is disappointing. I encourage them to do so.” 

There’s a very real risk-reward debate worth having on the subject.

Everyone should agree by now that Josh Allen is the most important employee at One Bills Drive. He’s the one making $43 million per year, a number that’ll soar again. With him, the Bills are a Super Bowl contender. Without him, they may be a six- or seven-win team. It’s always been crucial for the organization to view everything through the Josh Allen Super Bowl Window.

Operating with caution, Nowinski believes, is the smart long-term play. For 2024, for beyond.

The urge for a team’s best player to stay on the field in a close game is always high… but therein lies the rub. Where do you draw the line? Emotion easily clouds judgement in the heat of a fourth quarter. Difficult conversations must be held before the opening kick so all parties involved are in lockstep. Take Tom Brady’s documentary, “Man in the Arena.” The GOAT admitted he suffered a head injury with 3:30 remaining in the fourth quarter of the New England Patriots’ epic “28-3” Super Bowl comeback win over the Atlanta Falcons — ironically enough in that same Houston stadium. “From that point on,” Brady said, “it was basically auto-pilot.” The Patriots quarterback led a 91-yard TD drive to tie the game and a 75-yard TD drive to win it.

His performance that night will live forever.

“At least that should be the standard for — if you’re going to risk it — it’s the fourth quarter of the Super Bowl,” Nowinski says. “But to do it in week, whatever this is, doesn’t make any sense. The Bills just saw Tua (Tagovailoa) get knocked out from a hit that wasn’t that bad. And you would think they would be inspired to not let Josh Allen go down that same road.”

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Last week was an eerie reflection of what we’ve seen out of Tagovailoa on the ground.

Once Allen’s head bounces off the ground, his arm goes completely limp and trails behind him.

His hand is not palm down. His wrist is rolls up.

“Anyone who’s done that move knows that your wrist can only bend 90 degrees there,” Nowinski adds, “and if it bends any further, something’s going to break or something’s going to tear. Every athlete would avoid bending their wrists in that direction. The fact that he didn’t suggests that he was not aware of where his wrist was or that he had a wrist at all.”

Allen stayed on the turf for several moments and then headed into the blue tent for evaluation. The NFL lists its sideline protocol by an independent neurologist on its website. (Of note: One sign of a potential concussion listed is a “blank or vacant look.”) Inside that tent, Nowinski adds, players are asked basic questions such as “Do you have double vision?” and “Do you have a headache?” Check the necessary boxes, say “no,” match your results with the baseline test taken before the season and you’re theoretically good to go. For what it’s worth, former MVP Peyton Manning once revealed that he gave his team terrible answers on his concussion baseline test so it’d be easier to re-enter the game.

Whatever happened inside that tent was enough for the Bills.

Before the quarterback took the field, yes, it appears he is given smelling salts. Medical experts have noted that this can mask the symptoms of a concussion — a scary idea.

In 2018, Dak Prescott was caught on camera huffing smelling salts after being evaluated for a concussion. The Cowboys radio broadcast said then the QB was getting his hand checked.

Says Nowinski: “We don’t know if this is a routine issue for Josh Allen or not, so it’s hard to say that was specifically to address the concussion. But the optics are horrifying. And I do think the NFL has to get a handle on this. They either need to ban that stuff from the sideline — only leave it with the doctors — or just make some other adult decision so that we don't appear to see people being revived to go get more brain damage.”

The Hall of Famer that Allen most resembles on the field — Green Bay Packers great Brett Favre — once suffered a concussion in 2004 vs. the Giants, missed one play, and returned to throw a touchdown on fourth down. When I brought this play up last season on our podcast with the three-time MVP, he cut in to say he wasn’t considering the long-term effects at all when he sprinted back onto the field.

“Concussions then were not thought of how they are now,” Favre said. “And they still have a long ways to go. But the long-term repercussions are not good. At 23, 35, 30, you don’t think about it. You’re like, ‘I’m bulletproof.’ And then it comes back to haunt you. … Do you want to be the one who gets one concussion and can’t remember your wife’s name at 55?”

Favre vividly remembers experiencing three blackout concussions. But when Dr. Bennet Omalu, the man who discovered CTE, asked Favre how many times he saw stars or had ringing in his ears, the quarterback thought to himself, I can’t count that high.

“Maybe thousands,” Favre said in our chat. “Every time I slammed my head on the turf, there were fireworks and stars. Ringing. Echoing in my head. And he said, ‘That’s a concussion. Everyone thinks a concussion is knockout. Yeah, that is. But it’s the jabs that are the worse.’”

Favre is living the ramifications of those jabs today. A helmet only does so much. The brain’s still jiggling within the skull. At a congressional hearing last month, Favre revealed that he was diagnosed with Parkinson’s. A study in 2020 found that one concussion increased the risk of getting Parkinson’s by 57 percent. Favre turned 55 years old on Thursday.

Vast improvements have been made — obviously. There’s far more awareness than there’s ever been. New York’s star receiver Malik Nabers will miss a second straight game with a concussion. Still, one fact’s as true now in 2024 as it was in 2004 when Favre threw that touchdown to wide receiver Javon Walker: Many players must be pried off the field. Especially quarterbacks who feel like everything is riding on their shoulders. Kolb felt that burden. He signed a monster contract in Arizona, suffered concussions and the pressure to play on was suffocating. Nowinski worries that the sport may drifting back to how it used to be, to teams not letting concussions keep their best players off the field.

That’s why his foundation releases CTE cases and studies as much as possible.

He wants to remind everybody there are consequences. Same as Favre, who released a documentary of his own last month.

“You can’t see them today,” Nowinski says. “They may not come for years or decades, but they are consequences. And hopefully it encourages people to remain vigilant even though it feels like it’s a pain.”

Elsewhere in the division, Tua Tagovailoa is hoping to return soon for the Dolphins.

While Kolb’s regression was haunting — Concussion No. 1 to Concussion No. 4 — Nowinski has also met Steve Young and Troy Aikman in recent years. Both seemed fine. Both suffered more concussions than Tagovailoa. CTE is always a reason to consider retiring. I first connected with Nowinski through Chris Borland for this story at Bleacher Report in 2016. The linebacker famously retired due to CTE concerns after one pro season. Nowinski, a former WWE himself, suffered 10 years of concussion symptoms.

But he also acknowledges grown men can make their own choices in life. That’s America.

If Tagovailoa is asymptomatic — and he wants to play — that is his right.

Only Allen knows if he’s in the thick of what Tagovailoa experienced at the start of the 2022 season. If so, playing on Monday does come with the same danger. The sooner one returns from a concussion, the more susceptible they are to another.

“There is a non-zero percent chance that he takes another hit and has a Tua Tagovailoa, two concussions-in-a-week scenario, and his future goes down a different path,” Nowinski says. “Nobody recovers from a concussion in a week anyways. Most people, when they’re diagnosed, are not going back in a week. You definitely don’t do it with a quarterback who really needs his brain to be functioning at the highest level to succeed. And I say that as a former defensive lineman who knew I just had to react to what was happening in front of me.

“From a strategy perspective, if you like the person and you want him to remain your quarterback, he doesn’t play football on Monday.”

The Bills aren’t looking back. They’re an injury-riddled bunch, at 3-2, hoping to get their season back on track against the New York Jets. A win quickly recalibrates their season. This is a critical AFC East match-up, but not exactly the fourth quarter of a Super Bowl.

While viewers will be closely watching Allen, play to play, we probably shouldn’t hold our breath for too much concussion discussion from ESPN’s broadcast crew. (Which includes Aikman.) The league’s done a masterful job of creating business partnerships with nearly every video platform available. TV networks know better than to make brain trauma a lively topic of conversation. Even the word “concussion” has been replaced by “head injury.”

Par for the course. The NFL too often fails to own its own inherent violence. Owners would rather ignore the realities of their game because that’s better for business. Mothers are more apt to let their kids play at a young age.

So, Goodell will continue to be the ostrich with his head in the sand.

Go ahead and try to find that Hamlin game. Head over to NFL+ and dive into the archives. Under Week 17 of the 2022 NFL season, you cannot even watch Buffalo’s game in Cincinnati, the night Damar Hamlin nearly lost his life. You’re greeted with a “please come back later” message instead:

Football is a dangerous game. That’s why we watch. It’s not for everybody.

It’d simply be nice if the NFL didn’t pretend otherwise.

Hey, Josh Allen may be fine — all should hope for the best. He could play freely Monday night and lead the Bills to a win they desperately need. That’s Buffalo’s hope.

Either way, please do not hold your breath for NFL+ to open up that 2022 replay.

Nothing to see here, folks.

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