Lakers play Larry Nance Jr. through concussion, Luke Walton praises his toughness

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The Lakers watched Larry Nance Jr. hit his head on the court. They called timeout. They had a trainer examine him.

And they left him in the game with a concussion.

Of course, they hadn’t yet diagnosed him with a concussion – which is the problem. When Nance suffered the injury against the Suns last week, the Lakers either violated the NBA’s concussion protocol, showed it to be toothless or both.

Nance dove for a loose ball late in the first quarter, and his head ricocheted off the floor while he was fouled. He appeared to be in considerable pain, and the Lakers called timeout. Nance remained in the game for two free throws, and the Lakers apparently planned to intentionally foul afterward to sub him out – though that took 13 seconds. After Jordan Clarkson finally committed a foul, Nance took a seat on the bench.

The NBA concussion protocol states:

If a player is suspected of having a concussion, or exhibits the signs or symptoms of concussion, he will be removed from participation and undergo evaluation by the medical staff in a quiet, distraction-free environment conducive to conducting a neurological evaluation.

There seems to be an implied “as soon as possible” with that.

The Lakers didn’t remove Nance from participation as soon as possible. They could have pulled him during the stoppage before his free throws.

They didn’t evaluate him in a quiet, distraction-free environment as soon as possible. Once he finally left the game, he took a seat on the bench.

And if they didn’t suspect he had a concussion after this crash to the floor, there are other issues. That level of monitoring would be negligent.

Why make a big deal about those free throws and the ensuing 13 seconds? Dr. Ben Wedro of the DocTalk blog on MDDirect.org, addressed it last year:

“The concern is something called second-impact syndrome,” Wedro said. “And that says that, if you have a brain that is concussed and has not healed, it may not be able to protect itself against a second injury as well, and you can get swelling of the brain that spins out of control and people die. This is a rare situation. Some people believe it does not exist. Other people do. But that’s the concern – that if you stack concussions, that disaster can happen.”

With the ball in play, the Lakers had no way to keep Nance suitably safe. What if he missed the second free throw and the ball bounced back toward him? A collision going for the rebound could have turned catastrophic. Even a partial defensive possession, with Phoenix dictating the action, could have produced tragic consequences.

That was the downside. The upside? A slightly better chance to win the game.

If the Lakers pulled Nance before his free throws, he would have been disqualified from the rest of the game, and Phoenix could have put the Lakers’ worst free-throw shooter from the bench on the line. But so what? Nance’s long-term health is more important than one game – a belief the concussion protocol was designed to institutionalize.

The protocol is necessary to fight a culture in professional sports that playing through pain is always admirable. It’s not. Head injuries are different. Yet, Lakers coach Luke Walton perpetuated the idea concussions are like any other break, scrape, bruise, strain, pull or tear.

Mark Medina of The Orange County Register:

Since then, Lakers coach Luke Walton raved about Nance’s “basketball IQ,” “pride in doing the little things” and making a pair of foul shots despite his dire medical state.

“He’s a tough kid. He’s a skilled kid,” Walton said. “He got up there, did what he had to do and walked off. He wanted to keep playing.”

So much so that it took Lakers guard Jordan Clarkson 13 seconds to foul so Walton could remove Nance from the game.

“They didn’t foul because he told them all that he was good,” Walton said. “When I tried to take him out, he tried to argue his case to stay in. But we took him out.”

Nance missed a loss to the Mavericks two days later then returned to the lineup two days after that. It seems this was handled correctly in the aftermath, but it should have been dealt with better during the game.

The NBA should have a stricter policy for removing a player suspected of having a concussion. Potentially, the league should allow players in Nance’s situation – who are suspected of having a concussion and due for free throws – to return if an evaluation doesn’t return a concussion diagnosis. This example shows we’re probably not ready to trust teams about removing players suspected of having concussions from play.

Teams are “punished” for suspecting a player has a concussion. Too often, they pretend not to hold the suspicion in order to keep the player on the court.

It’s bad enough when it happens in the NBA Finals. That it happened in a November game shows the stakes matter only so much.

The league has problems dealing with concussions, and the protocol – whether because it’s too vague or not properly adhered to – hasn’t solved it.