Philadelphia Eagles quarterback Jalen Hurts was forced to leave Sunday’s Week 16 game against the Washington Commanders with a concussion. The team announced that Hurts will not return to Sunday’s game, meaning he has entered the NFL’s concussion protocol.

The league’s concussion protocol is a complex process. Hurts will have to pass five steps to be medically cleared to play in time for Philly’s Week 17 home game against the Dallas Cowboys.

The Sporting News walked through the full NFL concussion protocol prior to the 2024 season. Here’s what it is, how players are placed in it, and how they are removed from it:

How does the NFL concussion protocol work?

If a player shows symptoms of a concussion, the protocol will be initiated by the person who spotted them. The player is taken to the sideline and examined for a concussion. They will be evaluated for any so-called “no-go” symptoms — loss of consciousness, gross motor instability, confusion, amnesia, fencing response, impact seizure — history of concussions, any other symptoms or a focused neurological exam. Following the findings of the investigation into the handling of Tua Tagovailoa’s 2022 injury, ataxia, defined as abnormality of balance/stability, motor coordination or dysfunctional speech caused by a neurological issue, was added to the list of no-gos. If a no-go is found, then the player is not allowed to return to the field.

If there are concerns a player might have a concussion, the player must undergo an exam by a team doctor or an unaffiliated neurotrauma consultant or athletic trainer. The protocol will be initiated if the examiners believe a player has a concussion. The protocol includes a follow-up neurological exam and periodic evaluation by the medical team. Players are not allowed to return to play during that time.

How long does the NFL concussion protocol last?

Players have to go through several steps before they can be medically cleared to play. Since each phase can take a different amount of time depending on the severity of the concussion, the timeline can differ wildly based on the player.

Here are the steps players have to take to leave the concussion protocol:

In this phase, players are asked not to engage in much activity. They are supposed to rest during this period and limit anything that could aggravate their symptoms. Eventually, players will be allowed to do limited stretching and light aerobic exercises, so long as team training staff are supervising.

Players will start to work on cardio exercises along with stretching and training, with team medical staff supervising. After this phase, players can start working on balance testing.

• Football-specific exercise

In the third stage, players can take part in football-specific exercises and start working with the team for up to 30 minutes under supervision. Players are also able to increase their cardio workloads.

• Club-based non-contact training drills

Players reaching the fourth stage are able to start throwing, catching and running and engage in activities more specific to their position. They also can continue to ramp up their exercise and training. By end of this phase, players have to have undergone neurocognitive and balance testing.

• Full football activity/clearance

The player has to be cleared by both the club physician and the independent neurological consultant to return to full activity.

How do the Philadelphia Eagles handle concussions? 

Each case is handled on a player-by-player basis, but Hurts is not the first key Eagles starter to be diagnosed with a concussion this season.

Wide receiver DeVonta Smith and right tackle Lane Johnson were both diagnosed with concussions during Philly’s Week 3 game against the New Orleans Saints. Smith was held back from practicing during the ensuing week, while Johnson returned to one limited session. Both players missed the team’s next game and returned in Week 6, following the Eagles’ bye week. 

Eagles reserve safety Sydney Brown was able to clear the NFL’s concussion protocol this past week, however, after exiting early during Philly’s Week 15 home game against the Pittsburgh Steelers. Brown was able to upgrade to a full practice participant from Wednesday to Friday, which will be a key signal for Hurts this week (although it’s not required).

In a nutshell, it’s possible that Hurts can clear the league’s protocol in time to face the Cowboys next week. It’s far from a guarantee, though, and it all boils down to how Hurts responds to treatment throughout the week.