[caption id="attachment_833822" align="alignnone" width="778"] Jersey-based Robb Rehberg leads game-day medical operations for the NFL. Photo: Courtesy of Robb Rehberg[/caption]When Robb Rehberg was a lineman at Ramsey High School in the early 1980s, football mentality was still in the dark ages. A player shaken by a hit to the head, who had had “his bell rung,” took a whiff of smelling salts and returned to the action.Life-altering impacts—especially brain injuries—were hardly top of mind. That gradually changed in the NFL as studies showed concussions and head-related blows could cause chronic traumatic encephalopathy (CTE), which can lead to debilitating symptoms and even death.Intrigued by the logistics of sports teams and emergency medicine, Rehberg carved a career as a New Jersey high school and college athletic trainer (AT). He rigorously studied concussions and spinal injuries and spoke frequently with John Davis, the longtime AT at Montclair State University. Davis had become an NFL concussion spotter three years after the program was implemented in 2011. ATs pass a board certification exam to become licensed or credentialed in their state of employment.Now, with the NFL season underway, Rehberg’s imprint can be felt in all 32 teams. Rehberg, 56, is the league’s senior medical adviser and director of game-day medical operations. Since 2015, he has significantly fortified the league’s AT Spotters program, which puts independent athletic trainers in a stadium booth to monitor at least 16 on-field cameras for possible concussions and musculoskeletal injuries. “The AT spotter is one of the few people who has the authority to stop a game,” Rehberg says. “If it’s apparent that a player is injured, the spotter can directly contact the referee.”ATs are multiskilled health care providers who identify injuries and prescribe rehab modalities. In extreme cases, such as when the Buffalo Bills’ Damar Hamlin suffered a cardiac arrest in a 2023 game, they even used their training to save lives.ATs are used as spotters because of their experience observing injuries. While physicians typically see athletes off the field, ATs at practices and games routinely see how injuries occur and the unique behavior athletes sometimes display after an injury.For Rehberg, who says he owes “everything to football” (he met his future wife, Joelle, now a sports medicine specialist, on the sideline of a high school game), making the game less risky is a consuming challenge. Recent NFL rule changes (such as a new kickoff format), greater education (players now self-reporting concussion symptoms) and Guardian Caps (the soft-shell helmet covers worn mostly during practices to mitigate the force of impact) led to a significant decrease in concussions in 2024. The total of 182 diagnosed concussions was the lowest since the NFL began tracking 10 years ago.Rehberg and Davis, who teach at William Paterson and Montclair State universities, respectively, have witnessed improvements, such as better helmet technology. However, the number of New Jersey high schools with no access to athletic training services “is concerning,” says Rehberg. “Most schools have one AT, if that, to care for hundreds of student athletes, and they can’t be everywhere at once.”For now, both take pride in safeguarding the health of NFL players. Yet they’re aware the demands on athletic trainers, at every level, are ever-changing. “I remind my students,” says Davis, “they are preparing for a job that has not been invented yet.”The post How a Jersey Athletic Trainer Helped Shape the NFL’s Concussion Protocols appeared first on New Jersey Monthly.