NBA concussion protocol, explained: Dereck Lively exits Mavericks vs. Timberwolves Game 3 with neck sprain

A scary neck injury casts doubt around the availability of Mavericks rookie Dereck Lively II in the Western Conference Finals.

In Game 3, Lively was on the receiving end of an inadvertent knee to the back of the head from Timberwolves forward Karl-Anthony Towns. Lively remained on the floor for some time before he was helped to the locker room by his teammates and members of the Mavericks training staff.

Here's what we know about Lively's injury and an explanation of the NBA's concussion protocol.

Dereck Lively injury update

Lively has been ruled out of Game 4 of the Western Conference Finals due to a neck sprain he suffered in Game 3, per Chris Haynes. The Mavericks lead 3-0 and can close the series out at home on Tuesday.

Dallas Mavericks center Dereck Lively II (neck sprain) will not play in Game 4 against the Minnesota Timberwolves in the WCF, league sources tell @NBAonTNT, @BleacherReport. pic.twitter.com/WIaKwkET3L

— Chris Haynes (@ChrisBHaynes) May 27, 2024

Lively was taken to the locker room after receiving a knee to the back of the head during Game 3. As Dallas and Minnesota vied for a rebound, Lively fell to the floor and took a knee from Towns, who had jumped to make a play on the ball.

Dereck Lively took a knee to the back of the head.

Lively took some time to get up, and once he did, he appeared disoriented as he was helped to the locker room. The injury has been ruled as a neck sprain, according to TNT Sports' Chris Haynes.

Dallas Mavericks center Dereck Lively II is questionable to return with a neck sprain.

— Chris Haynes (@ChrisBHaynes) May 27, 2024

After he was initially ruled questionable to return, Lively was ruled out for the remainder of Game 3.

Due to the nature of the injury, Lively will be evaluated for a concussion.

NBA concussion protocol, explained

Understanding that concussions are diverse injuries that may have significant long-term consequences, the NBA Concussion Policy is designed to maximize the health and safety of NBA players by providing a framework of education and clinical management that best reflects the current scientific understanding of the injury. Prior concussion history, genetic predisposition, a history of learning disorder, ADHD, migraines, and mood disorder have all been suggested, among other things, to affect the risk of sustaining a concussion or having a more protracted or complicated course. The policy was created, therefore, under the core principle that each concussion, and each athlete, is unique.

The NBA Concussion Policy outlines the steps required for a player to return to participation. Within these steps is a return-to-participation exertion process of physical activity, which a player cannot begin until 24 hours after sustaining the concussion.

Per the policy, a player may not return to participation until these conditions are met:

• The player is without concussion-related symptoms at rest.
• The player has been evaluated by a physician.
• The player has successfully completed the NBA's return-to-participation exertion process.
• A team physician has discussed the return-to-participation process and decision with the director of the NBA Concussion Program. The final return-to-participation decision is made by the player's team physician.

NBA return-to-participation exertion process

• Several steps of increasing exertion — from a stationary bike to jogging, to agility work, to non-contact team drills.
• With each step, a focused neurological examination is performed. A player must be symptom-free to move to the next step. If a player is not symptom-free after a step, he stops until he is symptom-free and begins again at the last step he passed without any symptoms.
• There is no timeframe to complete the process.