Winslow enters NBA concussion protocol

LOS ANGELES — Although Justise Winslow was formally listed in the official box score as missing Thursday night’s 124-108 victory over the Phoenix Suns due to a “headache,” both Winslow and the Miami Heat came to suspect it was something more.

Those suspicions were confirmed, with Winslow set to enter the NBA’s concussion protocol.

“Justise does have a concussion,” Heat coach Erik Spoelstra said before his team turned its attention to Friday night’s game against the Los Angeles Lakers at Staples Center.

“He’s going to go into the protocol. He didn’t have really any symptoms until [Thursday]. And so we had him checked out by the Suns doctor.

“We’ll find out more when he goes through the protocol. He met with the doctor.”

Winslow sustained a blow to the head in Tuesday’s blowout loss to the Denver Nuggets in a collision that left Nuggets forward Paul Millsap requiring stitches, on a play that resulted in a flagrant foul on Heat center Meyers Leonard. Winslow continued on in that game, but Millsap retreated to the Denver locker room for the night after shooting his free throws.

The Heat have dealt with concussion issues before, with forward Mike Miller undergoing concussion tests twice in a single week in February 2011, prior to the league’s formal introduction of a concussion protocol in 2011-12.

Winslow is believed to be the first Heat player to enter the program.

Per the NBA, “If a player is suspected of having a concussion, or exhibits the signs or symptoms of concussion, he will be removed from participation by either a team physician or the player’s team athletic trainer and undergo evaluation in a quiet, distraction-free environment conducive to conducting a neurological evaluation.”

Part of the program is “serial evaluation,” which apparently is what applied to Winslow.

“If a player undergoes a concussion evaluation and is not diagnosed with a concussion, the team’s medical staff will continue to monitor the player, and the player will undergo at least another concussion evaluation by the medical staff prior to the team’s next game or practice or approximately 24 hours after the initial concussion evaluation (whichever is first). If the player subsequently develops any signs or symptoms of concussion, the player will immediately be removed from participation and will undergo a concussion evaluation.”

A “prohibition from participation” follows, with the NBA policy reading, “If a player is diagnosed with concussion, he will not return to participation: (1) on that same day or the next calendar day; and (2) before completing the required return-to-participation process.”

The NBA defines that process as moving from a stationary bike, to jogging, to agility work, to non-contact team drills. With each step, a focused neurological examination is performed and 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 previous step of the process. The NBA notes, “there is no time frame to complete the process.”

Ultimately, a return is allowed only when the player in the protocol:

■ Is without concussion-related symptoms at rest.

■ Has been evaluated by a physician.

■ Has successfully completed the NBA 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.