To the Sports Editor:

Re “Tom Savage’s Return Raises Concussion Protocol Concerns,” Dec. 11: Following the Tom Savage concussion, many have criticized the N.F.L. medical staff for not immediately removing him from play, claiming that winning takes precedence over safety. The medical professionals implementing the concussion protocol must make complex decisions in real time without access to infinite video replay.

Video is utilized to a degree in Australian Rules Football and in the National Hockey League, but mandatory physician video review is not part of either league’s protocol. Less than 24 hours after the incident, the N.F.L. was proactively refining its concussion protocol to include video review. Until a perfect concussion detection tool exists, we support the self-refinement of the N.F.L.’s concussion policy and extension of the league’s safety efforts to all levels of play.

We feel the comments regarding second impact syndrome in your article serve only to generate fear rather than fairly represent a scarce and controversial disease entity rarely implicated as a cause of death. Football is safer today than ever before; we encourage balanced and informed discussion on the matter rather than one-sided commentaries.

Peter Cummings

Boston

The writer is a neuropathologist and an assistant professor of anatomy and neurobiology at the Boston University School of Medicine. He worked on the letter with Scott L. Zuckerman, a co-director of Vanderbilt University’s Sports Concussion Center, and Benjamin Brett of the Veterans Affairs Connecticut Healthcare System.

Blue as a Placebo

To the Sports Editor:

Re “What’s the Fastest Color? Olympic Speedskaters Now Say Blue,” Dec. 11: The most likely explanation for the putative benefit of adopting a blue racing suit is the one everyone interviewed in the article is skating around, namely the placebo effect. It’s well documented that the effects of placebo medication can be modulated by the color of the pill, which influences the expectation of the patient, just as the color of a uniform can for an athlete.

Moreover, the failure of the Mach 29 racing suit worn by the American team in 2014 could well have been due to the negative aspect of placebos, which is known as the nocebo effect. In an interview about the American team’s poor performance, Jillert Anema, the head coach for the triumphant Dutch team, said: “The suit was one of the reasons but not because it was bad. It is because they believed it was bad.”