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Let's Goooo!
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Players get hurt or are having pain multiple times during a game, but most of them can make it off the field under their own power. Another player checks in and the game goes on, while the player with pain gets checked out on the sideline, taped/retaped, cramps massaged, etc. Many, probably most, of those players re-enter the game as soon as they're cleared and the pain has subsided.
Hurry up offenses make it difficult or impossible to replace defensive players who are injured/in pain but not immobilized, so the only alternative is for those players to fall down and stop play. If you penalize teams for doing that, then players will either stay on the field with pain and a potential injury, or the team draws a penalty based on some arbitrary assessment of whether the player was truly in pain. Pretty soon every team will be running hurry up offenses all game long, because it causes opposing defenses to either play in pain/injured or get repeatedly penalized.
I can see a reasonable solution that helps prevent long injury pauses and still allows the offense to conserve game clock. Since offenses always have the option to substitute during the entire 40 second play clock, give defenses the same option. If the offense is in hurry up mode and the defense is trying to substitute, stop the game clock (but not the play clock) as soon as the offense is lined up and ready to snap the ball. Allow the defense to substitute until up to play clock expires (or maybe until 10 seconds left on the play clock) without penalty, and the offense gets a grace period to reset and snap. Then restart the game clock when the ball is snapped. If a player, either offense or defense, is down on the field and can't get off before the 40 play clock expires, then no penalty is assessed, but make the injured player sit out for 3 or 4 plays.
That allows the offenses to either save time or burn clock as always, but doesn't require officials to get in the business of deciding when a player actually needs to leave the game.
So, you want a rule that essentially neutralizes the strategic advantage of an offense that wants to play fast as part of their game plan. Got it.