Why Dolphins' Tua Tagovailoa faces similar NFL concussion protocol regardless of quite a few head accidents lately

Tua Tagovailoa is one in all just some NFL gamers who has been positioned in concussion protocol for a 3rd time prior to now 5 seasons, however the protocol by which the Dolphins quarterback can be cleared for future play will stay the identical, the league confirmed Saturday.

“The aim of the concussion protocol is to verify the individual does not return till they’re absolutely recovered from that harm,” Dr. Allen Sills, the NFL’s chief medical officer, tells CBS Sports activities.

“Clearly we do not put timestamps on the protocol due to the truth that each harm is exclusive. … Now I might additionally say that it is intuitively apparent that healthcare suppliers are more and more conservative in these time parts if somebody has a repeated harm. However once more, it has to account for the time interval between accidents and the length of signs.”

In Thursday evening’s loss to the Bills, Tagovailoa suffered his third known concussion within the NFL. He is one in all at the least 10 gamers since 2019 who has entered the protocol at the least 3 times, in line with CBS Sports activities analysis, and he is the one quarterback to be within the protocol three separate instances prior to now 5 years.

The league’s concussion protocol, developed in session with the NFL Gamers Affiliation, is a five-step program. Part One requires symptom-limited exercise, adopted by cardio train that continues with no signs. Part Three includes a return to football-specific train for not more than half-hour earlier than what would primarily be a return to observe. Part 5 is full analysis and clearance by a workforce physician and an impartial neurological marketing consultant.

Dolphins head coach Mike McDaniel has provided no timeline for Tagovailoa’s potential return to play. Debates have been had throughout the soccer world about whether or not Tagovailoa ought to proceed taking part in.

No matter Tagovailoa in the end decides will probably be as much as him.

“I’ve nice confidence within the Dolphins medical employees and their plan to work with the participant and his representatives and household to get by way of this harm after which sort out all of the questions that come alongside with that,” says Sills, who added he hasn’t handled Tagovailoa and has no inside details about his signs. “I believe in the end everybody within the medical subject would have a reasonably broad settlement about how to make sure somebody has recovered from a concussion. What we lack are particular tips about find out how to predict future dangers and lifelong numbers of concussions. And people are points upon which sensible, gifted and skilled practitioners disagree, which tells you none of us actually know the correct reply but.”

Tagovailoa was carrying a helmet that the NFL and gamers union agree is the highest of the market at lowering head-impact severity. The helmet, a VICIS ZERO2 MATRIX ID QB helmet, was examined by biomechanical consultants and ranks because the top-performing helmet obtainable to NFL quarterbacks this season.

The helmet underwent “laboratory affect situations which are consultant of high-severity impacts quarterbacks are prone to expertise on-field,” in line with the NFL. “The laboratory check situations have been meant to characterize doubtlessly concussive head impacts within the NFL for quarterbacks,” and Tagovailoa’s helmet had additional padding within the occipital space.

After all, a helmet can’t totally stop a concussion. Tagovailoa suffered the concussion on a red-zone play throughout the third quarter of Miami’s 31-10 loss to Buffalo. He lowered his head as he ready for a Damar Hamlin sort out. The fitting facet of Tagovailoa’s head hit Hamlin’s chest and arm, and because the quarterback went to the bottom, the again of his head struck the turf.

The league, in session with the gamers union, makes an attempt to reconstruct head accidents utilizing biomechanical knowledge, however that takes extra time than the few days for the reason that harm.

“It’s generally obscure precisely the place a concussion may need occurred as a result of there could also be a couple of head blow on a play,” Sills says. “… Attempting to pinpoint precisely which of these trigger the harm is actually tough to do.

A rising concern across the league is Tagovailoa’s susceptibility to a different concussion. A 2003 study of practically 3,000 college football gamers revealed that gamers “reporting a historical past of three or extra earlier concussions have been 3 times extra doubtless” of struggling one other concussion. It additional said that “slowed restoration was related to a historical past of a number of earlier concussions.”

Tagovailoa’s first recognized concussion got here in school in 2019. He suffered a damaged hip on the identical play that ended his school profession, and there is no public documentation of his restoration from that concussion.

His second recognized concussion — and first within the NFL — got here in Week 4 of the 2022 season in opposition to the Bengals. The scary scene the place he went into the fencing posture got here simply 4 days after successful that left him wobbly in opposition to the Payments. He was not identified with a concussion on that play vs. Buffalo and was allowed to play the next week. The concussion in opposition to the Bengals pressured him to overlook the following two video games.

On Christmas that 12 months, Tagovailoa suffered a concussion sooner or later throughout a sport in opposition to the Packers the place he threw three fourth-quarter interceptions. He reported signs the next day and was positioned in concussion protocol. Tagovailoa would miss the following three video games, which included a playoff loss, and it is unclear when he had a whole decision of signs. 

There was practically a 12 months and a half between concussions for Tagovailoa, and practically two years between concussions wherein he exhibited the fencing posture. However as scary a sight as that posture is, Sills says that is not at all times a sign of concussion severity.

“That is once more a degree that we nonetheless want extra analysis and understanding,” Sills says. “You’ll clearly suppose that fencing posture would indicate a extra extreme harm. However we regularly see gamers who’ve fencing posture recuperate and turn into symptom-free in even much less time than gamers who would not have fencing posture. It is a very unusual symptom.”

In August, Tagovailoa signed a four-year, $212.4 million contract that made him the fourth-highest paid participant by common annual wage in NFL historical past on the time.

The deal included $167 million that have been assured for harm, practically $43 million of which he is already collected. Ought to Tagovailoa be medically pressured into retirement, he’d be entitled to the remaining $124 million.

If Tagovailoa is cleared to return to soccer however chooses to retire, he would quit the remaining ensures except he and the Dolphins labored out an harm settlement settlement.

Raiders coach Antonio Pierce, a nine-year NFL linebacker, mentioned this week he would tell Tagovailoa to retire.

“It isn’t value it. It isn’t value it,” Pierce mentioned. “Performed the sport, I have never witnessed something like I’ve seen that is occurred to him 3 times. Scary. You may see immediately, the gamers’ faces on the sphere. You may see the sense of urgency to get Tua assist.

“I simply suppose that sooner or later, he’ll stay longer than he’ll play soccer. Maintain your loved ones.”

Whereas hypothesis round Tagovailoa will proceed, McDaniel mentioned this week any dialog round his future taking part in profession is untimely.

“I simply want that individuals would for a second hear what I am saying that mentioning his future is just not in the very best curiosity of him,” McDaniel mentioned, “so I’ll plead with everyone that does genuinely care, that that must be the very last thing in your thoughts as a result of — what do you suppose if I have been to reply that query, I might be like, ‘All proper, that is my ideas on his profession’ and he learn it. If he agreed with it or he disagreed with it, both manner I’ve simply made him worse. So I am not taking this chance.

“I do not suppose it is applicable merely due to my care and regard, and I do not suppose these kinds of conversations once you’re speaking about any person’s profession — it most likely is simply honest that their profession must be determined by them.”