The Dolphins have more questions to answer about Tua Tagovailoa’s head injury

NewsTimeMedia September 30, 2022
Miami Dolphins v Cincinnati Bengals
Photo by Andy Lyons/Getty Images

There’s a lot of blame to go around for Tua Tagovailoa’s scary injury on Thursday.

Early in the second quarter of Thursday night’s game between the Cincinnati Bengals and the Miami Dolphins, quarterback Tua Tagovailoa dropped into the pocket to throw.

Cincinnati defensive tackle Josh Tupou burst through the Miami defensive line and got to the quarterback, spinning him to the turf for the sack. In the process, Tagovailoa’s helmet bounced off the turf at Paycor Stadium, and it was immediately apparent that the quarterback had suffered an injury. Tagovailoa’s hands drew close to his face, and the passer stayed on the turf as his teammates and later medical personnel rushed to his aid.

Tagovailoa was taken off the field on a stretcher, and the Dolphins announced he was being transported to a nearby hospital for further evaluation. The team’s social media account noted that he was conscious, with full movement in his extremities:

Two hours later, the team reported that Tagovailoa was “expected” to be discharged from the University of Cincinnati Medical Center, and would fly back to Miami with the Dolphins:

While that is certainly welcome news, Dolphins head coach Mike McDaniel and the organization must provide answers over the next few days regarding Tagovailoa playing in Thursday night’s game to begin with. Remember, Tagovailoa suffered an injury during Miami’s game Sunday against the Buffalo Bills, where he was knocked to the turf after releasing a pass and — similar to what we saw Thursday night — hit the back of his head on the playing surface at Hard Rock Stadium.

Then, as Tagovailoa got to his feet, he stumbled back to the turf:

Tagovailoa was immediately taken out of the game, and the team reported initially that he had a head injury, and was questionable to return:

But then, reports emerged that Tagovailoa was really dealing with a back injury, passed concussion protocols, and would be returning to the game:

Tagovailoa indeed returned to the game, leading the Dolphins to a win over the Bills. After the game, he appeared at the podium and addressed the situation, pointing to a back injury as the reason for him being visibly shaken on the field:

And the word from his coach was that Tagovailoa played through “some back pain:”

Under the terms of the league’s Collective Bargaining Agreement, when a player displays “gross motor instability,” then the player cannot return to the game if it is determined “by a team physician, in consultation with the unaffiliated neurotrauma consultant,” to have a neurological cause.

In Tagovailoa’s case, doctors determined that his instability was not caused by a head injury:

Furthermore, an NFL spokesperson stated after the game that the quarterback “underwent an examination by the Dolphins’ team doctor and an independent sideline neurologist and was cleared for return.”

However, the NFLPA was not convinced. Shortly after the game, the NFLPA stated that it would initiate an investigation into how Tagovailoa’s injury was handled. Under the CBA, the NFLPA, the NFL Management Council, or any player have the right to bring a complaint regarding an alleged failure to follow concussion protocol. Such complaints will be investigated and resolved by the union and the management council:

The status of that complaint? It is still in process, and was still in process when Tagovailoa traveled to Cincinnati with the team, and it was still in process when Tagovailoa took the field Thursday night, just days after his game against the Bills.

But according to reporting from Mark Maske of The Washington Post, the league believes protocols were followed:

After Tagovailoa’s injury on Thursday night, the NFLPA stated that their concerns are focused on Tagovailoa and his health, and that their investigation into the potential “protocol violation” is ongoing:

The timeline calls into question the current process under the CBA. According to the CBA, investigators can interview involved parties and anybody:

... reasonably believed to be in possession of information relevant to the inquiry (including players, league employees, club employees and members of the involved club’s medical staff) and, upon request from any Representative, shall be provided, as quickly as reasonably possible, with a copy of all game film, other recorded evidence and any other documentation relevant to the investigation of the complaint.

Then, the investigators must complete their investigation and produce a report of their findings within two weeks.

Following that, the Executive Director of the NFLPA will meet with the league’s Deputy General Counsel to determine if a violation indeed occurred, and/or what the appropriate discipline should be. If they cannot agree on whether a violation occurred, or what the discipline should be if they find a violation occurred, then the matter is referred to an impartial arbitrator. In that scenario, the arbitrator will hold a hearing no later than 30 days following the referral, and within a week after the hearing closes, they will present a written report to the NFL.

But in the interim, the player can still suit up and play.

As Tagovailoa did on Thursday night.

Now, perhaps all the protocols were indeed followed in Tagovailoa’s case, and as the early reporting from Maske indicates, the league at this point believes the Dolphins followed appropriate procedures last Sunday in Miami.

But allowing Tagovailoa to take the field on Thursday night, just days after that injury and while the matter was under further investigation to determine if concussion protocols were indeed followed, certainly seems misguided with the benefit of hindsight.

For some, however, the hindsight was not necessary.

Chris Nowinski is a Behavioral Neuroscientist, and a former professional wrestler. Following his days in the ring, he earned his Ph.D. in Behavioral Neuroscience from Boston University. Nowinski also founded the Concussion Legacy Foundation, and has dedicated his career to a better understanding of head injury and brain trauma in sports.

Hours before Tagovailoa took the field, Nowinski posted this on social media:

That last sentence turns one’s stomach this Friday morning.

Football is a dangerous game, a collision sport where injuries can and will occur. But as our understanding of head injuries grows by the day, the processes in place to safeguard the players on the field must grown and adjust accordingly. Perhaps the Dolphins did indeed follow every element of the current concussion protocol. But it seems that if there is enough concern to initiate an investigation into how a player’s head injury was handled and evaluated, then further safeguards should be in place before a player sees the field again.

Currently, players who go through the protocol are required to have a follow-up evaluation the next day, but it stops there:

Perhaps further follow-up testing should be required, especially in cases where an investigation has been initiated, before they take the field again.

Sometimes, teams need to step in and protect a player from himself. At an early age football players are taught that “the best ability is availability.” They are taught the difference between “being hurt, and being injured.” They learn to play through pain, and through injuries, to keep their job.

Rich Ohrnberger, a former NFL offensive lineman, offered this insight into suffering a concussion when Andrew Luck retired from the NFL:

On Thursday night, Ohrnberger took to social media to share how the New England Patriots handled his concussion back during the 2011 season:

In his words, the Patriots saved him from himself.

Should Tagovailoa have been saved from himself as well? Perhaps, and maybe the Dolphins tried. Maybe not. But those are just some of the questions the team needs to answer in the wake of what we all saw Sunday, and Thursday night.

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