Photo: Getty
  /  11.16.2022

The debate surrounding the health concerns that tackle football creates has been around probably longer than Tua Tagovailoa has been in this world. Still, when the Miami Dolphins signal caller was put back into the game after suffering what looked like a sure concussion, the concerns grew to a fever pitch. On Sept. 25, Tagovailoa’s head bounced off the ground after a hit by Buffalo Bills linebacker Matt Milano. He got up before stumbling back to the ground and had to be helped off the field by trainers. To even the most casual football fan, it looked like a sure concussion. It was announced that the Alabama product was being evaluated for a head injury, and it was questionable whether he’d return to the game that was tied 14-14 at the time of the hit. Still, he was under center to start the second half after the Dolphins announced that he passed the concussion protocol. The only collateral damage from the play was the roughing the passer penalty Milano was hit with.

Fans and analysts alike were appalled and very critical of the Dolphins organization for what seemed like an incredibly selfish move. Sure, their quarterback was coming off a six-touchdown performance a week earlier against the Baltimore Ravens. Of course, there was a lot on the line when the Bills came to town – namely, the lead in the AFC East division. However, none of those factors justifies endangering the brain health of any of your players. What throws a monkey wrench into all of this was the fact that both Tagovailoa and head coach Mike McDaniel denied the presence of a head injury altogether. Following the game, both attributed the stumble to a back injury and prepared for a quick five-day turnaround to get ready for Thursday Night Football.

When the Dolphins traveled to Cincinnati a few days later to face the Bengals, QB1 was back in action, but it wouldn’t last long. With six minutes left in the second quarter, the third-year quarterback was again thrown to the ground. This time, he didn’t get up. Instead, the No. 5 pick laid there on his back in Paycor Stadium, fingers splaying uncontrollably before being carted off the field. It was by far one of the scariest moments of an NFL season in recent memory. Football was the furthest thing from anyone’s mind as they watched the 24-year-old get transported to the ambulance on a stretcher. The first thing that comes to mind is a serious brain injury and the after-effects that could transform the rest of his life, let alone a football career. There would be no denying a concussion — at the least — this time. The 2017 national champion entered the concussion protocol and missed the next three games. Although the NFL has taken steps to help mitigate and decrease the chances of brain-related injuries, there’s still more work to do. The Dolphins’ actions during this entire incident made that more evident.

Possible long-term effects of repeated hits to the head include CTE, ALS, dementia, and other mental health disorders. CTE, or chronic traumatic encephalopathy, can only be diagnosed after death. The condition was found in both former players Junior Seau and Aaron Hernandez following their suicides. It was even stated that Hernandez, 27 years old at the time of his death, had stage 3 CTE, which had never been seen in anyone less than 46 years of age. Seau was suffering from stage 2. Former player Phillip Adams was also in stage 2 when he shot and killed six people before killing himself in April 2021. His six-year NFL career concluded in 2015, and he complained to his family about severe pain, memory loss, and difficulty sleeping near the latter stage of his life. According to Dr. Ann McKee, a neuropathologist and expert on neurodegenerative diseases at Boston University, Adams’ CTE pathology was “different” from the other young NFL players with the disease. It was severe and present in both frontal lobes. He was only 32 at the time of his death.

The most reliable information correlating football with CTE has traditionally come from Boston University, despite efforts that undermine the research citing selection bias. However, history has shown that the “repetitive head injuries were a definitive cause of CTE,” states. With all eyes on them, the NFL has had no choice but to come to terms with the occupational hazards of its sport. In recent years, the league has settled more than a few concussion-related lawsuits to the tune of billions of dollars. Efforts to mitigate the risk has shown up in more aggressive enforcement of penalties such as unnecessary roughness, targeting, and roughing the passer. They’ve even changed kickoff return procedures in efforts to better protect defenseless players.

Of course, as with most things, there has been criticism. Most of the blowback has been due to the lack of consistency with such calls. Some feel that the rules have “softened” the sport; but then, there are others that feel all players don’t receive the same protection as others. Additionally, there is a more detailed concussion protocol. If it is determined that a player has suffered a concussion, there is a five-phase protocol that must be met before the player can return to action. That is why McDaniel and the Dolphins were under so much fire for putting the 2018 Maxwell Award winner back on the field only four days after his initial injury. The team’s 0-3 record with Tagovailoa out tells you exactly why. The decision was selfish and led to the termination of the neurotrauma consultant that helped to clear the quarterback after the hit in the Bills game. The NFL Players Association, or NFLPA, announced they fired the doctor on Oct. 3, days after the Bengals game.

In his first year at the helm in Miami, McDaniel also took a brunt of the lashing in mainstream media. “That was an emotional moment that is not part of the deal that anyone signs up for — even though you know it’s a possibility in football to have something that you have to get taken off on a stretcher,” he stated on the night that his starting quarterback was in the hospital. It’s natural to point fingers when something like this happens, but who is to blame? It certainly doesn’t start and end with the head coach and the neurotrauma doctor. The NFL also has an injury reporting procedure that all teams must follow called the Personnel (Injury) Report Policy, which states:

“The intent is to provide full and complete information on player availability. It is NFL policy that information for dissemination to the public on all injured players be reported in a satisfactory manner by clubs to the league office, the opposing team, local and national media, and broadcast partners each game week of the regular season and postseason (including for the two Super Bowl teams between the championship games and Super Bowl).”

The idea that Tagovailoa initially suffered from a back injury is painfully laughable. Furthermore, the policy states, “Injuries must be identified with a reasonable degree of specificity in terms that are meaningful to coaches, other club officials, the media and the public.” If found that they neglected to protect their injured player, the Dolphins can face punishment from the NFLPA. The club has already come under fire for tampering with Tom Brady and Sean Payton and are named in a discrimination lawsuit by former head coach Brian Flores. Their gross negligence in this situation could have impacted Tagovailoa far beyond his playing years.

After sharing that he didn’t even remember being put on the stretcher and that he lost consciousness for a while, there should be a fear that cognitive impairment could come at a later date. Dr. McKee shared that the position Tagovailoa laid in, fingers spread, is “a clear sign of a brain injury with brainstem dysfunction.” While the lasting effects of the injury are unknown right now, it is also a time to remember the work the NFL needs to do regarding healthcare and support for former players. That is a whole other bone of contention that needs to be addressed sooner rather than later. In the meantime, players will continue to navigate the nuances of a sport that most of them have played since childhood while trying not to sacrifice their quality of life.


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