Dolphins’ QB Injury Sparks Criticism of NFL

Tale of Two Injuries

Tua Collapses. During a high-profile matchup between the Miami Dolphins and Buffalo Bills on Sunday, September 25, a Bills player knocked Miami’s quarterback Tua Tagovailoa to the turf, hitting his head on the ground. After attempting to stand, he fell back down, prompting the team to remove him from the game. While the Dolphins initially reported Tagovailoa had a head injury, they later said he was dealing with a back injury and had passed concussion protocols. Tua returned to the game, leading Miami to a win.

Concussion. Then, four days later, Tagovailoa suffered a frightening head injury in the Dolphins’ next game against the Cincinnati Bengals. A defensive tackle knocked Tagovailoa to the ground, and his helmet bounced off the turf. His fingers flexed into a “fencing response” — often an involuntary sign of a brain injury. Physicians ultimately took him off the field on a stretcher and moved him to a nearby hospital for further evaluation. Doctors later discharged Tua, who flew back to Miami with his team. He remains in the concussion protocol and will not play in the Dolphins’ upcoming game against the New York Jets. Tua says he is focused on recovering so he “can get back out on the field.” It remains unclear when or if he will return to play this season.

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Severity Explained. Concussions occur following a blow or jolt to the head that stretches or damages neurons in the brain. While most recover within days or weeks, some take longer, especially when there is a history of hits to the head. Additionally, if a person sustains a second concussion before an earlier injury heals (something many believe happened to Tagovailoa), the permanent effects can be severe. Repeated head injuries heighten the risk of developing degenerative brain diseases like dementia and chronic traumatic encephalopathy (CTE).

Impact

More Caution. The Tagovailoa incident seems to have already had a significant effect across the league. Many reporters have noted teams appear more hesitant to put players with potential head injuries back into the game so fast. Still, many observers believe extra caution is not enough.

Investigations. The NFL Players Association (NFLPA) — a union representing NFL players — announced a joint review with the league into whether the Dolphins violated any rules by allowing Tagovailoa to play following the injury. Last week, the union fired the independent neurologist who initially cleared Tagovailoa from the concussion protocol. Following interviews with the Dolphins’ medical review team, the organization said the consultant “made several mistakes” in allowing Tua to reenter the game. The NFL has pledged to make the results of its investigations public.

Debate

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Organization’s Failure? NFLPA President J.C. Tretter criticized existing procedures, saying: “Until we have an objective and validated method of diagnosing brain injury, we have to do everything possible, including amending the protocols, to further reduce the potential of human error.” Tretter claims Tagovailoa exhibited so-called “no-go” symptoms following the hit and insists medical staff should have prevented him from returning to the game.

Dolphins’ Defense. However, Dolphins Coach Mike McDaniel insisted the team followed all the league’s protocols when clearing Tagovailoa to return to the game, saying there was “no medical indication” that he should not have taken to the field. He claims the team’s physicians went “above and beyond” existing rules to ensure it was safe for Tua to play. Additionally, NFL Chief Medical Officer Dr. Allen Sills says that medical staff checked Tagovailoa for concussion symptoms “every day” since his injury Sunday before ultimately clearing him to suit up against the Bengals.

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Protecting Players. Some observers say that while the team may have strictly followed existing guidelines, these rules are insufficient in protecting players. Reportedly, the medical staff cleared Tagovailoa on Sunday in part because he told them the issue arose from his back, not his head. This revelation has sparked concern among many observers, who say players — who have a strong incentive to return to the field — should not be involved in the medical decision as to whether they should get back in the game. These critics say the league rules should protect players from themselves, especially when they are potentially risking their long-term health interests for their team.

Changes

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Tightened Procedure. Following an agreement with the NFLPA, the league plans to update some of its concussion protocols. Perhaps most significantly, the NFL will change its policies around gross motor instability.

Under the current guidelines, a team only has to bench a player if its physician and unaffiliated neurotrauma consultant (UNC) determine that the gross motor instability — when players lose the ability to do tasks that involve large muscles in their torso, arms, and legs — is linked to a head injury. The new rules will change that, forcing a team to sit any player showing gross motor instability.

Discussion Questions

1. Given the severe risks associated with suffering multiple concussions, do you believe the league takes these injuries seriously enough? Explain your view.
2. Are changes to the NFL’s existing concussion protocols necessary? Why or why not? 
3. Who bears responsibility for Tua’s injuries?
4. What incentives might a player have to return to the field despite a severe injury? What about their team? What about the NFL?
5. Are the suggested updated protocols sufficient for protecting players? Why or why not?

Classroom Content

NFL

NFL, NFLPA agree to parameters of updated concussion protocols

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• 9/1/2022

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