As the saying goes, one can be accident, two can be coincidence, but three is often a trend. Miami Dolphins quarterback Tua Tagovailoa was just diagnosed with the third concussion of his NFL career. This came after his helmet—with his head in it—had collided with Buffalo Bills safety Damar Hamlin’s body during the third quarter of their Thursday night football game. The Dolphins lost that game 31-10. But the team lost more than that as Tagovailoa’s return and perhaps even his career remains up in the air.
That’s because in the four-plus NFL seasons since he was drafted in 2020 from the University of Alabama (with the plus being a very little plus), Tagovailoa has already had three diagnosed concussions. The emphasis here is on the word “diagnosed” because who knows how many undiagnosed concussions he may have had. Although Tagovailoa was able to stand up after a few minutes of being attended to by trainers and walk off the field into the locker room under his own power, you’ve gotta worry about what all of it means going forward. Having had that many concussions makes you wonder when the next concussion may come.
His career hasn’t exactly been injury-free otherwise. In fact, he’s only had NFL season free of game-missing injuries. That being the 2023 NFL season. During the other seasons, a total of 14 games have gone by the wayside due to various ailments including concussions. Chances are that number will grow as Tagovailoa will have to at least go through the NFL concussion protocol before he is even able to return.
The protocol consists of the following five steps for the player to return-to-participation:
- Symptom-limited Activity: This is the rest-until-your-symptoms-resolve part of the protocol. It also includes the and-don’t-do-anything-that-worsens-your-symptoms kicker.
- Aerobic exercise: This can include dynamic stretching and balance training as well. But it should all be under the direct supervision of the football team’s medical staff. At the end of this phase, neurocognitive and balance testing should show that the player is back to baseline.
- Football-specific Exercise: This is the mimic-some-football-activities-but-don’t-actually-play-football phase. The player can practice with the team for up to 30 minutes at a time, mimicking football activities but again not actually doing football. All of this should be under close supervision.
- Club-based Non-contact Training Drills: This is the first are-you-ready-for-some-football phase with one key limitation. Everything has to be non-contact.
- Full Football Activity/Clearance: Once the team physician says that you can go back to contact football, you then need to be cleared by an Independent Neurological Consultant (INC), who is assigned to your team. Only after the INC has inked his or her approval can you then play in the next practice or game.
While Tagovailoa is sidelined, third-year quarterback Skylar Thompson will probably be at the helm unless the Dolphins go with third-stringer Tim Boyle or sign another quarterback like former Dolphina QB Ryan Tanneyhill or even, who knows, someone like Tom Brady, perhaps?
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