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Tua Tagovailoa rejoined the Miami Dolphins on Sunday, 10/23, following a two-week absence due to multiple head injuries. The quarterback was brutally sacked in a game during Week 3 of the National Football League (NFL) season against the Buffalo Bills, where his head was hit with immense force on the turf and he struggled to walk after. The team’s medical staff, however, cleared Tagovailoa to play for the rest of the game. The next week, the 24-year-old suffered a concussion in Cincinnati during a game, this time with much more serious consequences. After an intense hit, he was seen lying on the field unmoving with his fingers clenched in stiff, unnatural positions.
This was startling for many football fans watching the game, but was especially worrying to concussion experts. According to Chris Nowinski, neuroscientist and CEO of the Concussion Legacy Foundation, Taglovailoa’s inability to move, save the awkward hand positions, implies "decorticate posturing." This brain response shows severe damage to the frontal cortex. Nowinski says this reaction is “a primitive movement controlled by the brain stem.” When patients show this type of reaction, usually their cortex is no longer in control of their body – their brain stem, the lower part of the brain connected to the spinal cord, has taken over. Nowinski says this is what happens when one has a damaged cortex. Tagovailoa was rushed to the hospital immediately following the hit, but he was discharged just hours later and flew back to Florida with the team on Thursday night.
Despite the severity of the hit, the Dolphins declared that Taglovailoa cleared concussion protocol and was able to continue playing in just two weeks. The NFL Players Association launched an investigation into whether all the steps of the NFL's concussion protocol were properly followed, the results of which have still not been released. Dolphins’ coach Mike McDaniel defended the team’s choice to keep Tagovailoa in the game after his Week 3 hit, saying the previous injury was related to his back, not his head. Following the first injury, McDaniel told reporters that he had “no worries whatsoever” about Tagovailoa’s head injuries. McDaniel went on, saying, “I'm in steady communication with this guy. There were absolutely no signs. He had no head injury symptoms whatsoever. There was no medical indication from all resources that there was anything regarding the head.”
While McDaniel and the Dolphins insist Tagovailoa’s first injury was related to his back, Nowinski is certain that it is a head injury, which makes the consequences of the second hit all the more serious. Nowinski said in an interview with Insider, "If I'm Tua, I'm not going back this season, because God forbid you have three concussions in 12 weeks…Now we have to wait and watch if the Dolphins will finally admit that it was a concussion last week," Nowinski said. "Because if they tried to lie again and put him back in, we're basically going to watch and just hope he doesn't die.”
While it’s understandable that McDaniel did not want his star quarterback out for any longer than two weeks mid-season, Tagovailoa should not sustain another injury. This is according to advice from Dr. Bennet Omalu, a world-renowned physician, forensic pathologist, and neuropathologist who was the first to discover and publish findings on chronic traumatic encephalopathy (CTE) in NFL players. One of the most credible and well-known neurologists in the world who inspired the 2015 film Concussion, Omalu told TMZ Sports in an interview that Tagovailoa needs to walk away from the sport. In an ominous message to the 24-year old quarterback, Omalu said, “If you love your life, if you love your family, you love your kids – if you have kids – it's time to gallantly walk away. Go find something else to do." Omalu claims Tagovailoa "suffered severe, long-term permanent brain damage” during the games, and called for him to hang up his helmet.
While Tagovailoa took two weeks off to recover, he returned speedily on Sunday, October 23 for an evening game against the Pittsburgh Steelers, which brings up larger questions surrounding the ethics of the NFL and their subpar concussion protocols. There is a long and arduous process in making sure a player is cleared after a serious head injury to play again. This includes the Concussion Game Day Checklist, which has two steps: diagnosing the concussion itself during the game, and ensuring the diagnosed player does not return to play until they are fully recovered. However, these steps are only launched if the player is suspected to have a true concussion. According to the NFL Player Health and Safety website, only if “the player exhibits or reports symptoms or signs suggestive of a concussion or stinger (a nerve pinch injury) or the team Athletic Trainer…initiates the protocol” will the player goes into concussion protocol, which includes long periods of rest without any training. Tagovailoa allegedly “cleared” this stage, allowing him to continue to play.
The NFL has previously denied any connections between CTE, or any long-term brain damage, and injuries obtained while playing the sport and blows to the head. They refused to even acknowledge the disease was a problem for a long time, until major strides in the field were made by doctors like Bennet Omalu and Dr. Ann McKee, a neuropathologist and the director of the C.T.E. Center at Boston University, who created a system of ranking levels of CTE, from mild (stage 1) to severe (stage 4). In fact, 2016 was the first time that a league official, speaking in front of congress, even acknowledged a correlation between the sport and the disease. Hall of Famer Mike Webster was the first professional player found to have CTE, which wasn’t diagnosed until 2002, three years after his death. Since then, over 320 players have been posthumously diagnosed with the condition, and it is hard to tell how many players currently have it. Most recently, former Denver Broncos wide receiver Demaryius Thomas, who passed away in 2021 at age 33 from a seizure, was found to have contracted CTE from multiple head injuries over his career.
In a Boston University study, published in the Journal of the American Medical Association in July 2017, 202 American football players, from high school to professional levels, were studied. CTE was found in 87% of them. 21 percent of high school football players showed CTE in their brains, 91 percent of college players, and an incredible 99 percent (110 out of the 111) of the professional football players studied were found to have CTE. In contrast, it’s extremely rare for the average American to contract brain disease. In fact, there is almost no data on it. While nearly 1 in 4 Americans have reported having a concussion at some point in their lives, to contract CTE takes repeated head trauma, the likes of which simply isn’t a part of the average American's life. In a sport as violent and unregulated as football, however, it is much more common.
The consequences of CTE are also extremely dire, and raise concerns for Tagovailoa’s future. Amongst the countless players before him who have suffered from CTE, many like Phillip Adams (San Francisco 49ers), Junior Seau (San Diego Chargers), Jovan Belcher (Kansas City Chiefs), Aaron Hernandez (New England Patriots), and Kenny McKinley (Denver Broncos) have committed suicide as a result of CTE, which causes short-term memory loss and extreme mood swings, including depression, feeling anxious, frustrated or agitated, and confusion and disorientation. These symptoms have led players to take not only their own lives but physically harm significant others and people around them. According to FiveThiryEight, domestic violence makes up 48 percent of arrests for violent crimes among NFL players, compared to only 21 percent nationally. And according to Forbes, “NFL players are about four times more likely to be arrested for domestic abuse than you’d expect, based on their overall arrest rates. Counting Ray Rice, more than two-dozen pro football players have been arrested for domestic abuse in the past five years alone.”
There is an astounding correlation between CTE and domestic violence, as well as self-inflicted violence, and the alarming rate at which we are seeing these two rise in football players tells us that head injuries in football can have dire consequences. The lack of action and short recovery time, in Tagovailoa’s case, is only one example of this. While we may not see the consequences right away, we need only look at his fellow players, alive and deceased, to see what a future with CTE could look like for the Dolphins’ quarterback.