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Tua Tagovailoa suffers a head injury during Thursday Night Football

The Miami Dolphins quarterback, Tua Tagovailoa, suffered a potentially traumatic brain injury on Sept. 29.

It all started on Sept. 25 when the Dolphins played the Buffalo Bills. During the game against the Bills, Tagovailoa was shoved to the ground. He immediately grabbed his head and stumbled off the field. The Dolphins originally had this labeled as a head injury but then later claimed it to be a back injury. This allowed him to finish the game after he cleared an evaluation during halftime. People were suspicious of him coming back into the game because his stumbling suggested a display of gross motor instability. Tagovailoa was allowed back in the game after his gross motor instability was attributed to a back injury, not a concussion.

Leading up to Thursday night's game, Tagovailoa was evaluated daily. The Dolphins were not sure if he was going to play in Thursday's game because he was dealing with back and ankle soreness throughout the week. A final decision on his availability was not made until Thursday morning when it was announced he would be playing.

This is where the whole situation becomes scary. During Thursday’s game, Tagovailoa got sacked. He hit his head on the ground and his arms became rigid. His fingers curled in what appeared to be a "fencing response." The fencing response is an involuntary neurological response to a significant concessive event, in which the forearms become rigidly positioned outward for a brief period. Tagovailoa was placed on a stretcher and wheeled to an ambulance. He was treated at the University of Cincinnati Hospital and was discharged before the Dolphins left the city. Tagovailoa underwent many tests, which showed no structural damage to the head or neck area. He was alert and in good spirits when getting on the team plane where he wore a neck brace. He is still expected to undergo an MRI and receive a second opinion for his injury. Tagovailoa is currently in concussion protocol.

There are five steps to the National Football League’s (NFL) concussion protocol that Tagovailoa will have to do if he wants to return to the field.

  • Step one is rest. This also includes limiting or avoiding physical and cognitive activities if they make symptoms worse. There is also the introduction of limited stretching and balancing work, plus moving to light aerobic exercise.

  • Step two is the gradual process of cardiovascular exercise. Neurocognitive and balance testing can be administered during this phase. If the results of these tests come back to baseline levels, then step two is satisfied.

  • Step three is increased cardio exercise to mimic sport-specific activity along with the player being allowed to practice with their team for 30 minutes or less.

  • Step four is when the player can advance to non-contact football activities such as catching, throwing, and running. Another round of neurocognitive and balance testing is administered to confirm results remain at baseline.

  • The last step, step five, is when a club physician has to clear a player for full football activity, including contact. An independent neurological consultant, which is assigned to the team by joint agreement between the NFL and the National Football Player’s Association (NFLPA), must talk with the team's physician after the concussion has been resolved. At this point, the player is clear to play in his team's next game.

Currently, the NFLPA is holding an investigation into the Dolphin's handling of Tagovailoa's injury during the Bills game. On Saturday, Oct. 1, the unaffiliated neurotrauma consultant involved in clearing Tagovailoa during the Bills game was fired. He was fired because of "several mistakes" in his evaluation of Tagovailoa. The NFLPA exercised its right to initiate a review of the league's concussion protocol because "modifications to the concussion protocol are needed to enhance player safety."

As of right now, there is no timeframe for Tagovailoa’s return. Teddy Bridgewater will most likely cover for him until he is able to play again.

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