How Tua Tagovailoa Changed Concussion Protocol For the NFL

ABBY GIORDANO – Although the NFL has constantly endorsed safer helmets and equipment, concussion protocol has not been updated since 2011, until a recent scary collision involving Tua Tagovailoa. The league has continuously denied the correlation between early-onset brain injuries and major-league football; however, the new protocol is intended to make the game safer and decrease the potential for long-term brain conditions such as CTE. The new concussion protocol went into effect last month for the NFL in week 6, following the concussion of Miami Dolphins quarterback, Tua Tagovailoa. Under the updated protocol, ataxia has been added to the list of “no-go” symptoms that would mandate the immediate removal of a player from a game. Ataxia is defined as motor instability that includes loss of muscle control, difficulty walking, bad hand coordination, and mumbling. Along with ataxia, other “no-go” symptoms include confusion, amnesia, and loss of consciousness. If these are observed, the player will not return to the field, stay in the locker room, and have a further neurological evaluation. These symptoms are monitored by team physicians as well as sideline independent physician contractors called unaffiliated neurotrauma consultants (UNCs) after a head collision or significant injury and recorded in their official sideline survey. Along with physical symptoms of a concussion, a set of five questions called the Maddocks questions are asked in order to assess the consciousness and amnesia of the player (Maddocks). The role of the UNCs is to oversee sideline evaluations and confirm that physicians are following the NFL protocols, as NFL protocol supersedes the individual teams’ process. 

The NFL physician followed the prior concussion protocol, allowing Tua to continue to play after hitting the back of his head on the turf in week 3 against the Bills. Although he was stumbling back to the line and was taken off the field, he returned in the second half. He later played in week 4 against the Bengals where fans saw Tua clench his arms and fingers toward his face after being sacked by Bengals defensive tackle, Josh Tupou. Tua’s response is called “decorticate posturing” in which the arms seize in front of the person’s face or chest with stiff hands and inward-rotated legs and feet. In an interview, Chris Nowinski, a neuroscientist and CEO of the Concussion Legacy Foundation, explained that the damage to Tua’s cortex resulted in the loss of control of his limbs, the brain stem taking over and causing the uncontrollable response (Business Insider Interview). Nowinski expressed his concern as the decorticate posture is a sign of serious brain injury to the cortex, similar to that of a stroke. 

Tua was then transported to a hospital, put under concussion protocol, and instructed not to attend practice as well as week 5 and 6 games. In an interview with The Athletic about his concussion, Tua recounted, “there was a point I was unconscious… I don’t remember being carted off. I do remember some things from the ambulance and the hospital,” (Tua Tagovailoa Interview). Additionally, the Dolphins were criticized for disregarding concussion symptoms with Tua; however, after further investigation, the Dolphins were cleared for following the protocol correctly. Blame further turned to the UNC doctor that evaluated Tua after his initial impact on the turf against the Bills, even though it was also confirmed that he had followed the previous NFL protocol correctly. Several theories followed this investigation due to Tua’s irreplaceable performance for the Miami Dolphins, proposing that the UNC was bribed or had personal motives to clear Tua when he had visible concussion symptoms in week 3. Nevertheless, the updated ataxia symptoms to the protocol would have protected Tua in week 3, to prevent the major injury to his cortex in week 4.

Copy Editor – Jessica Schumaker

Photography source – https://www.nbcnews.com/mach/science/can-science-solve-football-s-concussion-crisis-ncna809771