Tua Tagovailoa’s horrible injury: Proof that the NFL need a complete overhaul of their concussion protocol

The response from fans across the NFL last night when Tua Tagovailoa was carted off the field having suffered a concussion in the Miami Dolphins’ 27-15 loss to the Cincinnati Bengals was a collective “Jesus Christ I hope he’s okay”. Following a sack from Bengals defensive tackle Josh Tupou, Tua hit his head against the floor where he lost consciousness and was rendered into a fencing response, this is where the forearms are extended into the air and seize for a few seconds following a concussion or head trauma. If you’re a UFC fan you might remember this happening to Ben Askren when Jorge Masvidal caught him with a flying knee in their bout at UFC 239, or a football fan to John Terry when Abou Diaby caught his head with his boot when they both went for the ball in the 2007 Carling Cup Final.

To the naked eye, Tua didn’t hit the deck particularly hard, however the issue comes when he shouldn’t have been on the field in the first place. On Sunday the 25th of September, the Dolphins played against the Buffalo Bills where Tua sustained what looked like a concussion. He took a nasty hit from Bills line-backer Matt Milano hitting his head hard against the turf and lost his balance when trying to run after it. He shook his head a few times, lost balance and fell when trying to run, and looked very uneasy on his feet. Tua only missed the last three snaps of the half before being cleared to play in the third quarter. Following the game the Dolphins said he wasn’t concussed (despite it looking like he was) and only fell because of back and ankle injuries. Tua then ended up getting cleared (for some reason) to play the Thursday night game against the Bengals where he ended up suffering the concussion. Because the Dolphins and NFL doctors didn’t think Tua was concussed during or after the Bills game he didn’t enter the league’s concussion protocol, no seriously. He was assessed during the Bills game, deemed fit to play the last 2 quarters, and cleared to play against the Bengals. This just showcases how much the NFL need to step up their concussion protocol. Tua wasn’t entered into it because the doctors didn’t think he was showing symptoms of concussion after hitting his head against the Bills. I’m no expert but just look at the video of him trying to run after it, it’s grim viewing and there’s obviously something wrong.

If Tua did end up sustaining a concussion in the Bills game (and it wasn’t properly diagnosed) then it explains why he ended up with one against the Bengals with a hit that wasn’t as hard. Once you have a concussion and are in the recovery period your head is more vulnerable and thus you’re more susceptible to end up suffering another one from a blow to the head, even with significantly less contact. It takes around 10-14 days to fully recover from a concussion, Tua would’ve been on day 4 since the Bills injury. After Tua was taken off against Cincinnati, the NFL’s Players Association said that an investigation was in progress as to whether the Dolphins knew Tua was concussed against the Bills and they just told him to carry on playing (something that Miami deny). Again, no seriously. It should’ve been investigated straight away and yes these things take time but when something as serious as a potential concussion is involved this should be top priority, especially when the team were playing again in 4 days.

The NFL have been rightly torn to shreds by fans, pundits, players, and ex-players alike on social media following Tua’s injury. Their concussion protocol is an absolute farce and needs serious re-evaluation. Tua was showing concussion symptoms against the Bills after he hit his head, yet he was allowed to play another entire half and start against the Bengals. Even though the Dolphins and the NFL said that the concussion protocols were followed they’re clearly not enough. If it’s true that Tua wasn’t concussed against the Bills and he was uneasy on his feet because of a back and ankle injury, why was he still allowed to play 4 days later? Spinal injuries are just as serious as head injuries, because what’s that thing that the spine and neck supports called again? Oh yeah, the head. If the spine is injured or weakened then it doesn’t take a genius to work out that it won’t take as much to get a head injury too. Plus playing through injury can lead to further issues in the long-term and will affect the player’s performance, just look at Baker Mayfield last year.

So what is the solution? It’s simple, adopt the in-game Head Injury Assessment protocol that is used in rugby. When a player has possibly suffered a concussion, whether they have symptoms or are asymptomatic, they’re taken off the field. If they’re showing clear signs of concussion then they’re taken out of the game permanently for further assessment and scans. If not, then they’re taken out for 12 minutes while doctors can assess the player and use video replays of the incident to come to a conclusion as to whether the player has sustained a serious head injury. Even if doctors think that the player can be allowed back on to the field of play, they’re still entered into second and third stages of assessment for further tests and potential diagnosis after the game. Stage 2 consists of an assessment by a SCAT5 up to three hours after the game finishing for an early diagnosis, and step 3 is another scan after two night’s rest (36-48 hours after the injury) to assess progress of the injury and identify a late diagnosis. Even if the NFL have to copy it exactly how it is then so be it, it’ll prevent instances like what happened to Tua from occurring in the future.

I criticise World Rugby and certain International Rugby Unions quite a lot (some more than others, here’s looking at you WRU) for some of their decisions they make, but this is one of the best things to happen to the sport. It’s saved countless lives because it’s not uncommon for concussed players to be unaware that they have one (which is another thing I’m sick to my teeth of seeing online. Most people with concussions don’t know that they have one and rely on other people to spot it, like when somebody’s very drunk it’s usually someone else who has to say to stop drinking for a bit, so Tua wouldn’t have been in the right frame of mind to say in the Bills game if he thought he was concussed). If those players who didn’t know they were concussed were allowed to carry on they could’ve sustained even further head trauma and further injury. Sound familiar? With World Rugby’s HIA system in play then Tua wouldn’t have played the last two quarters of the Bills game and definitely wouldn’t have started against the Bengals. While the NFL’s concussion protocol is in a better state than it was 20 years ago, where the approach was essentially “eh you’ll be fine, get back out there”, it still needs to be changed further. In a game where 300+ lb defenders batter into considerably smaller opponents it should be a no-brainer to have the procedure and steps in place to ensure you’ve got the best concussion protocol in the world, yet in its current form the protocol is nothing but a joke that stopped being funny years ago.

If Tua turns around tomorrow and decides he’s never playing football again then he’ll get nothing but support. Players know the risks of playing the game, however there’s more to life than football. He should have been nowhere near the action against the Bengals and the horrific injury he was on the receiving end of proves it. I seriously hope that the Dolphins give Tua the time off he needs to fully recover and is eased back into the team, and that the NFL use this as a wakeup call to put a better concussion protocol in place because it’s long overdue.