NFL implements new concussion protocol for Week 5, releases findings from Tua Tagovailoa investigation


When the NFL Week 5 schedule kicks off on Sunday, teams will be operating under new concussion protocols following an investigation into how the Miami Dolphins medical staff treated quarterback Tua Tagovailoa in Week 3 against the Buffalo Bills.

Late in the second quarter against the Bills, Tagovailoa was pushed to the ground and his head bounced off the turf. He grabbed at his head and then struggled to walk under his own power immediately after getting up. After falling down and repeatedly losing his balance, the Dolphins’ medical staff helped him leave the field.

While Tagovailoa was evaluated for a concussion, he cleared the testing and said he suffered a back injury. Miami allowed him to return to the game in the second half. A few days later, he was tackled in a Thursday Night Football matchup against the Cincinnati Bengals. As his body was thrown into the turf, his head violently bounced off the ground.

The 24-year-old quarterback immediately experienced a fencing response, with his arms up in the air in an unnatural position and his fingers twitching. He was taken off the field on a stretcher and both the league and the Dolphins’ medical staff received intense scrutiny for allowing him to play in Week 4.

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Tagovailoa was interviewed by the NFL and players’ union as part of an inquiry into what he experienced. During the investigation, the NFLPA exercised its authority to fire the medical consultant who cleared the Dolphins’ quarterback to return.

During the inquiry, the league and players union also discussed adjustments to the concussion protocol and putting more emphasis on player safety. In Week 4, the number of documented concussions rose and teams seemed to exercise caution with players who showed gross motor instability after a hit to the head.

Before Sunday’s games, the NFL announced new adaptations to the concussion protocols and released its findings from the investigation.

Findings from NFL investigation into Tua Tagovailoa’s injury management

NFL: Miami Dolphins at Cincinnati Bengals

The NFL and NFLPA announced on Saturday that they agreed the Dolphins followed the proper concussion protocols with Tagovailoa in Week 6. However, both sides also agreed that the guidelines in place at the time were insufficient.

Findings from the inquiry determined that Tagovailoa did not “report or exhibit any signs or symptoms of concussion” during his examination on Sep. 25 in the locker room nor did he display any symptoms when he returned to action or in the days leading up to the game against Cincinnati.

“Our job really is to continue to modify those as medical experts or other experiences tell you this is something you can do differently.”

NFL commissioner Roger Goodell on adjusting medical protocols and safety rules (H/T ESPN)

While the league recognizes the authority of the players union to terminate the employment of the Unaffiliated Neurotrauma Consultant, it also stated that it did not support the decision to fire the independent doctor.

Dr. Allen Sills, the league’s chief medical officer, adamantly denied any notion that the concussion protocol is broken. However, he also acknowledged that Tagovailoa would not have returned to the game against Buffalo if the new protocols were in place when it happened.

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“The concussion protocol is not broken. It can always improve, that’s the nature of medicine.”

Dr. Allen Sills, NFL Chief Medical Officer (H/T Tom Pelissero)

Under the new protocols, the league is adding the term “ataxia” to the symptoms that would automatically declare a player ineligible to return to the game. The term is used to define when a person displays an abnormality of balance/stability, motor coordination, or dysfunctional speech caused by a neurological issue. per the official release.

While the new protocol wasn’t in place for Thursday’s game between the Indianapolis Colts vs Denver Broncos, there was an example of what it will look like. Colts’ running back Nyheim Hines stumbled after being tackled. Unable to walk on his own without displaying gross motor instability, Hines was assisted into the locker room and ruled out for the remainder of the game.

As for Tagovailoa, the Dolphins’ quarterback remains in concussion protocol more than a week after suffering his head injury. Miami doesn’t have a current timetable for his return to the field.

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