Dolphins QB Tua Tagovailoa still faces concussion concerns

IT WAS GETTING late the night time of Sept. 12, and Dr. Julian Bailes had settled in to observe a little bit soccer. The famend neurosurgeon and concussions knowledgeable tuned in simply as Miami Dolphins quarterback Tua Tagovailoa sustained one more head damage.

There was Tagovailoa, mendacity on the bottom together with his arms outstretched and his fingers curled into the fencing response, an involuntary place that happens after a mind damage. To Bailes, it appeared nearly like a replay from a earlier Thursday night time sport, Sept. 29, 2022, with Tagovailoa on his again, his fingers splayed in entrance of his face in one other computerized response to a concussion.

Bailes was one of many docs the Dolphins consulted throughout Tagovailoa’s string of concussions two years in the past, and the quarterback finally sat out the remainder of the season after struggling one other one in a Christmas Day sport towards Inexperienced Bay.

“Why do you suppose we’re again right here in the identical state of affairs two years later?” Bailes stated. “It is the fashion of play for him. He caught his head in there and he isn’t afraid and he is an excellent athlete and he needed to get just a few extra yards. He caught his head in there with out pondering in that break up second.

“So, that is a giant a part of why we’re again once more. Similar man, similar susceptibility and similar fashion of play.”

Tagovailoa is a high-profile quarterback who has now sustained three recognized concussions over the span of two years, plus one other head damage that prompted the NFL to vary its concussion coverage. So, naturally, Tagovailoa’s well being and enjoying future have been among the many most closely scrutinized tales within the NFL this season.

Pundits have mentioned what number of concussions are too many; TV analysts and social media varieties implored Tagovailoa to retire; and South Floridians held their collective breath as Dolphins coach Mike McDaniel delivered updates within the weeks since Tagovailoa was positioned on injured reserve.

When Tagovailoa addressed reporters’ questions Monday, the matter gave the impression to be settled. He plans to return to follow Wednesday with the hope of being cleared to play Sunday towards the Arizona Cardinals. And he firmly said he wouldn’t put on a Guardian Cap for extra head safety, saying that is his “private selection.”

“I like this sport, and I like it to the loss of life of me,” Tagovailoa stated. “… For me, that is what I like to do. That is what makes me pleased, and I’ll do it.”

Tagovailoa stated he has been symptom-free for the reason that day after the Sept. 12 sport towards the Buffalo Payments and has been cleared by docs to renew enjoying.

He stated he has no plans to retire. It has by no means been an possibility for him.

Bailes, a system doctor govt in neurosurgery with Endeavor Well being within the Chicago space, was not one of many impartial docs consulting Tagovailoa this time. However he does have considerations about Tagovailoa’s intent to play this season.

“The largest query is, does he want a chronic interval of relaxation?” Bailes stated. “That is No. 1, which might imply most likely not returning this 12 months.

“In case you have three or extra concussions in a finite time period, then that is consideration for pause. … I am positive he and his advisers are going to make no matter choice they make, however it’s important to be involved.”

ESPN spoke with concussion specialists and former NFL athletes who’ve grappled with head-injury points, and none of these interviewed the previous few weeks stated definitively that Tagovailoa ought to retire. That call is nuanced, with no hard-and-fast tips to find out which concussed athletes can proceed their careers and which of them ought to give up enjoying soccer.

However in the case of Tagovailoa, everybody has an opinion.

IN MANY MODERN-DAY occasions, perceptions shift inside a modicum of time. The declarations have been swift within the hours after Tagovailoa’s concussion on Sept. 12, with passionate pleas for him to retire. On Corridor of Famer Shannon Sharpe’s account on X, a publish stated that he hoped the quarterback was OK however that “he is gotta critically take into consideration shutting it dwn … His concussions are getting worse and worse and he is a younger man together with his whole life forward of him.”

A publish on ex-Cowboys receiver Dez Bryant’s account learn:

“That is it….

“NFL go forward and do the suitable factor

“Tua has had completely approach too many concussions

“He must retire for his longevity well being considerations”

A day after Tagovailoa’s most up-to-date concussion, a present NFL coach — a former linebacker, no much less — advised reporters he thought Tagovailoa ought to retire.

“It isn’t price it,” Las Vegas Raiders coach Antonio Pierce stated. “I have not witnessed something like I’ve seen that is occurred to him 3 times. Scary. You may see immediately the gamers’ faces on the sector. You may see the sense of urgency from everyone to get Tua assist.”

Six weeks later, Tagovailoa continues to be the middle of the NFL’s consideration, however now that his return seems inevitable, the questions are shifting: Can he save the Dolphins’ season and defend himself?

Tagovailoa has turn into a modern-day avatar for the brutality of soccer. He was projected to be the No. 1 decide within the 2020 draft, a part of the NFL’s subsequent technology of dominant quarterbacks. He had ankle surgical procedure in his remaining season at Alabama in 2019, and that was the least of his issues. He returned three weeks later and, in his second sport again, was main his staff to a blowout victory over Mississippi State however needed to maintain enjoying.

Proper earlier than he was to be pulled, two defenders got here up from behind and sacked him. His helmet spun off, his nostril was bloodied and Tagovailoa needed to be helped off the sector. He suffered a dislocated hip, a fractured posterior wall, a damaged nostril and a concussion. Six months later, the Dolphins chosen him with the fifth decide of the 2020 draft.

He broke a number of ribs in 2021 and was carted off the sector. His head-injury points within the NFL began within the third sport of the 2022 season. In a sport towards Buffalo, Tagovailoa’s head bounced off the bottom after he was pushed, and he shook his head as he bought up, then stumbled and needed to have two teammates prop him up. However Tagovailoa was listed with a again damage and returned within the second half.

4 days later, in Cincinnati, Tagovailoa was knocked unconscious and stretchered off the sector. He was undeterred. Every of his three head accidents in 2022 was the results of him falling and hitting the again of his head, so Tagovailoa spent that offseason coaching in jiu-jitsu so he might study a safer approach to fall to minimize his threat of one other concussion. And he went concussion-free in 2023, main the NFL in passing yards.

Vinny Passas, Tagovailoa’s highschool quarterback coach, stated Tagovailoa has a excessive threshold for ache. “He is 10.5 on a scale of 1 to 10,” he stated.

He additionally is aware of Tagovailoa’s intense need to not let anybody down.

“It is simply that aggressive spirit in him and his obligation he feels to his staff,” Passas stated. “As a result of in soccer, all of them work arduous collectively and also you get this bond that you simply set up with everybody the place it turns into household. Tua is a giant household man, and he by no means, ever needed to disappoint his household.”

Passas stated he cried and prayed throughout that Thursday night time sport final month, ready for any updates after the business break, which appeared to take hours. Passas now trains youthful kids to play the place, and up to now two years since Tagovailoa’s concussion struggles, mother and father after all have requested him about Tagovailoa. He hopes the person he calls a “brother” finally can have some form of readability.

“Generally I simply hope that he reconsiders fascinated with his future,” Passas stated. “Now that he has a boy and a woman and a spouse. It isn’t like highschool [when] you’ll be able to simply go house to Mommy and Dad. … I simply suppose he has a lot extra to supply, not solely to his household however the folks round him.

“He believes that God has a path for him, and I am simply going to consider in what path God has for him. That is what I pray for is that God has the suitable path for him and sends him in the suitable route.”

DR. DAN DANESHVAR, chief of the division of mind damage rehabilitation at Harvard Medical Faculty, stated he by no means formally clears a concussed athlete who participates in touch sports activities. He approaches it as a dialog about threat.

If an individual is cleared, he stated, they could suppose they’re utterly effective to return and have interaction within the high-risk actions that prompted the concussion. Some athletes, Daneshvar stated, are by no means utterly again to regular after a mind damage. There may be at all times threat, he stated, as a result of each mind is totally different.

“We all know that hits to the top, getting hit within the head loads, is just not good for you,” stated Daneshvar, who additionally serves as co-chair of sports activities concussion at Mass Basic Brigham. “But when somebody’s utterly again to their baseline by way of signs, then they’re extra prone to get again towards that inexperienced[-light] facet.

“Now, for somebody like, like Tua — I’ve by no means evaluated him, so I can not say for positive what is going on on with him, his mind and him total by way of his restoration — however with somebody who it seems with hits which are related to much less and fewer drive or increased frequency is getting symptomatic head impacts, is getting concussions in response to those lower-force hits, that makes me suppose that they could by no means get again to that inexperienced stage the place there’s going to be low threat for future issues. And that is form of how I method conversations with the athletes.”

CTE is the pall looming over sort out soccer, however concussions, Daneshvar and Bailes stated, are simply a part of the general image, a sliver of the overall quantity of mind damage an athlete has skilled.

Junior Seau and Mike Webster, former NFL stars who have been discovered to have CTE (persistent traumatic encephalopathy) after their deaths, had no reported concussions of their careers.

Daneshvar stated helmet-sensor research have proven that on common, a university offensive lineman recognized with one concussion most likely has skilled greater than 300 hits to the top that have been the identical drive or higher than the one which gave him the concussion. All of these hits, he stated, are what enhance the chance of CTE.

Bailes, who has served on concussion committees from Pop Warner soccer to the professionals, stated that, in his three many years of labor, he has been tasked with telling greater than 100 soccer gamers they wanted to retire. He bases that call on components comparable to how previous the participant is, how lengthy they have been enjoying, what place they performed and their fashion of play.

Quarterbacks, for instance, aren’t vulnerable to as many repetitive blows to the top as a lineman. However Tagovailoa’s calculus is adjusted by the way in which he performs. “As an alternative of sliding,” Bailes stated of the most recent concussion, “he went headfirst … and his neck flexed to the facet form of violently.

“In order that fashion of play, the overall variety of concussions, that does not inform your entire story as a result of it’s kind of of a surrogate of the publicity they’ve had.”

He weighs private circumstances and the desires of the household. He weighs the risk-reward advantages, particularly with youthful individuals who have smaller our bodies.

“I’ve made many highschool gamers who’re 130 kilos with lengthy skinny necks retire,” he stated. “What extra have they got to achieve by enjoying monetarily? [Can they] make a profession, make a reputation for themselves, get a university scholarship and perhaps that is their solely approach out form of factor. … With a knee damage, perhaps it is extra simple. With the mind, there’s plenty of components to contemplate.”

DEEP IN JT DANIELS’ Instagram is a photograph of him with Tagovailoa once they have been excessive schoolers enjoying 7-on-7 soccer collectively. They as soon as had related goals of being NFL quarterbacks, and Daniels’ journey took him from USC to Georgia to West Virginia to Rice. Now he is retired from soccer due to concussions.

His choice to let go got here in a health care provider’s workplace in Houston late final 12 months. Daniels had suffered what he believed to be his fourth concussion in November 2023. It wasn’t even from a giant hit, he stated. Daniels was sacked and got here up feeling a bit dizzy, however he had felt that approach after hits earlier than and never been concussed. So he saved enjoying, however “wasn’t in the perfect of head areas.” He remembers getting hit once more — on second down, he thinks — and sooner or later was residing that previous battered quarterback saying: For those who’re seeing triple, throw it to the man within the center.

He threw a landing on third down on the finish of the primary half. And that was it. The coaching employees noticed him strolling awkwardly, he stated, then observed that his eyes “weren’t adjusting.” He was pulled into the coaching room, was dominated out for the second half and started to really feel progressively worse within the days that adopted.

Weeks later, his eyesight was nonetheless so unhealthy that he needed to prepare a journey to see his physician on the Houston Medical Heart. He had been staying indoors principally, as a result of when he’d see one thing shifting too quick, he’d get a pointy head ache. The lack of visible acuity was inflicting him to typically see one image in his proper eye and a unique one within the left.

It wasn’t the primary time he had saved enjoying after a concussion. In highschool, Daniels stated, he bought “knocked free” early in a sport and performed all 4 quarters. That concussion compelled him right into a darkish room for just a few weeks.

The worst concussion he ever had was when he was in a sport towards Utah, he stated. Daniels stated he had extra reminiscence points with that one.

Docs would inform him there have been dangers if he saved enjoying, however after every concussion, his restoration appeared to take longer and the signs have been extra pronounced. The imaginative and prescient issues this previous winter have been jarring. “Once you actually want somebody to come back decide you up each single day or it’s important to Uber in every single place … that alone is a reasonably large deal,” he stated.

So he requested his physician what he ought to do, if he ought to preserve going. He stated the advice was a “sturdy no.”

Daniels stated his signs have abated and his imaginative and prescient is again to regular. He’s now a graduate assistant on the College of West Georgia, however there’s nonetheless a pure void.

“I performed soccer just about each month of the 12 months since I used to be 5 years previous,” Daniels stated. “It was arduous for my mother and pop. That is the primary 12 months they did not watch me play soccer, and my grandpa as properly. We speak on a regular basis about it.

“There’s undoubtedly a stage of unhappiness. There may be completely a stage of reduction. Everybody that goes on the sector, at the least to some extent, acknowledges the potential important hurt that would come throughout you. And for most individuals, that’ll by no means occur, proper?”

IN 2012, WHEN greater than 1,000 former NFL gamers sued the league for failing to guard them from head accidents, Dominic Raiola was requested whether or not sometime he would do the identical. Raiola, then a longtime middle for the Detroit Lions, stated he could not think about himself at 40, in a rocking chair, pondering suing the NFL.

“I’ve a lot enjoyable enjoying the sport, I actually don’t fret about it,” Raiola stated then. “It’s normal information that individuals are going to undergo. Reminiscence loss goes to come back. You are hitting each time you step on the sector. I’m prepared for it. It is price it — completely price it. That is the perfect job on this planet. I might by no means commerce it for something.”

Raiola is 45 and retired now. In an interview with ESPN earlier this month, he stated he remembered one concussion in his 13-year NFL profession. It was in a sport towards Arizona. He performed the entire fourth quarter with it. Raiola watched movie of the sport later, and the typical individual would by no means know he was concussed.

However after the sport he saved asking for teammate Kyle Vanden Bosch, who wasn’t round as a result of he was on injured reserve with a torn ACL. He additionally needed to name his neighbor to offer him a journey house as a result of he could not drive.

“To me it was a part of the sport,” Raiola stated. “You may name it ignorance; you’ll be able to name it what you need. However I suppose I used to be by no means going guilty the NFL. Or blame concussions.”

He stated these days, he most likely would not have gotten by that final quarter due to the expanded protection of the NFL and all of the eyes which are on the sport. Raiola stated that he thought that was factor however that he most likely would not change something he did.

Raiola, who went to the identical highschool as Tagovailoa — St. Louis Excessive in Honolulu — stated soccer was a approach to supply for his household. He was good at it and did every thing he might to be the perfect at it, so that is what he did.

He stated his thoughts nonetheless feels sharp. There are moments when he forgets one thing, however he would not suppose that has as a lot to do with concussions because it does with being 45.

“There may be a day the place I do not know the place this factor might go,” he stated. “However I do suppose you bought to maintain your self. You bought to be wholesome, you bought to be lively. You do the issues that preserve you shifting. My children tease me on a regular basis about lifting weights, and I bought to get my farmer’s stroll in day by day.

“I’ll run this race till the wheels fall off. That does not imply being reckless. It simply means to maintain going.”

Raiola stated Tagovailoa’s current concussion gave him pause. Raiola has two sons who’re quarterbacks. Dylan, a freshman, begins for Nebraska, Dominic’s alma mater, and Dayton is a junior at Buford Excessive in Georgia.

He says he thinks in regards to the well being of his sons each on the sector and when their enjoying careers are over. He’d by no means ask them to robust it out; he stated that is not his race to run. He stated the household handled concussions with daughter Taylor, a former outdoors hitter for the TCU volleyball staff. She suffered two of them.

Raiola stated he was grateful his sons aren’t run-first quarterbacks. He tells his sons to construct up their neck muscle groups the way in which he did in faculty and the NFL. That, he believed, helped maintain him by his profession. And Daneshvar stated there have been some research that counsel stronger neck muscle groups may assist lower the drive of a head damage.

Nonetheless, Raiola will fear like some other father or mother.

“There’s going to be a time once they go get that first down, and it is scary,” he stated.

“I might be mendacity to you if I did not say it was scary watching [Tua], particularly as a result of it is his third one. However man, if he will take the required steps to make a return, I like that too.”

FORMER MIAMI DOLPHINS quarterback Don Strock says he figures he had 4 main concussions throughout a 15-year NFL profession that included backing up Bob Griese and Dan Marino. In contrast to Tagovailoa, the violent hits Strock suffered didn’t play out in entrance of tens of millions in Thursday night time showcase video games.

In Strock’s day, the concussion protocol went one thing like this: A coach would come and wave a finger in entrance of his eyes. He’d administer some smelling salts and ask Strock how he was feeling.

“I feel I can nonetheless go,” Strock would say.

Strock is 73 and nonetheless lives in South Florida. He stated he is doing OK all these years later. However he attends Dolphins reunions and notices a few of his former teammates who aren’t the identical.

“They preserve saying that concussions are down,” he stated. “That is what I preserve studying within the newspaper. But it surely’s a bodily sport. It is going to occur each sport sooner or later.”

A couple of months in the past, Strock stated the thrill in South Florida was palpable. The Dolphins, who’ve been looking for a franchise quarterback since Marino retired in 2000, have been coming off one other playoff season, and this time, their quarterback was wholesome.

Over the summer time, Miami signed Tagovailoa to a four-year, $212.1 million contract extension. Shortly after that, the Dolphins prolonged McDaniel, too.

A couple of months later, the temper is totally different.

“There’s an uneasiness down right here proper now,” Strock stated.

He is unsure he would play once more if he have been Tagovailoa. Strock remembers that concussion, hip damage and damaged nostril Tagovailoa sustained at Alabama. He says he thinks about what has occurred to the quarterback since then.

“It is going to be a name for him and his household,” Strock stated. “I’ve a good suggestion of what my spouse would say.”