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| Photo Credit: AP. |
(AP) - The NFL’s handling of concussions has evolved dramatically from the days when players were given smelling salts on the bench and sent back into the game.
The league
and the NFL Players Association have implemented extensive protocols and hired
unaffiliated neurotrauma consultants (UNC) to work with team physicians at each
game to diagnose concussions.
Still,
football is a violent sport and injuries similar to the frightening one Miami
Dolphins quarterback Tua Tagovailoa suffered Thursday night seem unavoidable
unless the NFL bans tackling and turns the game into flag football like it did
for the Pro Bowl.
That’s not
happening, and the most effective means of protecting players remains enforcing
strict concussion protocols, which players, fans and others are concerned
didn’t happen with Tagovailoa.
It would be
difficult to prevent what happened to Tagovailoa when 6-foot-3, 340-pound
Bengals defensive tackle Josh Tupou slammed him backward into the turf. The
main question is why he was even playing just four days after he stumbled off
the field and was unable to walk following a hit to his head during a home game
against Buffalo.
Tagovailoa’s
hands froze up and his fingers flexed awkwardly in front of his facemask for
several seconds as he laid on the turf in Cincinnati, a scary scene witnessed
by millions of viewers. He remained on the ground for several minutes until he
was taken away on a stretcher and sent to a hospital.
This time —
unlike Sunday when he seemed to exhibit concussion symptoms but was cleared by
a team physician and UNC to return — Tagovailoa was diagnosed with a
concussion. He was released from the hospital and flew home with the team.
Flying hours after suffering a concussion raised questions, but NFL chief
medical officer Dr. Allen Sills said the hospital makes that decision.
Tagovailoa’s
quick return Sunday prompted a joint review by the NFL and NFLPA. The interview
process has started and results aren’t expected for at least another week.
Tagovailoa and the team explained his legs were wobbly because of a back
injury.
It’s unknown
whether there’s any correlation between the two incidents. Concussions are
common in the NFL, especially when a player is thrown to the ground by a man
Tupou’s size and his head hits the turf.
Sills said
“it’s impossible to know” if the injury Tagovailoa sustained Thursday was
exacerbated by the hit he took Sunday.
“That’s one
of the factors that we want to look at,” Sills said on NFL Network. “Every
injury is one we want to prevent.”
Chris
Nowinski, a founder of the Concussion Legacy Foundation who played football at
Harvard, is adamant Tagovailoa sustained a concussion against Buffalo and
shouldn’t have played at Cincinnati.
“Tua showed
five distinct signs of concussion,” Nowinski told The Associated Press.
“Anybody who has any training on concussions or cares about Tua as a human is
not putting him on field four days after what he showed on Sunday, so this
makes it so much worse because we know that this could be career-ending or
season-ending. It should be season-ending, in my opinion. And it just shows
just a lack of care for him as a human being.”
The league
and the NFLPA instituted concussion protocols in 2011 when Colt McCoy took a
helmet-to-helmet hit in a game and returned without being tested for a
concussion. The protocols have been expanded since.
There are
three UNCs, who are paid jointly by the NFL and NFLPA, at each game. They work
in conjunction with team physicians to diagnose whether a player has a
concussion. Independent certified athletic trainers (ATC spotters) sit in a
booth and monitor the players on the field to have someone removed from the
game if they see an impact to the head. Team trainers, coaches or physicians,
teammates, game officials, sideline UNCs or booth ATCs also can initiate the protocol.
All players
who undergo any concussion evaluation on game day must have a follow-up
evaluation conducted the following day by a member of the medical staff. Sills
said Tagovailoa was evaluated every day leading up to the game, even though he
wasn’t in concussion protocol.
Several
players have spoken about passing protocol even when they had concussions.
Andrew Whitworth, the former Rams offensive lineman, said on Amazon’s broadcast
he once played through a concussion during a game until a teammate noticed he
wasn’t right and alerted doctors.
The league
has experimented with other means to mitigate head injuries. This year,
offensive linemen, defensive linemen, tight ends and linebackers were required
for the first time to wear Guardian Caps — a soft-shell, padded covering on top
of their helmets — during practices from the start of training camp until the
second preseason game.
The average
number of concussions among those positions groups dropped from 23 over the
previous three-year period to 11 this summer, the league said. Of those 11
concussions, six resulted from blows to the facemask, which didn’t have added
protection.
Tagovailoa
is under pressure to perform this season and has battled injuries in the past,
so it’s natural for him to want to play regardless of injury. Former players
who have criticized the decision to let him play Sunday say they want to
protect players from themselves.
“We are all
outraged by what we have seen the last several days and scared for the safety
of one of our brothers,” NFLPA president JC Tretter wrote on Twitter. “What
everyone saw both Sunday and last night were ‘no-go’ symptoms within our
concussion protocols. The protocols exist to protect the player and that is why
we initiated an investigation. Our job as the NFLPA is to take every possible
measure to get the facts and hold those responsible accountable. We need to
figure out how and why the decisions were made last Sunday to allow a player
with a ‘no-go’ symptom back on the field.
“Until we have an objective and validated
method of diagnosing brain injury, we have to do everything possible, including
amending the protocols, to further reduce the potential of human error. A
failure in medical judgment is a failure of the protocols when it comes to the
well being of our players. We have come a long way over the past 15 years but
the last week proves how far we have left to go.”
The decision
to allow Tagovailoa to return Sunday was made by the team physician and UNC. It
was determined Tagovailoa’s instability was caused by a back injury. The joint
review by the league and NFLPA will examine the steps taken and a report will
be issued.
“Based on
everybody I’ve talked to and I know a lot of doctors who are brain injury
people and sports medicine people, I don’t know anybody who thinks it’s sound
medicine just based on the observation of what was seen on the field and him
stumbling afterward to say it’s OK for him to play again in that game and then
four days later,” said attorney Brad Sohn, who has represented hundreds of
players in concussion litigation and is among the possible successors to NFLPA
executive director DeMaurice Smith.
NFL
spokesman Brian McCarthy said there has never been an incident where a team
physician and the UNC disagreed about a concussion.
In 2017,
Seattle was fined $100,000 and the coaching and medical staffs were required to
attend remedial training regarding the protocol after a joint review determined
the team didn’t follow the protocol when Russell Wilson was directed to the
sideline for an evaluation after the referee, Walt Anderson, concluded that a
medical examination was warranted.
Follow Rob
Maaddi on Twitter at https://twitter.com/robmaaddi
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