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 bit of soccer. The famend neurosurgeon and concussions knowledgeable tuned in simply as Miami Dolphins quarterback Tua Tagovailoa sustained yet one more head damage.

There was Tagovailoa, mendacity on the bottom along with his arms outstretched and his fingers curled into the fencing response, an involuntary place that happens after a mind damage. To Bailes, it regarded virtually 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 ultimately sat out the remainder of the season after struggling one other one in a Christmas Day sport towards Inexperienced Bay.

“Why do you assume we’re again right here in the identical scenario two years later?” Bailes stated. “It is the fashion of play for him. He caught his head in there and he is not afraid and he is a fantastic athlete and he needed to get a number of extra yards. He caught his head in there with out considering in that break up second.

“So, that is an enormous 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 identified 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 sorts 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 seemed to be settled. He plans to return to apply Wednesday with the hope of being cleared to play Sunday towards the Arizona Cardinals. And he firmly acknowledged he wouldn’t put on a Guardian Cap for extra head safety, saying that is his “private alternative.”

“I really like this sport, and I find it irresistible to the loss of life of me,” Tagovailoa stated. “… For me, that is what I like to do. That is what makes me joyful, and I will 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 government 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 issues about Tagovailoa’s intent to play this season.

“The most important 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.

“If in case you have three or extra concussions in a finite time frame, then that is consideration for pause. … I am positive he and his advisers are going to make no matter resolution they make, however you need to be involved.”

ESPN spoke with concussion consultants 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 stop enjoying soccer.

However on the subject of Tagovailoa, everybody has an opinion.

IN MANY MODERN-DAY occasions, perceptions shift inside a modicum of time. The declarations had 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 severely take into consideration shutting it dwn … His concussions are getting worse and worse and he is a younger man along with his total 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 fully method too many concussions

“He have to retire for his longevity well being issues”

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

“It is not value 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’ll be able to see immediately the gamers’ faces on the sector. You’ll be able to 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 shield himself?

Tagovailoa has turn into a modern-day avatar for the brutality of soccer. He was projected to be the No. 1 choose within the 2020 draft, a part of the NFL’s subsequent era of dominant quarterbacks. He had ankle surgical procedure in his last 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 crew 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 choose 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 received 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 may be taught a safer option 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 crew,” 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 an enormous 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 industrial break, which appeared to take hours. Passas now trains youthful youngsters to play the place, and previously two years since Tagovailoa’s concussion struggles, mother and father in fact have requested him about Tagovailoa. He hopes the person he calls a “brother” ultimately could have some sort of readability.

“Typically I simply hope that he reconsiders fascinated by his future,” Passas stated. “Now that he has a boy and a woman and a spouse. It is not like highschool [when] you may simply go residence to Mommy and Dad. … I simply assume 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 imagine 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 path.”

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 involved sports activities. He approaches it as a dialog about threat.

If an individual is cleared, he stated, they may assume they’re utterly wonderful 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’s at all times threat, he stated, as a result of each mind is totally different.

“We all know that hits to the pinnacle, getting hit within the head loads, shouldn’t be 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 general by way of his restoration — however with somebody who it seems with hits which might be related to much less and fewer drive or larger frequency is getting symptomatic head impacts, is getting concussions in response to those lower-force hits, that makes me assume that they may by no means get again to that inexperienced degree the place there’s going to be low threat for future issues. And that is sort of how I strategy conversations with the athletes.”

CTE is the pall looming over deal with 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 had 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 school offensive lineman identified with one concussion most likely has skilled greater than 300 hits to the pinnacle that had been the identical drive or better than the one which gave him the concussion. All of these hits, he stated, are what improve 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 elements comparable to how outdated the participant is, how lengthy they have been enjoying, what place they performed and their fashion of play.

Quarterbacks, for instance, aren’t inclined to as many repetitive blows to the pinnacle as a lineman. However Tagovailoa’s calculus is adjusted by the way in which he performs. “As a substitute of sliding,” Bailes stated of the most recent concussion, “he went headfirst … and his neck flexed to the facet sort 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 is a bit 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 realize by enjoying monetarily? [Can they] make a profession, make a reputation for themselves, get a school scholarship and perhaps that is their solely method out form of factor. … With a knee damage, perhaps it is extra simple. With the mind, there’s loads of elements to think about.”

DEEP IN JT DANIELS’ Instagram is a photograph of him with Tagovailoa after they had been excessive schoolers enjoying 7-on-7 soccer collectively. They as soon as had comparable desires 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 resolution to let go got here in a physician’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 an enormous hit, he stated. Daniels was sacked and got here up feeling a bit dizzy, however he had felt that method after hits earlier than and never been concussed. So he stored enjoying, however “wasn’t in one of the best of head areas.” He remembers getting hit once more — on second down, he thinks — and in some unspecified time in the future was residing that outdated battered quarterback saying: In case you’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 workers noticed him strolling awkwardly, he stated, then seen that his eyes “weren’t adjusting.” He was pulled into the coaching room, was dominated out for the second half and commenced to really feel progressively worse within the days that adopted.

Weeks later, his eyesight was nonetheless so dangerous that he needed to organize a experience to see his physician on the Houston Medical Middle. He had been staying indoors largely, 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 generally see one image in his proper eye and a special one within the left.

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

Medical doctors would inform him there have been dangers if he stored enjoying, however after every concussion, his restoration appeared to take longer and the signs had been extra pronounced. The imaginative and prescient issues this previous winter had been jarring. “Whenever you actually want somebody to return choose you up each single day or you need 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 maintain going. He stated the advice was a “robust 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 outdated,” Daniels stated. “It was arduous for my mother and pa. That is the primary 12 months they did not watch me play soccer, and my grandpa as effectively. We discuss on a regular basis about it.

“There’s undoubtedly a degree of disappointment. There’s completely a degree of aid. 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 persons are going to endure. Reminiscence loss goes to return. You are hitting each time you step on the sector. I’m prepared for it. It is value it — completely value it. That is one of the best job on the 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 common particular person would by no means know he was concussed.

However after the sport he stored 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 present him a experience residence as a result of he could not drive.

“To me it was a part of the sport,” Raiola stated. “You’ll be able to name it ignorance; you may name it what you need. However I assume I used to be by no means going responsible 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 might be 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 method to offer for his household. He was good at it and did all the things he may to be one of the best 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 assume that has as a lot to do with concussions because it does with being 45.

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

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

Raiola stated Tagovailoa’s latest 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 concerning 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 exterior hitter for the TCU volleyball crew. 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 muscular tissues the way in which he did in school and the NFL. That, he believed, helped maintain him by his profession. And Daneshvar stated there have been some research that recommend stronger neck muscular tissues would possibly assist lower the drive of a head damage.

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

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

“I would 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’ll take the required steps to make a return, I love 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 believe 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 maintain saying that concussions are down,” he stated. “That is what I maintain studying within the newspaper. However it’s a bodily sport. It will occur each sport in some unspecified time in the future.”

Just a few months in the past, Strock stated the joy in South Florida was palpable. The Dolphins, who’ve been trying to find a franchise quarterback since Marino retired in 2000, had been coming off one other playoff season, and this time, their quarterback was wholesome.

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

Just a few months later, the temper is totally different.

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

He is undecided he would play once more if he had 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 will be a name for him and his household,” Strock stated. “I’ve a good suggestion of what my spouse would say.”