Amid calls for Tua Tagovailoa to step away, his coach calls for patience

He was being evaluated under the NFL’s concussion protocols that put doctors solely in charge of determining when he can return to the field, and Dolphins Coach Mike McDaniel said it was inappropriate for others to speculate on whether the standout quarterback should retire after at least his third diagnosed concussion since 2022. “The most important person in this whole equation is Tua,” McDaniel said during a news conference Friday. I have zero idea what any sort of timeline is.” Tagovailoa left the Dolphins’ loss Thursday night to the Buffalo Bills in Miami Gardens, Fla., after lowering his head into a jarring collision with Bills safety Damar Hamlin to end a third-quarter run. That did not include a controversial episode in which he was cleared to return to a game after stumbling on the field following a hit, an incident that led the NFL and the NFL Players Association to modify their concussion protocols to disqualify a player from being allowed to reenter a game under such circumstances. Las Vegas Raiders Coach Antonio Piece, a former NFL player, said during a news conference Friday: “I’d tell him to retire. Take care of your family.” Mohammed Elamir, the lead physician at Aviv Clinics, a leading brain health clinic, said Friday in emailed responses to questions from The Washington Post: “I’ve seen so many different brain injuries cause irreparable damage. However, it’s important to advise of the risks associated with repeated concussions, not just for now but for the rest of their life. Because of this I would strongly recommend he consider retiring.” Advertisement McDaniel said earlier Friday that “it would be so, so wrong of me to even sniff that subject,” adding that “his career is his.” Tagovailoa played in all of the Dolphins’ games last season and was selected to the Pro Bowl. “I totally understand it, and it’s not misplaced,” McDaniel said of the concerns. And I don’t think those types of conversations when you’re talking about somebody’s career, I think it probably is only fair that their career should be decided by them.” Thomas Bottiglieri, a sports medicine physician at New York-Presbyterian/Columbia University Irving Medical Center, is not treating Tagovailoa but said that, in general, a patient’s “total number of diagnosed concussions must be taken into consideration with exposure history, recovery” and other considerations. Advertisement “In every diagnosed concussion, a thorough history of prior exposures and recovery in the context of clinical testing must be performed,” Bottiglieri said via email. Exposure history and prior delays in recovery, with notable severe injuries, are taken in the context of an overall approach to a next steps discussion.” Bottiglieri, who co-authored a sports-related concussion retirement algorithm, said the long-term risks “of repeated head injury are well established and have been since the description of dementia pugilistica or ‘punch drunk syndrome’ in boxers,” adding that repeated head traumas, whether diagnosed as concussions or not, “can lead to permanent injury and chronic traumatic encephalopathy,” or CTE. “[W]e currently have no diagnostic markers that allow us to predict chronic traumatic encephalopathy,” Bottiglieri said. “That being said, we have established a framework for understanding increased risk over time and there is good data on exposure history and the risk of future chronic traumatic encephalopathy.” #Raiders HC Antonio Pierce says he would tell Tua Tagovailoa to retire from the NFL. … Take care of your family.” pic.twitter.com/8b9MNt8CEE — Ari Meirov (@MySportsUpdate) September 13, 2024 Elamir likewise is not involved in Tagovailoa’s care and said he was not watching the game when Tagovailoa was injured. But he saw replays and said the “first thing” he noticed “was that he unfortunately displayed a ‘fencing posture’ after the impact, which is an involuntary position with one arm bent toward the body and the other arm outstretched. This reflex is often indicative of severe traumatic brain injury.” Advertisement Elamir also wrote, “Unfortunately every successive concussion can propagate brain damage. But not all concussions are created equal, so there isn’t a definite number of concussions that would dictate when to end a career. In some cases, just one severe concussion could be enough to call it quits, but no doubt the risk-benefit calculus changes with each successive hit.” Tagovailoa is now subject to the NFL’s step-by-step return-to-participation protocol that includes evaluation and clearance by both the team medical staff and by an independent neurological consultant. McDaniel said he took it as perhaps an encouraging sign that Tagovailoa was permitted to walk off the field Thursday and that he was “highly communicative in the locker room with the trainers and the doctors.” He said he does not expect Tagovailoa to be cleared to play in the Dolphins’ next game, scheduled for Sept. 22 in Seattle. Advertisement Unlike those in 2022, Tagovailoa’s latest concussion did not generate scrutiny over whether the NFL’s concussion protocols were followed properly or need to be adjusted. Tagovailoa is believed to have been wearing a position-specific helmet for quarterbacks, designed to provide all-around protection — particularly for the back of the head, to protect a quarterback’s head when falling backward after a hit. “I told him he’s the starting quarterback of his family and to go in the locker room, take a deep breath and I’ll see you soon,” McDaniel said Friday. – This Summarize was created by Neural News AI (V1). Source: https://www.washingtonpost.com/sports/2024/09/13/tua-tagovailoa-concussion-retirement/