Local neurosurgeon offers caution on Tagovailoa, says risk of concussion ‘probably high’
When Tua Tagovailoa sustained at least two, and likely three concussions during the 2022 season, two prominent experts on brain trauma were hesitant to say that the Dolphins quarterback is more likely to sustain concussions than the average person. They said it was simply too soon to know.
But the most recent concussion against Buffalo, on a hit that wasn’t particularly vicious, suggests that he is more susceptible, a local neurosurgeon said Monday.
Neurosurgeon Evan Packer, a managing partner for the Brain and Spine Center of South Florida, offered a somewhat sobering outlook, while noting that he has not examined Tagovailoa or his medical records.
“My guess is he’s far more likely to be susceptible to future [concussions],” Packer said in a phone interview Monday. “The hit he took didn’t look that bad; you see quarterbacks take these hits all the time. He’s unfortunately in that group of people that have high susceptibility to that type of injury.
“Every time a concussion occurs, it results in a major neurological outcome. He has this huge response to hits that are relatively minor. You see quarterbacks taking far worse hits than Tua” and not be concussed.
Packer said the fact that Tagovailoa exhibited fencing in his hands after two of those concussions — against Cincinnati in 2022 and against Buffalo on Sept. 12 — does not make him more susceptible but “you don’t see that often. I would suspect that’s his body’s reaction.”
Parker said that retirement is a personal decision, and he would never say Tagovailoa should retire.
But he cautioned that “the likelihood of another head injury is probably high. The law of averages is he will probably suffer another one. The more concussions you have, the threshold to create clinical symptoms is lower. It may be a lesser hit that creates fencing or some other type of response.”
What would he tell Tagovailoa if he returns and sustains another concussion?
“If he was my son and there was another substantial injury, I would say you’re playing with fire,” Packer said. “You look at long-term personal health. If he decided to play, I would make him aware of potential consequences. The risk is too great to cause future problems.”
Packer said that it has been medically proven that multiple concussions are a precursor to CTE (a degenerative brain disease) and “Parkinson’s disease and other neurological conditions.”
Even though Tagovailoa is eligible to return from injured reserve after four games, Packer said his “gut feeling is it will be a lot longer than four games. That will be largely based on imaging studies and cognitive tests they’re performing.
“How it was conceptually mismanaged against the Bills two years ago [when Tagovailoa was initially diagnosed with a back injury], they will be more cautious. He would have to come out with flying colors for him to play again this year. They’re looking closely to see if impairment is super subtle.”
The Dolphins have declined to say when or if Tagovailoa will play again this season. CBS and NFL Network reported Sunday that a return date is unknown and he won’t necessarily be back Oct. 27 against Arizona, the first game he would be eligible to come off injured reserve and play.
Tagovailoa, who traveled with the team to Seattle, remains in the NFL’s five-step concussion protocol system and is meeting with neurologists this week, Mike McDaniel said. The Dolphins aren’t saying what stage he’s in. ESPN’s Adam Schefter reported Monday that Tagovailoa “feels fine.”
Though some players have cleared concussion protocol quickly, Packer said any future concussion for Tagovailoa likely would necessitate a lengthy absence because of his history.
“I would believe there would be an extended absence for any future concussions,” Packer said. “The length of time would be greater and greater…If the average person needs three weeks to return from a concussion, maybe in Tua’s case it’s a year to get him back to baseline. He would still be at risk for repeat concussions. He’s dealing with potential long-term consequences.”
THIS AND THAT
▪ Left tackle Terron Armstead and cornerback Kendall Fuller remain in concussion protocol.
“No timelines,” McDaniel said, noting he spoke with both player on Tuesday. “Day to day. Making sure they get back to full health. I couldn’t rule anybody out for anything.”
▪ Receiver Odell Beckham Jr., working his way back from an offseason procedure, is eligible to come off the physically unable to perform list after the Tennessee game.
“I’m optimistic when his window opens up,” McDaniel said. “We will see how his body responds. He hasn’t had the setbacks we made sure to avoid.”
This story was originally published September 23, 2024 at 12:32 PM.
