What will Tua Tagovailoa have to do to get back out on the field after sustaining a concussion?
In the aftermath of Tua Tagovailoa’s concussion diagnosis Thursday, coach Mike McDaniel had the most prescient response concerning his franchise quarterback’s NFL future.
“It would be so wrong of me to sniff that subject,” McDaniel said Friday when asked about Tagovailoa’s potential retirement, less than 24 hours after the Miami Dolphins lost to the Buffalo Bills 31-10. “It’s more in line with actually caring about the human being. You’re talking about his career. His career is his.... Bringing up his future is not in the best interests of him. I would plead with everyone that generally cares that that should be the last thing on his mind.”
That said, it’s helpful to note the hurdles that Tagovailoa will have to clear to return as well as how other quarterbacks fared in their recovery. Among quarterbacks who were in concussion protocol in recent years, some didn’t miss a game, while others missed several.
Teddy Bridgewater sustained two concussions while playing for Denver in 2021 during Weeks 4 and 15. He didn’t miss a game after the first concussion on a big hit in Week 4 against Baltimore, returning in Week 5 and throwing for 288 yards in a loss to Pittsburgh. But he was ruled out for the rest of the season after the concussion in Week 15 — a frightening incident when he was upended while scrambling and landed awkwardly on his facemask and shoulder pads. He was hospitalized for a day.
Saints quarterback Taysom Hill sustained a concussion and was carted off the field after a helmet-to-helmet hit during the Saints’ 2022 game against Washington on Oct. 10. He missed three weeks (including a bye week) and returned Nov. 7, later noting that he had no memories of a 45-minute period on the day he was carted off.
Chiefs quarterback Patrick Mahomes entered concussion protocol after taking a big hit late in a loss to Tennessee in October 2021 but was quickly cleared and played the following week.
In 2017, a Kiko Alonso hit sent Joe Flacco into protocol during a Thursday night Dolphins-Ravens game, but Flacco was cleared to play in Baltimore’s next game, 10 days later.
Here’s the NFL’s five-step system to clear players to return from concussion protocol:
Phase 1 is symptom limited activity: “The player is prescribed rest, limiting, or if necessary, avoiding activities that increase or aggravate symptoms. Under athletic training staff supervision, limited stretching and balance training can be introduced, progressing to light aerobic exercise, all as tolerated.”
Like every step in this process, Phase 1 must be done without an aggravation of concussion symptoms to move on to Phase 2.
Phase 2 is aerobic exercise: “Under the supervision of team staff, players should begin graduated cardiovascular exercise and may also engage in dynamic stretching and balancing training. If the player demonstrates the ability to engage in cardiovascular exercise without an increase or aggravation of symptoms, they move on to next phase.”
Phase 3 is football-specific exercise: “The player continues supervised cardiovascular exercises that are increased and may mimic sport-specific activities, and supervised strength training is introduced.”
Phase 4 is noncontact training drills: “The player is encouraged to continue cardiovascular, strength and balance training, team-based sports-specific exercise and participate in non-contact football activities.”
Phase 5 is full football activity/clearance: “The player is finally cleared by the club doctor for full football activity involving contact. The player must be examined by the independent neurological consultant assigned to his club.”
If the consultant agrees with the club physician that the player’s concussion has been resolved, then the player can participate in practice and contact without restriction.
NFL teams keep confidential what stage a concussed player is in. So if Tagovailoa has advanced past Phase 1, it would not be revealed publicly.
According to medicinenet.com, the length of time that NFL players are sidelined after a concussion has tripled this century, a 2019 study determined.
Researchers analyzed data from the 2012 to 2015 NFL seasons. They found that the players who sustained a concussion returned to play an average of 19 days later, which means they missed about 1.5 games.
Data collected between 1996 and 2001 indicated NFL players typically were sidelined only six days after a concussion.
If Tagovailoa is placed on injured reserve, he would be required to sit out four games; the Dolphins’ Oct. 13 bye would not count toward those four. So Tagovailoa, if placed on IR, would miss games at Seattle, home against Tennessee on “Monday Night Football”, at New England and then at Indianapolis after a bye.
He would be eligible to return Oct. 27 vs. Arizona. The Dolphins have declined to say if Tagovailoa might be placed on IR.
This story was originally published September 13, 2024 at 4:25 PM.
