Tagovailoa moves closer to return. And why the Dolphins needed to sideline him a month
Dolphins quarterback Tua Tagovailoa was well enough to attend Disney on Ice a day after being concussed on Sept. 12 against Buffalo and hasn’t experienced any symptoms, according to ESPN. But there was science behind the team’s decision to sit him out for a least a month.
ESPN’s Adam Schefter reported Monday night that Tagovailoa has not had any symptoms in the wake of his concussion and “there’s a real possibility” he will be back Oct. 27 against Arizona.
Schefter also said he does not believe a single neurologist has encouraged him to retire.
Because he doesn’t have symptoms, some fans have wondered why the Dolphins placed Tagovailoa on injured reserve, a decision that requires him to sit out four games.
But sitting Tagovailoa for an extended period was not only a prudent decision but a necessary one, according to concussion experts and a study on how the brain responds after concussions.
Chris Nowinski, co-founder and CEO of the Concussion Legacy Foundation, said: “It’s a myth the brain recovers in a week. Symptoms go away, and it functions OK, but on a cellular level all brains need weeks to physiologically recover.”
Two days after Tagovailoa sustained the concussion (at least the fourth of his life and likely his fifth), Nowinski told me that Tagovailoa needed to sit out at least a month. A scientific study supports that conclusion.
A study by Roberto Vagnozzi and colleagues that used advanced imaging — “proton magnetic resonance spectroscopy” — suggests that brain metabolite ratios do not return to normal by Day 15 after a concussion, but do return to normal by Day 30.
Even after three weeks, those ratios are not completely back to where they were before brain trauma, suggesting it was sensible to sit Tagovailoa for at least a month, especially considering his history of concussions.
Also, studies also have suggested that the risk of a severe brain injury increases for a short time after a first concussion, and the results of a second concussion within that short period could be dire.
Here were some of the findings from the study, according to Vagnozzi’s team:
“Concussive head injury opens a temporary window of brain vulnerability due to the impairment of cellular energetic metabolism. As experimentally demonstrated, a second mild injury occurring during this period can lead to severe brain damage, a condition clinically described as the second impact syndrome....
“Athletes with concussion exhibited the most significant alteration of metabolite ratios at Day 3 post-injury… On average, metabolic disturbance gradually recovered, initially in a slow fashion and, following Day 15, more rapidly. At 30 days post-injury, all athletes showed complete recovery, having metabolite ratios returned to values detected in controls.”
Concussion experts have said that Tagovailoa likely will need to sit out an extended time after future concussions.
Nowinski said that “concussions tend toward getting more severe with longer recoveries [as they add up]. That’s not the case for everybody.”
Because of that, it’s difficult to envision Tagovailoa ever being quickly cleared if he sustains another concussion and opts to continue playing, two local concussion experts said.
