Tagovailoa out Sunday; what he must do to be cleared to return
Dolphins coach Mike McDaniel said Monday that Tua Tagovailoa will miss Sunday’s game at the Jets because of a concussion, but McDaniel remains uncertain of any timetable beyond that.
“He’s in the building. He’s had a couple good days,” McDaniel said. “He’s trying to go through the proper procedure and protocols so he’s feeling 100 percent.
“He’s going to be diligent with it. And if there is anything giving him issues such as light or anything, we will shut that down.”
Regarding how many games Tagovailoa will miss, “anything beyond [missing Sunday is unknown],” McDaniel said. “We’re making sure he’s at optimal health. It’s a little early” on timetables.
With Tagovailoa in concussion protocol, the Dolphins signed former Dolphins quarterback Reid Sinnett to the practice squad. Teddy Bridgewater will start Sunday at the Jets, and rookie Skylar Thompson will be the No. 2 quarterback.
Since leaving Thursday’s Bengals game on a stretcher, medical examinations of Tagovailoa have yielded generally encouraging results. McDaniel confirmed that Tagovailoa’s MRI came back clean.
He said he had no confirmation of an ESPN report that Tagovailoa will seek three additional independent medical opinions on his brain and neck but said: “We don’t bat an eye on second or third opinions. When it comes to adding information for a player to understand where he’s at from health perspective, that’s encouraged.”
McDaniel said not one person will decide when Tagovailoa is cleared to play. “We will always have our media opinions from our in-house guys. It’s not just one doctor. It’s a collection of people advising.”
Among quarterbacks who were in concussion protocol in recent years, some didn’t miss a game, while others missed several.
Bridgewater sustained two concussions while playing for Denver last season, in Week 4 and Week 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’ 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 last October 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.
But everyone responds differently to a concussion. Dolphins tight end Cethan Carter remains in concussion protocol, having missed three games, and it’s unclear when he will return.
Tagovailoa also is dealing with back and ankle injuries, according to McDaniel.
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 one 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 2012-2015 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.
The longer return-to-play time after a concussion is due to the stronger concussion protocol now used by the NFL.
Tagovailoa has eight touchdown passes, three interceptions and 109.9 passer rating this season.
“I’m feeling much better,” he said Friday, “and focused on recovering so I can get back out on the field with my teammates.”
This story was originally published October 1, 2022 at 10:02 AM.
