How the NFL’s concussion protocol will be changed after the Tagovailoa review

MIAMI GARDENS, Fla. (AP) — The NFL and NFL Players Association have agreed to make changes to the league’s concussion protocol after a joint investigation into procedures after Miami Dolphins quarterback Tua Tagovailoa suffered a so-called back injury against the Buffalo Bills to do in the past month.

The league and players’ union said in a joint statement Saturday that while the Dolphins followed protocol after the injury, the outcome of the Tagovailoa case “was not what was intended when protocol was drafted.” As a result, language was added to the league’s log list dealing with balance/stability anomalies that would discourage a player from returning to the game.

In the first half on September 25 against Buffalo, Tagovailoa received a hit from Bill’s linebacker Matt Milano that knocked him to the ground. Afterward, he appeared disoriented and stumbled trying to get to his feet.

Tagovailoa was immediately taken to the locker room to go through the NFL’s concussion protocol, after which he was cleared of all head injuries. He started the third quarter and drew widespread criticism for why he was allowed to return to the game.

The NFL and NFLPA said they reviewed the video and jointly interviewed members of the Dolphins medical staff, the head athletic coach, the Booth ATC spotter, the now-quited independent neurotrauma counselor, and Tagovailoa.

Tagovailoa showed no signs or symptoms of concussion during the dressing room examination, the rest of the game or the following week, the league and union said. But gross motor instability was present immediately after receiving Milano’s goal as Tagovailoa was visibly disoriented.

After the game, Tagovailoa and Dolphins coach Mike McDaniel said the player sustained a back injury on a quarterback sneak early in the contest.

The inquest revealed that Tagovailoa told medical staff that his back injury had worsened when he was hit by Milano and that his back injury caused him to stumble. The review also said that medical staff determined that the gross motor instability was not due to a concussion.

In their statement Saturday, the NFL and players’ union said the quarterback’s back was not examined during the examination for a concussion, but medical staff “relyed instead on the earlier examination performed by other members of the medical staff.” . The conclusion then was that the back injury was the cause of Tagovailoa’s instability.

As a result of the joint investigation, the league and union agreed to amend the league’s concussion protocol to include the term “ataxia.” The statement defines ataxia as “an abnormality in balance/stability, motor coordination, or speech disorder caused by a neurological problem.”

Ataxia replaced the term “gross motor instability” and was added to the list of symptoms that would prohibit a player from returning to the game. The other symptoms are confusion, amnesia, and unconsciousness.

“The protocol exists to establish a high standard of concussion treatment for every player,” the league and union statement said, “with each medical professional conducting a meaningful and rigorous examination of the player’s patent.” To that end, the parties remain committed to further evaluating our protocol to ensure it reflects the intended conservative approach to screening player patients for potential head injuries.”

On October 1, the union fired the independent neurotrauma counselor who was handling Tagovailoa’s situation during the game.

Jeff Miller, the NFL’s executive vice president of health and safety, said in a virtual news conference Saturday that he believes this is the first time a UNC has been fired and that the NFL does not approve of the decision to fire him has supported.

Less than a week after the injury, Tagovailoa started in a Thursday night game against the Cincinnati Bengals. He suffered a concussion in the first half after receiving a hard sack and showed the fencing reaction after the scary strike. He was carried off the field and immediately taken to the hospital. He remains on concussion protocol and will miss Sunday’s game against the Jets.

dr Allen Sills, the NFL’s chief medical officer, said with the league’s changed protocol, Tagovailoa would have been diagnosed with a concussion on Sept. 25 under the term ataxia, making him unfit to return to the game.

Sills said there is no precise timetable for the return of a player diagnosed with a concussion, but it would be “extremely unlikely” that a player diagnosed with ataxia would be able to play Thursday night. The median time out with a concussion is nine days, he added.

Sills also alluded to how difficult it is to definitively diagnose concussions. He mentioned that blood and saliva tests could help make concussion exams more accurate.

Commissioner Roger Goodell said at a fan forum in London on Saturday that the NFL will make a change or two to its concussion protocol.

McDaniel, who was repeatedly asked about the decision to allow Tagovailoa to return in the days following the incident, stressed his confidence in the team’s handling of the situation.

“This is a player-friendly organization and I make it very clear from the start,” McDaniel said last week, “that my job as a coach is for the players. I take this very seriously and no one else in the building is backing down from that.”