The concussion discussion in the NFL

A terrifying moment happened in the NFL on Thursday night when Miami Dolphins quarterback Tua Tagovailoa was carted off the field on a stretcher. His head hit the ground hard after a tackle and his fingers contorted involuntarily, a sign of severe head trauma. Since that moment, there has been much public outrage. Last week, Tagovailoa suffered a hard hit in the first half of the game against the Buffalo Bills, but came back in to play anyway, which caused a league investigation into how the Dolphins handled the concussion protocol in that incident.

Concussions in the NFL

We hear a lot about concussions in specific sports - boxing, soccer, and football. Why is that? And why is it that, despite the NFL’s restrictions and exhaustive scientific studies, concussions continue to be the most dangerous and threatening part of the game? In football, it starts with the obvious - repeated blows to the head week after week, which can then have dramatic long-term effects like degenerative brain disease which can cause dementia and even death.

A direct blow to the head, face, or neck can create movement that shakes the brain. If the hit has enough force or comes from a specific direction, the brain can move so that it hits the skull or twists on itself. Just like in other parts of the body, bruising and cell damage can occur and when those cells are neurons, the result is a concussion. One major problem of concussions is that sometimes the signs don’t show up for days, making it difficult to diagnose right after the fact. The impacts of a concussion are severe. Signs to look for include loss of consciousness, amnesia, nausea and vomiting, ringing in the ears, bruises, difficulty with motor skills and coordination, seizures, and confusion. And those are just the short-term effects. The long-term effects are much, much worse.

“I went through a period of about four or five years where I had headaches literally every single day,” said former NFL player Jeff Olson. “I had like a year and a half where I could not sleep.” Olson was forced to quit playing professional football after suffering from several concussions. The risk was too serious, and this is all too common. Long-term effects can include insomnia, anxiety, irritability, and even Alzheimers disease. The most commonly-linked disease to concussions in the NFL is chronic traumatic encephalopathy, or CTE. CTE is a degenerative brain disease resulting in depression, anxiety, memory loss, and dementia.

The NFL has spent years evaluating and imposing regulations to avoid direct helmet-to-helmet hits. They have made changes, not just in games, but also in practices, which are now done with limited contact and with some potentially dangerous exercises completely prohibited. Then, there is the problem of the hardness of the helmets, which can give players a false sense of protection. The NFL has thus spent time and money researching different types of helmets and restricting the use of those that have become obsolete. For what it’s worth, the number of concussions is continuing to go down each year, but the threat has not and probably never will be eliminated.

What is the NFL concussion protocol during a game?

There is a reason that people are outraged about what happened to Tua Tagovailoa. If a head injury is suspected during an NFL game, the player is supposed to undergo an extensive medical examination before he can be cleared to return to the field. He is first examined on the sidelines and if there are any signs at all that it could be a concussion, the player is sent to the locker room to be evaluated further and should not return until he is cleared by medical staff. But remember, sometimes those signs don’t show themselves until much later.

In Tua’s case, he was immediately sent back into the game on Sunday last week and cleared to play again this Thursday. After the hit occurred last week, the initial thought was that it was a head injury. But Dolphins coach Mike McDaniel rescinded that, saying it was actually a back issue, and he was sent back out onto the field.

Tagovailoa was taken to the hospital on Thursday after the hit and the Dolphins said he was conscious and has movement in all his extremities. McDaniel said that before the game, Tagovailoa was cleared to play by an independent neurologist.

“Absolutely zero patience for or will ever put a player in position for them to be in harm’s way,” said McDaniel. “That’s not what I’m about at all. No outcome of a game would influence me to be irresponsible as a head coach of a football team.”

Not everyone is buying what McDaniel is saying.

“The bottom line regarding Tua is LIFE is bigger than football,” former NFL quarterback Robert Griffin III said. “Teams should always put the person before the player. Health before competitive advantage. Putting Tua out there isn’t just a player safety issue. It’s a quality of life issue.”