The Updated Concussion Protocol In Action

If you have been following the Tua Tagovailoa situation, it was clear that the NFL had work to do in terms of keeping its players safe. After issuing a statement days after the NFLPA’s investigation began, the NFL and the NFLPA jointly announced that they were working towards updated protocols centered around “Gross Motor Instability” and “Ataxia.”[1] On, October 8, the NFL and the NFLPA officially adopted new concussion protocols after their investigation into the Tua Tagovailoa incident concluded.[2]

After the NFLPA’s investigation into the handling of Tagovailoa, the NFL and the NFLPA surprisingly found that the NFL’s concussion protocol was followed, and the issue was the protocol in itself. The NFL and the NFLPA issued a joint statement saying that the “the step-by-step process outlined in the concussion protocol was followed, the outcome in this case was not what was intended.”[3]

A Flawed Protocol

The NFL and the NFLPA stated that the Dolphins medical staff and the unaffiliated neurotrauma consultant followed all of the steps on the NFL’s game day concussion checklist.[4] They reviewed video of the hit, examined Tagovailoa, found that there were no symptoms of a concussion, and determined that Tagovailoa’s Gross Motor Instability was a result of a back injury that he had previously been dealing with.[5] During the examination of Tagovailoa, they did not look at his back to confirm this, rather they relied on an examination that was conducted earlier when Tagovailoa first complained about his back.[6] The investigation also revealed that Tagovailoa continued to be symptom free throughout the week.[7]

The results of this investigation do not mesh well with the actions of the NFLPA, which fired the unaffiliated neurotrauma consultant on October 1 after the investigation began and it initially found this person made “several mistakes” during the evaluation at halftime.[8] I have a hard time understanding how it was determined so fast that this consultant made several mistakes, including “failure to understand his role as UNC and hostility during the investigation process.”[9]  A week later when the investigation was over, the NFL and the NFLPA said that the protocol was followed, many people, including myself, were asking why the unaffiliated neurotrauma consultant was fired in the first place then? Shortly after the investigation concluded, the NFL’s VP of Communications, Jeff Miller, and Dr. Allen Sills, the Chief Medical Officer, said that based on what the investigation concluded, this individual should not have been fired.[10] They further said that they did not support the NFLPA’s decision in doing this and that it is extremely unfortunate to make a decision like that before a review is completed.[11]×900

Is The Updated Protocol Too Much?

Since the NFL and the NFLPA’s investigation revealed that the protocol was followed, it was obvious that it needed to be updated, because it is clear that a player in Tagovailoa’s shoes should never be allowed to return to the game. In the updated protocol, the NFL replaced “Gross Motor Instability,” with “Ataxia.” The NFL defines ataxia as, “abnormality of balance/stability, motor coordination or dysfunctional speech caused by a neurological issue.”[12] Ataxia is now one of the “no go” symptoms, along with loss of consciousness, confusion, and amnesia.[13] If a player shows ataxia, they will not be cleared to return, no matter what they say the cause of it is. In Tagovailoa’s case, had this updated protocol been in place, Dr. Allen Sills says that he would not have been cleared to return to the game against the Bills.[14]

This new protocol was put on display in Week 5, of course with the Dolphins. This time, Dolphins’ Quarterback, Teddy Bridgewater (who was starting in place of Tagovailoa who is still in the NFL’s concussion protocol) was hit by Jets’ Defensive Back Sauce Gardner. After the hit, according to the game’s concussion spotter, Bridgewater appeared to stumble.[15] This stumble was nothing like what happened to Tagovailoa; most people cannot even make out where the stumble occurred in the replay, it was that minor. However, it does not matter how minor, or what the cause was, this was ataxia as defined by the NFL, and a “no-go” to return.[16] Bridgewater was taken to the locker room, he passed a concussion test and displayed no symptoms of a concussion, however that was irrelevant because once he stumbled, he entered the concussion protocol.[17]

The situation with Teddy Bridgewater was a perfect display of the updated protocol, especially when you compare it to his teammate Tua Tagovailoa. Tagovailoa would not have been allowed to remain in the game under the new protocols, and it is almost certain that Bridgewater would have remained in the game under the old protocol. Comparing these two situations these side by side demonstrate how powerful the minor tweak to the policy really is. Before the update, a player who could not walk to his sideline without extreme stumbling was cleared to return. Now, after the update, a player who maybe stumbled was out for the game no matter what. Quite the sharp contrast.

The NFL definitely has been and continues to be headed in the right direction regarding concussions. With this updated protocol, the NFL sent the message that they value player safety and will do everything in their power to protect their players. However, is this protocol too far or unreasonable?

Bridgewater does not appear to have sustained a concussion and he still has no symptoms. Yes, it is always best to err on the side of caution, but if what Teddy Bridgewater did constitutes ataxia in the NFL’s eyes, you can find that that happens to someone on almost every play. Perhaps there is just extra scrutiny on Dolphins players, or maybe the NFL has turned the corner and will truly start valuing player safety over competition, no matter what.

This was only the first week of the protocol being in effect, so it is possible that they are still working out the kinks. However, if this is the final product, I think that it may be very hard for the NFL to apply this strict standard of ataxia consistently. If a player were to “stumble” as Bridgewater apparently did in the Super Bowl, would he be pulled out?

While many are unhappy with how the Teddy Bridgewater situation played out, the NFL made one thing clear, and that is that the Tua Tagovailoa situation was unacceptable and they will never allow that to happen again.

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[4] Id.

[5] Id.

[6] Id.

[7] Id.



[10] Id.

[11] Id.


[13] Id.



[16] Id.


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