The details on Dolphins QB Tua’s horrific injury and everything we know about the controversy surrounding it

Lance left the crowd in the stadium fearful and stirred up the NFL world

The joint concussion protocol of NFL and provides NFL Players Association faces severe bother on Friday, a day after the quarterback of the Miami Dolphins, Tua Tagovailoa suffered a concussion and was briefly hospitalized throughout his workforce’s 27-15 loss for Cincinnati Bengals.

The injury occurred with 5 minutes, 15 seconds remaining in the second quarter at Paycor Stadium in Cincinnati. Tagovailoa’s head hit the floor when he was sacked by Bengals linebacker Josh Tupou. Tagovailoa’s fingers stiffened and his fingers curled into what seemed to be a “fencing response.” Medical authorities put him on a stretcher and took him to an ambulance.

After the Bills punt, what occurred at halftime?

Tagovailoa’s stumble after hitting his head on the floor suggests gross motor instability — which, based on the NFL’s concussion protocol, requires him to be taken on to the locker room for analysis. Dolphins coach Mike McDaniel mentioned Tagovailoa insisted the reason behind the stumble was a again injury he suffered early in the recreation. The quarterback mentioned Monday he underwent a concussion analysis at halftime Sunday and has been cleared to return to motion.

McDaniel mentioned Monday that if “any purple flag” got here up throughout the analysis, Tagovailoa wouldn’t play. He added that the workforce and an unrelated neurological marketing consultant went “above and past” to the level the place Tagovailoa was “exasperated” by the quantity of questions he was being requested about a doable head injury. The Dolphins initially reported he was questionable to return with a head injury, however later mentioned it was ankle and again accidents. — Marcel Louis-Jacques

Why would somebody with gross motor instability return to play?

After taking the preliminary snap in Week 3 towards the Bills, Tagovailoa visibly tripped and needed to be stabilized by teammates. The NFL’s concussion protocol refers to any such tripping as “gross motor instability” and requires analysis to find out the trigger.

This part of the protocol concludes: “If the workforce physician, in session with the sideline [consultor de neurotrauma não afiliado]decide that the instability is neurologically brought about, the participant is labeled “Banned” and can not play once more“.

In Tagovailoa’s case, the gross motor instability was attributed to a again injury, not a concussion. Because he was not “neurologically induced” as decided by the workforce and unrelated medical doctors, he was cleared to play underneath the protocol. — Kevin Seifert

When Tagovailoa was fired on Thursday, it was reported that he had a fencing response. What is that this?

The fencing response is an involuntary neurological response to a major concussion during which the forearms are held rigidly outward for a brief time frame. The time period derives from the sport of fencing with the place of 1 arm bent and the different prolonged. — Stefania Bell

Tagovailoa is in concussion protocol, so what’s subsequent?

Tagovailoa should undergo a five-step course of earlier than returning to the subject. Here’s what it’ll be like, to paraphrase the return-to-play portion of the protocol:

Phase 1: Rest and then restrict or keep away from bodily and cognitive actions if signs worsen. Introducing restricted stretching and steadiness work and transitioning to gentle cardio train.

Phase 2: Gradual development to cardiovascular train, dynamic stretching and extra steadiness. Neurocognitive and steadiness assessments could also be administered. If the outcomes are interpreted as a return to baseline (pre-shock) ranges, part 2 might be happy.

Phase 3: Increased cardio to imitate sport-specific exercise, together with managed energy coaching. A participant can prepare with the workforce by doing sport-specific drills in half-hour or much less.

Phase 4: The participant can progress to non-contact soccer actions reminiscent of passing, receiving and operating. Another spherical of neurocognitive and steadiness assessments was administered to verify that scores remained at baseline.

Phase 5: A membership physician should clear the participant for all soccer actions, together with contact. An impartial neurological marketing consultant (INC) assigned to the workforce by means of a joint settlement between the NFL and the NFLPA should then agree with the workforce doctor that the concussion is resolved. At this level, the participant is cleared to play in his workforce’s subsequent recreation. — Seifert

What can we count on from the NFL/NFLPA investigation?

As is their proper underneath protocol, the NFLPA requested a joint investigation into how the Dolphins dealt with Tagovailoa’s injury in the Bills recreation. The investigation started instantly. On a convention name three days later, NFL government vice chairman Jeff Miller mentioned “each indication from our perspective” suggests the Dolphins are following protocol.

Miller estimated {that a} formal response to the investigation would take per week or two.

Separately, NFLPA Executive Director DeMaurice Smith mentioned in an announcement launched Thursday night time to Amazon that the union will pursue “all authorized choices” as the investigation continues. Generally talking, underneath the phrases of the collective bargaining settlement, disputes between the league and the union are resolved by means of personal arbitration.

On Friday, NFLPA President JC Tretter launched an announcement that learn partly: “We are all outraged by what we have seen over the previous few days and concern for the security of one in all our brothers.

“Until we have an goal and validated technique for diagnosing mind accidents, we should do everything we can, together with altering protocols, to additional cut back the potential for human error.” the well-being of our gamers.” — Seifert

Will the league revise its concussion protocol?

That’s an inexpensive expectation, particularly if the NFL/NFLPA investigation finds no violations of protocol, as Miller indicated. An apparent goal for additional dialogue is whether or not a participant with gross motor instability, no matter trigger, needs to be allowed to proceed enjoying.

There is current precedent for in-season changes to the protocol. In 2017, Houston Texans quarterback Tom Savage was cleared to return to the recreation after exhibiting apparent signs of a concussion after successful, together with a fencing response and trembling fingers. He was later identified with a concussion and didn’t end the recreation.

After an investigation revealed that no protocol violations had occurred, the league and union made a sequence of enhancements to present guidelines to cowl such circumstances. The dietary supplements require a participant to be completely faraway from a recreation in the event that they present any indicators of fainting, and additionally require referees who witness the signs to tell the workforce’s medical employees. In addition, the league added an impartial neurotrauma marketing consultant to its game-day operations in New York to assist oversee the course of. — Seifert


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