NFL, Players Union agree to change concussion protocol

The NFL and its players’ union said Saturday that doctors followed a concussion protocol in treating the Miami Dolphins quarterback. Tagovailoa after he headed in a September 25 game, but the protocol will be changed as Tagovailoa’s return to the field is not as intended by the brain injury assessment rules.

In the second quarter of the game against the Buffalo Bills, Tagovailoa hit his head on the field after a late strike by a defender, then he grabbed his helmet, tried to get up, and fell again. . He returned to the game in the second half. The Players’ Union – the NFL Players Association – has begun a joint investigation with the federation into the handling of the episode by the Dolphins medical staff and an unaffiliated neuro-injury consultant. handling margin.

That review found that the protocol was followed and that Tagovailoa did not display concussion-like symptoms during the dressing room assessment or the days after. Instead, he said he aggravated a back injury, causing him to stagger and fall. The scene where Tagovailoa wobbled as his teammates picked him up after the blow caused many to assume he was concussion. The team doctor and consultant failed to examine Tagovailoa’s back before concluding that a back injury caused his instability and returning him to the game, the review found.

Tagovailoa also played four days later with the Cincinnati Bengals and headed again when he fell to the field after a challenge. He was taken to the hospital and released that same night. Tagovailoa is currently in concussion protocol, which requires concussion players to complete a five-stage recovery process before they can be cleared to play. Tagovailoa was dropped from Sunday’s game against the Jets.

The revised protocol, which will go into effect during Sunday’s games, would bar a player from returning to play if he exhibits ataxia, a term that describes a decline in balance or coordination due to damage brain or nerve damage. Under the previous protocol, used in Tagovailoa’s case, a player with “gross motor instability” – such as difficulty getting up or walking – could return to play if doctors decide There was supposed to be an orthopedic reason for his unsteady walk.

Allen Sills, the NFL’s chief medical officer, didn’t say definitively that Tagovailoa didn’t have a concussion during the Bills game – only that the review found that the doctors took the appropriate steps and made a medical judgment based on it. information they had at the time. Under the new rule, Sills said, Tagovailoa would be disqualified and not allowed to return to that match.

“We want to be even more conservative, and if we think ataxia is present, let’s just assume it’s coming from the brain and we’ll knock someone out,” says Sills. “Because if we’re wrong, we’d rather keep someone free of traumatic brain injury but we’re being cautious, than dismiss someone who might have a brain injury and we can’t diagnose. . “

If ataxia is observed during play, the player is automatically diagnosed with a concussion, as is the case with symptoms such as loss of consciousness or impact seizures. Players will then be asked to follow a five-step return to play process.

The players’ union took the unprecedented step of firing the unrelated nerve injury consultant involved in the care of Tagovailoa during the Bills game, a decision the NFL said it did not support. . The doctor’s name was not disclosed. Under the concussion process, while the consultant collaborates in assessing the player, the responsibility for diagnosing the concussion and deciding to return the player to the game “remains exclusive” with the evaluation of the physician. Team leader or team doctor assigned to handle concussion care.

The Dolphins’ chief physician, John Uribe, is a board-certified orthopedic surgeon and, according to his profile on the NFL Physicians Association website, has received a certificate of professional qualification in sports medicine in 2007. He is affiliated with Baptist Health Medical Group in south Florida and is also the physician of the NHL’s Florida Panthers.

The Dolphins did not respond to a message seeking comment on the results of the joint assessment and asked if Uribe, who accompanied Tagovailoa to the locker room during the Bills game, was the team doctor who had given him his return. again or not.


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