When the Miami Dolphins take the field in their Wild Card Weekend showdown with the Buffalo Bills Sunday, Tua Tagovailoa will not be in the huddle. The latest Tagovailoa injury update: Miami’s QB1 remains in the concussion protocol after suffering his second, if not third, traumatic brain injury of the season.
Doctors, as of late in the week, still had not cleared him to practice, let alone play. As a result, he will miss his third consecutive game. Skylar Thompson will start, and Teddy Bridgewater will be the backup.
Tua Tagovailoa Injury Update
Tagovailoa suffered his latest concussion in the Dolphins’ Week 16 loss to the Green Bay Packers on Christmas Day. Three weeks later, he remains in the preliminary stages of the protocol — either Stage 2 or 3 of a five-stage process. Dolphins coach Mike McDaniel gave the following update the Friday before the Bills game:
“The current stage is the same as it was last. He’s been around and been good, and I’m just worried about his day-to-day health. I’ll let you know when it does advance, but besides checking on him and how he’s doing, it’s a big-time life adjustment when you go from playing to being out.
“That’s for every player that’s injured. So you try to make sure that they’re still feeling as involved as possible in general, and then besides that, I’ve just been focused on preparing this team for a Wild Card game on Sunday.”
Sunday marks the 10th game Tagovailoa will miss due to injury in his three-year NFL career, including five this season due to concussions.
But his injury history far predates his time in Miami.
Tua Tagovailoa Injury History
Tagovailoa needed at least four surgeries during his three seasons at the University of Alabama. During spring practice before his sophomore year, Tagovailoa broke the index finger on his throwing hand. Although the procedure to get it repaired did not cause him to miss any games.
He twice — once in 2018 and again in 20219 — underwent the so-called tightrope procedure to speed up recovery time from a high-ankle sprain. What is the tightrope surgery, and when is it needed? Northwell Health’s Orthopaedic Institute had this explanation:
“A high-ankle sprain denotes injury to the ligamentous complex bridging the two leg bones, tibia and fibula specifically, where they articulate at the ankle joint. The syndesmotic ligaments between the two bones are torn, and in the most severe cases there is increased separation or diastasis between the two bones.
“In this instance, surgeons anatomically reduce the gap, drill across the two bones and place heavy non-absorbable suture construct with metallic buttons at either end (the “tightrope”) to hold the bones close together. This offers long-term protection and stability, and allows the ligamentous complex to heal in optimal position.
“The implanted device actually stabilizes the ankle and serves as a replacement ligament while the native syndesmotic ligaments heal.”
But those were all relatively minor inconveniences compared to the injury that ended his college career.
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On Nov. 16, 2019, late in the first half of Alabama’s game against Mississippi State, Tagovailoa was tackled while trying to extend a play. Tagovailoa landed with full force (and the body weight of a Bulldogs defender) on his right side.
That force resulted in a dislocated hip with a posterior wall fracture. Tagovailoa also broke his nose and, significantly in retrospect, suffered the first known concussion of his playing career.
He’s since suffered two more — at least.
Tua Tagovailoa’s Diagnosed Concussions
Tagovailoa — who sustained injuries to his thumb, finger, and ribs that caused him to miss games early in his NFL career — this year has begrudgingly become the face of the NFL’s concussion problem.
The high-profile saga began on Sept. 25, 2022, when Tagovailoa was briefly knocked from the Dolphins’ win over the Bills with what in the moment appeared to be a concussion. He hit the back of his head on the ground after Bills linebacker Matt Milano shoved him backwards.
When Tua tried to get up and get to the huddle, he twice staggered and fell to the ground. Doctors immediately took him to the locker room for a concussion evaluation.
But he passed all the necessary tests, and the team’s medical staff determined Tagovailoa lost his balance due to a lower back injury. He was cleared to return and played the entire second half of the game.
The decision to allow him to return to play ignited a firestorm of criticism from many concussion experts, saying he exhibited all the signs of a head trauma and should not have been cleared to play. The NFL and NFLPA were concerned enough about the optics that they launched a joint investigation into the club’s decision-making process.
Meanwhile, the Dolphins had a game against the Cincinnati Bengals just four days later, and Tagovailoa — who insisted to reporters that he had not suffered a concussion against Buffalo — was determined to play.
That was a mistake. Because Tagovailoa again had the back of his head slammed into the ground by an opposing player, and this time, there was no question he was concussed. Tagovailoa lost consciousness and his fingers involuntarily contorted into what is known as the fencing pose, a sign of likely brain trauma.
Doctors immobilized Tagovailoa and rushed him to a local hospital. Tagovailoa was indeed diagnosed with a concussion, but after evaluating him, doctors determined it was safe for him to fly home with the team. He missed the next two games due to the injury, and during that time, the league and union released the findings of their joint inquiry.
They determined that while the Dolphins had followed the concussion protocol as it was written, the Bills episode showed that the protocol needed updating. So now, any player who demonstrates what is deemed as gross motor instability will be pulled from the game, regardless of whether or not he is diagnosed with a concussion.
Despite calls by some for Tagovailoa to retire following the Bengals game, he was determined to continue his career as soon as possible.
He explained why during an Oct. 19, 2022, news conference:
“I would say those kinds of things weigh more on my parents than they do for me, just with me being their son. But I mean, I just want to go out there and do good – do good for our team, do right for this organization, do right for the guys inside the building that I see every day that work really hard. That’s all. I mean, I enjoy being here. I enjoy all the guys in the building. So when I’m not able to do something about it and help our team and our organization, then that just really sucks.”
Tagovailoa was better than ever after his two-week recovery, and his return sparked a five-game Dolphins winning streak. And even with a late-season slump, Miami was in firm control of their playoff destiny when they hosted the Packers on Christmas Day.
Tua and the Dolphins raced to a 10-point first-half lead, and Tagovailoa was nearly perfect. But that all unraveled after suffering a concussion at some point midway through the game — an injury missed by both independent and team doctors at the time.
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He was allowed to play the entire game, although it was clear something was off in the second half. Tagovailoa threw three second-half interceptions, and the Dolphins lost 26-20.
The next day, Tagovailoa reported concussion symptoms, landing him in the protocol once again. He hasn’t played since, and some are wondering if he ever will — or should — again.
After ruling him out for the Bills game, McDaniel on Wednesday was asked by a reporter if Tagovailoa — and the doctors evaluating him — expects to resume his playing career at some point.
McDaniel’s response:
“You’re doing your job to ask the question, but come on. I’m just thinking about his day and him getting to full health as a human being. And then when it’s time to turn the page, I’ll turn the page, but I’m pretty – integrity in principle to a fault and stubborn as all get out.
“If I hear that’s the way that I should approach it, I will approach it that way, and I do not deviate. Really, the next step is for him to be fully through this protocol, and then we can see where the land lays, so to speak. But outside of that, I’m just worried about him.”