With Tua Tagovailoa’s future and health on the line, the Dolphins must be extremely cautious

It was the scene none of us wanted to see: Tua Tagovailoa lying unconscious on the soccer field after another collision and a blow to the head.

But there we were, late Thursday night, watching with fear for the Miami Dolphins quarterback’s well-being as medical personnel tended to him following his third-quarter scramble and collision with Buffalo Bills safety Damar Hamlin. Instantly, memories and mental images of Tagovailoa’s concussions from 2022 came flooding back.

The heart-wrenching fear his family members must have felt at that moment is hard to comprehend. But everyone from current and former NFL players, fans and everyone in between sympathized.

Tagovailoa was eventually helped to his feet and limped off the field under his own power. Just before the quarterback reached the sideline, Dolphins coach Mike McDaniel had a quick word with his player: “I told him he’s the starting quarterback in his family and to ‘go to the locker room, take a deep breath and I’ll see you soon.'” With that, McDaniel kissed Tagovailoa on the head and turned him over to the trainers, who escorted him to the locker room for evaluation.

.@KayleeHartung provides an update on Tua Tagovailoa. photo.twitter.com/hiEnuq9ISC

— NFL on Prime Video (@NFLonPrime) September 13, 2024

McDaniel’s emotions were impossible to hide for the remainder of the game and during his postgame press conference. McDaniel was quick to answer questions about how the Dolphins would handle Tagovailoa’s recovery, saying only that he expected Tagovailoa to undergo extensive evaluations on Friday and that the Dolphins would take the situation and the quarterback’s care “one day at a time.”

Now, faced with the question of how to handle their quarterback after a third known concussion in three seasons, the Dolphins’ leadership finds itself in an extremely difficult position. They must wait to learn how this latest concussion will affect the 26-year-old quarterback and then grapple with the decision of when/if he should return to the field.

The Dolphins and their doctors will undoubtedly be working hard to avoid a repeat of 2022, when Tagovailoa was seemingly allowed to return to action prematurely and subsequently suffered at least one more concussion. (Those decisions prompted a joint investigation by the NFL coroners and the NFL Players Association.)

If you recall, it was Week 3 of that 2022 season when Tagovailoa suffered a blow that left him stumbling and struggling to balance following an injury the Dolphins classified as a back injury, though there was always something about that diagnosis that felt off. Tagovailoa started the next game before ultimately suffering a sack that sent his back and the back of his helmet to the ground. Tagovailoa’s body involuntarily going into the fencing reaction before he was carried off the field on a stretcher. In Week 16, Tagovailoa suffered another concussion and missed the final two games of the regular season and Miami’s playoff game.

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If the Dolphins learned anything from that Week 3-4 series, it’s that medical exams and league-mandated protocols aren’t always as comprehensive or airtight as you’d hope. So this time around, measures that might even seem extreme are required as they navigate this latest brain injury recovery with their quarterback.

Almost immediately after Tagovailoa’s injury Thursday night, social media exploded with opinions from former players, including Hall of Fame tight end Tony Gonzalez, who was covering the game for Amazon Prime, and fans suggesting that Tagovailoa retire — never play football again. The risk of the quarterback returning to action and suffering another (and potentially more devastating) concussion appears to far outweigh the reward of a continued playing career, they believe.

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But it’s not that simple. How do you tell a young man that he is not fit to work? How do you tell him that he can no longer make his dream come true?

Tagovailoa has certainly proven he can play at an elite level. He led the NFL in passing yards last season and was productive again in Week 1. But his injury history suggests his body isn’t designed to withstand the rigors of this brutal game.

There is a fine line between supporting a player while allowing him to live his own life and make his own decisions and protecting a player from himself. Determining where that line falls is painfully complicated and perhaps impossible to determine.

Tua Tagovailoa led the NFL in passing yards last season and was the league leader through Week 1 of this season. (Jasen Vinlove / USA Today)

It’s an unenviable position for the Dolphins, who agreed to a four-year, $212.4 million contract extension with the quarterback earlier this summer. The deal is the last thing on anyone’s mind at the organization right now. Protecting and supporting a family member in the hopes of getting him back to full health and living a quality life is at the top of their list of priorities.

The Dolphins will not be able to adhere to the usual concussion protocol for resuming play, which involves daily monitoring, a gradual increase in physical activity, and a potential return to play by the end of the same week.

It seems that the Dolphins’ doctors will have to mandate extensive, advanced testing to learn as much as possible about Tagovailoa’s brain and recovery process before they even let him step foot on a treadmill. The problem is that brain damage from concussions is often difficult to detect, even with the most advanced technology. But extreme care is needed even if the quarterback is no longer showing symptoms of a concussion.

It’s still way too early to know what the recovery time will look like. McDaniel said Friday he didn’t even know if the Dolphins would place the quarterback on the injured list (a minimum of four games) to ensure he doesn’t return too soon.

“I literally won’t know anything, because again, that’s how we operate, as if we don’t know anything — because we don’t know,” the coach said. “The driving force behind every move — let’s say play at any point, let’s say IR, whatever those things are — the absolute most important opinion is the most important person in this whole equation, which is Tua. His opinion about what he wants to do with his life and his career, along with the experts in neuroscience — those are the driving forces behind those actions. … I’m not hiding anything. I’m being as transparent as I absolutely can. I have zero idea what any kind of timeline is, and I’m actually extremely motivated to be in the gray because I’m extremely motivated to do the right thing for, you know, the person that we’re talking about. I know that’s not necessarily an ideal way to do business. But this is more than business.”

McDaniel added: “Literally all I say to Tua is, ‘Everyone is counting on you to be a dad this weekend,’ and then we go from there.”

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If Tagovailoa ultimately decides he wants to keep playing and the doctors clear him, the Dolphins will have to do everything they can to protect him. That means taking him at a painfully slow pace to insulate him from setbacks, and perhaps having him wear a Guardian Cap in games over his already specialized helmet. But that’s just the beginning.

They have a lot invested in him right now. His contract contains $167 million guaranteed for injuries, including $43 million paid this year. Even if the team forces him to retire for medical reasons, it would owe Tagovailoa the remaining $124 million of the guaranteed money on his contract. If he chooses to retire on his own, he would forfeit that money unless he and the team reach a settlement for the injury. So the only move is to exercise patience and support.

McDaniel explained, “I consider Tua a family member of mine,” and his sentiments are shared by those within the Dolphins organization. So for now, the necessary steps are to ensure that the man’s well-being is prioritized over all football matters. Then those decisions will come.

If only there was some way to ensure the Dolphins quarterback would never have to endure something like this again in the future.

(Top photo of Mike McDaniel kissing Tua Tagovailoa as he leaves the court: Megan Briggs/Getty Images)