NFL Concussion Protocol: Ataxia Controversy

Tagovailoa left the game briefly but returned to open the third quarter of a tight game with Miami’s division rival. He played the rest of the game, helping the Dolphins to their third consecutive win.

After the game, Miami explained that Tagovailoa’s fall was caused by a back injury rather than a head and/or neck injury. Tagovailoa injured his back on a quarterback sneak attempt earlier in the game.

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Week 4

Days later, Tagovailoa and the Dolphins played on Thursday Night Football. Tagovailoa started the game, but he did not finish the game after being thrown to the ground by the Bengals’ Josh Tupou. Tagovailoa hit his head again, and his body went into the "fencing position," a warning sign for a traumatic head injury.

Teddy Bridgewater replaced Tagovailoa and finished the game. The Dolphins ended up losing.

Two days later, the NFLPA terminated the sideline consultant tasked with checking Tagovailoa’s concussion in Week 3. The unaffiliated neurotrauma consultant (UNC) examines players for head and neck injuries.

Week 5

Tagovailoa did not pass NFL concussion protocol, so Bridgewater started against the New York Jets. On Miami’s first play of the game, Bridgewater fired a pass before Ahmad Gardner planted him into the turf. Bridgewater got up and left the field – the pass was intentional grounding and was a safety – only to not return.

Skylar Thompson, Miami’s seventh-round pick in the 2022 NFL Draft, played the rest of the game. As Bridgewater works back from several injuries, he will start Miami’s next game, and Tagovailoa just passed concussion protocol.

An independent spotter said Bridgewater displayed ataxia – impaired balance or coordination. While Bridgewater did not have a clear moment as Tagovailoa did (his Week 3 stumble or Week 4 fencing pose), the independent spotter removed Bridgewater from the game just minutes into the action.

Concussion Protocol Change

After Tagovailoa’s Week 4 injury, the NFL and NFLPA rapidly changed the procedures around concussions. They introduced the ataxia clause into the protocol. If a player exhibits any ataxia, he would not be allowed to return to the game. This likely means Tagovailoa’s day would have been over as soon as he stumbled against the Bills.

The updated protocol began in Week 5, and Bridgewater was the first case. Whether Bridgewater had – or did not have – a concussion did not matter. As soon as he showed ataxia, he would be sidelined.

Bridgewater ended up passing concussion protocol, meaning he would have been able to return under previous rules. New Orleans Saints wide receiver Chris Olave also was removed from the action. After scoring a touchdown in the Saints’ win over Seattle, he was ruled out with a concussion.

Dolphins quarterbacks had sustained three potentially serious head or neck injuries within three weeks. The NFL made a dramatic midseason change in policy to protect the players.

Controversy

Ruling out a player with ataxia is the nuclear option, as it ends a player’s day immediately. Currently, the NFL has two ATC spotters – independent certified athletic trainers – per game. They are not solely focused on finding potentially concussed players, they look for any injury. They can call a medical timeout, giving a team the time to check on a player.

The process will certainly be criticized over time as some players are removed. Some examples, like Tagovailoa, will be obvious on replay. Others, like Bridgewater, will not be as obvious on replay. With the saturation of NFL content, any discrepancy will be attacked relentlessly.

In Week 6’s Thursday Night Football game, quarterback Justin Fields appeared to stumble multiple times. Fans, particularly Dolphins fans, flocked to Twitter with a bevy of videos pointing out any potential stumble from a player. Every NFL game will bring potential controversy if a player is removed without visual evidence (on the broadcast) or if a player is not removed despite a stumble.

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