Tua Tagovailoa Suffers Yet Another Concussion in the Dolphins-Bills Game

In the third quarter of Thursday night’s Bills-Dolphins game, Miami quarterback Tua Tagovailoa suffered a concussion—at least his third in the last two calendar years—and left the game. The injury happened on a fourth-and-4 play with five minutes to go in the quarter. Tagovailoa stepped up in the pocket and scrambled for a first down, but as he went to the ground, his head collided with, of all people, Bills safety Damar Hamlin, and then slammed backward into the turf.

Tagovailoa stayed down on the ground, and Bills defensive lineman DaQuan Jones immediately began to call for medical attention. Dolphins players quickly knelt around their quarterback, and after a commercial break Tagovailoa walked off the field and into the locker room. He was quickly diagnosed with a concussion and ruled out of the game.

The play and aftermath were eerily reminiscent of an infamous Thursday Night Football incident involving Tagovailoa that defined the 2022 NFL season and led to significant changes within the league. That year, Tagovailoa had seemed to suffer a head injury in a Week 3 game against the Bills when he hit the back of his head on the ground, got up, and then collapsed. The Dolphins categorized his injury that week as a back injury, and Tagovailoa played on Thursday Night Football four days later. In that TNF game versus the Bengals, Tagovailoa took another hit to the head and suffered a gruesome concussion. The combination of those incidents led many to question how the NFL and teams treat players who’ve possibly suffered a head injury.

Tagovailoa left that game, but he returned just two weeks later. And in Week 16 he recorded an additional concussion (though he finished that game and was diagnosed afterward).

The NFL investigated both the Week 4 and Week 16 incidents from that season and found that Miami had not violated the league concussion protocol. But the league decided to alter that protocol to add ataxia, or the lack of muscle coordination and balance, to the list of “no-go” symptoms—signs that would keep a player from reentering a game. Players who return from concussions before their brains are fully healed are at a higher risk for serious injury, including second impact syndrome.

Speaking in 2023, Tagovailoa said that after suffering those concussions, he had seriously considered ending his NFL career. “I considered [retirement] for a time, having sat down with my family, having sat down with my wife and having those kind of conversations, but it will be hard for me to walk away from this game with how old I am,” Tagovailoa said in a press conference. “I always dreamed of playing as long as I could to where my son knew exactly what he was watching his dad do. It’s my health. It’s my body. I feel like this is what’s best for me and my family. I love the game of football. If I didn’t, I would have quit a long time [ago].”

In the same press conference, Tagovailoa was asked about what long-term effects these concussions might have on his health. He said he had been told that the multiple concussions he’d suffered in the 2022 season didn’t necessarily mean that he was more likely to suffer another, and that CTE—a neurodegenerative disease—“wasn’t going to be a problem” for him.

Chris Nowinski, the cofounder of the Concussion Legacy Foundation, took issue with Tagovailoa’s explanation. “If somebody told him he doesn’t have to worry about CTE,” Nowinski said last September, “then he is definitely being misled, based on what we know today.”

Shortly after Tagovailoa’s Week 16 concussion ended his 2022 season, Dolphins general manager Chris Grier said he disagreed with the idea that Tagovailoa’s concussion history put him at a higher risk of more concussions. “From what our doctors and the consultants we’ve talked to through the NFLPA, that is not a true statement,” Grier told reporters. “So for us, I don’t think he’s any more prone than anyone else. … From everything we’ve been told that is not a concern.”

Some academics disagree, including Julie Stamm, a clinical assistant professor in the Department of Kinesiology at the University of Wisconsin-Madison. “There’s something about that previous concussion that can make the brain more vulnerable—especially multiple concussions,” Stamm told USA Today. “The data would suggest that there is an increased risk of concussion, because he had these previous concussions.”

Before returning to football in 2023, Tagovailoa took steps to try to prevent these types of injuries from happening again. He took jujitsu classes during the offseason to help him change the way he falls. And he also put on 10 pounds to make his body a bit more durable. He subsequently played a full season for the first time in his NFL career last year and led the league in passing yards.

This offseason, the Dolphins signed Tagovailoa to a four-year contract worth up to $212 million and guaranteed for $167 million. The contract was signed in late July after Miami head coach Mike McDaniel “went to bat” for Tagovailoa with owner Stephen Ross, according to Tagovailoa. The QB also cited his relationship with McDaniel as key to his improved performance after former coach Brian Flores was fired.

It’s unclear where Tagovailoa will go from here. Amazon announcer Al Michaels said toward the end of the Thursday night game, a 31-10 Bills win, that Tagovailoa had full movement in his extremities. But as of Thursday night, no information about the rest of his condition, or a possible return timeline, has been released. Richard Sherman, on the Amazon Prime postgame show, said that Tua would now have to have another serious discussion with his wife about playing. Your wife and kids, Sherman said, “are the ones who will have to deal with you.”