Why Tua Tagovailoa shouldn’t play even without symptoms and clear tests

The Miami Dolphins made it official today that Tua Tagovailoa will not play on Sunday against the Jets because he is still in concussion protocols. Even though his tests are clear, there is a reason this is important.

I don’t speak out a lot about things that I am not an expert on. I’m not a Twitter or Facebook doctor and I’m not currently employed by any hospital in the U.S. nor did I sleep at a Motel 6 last night. But I do actually have experience in this field. Quite a bit actually.

In no way am I suggesting that I know what happened to Tua against the Bills or on Thursday night but I can offer an educated opinion on the matter and why one week out may not be enough.

This writing gig is a hobby. It was, some 15-plus years ago, an escape from my real world. A way to put aside the stressors of my day-to-day job and discharge my mind from my job. It was and to an extent still is, an escape. I don’t “cover” the Miami Dolphins. I write about them and in the process, I tend to irritate many of you.

See, for 22 years, I was a paramedic and for two years before that, I was an EMT. Through my experiences on different levels of care, I have treated head trauma in the field, in an emergency room setting, in a critical care unit, and in neurological step-down units. I have gone through progressive care to neuro assisting. I have worked on patients paralyzed from motor vehicle accidents and helped in the treatment recovery plans. It wasn’t fun and more often than not, wasn’t rewarding.

It’s not glamorous and I have forgotten a lot about what happens when the head gets injured but I can say a few things with certainty on the subject.

On Sunday, Tua took a shot from a Bills defender and yes, it appeared he hit his head. I wasn’t overly concerned outside of being ticked off and I wasn’t surprised when he came back on the field if I am being honest. When they said, “back injury” I believed it. Not because I wanted to buy into it but because I’ve seen how lower back injuries can have a direct impact on someone’s gait, how someone walks, and how a nerve can completely disrupt a person’s ability to stand.

I’m not stupid enough to say Tua didn’t have a head injury, he very well may have. What I’m saying is that when they said “back injury” I knew what we saw on the field was a possible result of a back injury that was related to nerves and not the spinal column.

On Thursday, Tua was left in a position that had many fans, players, and media alike really concerned. His hands, in what is termed “fencing” was contorted, a sign of a potentially serious head injury but also something that happens after a concussion that includes being knocked unconscious.

I won’t pretend to know what caused the fingers to curl specifically or that it was a result of him being unconscious at any point because I wasn’t there and I can’t see the MRI or CT scans. And even if I did, I wouldn’t claim to be able to read them. I can read many X-rays but I was never in a position to read the other two. Was I worried? Absolutely but I also knew that he was heading to a level one trauma center and was moving his extremities according to broadcast reports.

I’ve worked in L-1 centers and they are the best of the best. They have to have specialized physicians available for every possibility. So when we learned that Tua was heading home with the team, I didn’t throw stuff at my TV, and I didn’t run to Twitter to voice my disgust. L-1 hospitals and their faculty are trained for these things. You simply don’t walk into an L-1 facility and are put in charge of trauma patients without extensive training or background.

So here we are, facing Tua’s potential clearing of all protocols. He is still in the concussion protocols but there has been a lot of debate and discussion on whether or not he should play when he is finally cleared. But here is the rub. A concussion isn’t something that simply goes away in a day or two. It’s one of those things that can have a long-lasting effect on someone. I’ve had many concussions in my life from playing sports and doing stupid things so, like many of you, we know what comes next.

So what does come next? Well, Tua could be cleared to play this week and be removed from the concussion protocols but keeping him out makes sense because he could find himself having returning symptoms next week or even the week after if this was serious enough and a lot of visual evidence points to it being that.

Tua may feel good now or later this week but he could begin to experience post-trauma headaches or even light sensitivity days after clearing the protocols. He could feel numbness or off-and-on tingling in his fingers or toes. He could feel his balance is off at times and could find himself tired at odd times without doing strenuous work.

By keeping him out this week, the Dolphins are going to make sure those symptoms don’t return. Post-concussion symptoms can return at any time but typically will manifest within a couple of weeks depending on the severity. That is why the MRI and CT scans are so important because those will tell the neuro physicians if there was significant bruising or other trauma to the brain.

Sitting Tua out through this week and possibly next week will give the Dolphins a better idea of his brain health and recovery prognosis.

This is where Tua becomes the most important person for his recovery because once he does clear the protocols, he has to be honest about any returning symptoms no matter how minor or insignificant they may seem. Even if the symptom may be something he experienced prior to the injury.

For Miami, protecting Tua from himself is just as important as diagnosing his concussion status. This week is a good start and makes complete sense but don’t be surprised if he sits the week after as well.