NFL, NFLPA Make Changes to Concussion Protocol After Tagovailoa Investigation

The two parties added the term “ataxia” as part of the “mandatory no-go” symptoms in the league’s concussion protocol list.

The National Football League and the NFL Players Association agreed on the changes to the league’s concussion protocol, the two parties announced Saturday.

While the investigation into Dolphins quarterback Tua Tagovailoa determined that Miami’s medical staff and unaffiliated medical professional followed the “step-by-step” process of the league’s protocol, the joint statement between the NFL and the NFLPA agreed that the “outcome” in the case “is not what was intended when Protocols were drafted” in 2013.

In doing so, the new protocol will include the term “ataxia” as part of the “mandatory no-go” symptoms. Per the statement, ataxia is defined as the “abnormality of balance and stability, motor coordination or dysfunctional speech caused by a neurological issue.” If a player shows any signs of ataxia during the concussion protocol, he will not be allowed to return to the game and will “receive the follow-up care” mandated by the league’s protocol. 

In the investigation, both the NFL and the NFLPA determined that when Tagovailoa stumbled after a hard tackle in the Dolphins’ game against the Bills, he “fell on his back” and then hit his head on the ground. Tagovailoa then “shook his head several times and after several steps he stumbled and fell”, the joint statement read.

Here’s the new NFL-NFLPA concussion game day checklist, which adds ataxia to loss of consciousness, confusion and amnesia as “no-go” symptoms for return to play, replacing gross motor instability.

Full updated protocols: https://t.co/YZkOscGT1M pic.twitter.com/p31u3dnJR7

— Tom Pelissero (@TomPelissero) October 8, 2022

The Dolphins medical team and the unaffiliated neurotrauma consultant properly viewed the video of the play in question as required and followed it with a locker room examination of Tagovailoa before he cleared to return to the game. The Dolphins’ physician cleared Tagovailoa to play.

After being cleared the report, the statement shared that Tagovailoa reported “back and ankle injuries” earlier in the game. He told the team medical staff that he “aggravated his back injury” in the play where he was tackled hard, which caused him to stumble. As such, Tagovailoa did not show signs or symptoms of a concussion during his “locker room exam, during the remainder of the game or throughout the following week.”

The Dolphins medical staff determined that Tagovailoa’s gross motor instability suffered was not “neurologically caused.” The staff determined that Tagovailoa’s back injury was the cause of his instability. However, the Dolphins physician and UNC failed to conduct an examination of Tagovailoa’s back during his concussion exam. Instead, the two relied on the “examination completed by other members of the medical staff.”

The change of the protocol comes a day after NFLPA requested changes to the protocol ahead of the Sunday slate of games in Week 5. The NFL agreed that the changes to the joint NFL-NFLPA protocols were necessary to "further enhance player safety."

Tagovailoa remains in concussion protocol and Dolphins coach Mike McDaniel confirmed to reporters on Monday that the quarterback would not play against the Jets on Sunday. The Miami signal caller also did not travel with the team for the game this weekend.