NFL and NFLPA accept parameters for updated concussion protocols

The NFL and NFL Players Association have agreed to parameters for updated concussion protocols that will exclude players who exhibit gross motor instability like Tua Tagovailoa did in the Dolphins’ Week 3 game against the Bills, regardless of are the possible contributing factors, sources briefed on the talks told on Saturday.

The deal is subject to official approval, including the NFLPA’s health and safety committee.

NFL Chief Medical Officer Dr. Allen Sills told NFL Media on Sunday morning that the NFL’s Head, Neck and Spine Committee and the Mackey-White Health and Safety Committee of the NFLPA are still in discussion on the final language and unintended consequences of the new protocol, but if approved, the changes could go into effect in Week 5.

Sills also pointed out that team doctors, unaffiliated neurotrauma consultants and certified athletic trainers will need to be trained on how to apply the updated protocols to ensure they are consistent across the league before anything comes into effect.

In a joint statement Saturday, the NFL and NFLPA said they both agree changes are needed “to improve player safety.”

“The joint NFL-NFLPA investigation into the enforcement of concussion protocol involving Miami Dolphins quarterback Tua Tagovailoa is still ongoing,” the joint statement said. “Therefore, we made no conclusions about medical errors or protocol violations.

“The NFL and NFLPA agree that changes to concussion protocol are needed to improve player safety. The NFL Mackey-White Health and Safety Committee and the NFL Head Neck and Spine Committee have already started conversations about the use of the term ‘Gross Motor Instability’ and we anticipate that changes will be made to the protocol in the coming days based on what has been learned so far in the review process.

“The NFL and NFLPA share a strong appreciation for unaffiliated neurotrauma consultants who dedicate their time and expertise to our game solely to advance player safety. This program has made our game safer for the athletes who play it. over the past twelve seasons.”

Although the updated protocols are not yet in effect, Saturday’s statement puts all parties on high alert as Week 4 continues with 14 games on Sunday: If in doubt, get the player out.

The league’s concussion protocols became a topic of widespread debate last week in light of two incidents involving Tagovailoa: injury; then Tagovailoa suffering a frightening concussion four days later in Cincinnati, during which his arms locked and his hands twisted in a fencing response before leaving the stadium in an ambulance.

Because Tagovailoa’s tripping last Sunday was attributed to his back, not neurological issues, it was not considered a “no-go” under existing, jointly negotiated concussion protocols – a conclusion disputed by the NFLPA and union president JC Tretter, who issued a statement friday saying the players were “outraged” by what he called a failure of medical judgement.

Tagovailoa was released from hospital on Thursday evening in time to return home with the team and, he released a statement on Friday, saying he “felt much better and focused on his recovery so I can return to the field. with my teammates.”

Tagovailoa has been on NFL concussion protocol since Thursday’s game, and he’s also been suffering from a sore neck. As a precaution, his neck was immobilized on the plane. He had follow-up CT scans and other tests, with an MRI coming Friday. According to a source, all of these tests came back clean.

The updated protocols will essentially close the loophole that allowed Tagovailoa to return to the field against the Bills, eliminating any subjectivity about the cause of a player’s instability and simply excluding the player. The league said Wednesday it believed protocols had been followed; under updated protocols, doctors won’t be able to judge why a player was unstable.

The NFLPA opened an investigation hours after the initial Sept. 25 incident over the treatment of Tagovailoa’s concussion assessment. Under the collective bargaining agreement, this investigation is being conducted jointly by the NFL and NFLPA with a resolution expected within the next week or two.

On Friday, review officials interviewed the Dolphins team physician and unaffiliated neurotrauma consultant who assisted with Tagovailoa’s concussion check last Sunday in Miami. On Saturday, the union exercised its right to terminate the UNC, citing several factors, including its failure to understand its role and its hostility during the investigation process, sources said.

Sideline UNCs are assigned by the NFL Head, Neck and Spine Committee and approved by Sills and the NFLPA Medical Director.

Sills deferred questions about UNC’s termination to the NFLPA, which made the termination decision. He also declined to comment on the investigation into the treatment of Tagovailoa’s concussion assessment, but reiterated that there will be full transparency once the investigation is complete.

According to the 2020 collective agreement: “The UNC Sideline may present their own questions or perform additional testing and shall assist in the diagnosis and treatment of concussions. Regardless, the responsibility for concussion diagnosis and decision to send a player back to a game is solely in the professional judgment of the team’s chief medical officer or the team doctor assigned to administer the TBI.”

In an emotional press conference on Friday, Dolphins coach Mike McDaniel said he had “100% conviction in our process” and repeatedly said the doctors’ conclusion was that Tagovailoa had no suffered a head injury last Sunday.

The Dolphins’ next game is Oct. 9 against the Jets — 10 days after Tagovailoa was injured in Cincinnati, where Teddy Bridgewater replaced Tagovailoa in a 27-15 loss, the first of the season at Miami. There is currently no timeline on Tagovailoa’s return.

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