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Tua Tagovailoa: His Injury History and His Hip Injury Explained

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SEC Championship - Alabama v Georgia Photo by Kevin C. Cox/Getty Images

So after much debate between the Miami Dolphins fans, that seemed more like a cage match at times, the team decided to select the talented starting quarterback from Alabama, Tua Tagovailoa. Even in the absence of a history of injuries and a successful college career behind him there still would have been mass debate among Dolphins fans because that’s what us die hard NFL fans do. Now add in a long history of injury capped off by the most serious of the injuries, the now famous hip injury that ended his 2019 campaign, those that were not on board with Tua or were on the fence now had another potentially powerful argument in their arsenal.

If somehow you missed the news, there are a lot of other things going on in our world right now, the aforementioned hip injury occurred in a game last season against Mississippi State on November 16th. The season ending injury was a dislocated hip and posterior wall fracture. While not totally uncommon, this is a serious injury normally seen in people that have had a bad car accident when their knee hits the dash of a vehicle and drives the femur into the hip, causing both the dislocation and normally a fracture or a break of some kind.

This injury in particular took the presumptive first overall pick in this weeks draft and put his entire draft-ability into question by fans, the media and presumably some NFL teams. This was so much in question that many believed that the Miami Dolphins would pass on Tua with rumors that one of the other top quarterbacks or even an offensive lineman had actually become the primary target of the Dolphins instead, despite the well known fact that the Dolphins had been interested in Tua long before the injury.

Before we get back to the injury that worries everyone the most, the hip lets go over some of his previous injuries as the anti Tua group likes to point out that he is “injury prone”. He has had a string of injuries but if most football fans looked at all of them one by one most would not even give you pause to worry as they come off as little more than the kind of so called “dings” that grown men playing a violent sport are use to and use to playing through as if they had never even happened.

The first injury was in March of 2018 when Tua struck a lineman’s helmet during a throw in practice. He broke his left index finger. He did receive a quick surgery on the finger and yet never missed a practice so nothing to see here. This is a common injury that in general heals easily and rarely keeps a starting quarterback out of the lineup or if it does it’s not for long and even then it’s more out of an abundance of caution with one of if not the most valuable player on your team. In October of the same year he “tweaked” his knee in a game against Missouri. I was revealed to be a sprain to the knee but it did not cause him to miss any time and he started the following week. So not much to see here so far.

Later that same year, in December of 2018, Tua had his foot accidentally stepped on by his left tackle. This occurred during the SEC Championship against Georgia. Tua was forced to sit out the remainder of the game with an ankle sprain. He later had a “tightrope procedure” performed on the ankle allowing him to return for the playoffs. The traditional method of addressing ankle sprains is normally something between rest and rehab up to the insertion of screws in the bones to bond them like fastening two pieces of wood together. In a tightrope procedure the surgeons place a high strength suture through small holes in the bone and then fasten it with small metal buttons that are then tightened like a zip tie. This procedure took Tua less than a month to return from, winning the Tides game over Oklahoma on December 29th.

In October of the following season, 2019, Tagovailoa again suffers an injury to the same ankle but this time it was a high ankle sprain. He again chooses the route of the tightrope procedure causing him to only miss a single game. Then in November Tua suffers his worst and now most famous injury, the injury to the hip that not only ended his college career but threw his entire draft status and possibility for a career in the NFL into doubt.

As I have previously mentioned this hip injury was a high impact injury more likely from a bad car crash than something you see in football players. This is of course not unknown in the world of football as this is the same injury that Bo Jackson suffered in 1991. This is often cited by the no Tua crowd as Jackson never played another down of football in his life following the injury. The difference, the HUGE difference between the two is one occurred in 1991 and the other in 2019. The ability to not only rapidly diagnose the injury properly but also the ability to successfully treat the injury as well as many other football related injuries have changed by leaps and bounds over that 28 year period. No one was aware of the severity of Bo’s injury for some time. Tua’s injury was diagnosed directly on the field by the Alabama team doctors.

Dr. Lyle Cain, the Alabama team orthopedic surgeon actually considered popping the hip back into place right on the field that day but chose not to realizing that causing a player some serious trauma in such a public setting might not be the wisest of moves. So instead the doctor carted Tua to the locker-room where they could x-ray the hip and with some help of his staff and that of Mississippi State medical staff they were able to quickly put the hip back into place. According to Cain his hip was back in place within 5 minutes of the injury happening.

By performing this procedure so quickly the doctors mitigated any future blood flow issues or any other possible long term affects to the hip. The staff went so far as to say that had the injury actually been less traumatic the outcome might have actually been worse. Because it was so traumatic the staff knew exactly what had happened and exactly what to do to treat it immediately.

Tagovailoa did suffer an early complication when it was reported that he had a posterior wall fracture. This was also something that Bo Jackson suffered from with his injury.

Here is the definition of a fracture of the posterior wall according to the Academy Of Orthopedic Surgeons-

“Fractures of the posterior wall of the acetabulum (hip socket) are the most common type of acetabular fracture, accounting for approximately 25 percent of all acetabular fractures. The simple appearance of the posterior wall fracture on plain radiographs underestimates its potential complexity. Rather than having one simple fracture fragment, most posterior wall fractures are comminuted or have areas where the articular surface along the margin of the primary fracture line is impacted into the underlying cancellous bone. In general, posterior wall fractures are amenable to nonsurgical treatment if the remaining, intact part of the acetabulum is large enough to maintain hip joint stability and congruity; however, this situation is often difficult to determine. Clinical outcome has been shown to be directly related to the accuracy of reduction, but accurate repositioning of all of the small posterior wall fragments is frequently a challenging task.”

Two days following the initial accident Tua was operated on in Houston, Texas by Dr. Chip Routt, a specialist in Ortho surgery specializing in trauma and pelvic and or hip socket fractures. Following the surgery the doctors announced that the surgery had gone as planned and was successful and that Tua would return to Tuscaloosa Alabama in the next few days to begin rehab. The following recovery and rehab period covered nearly three months.

Tua was placed on what was described as a “conservative” rehab process so that they could reduce any stress placed directly on his hip. His rehab began as most do with just working with the muscle groups to get them all activated and working properly again which would help him regain his range of motion in the hip. His rehab also included core strength training to help him regain control of his lower body and ultimately better control of his leg.

On February 10th of this year Tua had a CAT scan that according to the doctors showed that Tagovailoa’s hip “looked about as good as it could”. Now the doctors could focus on the next part of his rehab, making sure that there were no blood flow or cartilage issues as a result of the injury or the surgeries. Right before the 2020 NFL Combine Tua received an MRI that showed that he had none of these issues. This allowed him to intensify his rehab.

On the 26th of February, at the NFL Combine, Tua presented his scans to all NFL teams. He received “overwhelmingly positive” feedback from the teams that he spoke to about the scans. He was not yet cleared to participate in the normal drills of the NFL Combine but he was clear to resume normal football activities on the 10th of March. He later released a video to teams made on March 23rd that showed him going through various quarterback drills. He followed this up by conducting a personal pro day on April 20th where he threw 72 times to receivers. He also had his final MRI scheduled for the same day but it has been delayed due to the CoVid-19 pandemic.

His doctors have stated that the last and final MRI is really nothing more than a long term follow up to everything that they had looked at in the previous MRI. The Bama medical staff expect that there will be nothing new to see except more healing to the cartilage and less evidence that there was trauma. His doctor, Cain, stated that you could be more than happy with what was seen in the previous MRI alone and roll with that but noted that in the NFL process they like to see it one more time just to assure themselves.

The only hurdle left, as seen by his various doctors, is to get himself back into playing shape which might take him a while and he may not be ready to go at the beginning of the 2020 NFL season as it is presently scheduled but one is to assume that the Dolphins were more than aware of this when they drafted him and so early on in the rebuild phase of this team they seem content to allow him to rehab as needed if the team even gets to play this year. If not then you can expect him to be ready to roll when 2021 off season work begins, if and when that happens.