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New NFL Concussion Protocol language immediately impacts Dolphins, Teddy Bridgewater

The first player to be impacted by the NFL-NFLPA changes to the concussion protocol was Teddy Bridgewater, starting in place of Tua Tagovailoa, who was the imeptus for the change.

Miami Dolphins v New York Jets Photo by Edward Diller/Getty Images

The Miami Dolphins defense started the game on the field and forced a punt from the New York Jets after just four plays and 19 yards gained. The punt was a good one from New York’s Braden Mann, with the ball downed at the Miami eight-yard line. On the first offensive snap for the Dolphins, Jets cornerback Sauce Gardner blitzed off the side, catching Miami unprepared and giving him a clean shot on Teddy Bridgewater as the Dolphins quarterback attempted to throw the pass.

The referees ruled the pass intentional grounding, despite Bridgewater appearing to try to get the ball to running back Raheem Mostert and having the flight of the ball changed by the hit. Even with tight end Durham Smythe in the vicinity of the ball as it hit the ground, the ruling gave the Jets two free points on a safety and Miami had to kickoff to New York.

To add injury to that insult, Bridgewater headed into the blue medical tent to have his elbow checked out. Backup quarterback Skylar Thompson started loosening up on the sideline, but the elbow injury should not keep Bridgewater from getting back out on the field when the offense headed back out, right?

Right. Except, something else happened that no one really saw. An independent athletic trainer working as a booth spotter at the game determined Bridgewater stumbled as he got up from the hit - never mind the simple fact that he just had a six-foot-three, 200-pound man spear him in the ribs and take him the ground, so maybe he was just getting up a little shaken up - and therefore the updated league concussion protocol, which went into effect on Sunday, was now in play. Bridgewater would have to be checked for a head injury, which would seem to be a fine step in taking care of a player and his health.

The next part of the new protocol, however, also kicked in.

In the joint NFL-NFL Players Association statement on the updated protocol, a new term was inserted into the language, and that term immediately ruled Bridgewater out for the remainder of the game.

...[B]ased on the advice of the parties’ respective medical experts, the Protocol will be modified to enhance the safety of the players. Specifically, the term “ataxia” has been added to the mandatory “no-go” symptoms. “Ataxia” is defined as abnormality of balance/stability, motor coordination or dysfunctional speech caused by a neurological issue. In other words, if a player is diagnosed with “ataxia” by any club or neutral physician involved in the application of the Concussion Protocol, he will be prohibited from returning to the game, and will receive the follow-up care required by the Protocol.

The Protocol exists to establish a high standard of concussion care for each player whereby every medical professional engages in a meaningful and rigorous examination of the player-patent. To that end, the parties remain committed to continuing to evaluate our Protocol to ensure it reflects the intended conservative approach to evaluating player-patients for potential head injuries.

Bridgewater was determined to have ataxia because a spotter saw him stumble. The quarterback had no concussion symptoms. He reportedly passed every test in the protocols. However, he was not cleared to return to the game because of a reported stumble.

“Basically, what happened was a spotter saw him stumble,” head coach Mike McDaniel explained after the game. “Under the new rules, he’s ruled out and placed into (concussion) protocol. He doesn’t have any symptoms and he’s passed his evaluation, but under the new regulations, he’ll be in the concussion protocol moving forward.”

The first player impacted by the update protocol is the player starting in place of the player who led to the update. In Week 3, Dolphins quarterback Tua Tagovailoa was thrown to the turf, with his head bouncing off the ground. As he stood up, he stumbled and shook his head - signs that would be determined to be ataxia now. Tagovailoa was escorted off the field and straight to the locker room, where it was determined he had a back injury and not a concussion or any sort of head injury. He was cleared to return to the game and played the entire second half, leading Miami to a win over their AFC East rivals, the Buffalo Bills.

The NFL-NFLPA statement addressed the Tagovailoa situation, admitting the pre-modification protocols were followed and that Tagovailoa did not appear to have a concussion.

The Club medical team and the UNC properly viewed the video of the play in question as required by the protocol and engaged in a locker room examination of Mr. Tagovailoa before the player was cleared to return to play. The Team physician cleared Mr. Tagovailoa, following consultation with the UNC. The steps set forth in the Concussion Checklist were, therefore, conducted.

Mr. Tagovailoa suffered and reported back and ankle injuries earlier in the game. Mr. Tagovailoa told the medical staff involved that he aggravated his back injury on the play in question and that his back injury caused him to stumble.

Mr. Tagovailoa did not report or exhibit any signs or symptoms of concussion during his locker room exam, during the remainder of the game, or throughout the following week.

The medical staff involved determined that the Gross Motor Instability (“GMI”) suffered by Mr. Tagovailoa was not neurologically caused. They concluded the player’s back injury was the cause of his observed instability. However, the team physician and UNC did not conduct an examination of Mr. Tagovailoa’s back during the concussion examination, but instead relied on the earlier examination conducted by other members of the medical staff.

Four days later, Tagovailoa was again thrown to the turf, this time on a Thursday Night Football game, and this time he did sustain a concussion. As he lay on the field, Tagovailoa’s arms and hands clinched, with his finger splayed in an unnatural pose. The graphic nature of the injury led to many people calling out the Dolphins and the NFL for failing to protect a player, with the assumption that the Dolphins had hidden a concussion from the Bills game and then endangered Tagovailoa’s life by putting him back on the field.

While the NFL-NFLPA investigation would seem to clear any suspicion that Tagovailoa had a concussion against the Bills, the fact that a series of events led to that moment on Thursday led to the league and the union deciding they had to add ataxia to the concussion protocol so a player with any potential symptoms of a concussion, even if it could be diagnosed for a different reason or to a different injury, would immediately be ruled out of the game. The feeling was, while it could impact a player or a team, erring on the extreme side of caution made the most sense.

And immediately the extreme caution had an impact. The player replacing Tagovailoa was now out of the game because of ataxia. Bridgewater could not return to the game, even with no concussion symptoms and having passed every concussion test. The new protocol was doing what was intended - keeping a player out of a game for a stumble, even if it had nothing to do with a concussion.

And, it has longer last impacts as well. Bridgewater is now in the concussion protocol. He is stuck on the sideline until he clears the protocols. How long does it take to clear the concussion protocol when you do not have a concussion? Seems like we will find out this week.

Will the system let Bridgewater get back to practice and potentially play in next Sunday’s game? If Tagovailoa is not yet recovered from his concussion, and Bridgewater has to prove he is recovered from something he does not have, a potential contender in the AFC could be forced to start a seventh-round rookie quarterback because the updated protocols immediately impacted the Dolphins.

Keeping players safe is absolutely a necessity. But keeping a healthy player out of a game, or potentially multiple games, because he stumbled on the field with no other symptoms would seem to be going too far in the name of caution. Especially when the new protocols do not seem to be even applied across the entire league, where multiple players throughout the day on Sunday seemed to show signs of a concussion, were checked out, then cleared to return to the game.