Sport still values money over health
The NFL and rugby continued to be haunted by concussion issues – and there is no clear solution on the horizon
■ LAST weekend, the Miami Dolphins quarterback Tua Tagovailoa was shoved to the ground during his team’s defeat by the Buffalo Bills, his head bouncing hard off the ground as he fell.
Tagovailoa got up unsteadily, tried to run back towards the action and then stumbled again. The Dolphins assessed him, brought him back into the game and readied him to play against the Cincinnati Bengals on Thursday night.
‘If Tua takes the field tonight,’ wrote neuroscientist Chris Nowinski a couple of hours before the match, ‘it’s a massive step back for concussion care in the NFL. If he has a 2nd concussion that destroys his season or career, everyone involved will be sued & should lose their jobs, coaches included. We all saw it. Even they must know this isn’t right.’ Tagovailoa duly played against the Bengals. In the second quarter, his head was slammed into the ground on a sack. He appeared to have some sort of seizure as he lay on the turf and was carried away on a stretcher.
‘This is a disaster,’ Nowinski wrote. ‘Pray for Tua. Fire the medical staffs and coaches. I predicted this and I hate that I am right. Two concussions in five days can kill someone. This can end careers. How are we so stupid in 2022?’
It’s a good question but sadly it is one that sport seems little closer to answering. The night before, England women’s football star Beth Mead suffered a head injury during Arsenal’s Champions League game at Ajax but Arsenal could not bring on a concussion sub because they’d used their regulation subs and UEFA’s rules do not allow it.
Arsenal, at least, had the decency and the humanity to keep Mead off the pitch. Despite so much more knowledge about the damage brain injury can cause, players like Tagovailoa are still being fed to the wolves and the impression is allowed to persist that, in sport, money still counts more than health.
THIS week, a spotlight was shone on the bad old days of rugby, with three former professionals lodging legal proceedings against the IRFU and World Rugby in a landmark concussion case. This storm has been coming for a while after 185 players – including Steve Thompson, Alix Popham and Ryan Jones – took legal proceedings against the English and Welsh rugby unions earlier this year. The life-changing, long-term effects of repeated head trauma have been laid bare. Harrowing accounts of early-onset dementia and chronic traumatic encephalopathy (CTE) have been regaled. These are worrying times.
David Corkery, Declan Fitzpatrick and Ben Marshall are the first Irish players to take this matter to the High Court and it is believed that more former players are set to follow suit.
The landscape has changed dramatically since Corkery, Fitzpatrick and Marshall were playing the game. Corkery, a former Munster and Ireland flanker, hung up his boots in 1999, and the way concussions are managed now as opposed to back in the early days of professionalism is worlds apart.
That is no consolation to these ex pros, however. All three feel they were failed by the system, and this is only the tip of the iceberg. Even with the return to play protocols, world-class medical support and increased awareness and education, the system is still far from perfect.
Navigating through this minefield of concussion and brain injuries in a sport that is becoming increasingly physical and attritional is the greatest challenge facing the game in the 21st century. The looming legal cases are just the beginning, and rugby’s power brokers are searching for answers to this complex and deeply concerning issue. Across the water, this is another professional contact sport that is trying to find some solutions.
The NFL’s handling of concussions has evolved dramatically from the days when players were given smelling salts on the bench and sent back into the game, especially since 2013, when a settlement of $765million (€780million) was agreed after a protracted lawsuit with 5,000 former players after a landmark concussion case.
Two years later, a judge removed a cap on total damages, and it is estimated that the organisation may have to pay out almost a billion dollars in the decades ahead.
The league and the NFL Players Association have implemented extensive protocols and hired unaffiliated neurotrauma consultants (UNC) to work with team physicians at each game to diagnose concussions.
Still, NFL is a violent sport and injuries similar to the frightening one Miami Dolphins quarterback Tua Tagovailoa suffered on Thursday night seem unavoidable unless the NFL bans tackling and turns the game into flag football like it did for the Pro Bowl.
That’s not happening, and the most effective means of protecting players remains enforcing strict concussion protocols, which players, fans and others are concerned didn’t happen with Tagovailoa.
It would be difficult to prevent what happened to Tagovailoa when 6ft 3in, 340lb Bengals defensive tackle Josh Tupou slammed him backward into the turf. The main question is why he was even playing just four days after he stumbled off the field and was unable to walk following a hit to his head during a home game against Buffalo.
Tagovailoa’s hands froze up and his fingers flexed awkwardly in front of his facemask for several seconds as he laid on the turf in Cincinnati, a scary scene witnessed by millions of viewers. He remained on the ground for several minutes until he was taken away on a stretcher and sent to a hospital.
This time – unlike Sunday when he seemed to exhibit concussion symptoms but was cleared by a team physician and UNC to return – Tagovailoa was diagnosed with a concussion.
He was released from the hospital and flew home with the team. Flying hours after suffering a concussion raised questions, but NFL chief medical officer Dr. Allen Sills said the hospital makes that decision.
Tagovailoa’s quick return last Sunday prompted a joint-review by the NFL and NFLPA. The interview process has started and results aren’t expected for at least another week. Tagovailoa and the team explained his legs were wobbly because of a back injury.
It’s unknown if there’s any correlation between the two incidents. Concussions are common in the NFL, especially when a player is thrown to the ground by a man Tupou’s size and his head hits the turf.
Sills said, ‘it’s impossible to know’ if the injury Tagovailoa sustained last Thursday was exacerbated by the hit he took on Sunday.
‘That’s one of the factors that we want to look at,’ Sills said. ‘Every injury is one we want to prevent.’
Chris Nowinski, a founder of the Concussion Legacy Foundation who played football at Harvard, is adamant Tagovailoa sustained a concussion against Buffalo and shouldn’t have played at Cincinnati.
‘Tua showed five distinct signs of concussion,’ Nowinski said. ‘Anybody who has any training on concussions or cares about Tua as a human is not putting him on field four days after what he showed on Sunday, so this makes it so much worse because we know that this could be career-ending or seasonending. It just shows just a lack of care for him as a human being.’
Tagovailoa is under pressure to perform this season and has battled injuries in the past, so it’s natural for him to want to play regardless of injury. Former players who have criticized the decision to let him play on Sunday say they want to protect players from themselves. ‘We are all outraged by what we have seen the last several days and scared for the safety of one of our brothers,’ NFLPA president JC Tretter wrote on Twitter. ‘What everyone saw both Sunday and last night were “no-go” symptoms within our concussion protocols. The protocols exist to protect the player. Our job as the NFLPA is to take every possible measure to get the facts and hold those responsible accountable. We need to figure out how and why the decisions were made last Sunday to allow a player with a ‘no-go’ symptom back on the field. ‘We have to do everything possible, including amending the protocols, to further reduce the potential of human error. We have come a long way over the past 15 years but the last week proves how far we have left to go.’
The decision to allow Tagovailoa to return to play on Sunday was made by the team physician and UNC. It was determined Tagovailoa’s instability was caused by a back injury. The joint review by the league and NFLPA will examine the steps taken and a report will be issued.
‘I don’t know anybody who thinks it’s sound medicine just based on the observation of what was seen on the field and him stumbling afterward to say it’s OK for him to play again in that game and then four days later,’ said attorney Brad Sohn, who has represented hundreds of players in concussion litigation. Sports as inherently violent and confrontational as the NFL and rugby will always carry significant dangers for participants. There is so easy solution here but, as errors of the past resurface to haunt both codes, it is clear that much more needs to be done to ensure those dangers are minimised as much as possible.
It’s estimated the organisation will have to pay out almost a billion dollars