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The Cost of a Touchdown

Concussion in American Football and Rugby Union

The sight of the Miami Dolphins’ Tua Tagovailoa being swung to the ground by the Cincinnati Bengals defence in their Week 4 match-up was a sight no one wanted to see. Once Tagovailoa’s head hit the ground, his hands contorted into claws as he remained on the horizontal for several minutes. The quarterback was then stretchered off and taken to hospital in order to have potential injuries investigated, before flying back to Miami the next morning.

Injuries are of course an inevitable part of the physical game that is American Football, however this does not mean precautions shouldn’t be taken to protect players’ short and long term health. This is why Tagovailoa’s injury has caused so much controversy, as less than a week earlier he experienced a similar injury against the Buffalo Bills. After a completion to Waddle, the quarterback was pushed and fell, knocking his head on the ground in the process. Although he got on his feet, Tagovailoa proceeded to shake his head and stumble across the field, key signs of a concussion.

The fact that Tua continued to play after this on Sunday, combined with the fact he was cleared to play in Thursday night football, only to take another hit to the head, is a severely poor reflection on the hard fought concussion protocol in the NFL.

Repeated trauma to the head can lead to conditions such as chronic traumatic encephalopathy (CTE) which can lead to memory loss, depression, and anxiety. CTE can only be diagnosed posthumously; however, it has been found in the autopsies of many ex-NFL players such as Junior Seau, Andre Waters, and Dave Duerson, who all died by suicide after their retirement. The NFL only acknowledged the link between the sport and CTE in 2016, but have since introduced measures such as stronger rules against hitting quarterbacks, head-injury spotters at all games, and doctors and neurotrauma specialists on the sidelines.

However, cases such as Tua Tagovailoa’s show just how far the league still has to go. When faced with a close game against the Bills, the Dolphins prioritised the sport over Tagovailoa’s health. This decision could not be repeated in the Bengals game due to the increased severity of the head injury, however Tagovailoa should never have been put in that position in the first place. Even though the unaffiliated neurotrauma consultant involved in clearing him during the Buffalo Bills game has been fired, the Dolphins still maintain the injury sustained was to the quarterback’s back and neck.

The NFL and NFL Players Association concluded in a joint investigation that the Dolphins did follow the concussion protocol, however stated that 'the outcome in this case was not what was intended when the Protocol was drafted'. The confusion and ambiguity around whether the Dolphins followed the concussion protocol or not reflects the areas in which the NFL needs to improve their recommendations. When it comes to head injuries, it is quite literally a matter of life and death, and so there should be no room for grey areas within the protocol.

Yet since the NFL’s recognition of the link between head injuries and the sport in 2016, it would be unfair to say the organisation has not been proactive in protecting player safety. Even since Tagovailoa’s injury, the league has modified the concussion protocol — replacing the term ‘gross motor instability’ with ‘ataxia’, which would have ruled Tagovailoa out of the rest of the Bills game.

A similarly physical sport that has faced mounting criticism regarding the protection of player’s health is rugby. In early October, lawyers acting for 75 former players launched a legal claim against the Rugby Football League for negligence, stating that the RFL did not “take reasonable action to protect players from permanent brain injury caused by repetitive concussive and sub-concussive blows”.

The legal action comes at the same time as new research was published from a study examining a link between sport and neurodegenerative diseases such as Parkinson's, motor neurone disease and dementia. The research found that rugby players are 15.17 times more likely to be diagnosed with motor neurone disease than people of the same age range in the general population.

The real-life impact of this was reflected by a BBC documentary aired on October 5th which followed the dementia diagnosis of Steve Thompson. Thompson had a successful career playing as hooker for the Northampton Saints and England, and was diagnosed with early onset dementia and probable CET at aged 42. The documentary shows the effects the diagnosis has had on Thompson’s wife and young family, whose names he occasionally forgets when experiencing brain fog. Thompson is also one of a group of players who launched a legal case in 2020 to sue rugby's governing bodies for negligence.

A disheartening aspect of the differences between the NFL’s and RFL’s attitude towards head injuries is how the RFL are being provided with mounting, undeniable evidence by third parties of the long-term effects of repeated head trauma, and yet are failing to improve safety protocols. And the evidence will undeniably increase as research continues.

Protecting player safety is of course an issue not confined to rugby and American football. A problem across all sports, the impact of repeated head injuries are highly evident in these most physical of contact sports. As much as we all enjoy spending our weekends watching some of the best sportspeople go head-to-head, the question is at what cost? As we have seen with sports such as Formula One, the price should not be the lives of those involved, whether that be when they are active in the sports, or years after they retire.

Tua Tagovailoa is set to return to the field in their week 7 match-up against the Pittsburgh Steelers, hopefully with the knowledge that his injuries may protect players in his position in the future. However, it will also be with the undeniable cloud over his head of what his health may look like in 60, or even 10 years time. Until then, it is impossible to know the true cost of a touchdown.

Image: Wikimedia Commons

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