The NFL’s concussion protocol does little to protect players’ health

News: On Thursday night, Miami Dolphins quarterback Tua Tagovailoa was carried off the field on a stretcher after suffering head and neck injuries following a sack by Cincinnati Bengals defensive end Josh Tupou. Diagnosed with a concussion, Tagovailoa was released from the hospital and flew back to Florida with the rest of his team.

Dispute: Some critics questioned whether Tagovailoa should have played at all. Four days earlier, in a game against the Buffalo Bills, Tagovailoa’s head hit the turf after being hit by Buffalo Bills linebacker Matt Milano. Footage of him stands up, stumbles and falls back down; he was eventually helped off the field. But at halftime, the team said he had passed concussion protocol and he returned for the second half, leaving many fans saying, “I’m not a doctor, but…” His trainer said it wasn’t a head injury , and aggravated back injury.

While Sunday’s footage was alarming, four days later it was downright difficult for many fans (including this football fan) to watch. On the ground, Tagovailoa’s fingers curled into a “fencing response” near his face, a possible sign of a brain injury.

The controversy surrounding Tagovailoa’s story has renewed scrutiny of how the NFL handles traumatic brain injuries such as concussions, which research increasingly shows can have long-lasting, harmful effects. Here’s a summary of what you need to know.

Dolphins’ Tua Tagovailoa leaves field on stretcher with head injury – The Washington Post

Business/Institutions: The NFL has come under fire for how it handles brain injuries

The NFL Players Association was already looking into the team’s handling of Tagovailoa’s injury in Sunday’s game at the Bills when it announced it would review protocol Thursday night as well.

But many are skeptical about what the NFL investigation actually entails and whether any changes will be made (and perhaps even more importantly, enforced — especially when it comes to the best and most valuable athletes).

Aaron Hernandez suffers from the most severe form of CTE ever found in a person his age – The Washington Post

NFL Concussion Research, Tobacco Industry Ties Flawed – The New York Times

Study: CTE found in nearly all donated brains of NFL players – NPR

Race: Racial disparities in how the NFL handles concussions

Another factor in the dispute is race. The league considered race as one of the evaluation factors when players made dementia claims that were part of a large concussion settlement. Two former players sued the league and won to stop the practice.

More Black Former NFL Players Eligible for Concussion Payouts – The New York Times

Science: when concussion is especially dangerous

What exactly is a concussion? It is a type of traumatic brain injury in which some of the brain’s billions of neurons are stretched or damaged due to a blow or concussion to the head. This triggers a cascade of chemical changes in the brain that can alter normal functioning, causing a wide range of symptoms, including headaches, dizziness, difficulty concentrating, sensitivity to light or sound, anxiety and depression. While most concussions get better within days or weeks, some take much longer to recover from, especially when the person has a history of blows to the head.

And here’s where the Tagovailoa controversy really comes in: If a person suffers a second concussion before a previous injury has healed (which is what many believe happened with Tagovailoa), the consequences can, in rare cases, be fatal.

Called second shock syndrome, this extra shock can cause the brain to swell excessively, leading to potentially serious complications or death. More often, multiple concussions can compound brain damage, with each subsequent injury potentially causing worse symptoms that take longer to improve.

Smaller blows and concussions to the head, called concussions, don’t cause noticeable symptoms at the time, but can gradually take a cumulative toll on brain health. College football players can average 1,000 such impacts per season, and recent research shows that these hits are associated with measurable declines in cognitive ability.

Just how dangerous is football? —The New Yorker

Different, yet whole: Young scientist reflects on journey back from brain injury — Dallas Morning News (The Grid’s public health reporter John Lambert writes about his own recovery from traumatic brain injury.)

Aging: Even after a concussion heals, there can be consequences down the road

In the long term, individuals with a history of concussions and subconcussive head injuries have a two to four times greater risk of developing Alzheimer’s disease or other forms of dementia. Such individuals are also at higher risk of developing chronic traumatic encephalopathy, or CTE, a degenerative brain disease found in the brains of more than 320 former NFL players that also affects boxers, football players and hockey players.

CTE causes mental deterioration that can cause violent mood swings that eventually lead to dementia and death, but the condition can only be diagnosed postmortem. Affected brains contain tangles of a protein called tau, which inhibits brain function. Scientists are still trying to understand how CTE develops, but it appears to be related to accumulated sub-brain impacts; footballers with longer careers or who have played in positions more exposed to blows tend to have more severe cases.

What You Need to Know About CTE in Football – The New York Times

Philip Adams Had Severe CTE During Filming – The New York Times

110 NFL Brains – The New York Times

Thanks to Alicia Benjamin for editing this article.

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