Combat sports can teach football a lot about the short and medium term effects of traumatic brain injury

This is a column by Morgan Campbell, who writes opinions for CBC Sports. For more information on CBC Opinion Sectionplease consult the FAQs.

Videos hit social media midway through Wednesday afternoon – Miami Dolphins quarterback Tua Tagovailoa trotting around the practice field, stretching, laughing, spiraling with that slingshot of a left arm.

One reaction: relief.

We hadn’t seen Tagovailoa since Sept. 29, when he was carried off the field after passing out during a Thursday night game in Cincinnati. It was his first concussion of the season, technically, although he certainly looked dazed as he wobbled off the field after a blow to the head in a game against Buffalo the previous weekend. Officially, according to the Dolphins, the staggered gait stemmed from a back injury.

Either way, the sack in Cincinnati, in which Tagovailoa’s head hit the turf as 345-pound defensive tackle Josh Tupou threw him to the ground, led to two weeks out of the spotlight and speculation about his appearance when he finally returns. On Wednesday, Tagovailoa allayed concerns about his overall health. Alertness, balance, coordination – it’s all there.

But, of course, other questions arise. Will he play this week?

No chance, according to head coach Mike McDaniel.

« Talking about this week and playing, I don’t see a script, » he told reporters on Wednesday. « I don’t plan on playing him at all. »

So when will Tagovailoa play again?

Not clear. He will have to pass a few tests to clear the protocol and then demonstrate his sharpness before the concussion. If the team has a schedule, they haven’t revealed it.

My question: Why rush?

Compare Tagovailoa with Juan Macias Montiel, the boxer who lost by TKO to Carlos Adames last Saturday in Los Angeles, now serving an automatic suspension. He couldn’t compete anymore until November 22, and Montiel never hit the canvas. How long would a boxing commission suspend him if he curled up like Tagovailoa – arms stiff and raised in front of his face, fingers stiff and twisted?

60 days? 90?

Prior to the highly publicized Tagovailoa concussion, the NFL lagged combat sports like boxing and MMA when it came to head injuries. (Kareem Elgazzar/USA TODAY Sports/Reuters)

A similar schedule would push Tagovailoa’s next game into early 2023. The closest thing to safety in the sport.

The thing is, people who follow combat sports can tell you how high-profile football flirts with tragedy by expecting players to return quickly from concussions. Automatic suspensions linked to the severity of the knockout ensure that athletes, who are competitive by nature, and promoters, who are results-oriented, cannot hasten the process of returning to competition.

This is a rare and specific case where traditional team sports should follow the lead of the fighting game. When it comes to the short and medium term effects of head trauma, combat sports can learn a lot from football.

A month ago, few of us knew the word « ataxia ». It refers to a loss of gross motor control and has become part of the sports lexicon since Tagovailoa’s injury, and it’s a one-way ticket to the concussion protocol. Dolphins know. « Ataxia » got second-string pivot Teddy Bridgewater pulled from last week’s loss to the Jets, leaving rookie Skylar Thompson to start this week against Minnesota.

If you watched Saturday’s boxing card, you saw Adames knock Montiel into a state of « ataxia, » and you probably didn’t complain when the referee called a halt to the fight. Similarly, mixed martial arts fights are stopped the moment the fighters can no longer defend themselves, as they cannot control their limbs, either due to ataxia or outright unconsciousness.

It’s encouraging to see football catching up to the fighting game – if you can’t stand or raise your arms, you shouldn’t be competing. But it’s chilling to imagine that until the frightening nationally televised brain injury in Tagovailoa, the NFL was following boxing and MMA, two sports with built-in brain trauma, to deal with the blows to the head that make athletes ataxic.

If you’ve watched a lot of fights, you’ve seen people lose by knockout, then recover to conduct post-fight interviews, and later answer questions at press conferences, aware and in the know. But still concussed.

Keep these circumstances in mind as you listen to retired NFL quarterback Alex Smith on The ESPN Daily podcastdescribing how, as a member of the Chiefs, he passed a secondary concussion screening, only to return to the game and get knocked out.

« The experts cleared me. I passed, » he said. « Like Tua, [I] shouldn’t have. And I got back into the game. »

Combat sports regulations have a built-in recognition that consistent could always mean compromised. If a fighter is eliminated in the second round, you will not restart a fight in the third round just because they answered the questions correctly. And if they’re starched on Saturday, you wouldn’t book them for a fight the following Thursday, period. When a fighter suffers a knockout, the subsequent suspension is immediate and automatic, and tends to rule out people with underlying brain damage.

The word « underlying » should be for people who still don’t understand the issues.

In May 2019, I came back from the ring in an exciting but brutal title fight between Badou Jack and Adonis Stevenson. Late in the final round, Jack landed a thunderous uppercut to Stevenson’s jaw. The blow whipped Stevenson’s head and made sweat fly; the fight ended in a draw.

Six months later, I watched on my laptop as Oleksandr Gvozdyk put Stevenson into a coma.

The hindsight is still perfect, but I wondered if Stevenson, then 41, had fully recovered from the punishment he suffered in Toronto the previous spring. I called a neurosurgeon — Dr. Charles Tator, head of the Canadian Concussion Center — who explained to me that brain damage can persist for months, undetectable by CT scans, MRIs and the like « what city are we in? » questioning that we apply to athletes whose bells have rung.

« When you get beaten in May and fight again in December, has your brain really recovered? » Tator asked, pointing out that only a radioactive tracer can detect low levels of latent brain damage.

I’m not trying to be alarmist about Tagovailoa or any other NFL player currently concussed. And I get why the Dolphins might want him back in the roster when he looks ready.

Tagovailoa was Miami’s first draft pick of 2020, the quarterback the team plans its future around. Miami also traded for superstar receiver Tyreek Hill, paying him US$120 million over four years. Pairing Hill with the lightning-fast but confident Jaylen Waddle is almost not fair. Like Usain Bolt and Yohan Blake on the same relay team. If Tagovailoa is the quarterback Miami imagined him to be when they (allegedly) were willing to throw games for the right to draft him, he would have to put in huge numbers on his return.

He could return later this month and play the rest of this season, possibly the rest of his career, without further incident.

But enough people, with enough brain damage, returning to contact sports before they’re fully healed, will end up with a result that fans can tell you about.

Gerald McClelland. Michael Watson. Prichard Colon. Cleveland Denny. Patrick Day. Duk Koo Kim.

Consider the fact that brain damage occurs despite suspensions designed to limit it, and that raises another question.

What differentiates the brain of a footballer from that of a boxer?

The answer? Nothing.

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