The Dolphins have lived with an elephant in the room since QB Tua Tagovailoa suffered a concussion on Christmas in 2022.
While one hit to the head might knock a quarterback out for a week or two at most, Tagovailoa was one hit away from questions about his NFL future thanks to his concussion history. In Week 2 this season, the moment Miami feared arrived.
Tagovailoa suffered a concussion in a loss to the Bills, his third confirmed concussion in three seasons. In the days that followed, Dolphins coach Mike McDaniel refused to talk specifics about his quarterback's timeline or his future as a whole.
Here's the latest expert analysis on Tagovailoa's latest concussion and his path forward.
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Tua Tagovailoa injury update from medical expert
Dr. Michael S. George of KSF Orthopaedic Center in Houston, Tex. spoke to Sporting News about Tagovailoa's concussion history and his outlook going forward. Here are his comments:
Is Tua Tagovailoa at higher risk for another concussion?
"This is his third known concussion in the last three years with the Dolphins. A history of recent concussions puts the athlete at risk for another concussion, but it is not established how long that risk lasts. His last concussions were in 2022."
Will concussions affect Tua Tagovailoa's performance?
"Jideh and colleagues published their study in the American Journal of Sports Medicine in 2019 looking at 38 NFL players with concussions that missed an average of 1.5 games after injury and found there was no difference in their performance upon return."
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Is Tua Tagovailoa at elevated risk of CTE?
"Numerous studies have explored the relationship between multiple concussions and the development of neuro-cognitive and psychological problems later in life. It is still unclear in the literature how multiple concussions affect clinical outcomes compared to a single concussion, but intuitively, the more traumatic events that occur to the brain, the more damage occurs."
"[Zachary] Kerr and colleagues published their study in the American Journal of Sports Medicine in 2019 that evaluated former college football players that had had three or more concussions and found a significantly higher rate of moderate to severe depression than the controls."
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How long is Tua Tagovailoa out?
Tagovailoa's timeline for a return is still to be determined, but he won't return until at least Week 8 after he was placed on injured reserve on Tuesday.
As Dr. George indicated, a player's recovery timeline from a concussion (or repeated concussions) is a case-by-case situation, and Tagovailoa's complete path forward will be determined by conversations with doctors.
Tagovailoa is meeting with neurologists this week, according to ESPN's Adam Schefter, and those talks will include conversations about the "cumulative effect" of his concussion history.
McDaniel said Monday that the Dolphins were still unsure whether Tagovailoa would be placed on IR, which would keep him out for at least four games. The decision to place him on IR came Tuesday.
The only other absolute at the moment appears to be that Tagovailoa will not retire. It will still be a bit until the 26-year-old is back on the field. Tagovailoa wasn't ready for the Dolphins' wild-card playoff game about three weeks after his Christmas concussion in 2022, which pointed to a multi-week absence for the Dolphins QB this time around. Now, it's confirmed that Tagovailoa can't return until at least Oct. 27.
Skylar Thompson is set to start for the Dolphins until Tagovailoa returns, and Tyler Huntley is another option after he was signed off the Ravens' practice squad on Monday.
"Tagovailoa and his support team will undoubtedly have a very complicated and emotional ongoing discussion about how long he will take to recover, and how he can mitigate the risk of future concussions," George told SN.