As seen in the Miami Dolphins vs. Cincinnati Bengals game on Thursday September 29, 2022, the Dolphin’s quarterback Tua Tagovailoa was sacked during the second quarter, resulting in his head hitting the ground. While it not uncommon for professional football players to hit their heads and get tackled to the ground, this ended in Tagovailoa’s arms and his fingers flexing in front of his face. This position is also known as decorticate posturing, which is abnormal flexion of the arms and legs due to a harmful stimulus (Knight, 2022).
After coming across a video posted
by Dr. Betsy Grunch, MD, she believes that damage to the lateral vestibular
nucleus may have a role in Tagovailoa’s injury. The lateral vestibular nucleus
(LVN), also known as Deiter’s nucleus is located bilaterally to the vestibular
complex from the rostral medulla to the caudal pons and plays a major role in
maintaining equilibrium, head position, posture and clear vision (Hernandez,
2021). The LVN interconnect with nerves from the vestibulocerebellum which
provides input to the motor neurons of the extensor muscles in the back and extremities
(Hernandez, 2021). Damage to the LVN may indicate why Tagovailoa ended up in
the decorticate positioning that he did if the nerves responsible for his back
and extremities was injured.
Many have questioned the team at
the Miami Dolphins for allowing Tagovailoa to play during this game after his
previous injury in the game the week prior against the Buffalo Bills where he
was also pushed to the ground, hitting his head and after standing up, tumbled
back down. After evaluation, he returned
to the game. It is clear that the team made the wrong call in allowing him back
on to the field. Following the Bills game, Tagovailoa stated that he was okay
and was cleared from the concussion protocols from the team’s trauma
consultant, who has since been fired. There is clearly a lack of non-malfeasance
in their call to put him back in after sustaining a previous injury and for a
lack in proper evaluation. It could also be argued that Tagovailoa’s autonomy
was respected if he was notified of the possibility of his injury worsening but
decided to play regardless. Ethical consideration in the NFL is overlooked
while we should be putting the health of the players first rather than the
number of wins in the season.
Hernandez E, M Das J. Neuroanatomy, Nucleus Vestibular.
[Updated 2021 Oct 21]. In: StatPearls [Internet]. Treasure Island (FL):
StatPearls Publishing; 2022 Jan-. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK562261/
Knight J, Decker LC. Decerebrate And Decorticate Posturing.
[Updated 2022 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL):
StatPearls Publishing; 2022 Jan-. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK559135/
The harsh reality of American Football and the injuries (particularly traumatic brain injuries) have always been apparent, but no-one seems to mind. I think you're absolutely right about the autonomy of the players. Athletes from all sorts of sports and backgrounds have sacrificed many aspects of their own health and quality of life in pursuit of their athletic goals. I think a lot about someone like Ronnie Coleman, who was undoubtedly one of, if not the greatest bodybuilder of all time, but left nearly paralyzed by the end of his career. At the end of the day, these are adults making their own decisions, and the money and lifestyle associated with professional athletes is worth the sacrifice. I believe the biggest ethical dilemma with a sport such as American Football involves children and underage leagues. High school athletes sustaining injuries such as the one Tagovailoa did should not be tolerated in my opinion!
ReplyDeleteAfter hearing all of the opinions by sports broadcasters on these incidents, it also made me look deeper into the physiology and protocols behind Tua Tagovailoa’s injuries. Both of the games that the Miami Dolphins played that you mentioned I happened to be watching live. The first game you mentioned against the Bills I watched him stumble around and then get back up, and was surprised by him later returning to the game. However, when I read that he was checked by an independent neurologist before their next game with the Bengals and cleared I assumed he must be okay. I then watched his second injury you wrote about and knew many investigations would ensue. In hindsight, I would also agree that there was a clear lack of non-malfeasance by the decision-makers involving Tua’s quick return. However, if he had cleared concussion protocol and had been checked out by an independent neurologist (assuming the independent neurologist did his job correctly, thoroughly, and stayed non-biased in the decision to clear him) what would you recommend be done differently? The decision that was made after the first incident gave autonomy to the team and Tua himself, and he chose to return. How is the NFL supposed to protect players if the proper medical care is given, they are cleared for participation, and the player uses his autonomy to return to the field? Would you consider more protocols? If the decision was yours how would you proceed?
ReplyDelete