The “gross motor instability” loophole must be closed, immediately

USA TODAY Sports

Changes undoubtedly will be made to the NFL’s concussion policies and protocols after last night’s incident involving Dolphins quarterback Tua Tagovailoa. It’s possible that, ultimately, there will be an overreaction. And that’s fine; that would be far better than an underreaction.

The most immediate reaction should be simple, and immediate. The loophole regarding “gross motor instability” should be closed.

Under the current protocol, a player who demonstrates “gross motor instability” must be evaluated for a concussion. He can, however, return to play if the team physician and the Unaffiliated Neurotrauma Consultant conclude that the gross motor instability did not have a neurological cause.

Regardless of why that loophole ever existed (perhaps it’s as simple as allowing for the possibility that the player who stumbled simply tripped), it must be closed. Or at a minimum the language must change to something like this: “gross motor instability that has no clear and obvious alternative cause, such as tripping, pushing, shoving, slipping.”

It would be better to just close the loophole, and to trust the team physician and the UNC to know gross motor instability when they see it. Because we all knew it when we saw it. On Sunday, we saw it and we knew it. Tua was wobbly and woozy because his head had hit the ground. He should have been, in the language of the protocol, a “no go.”

For the fencing posture, which we saw last night after Tua’s head hit the ground, the player cannot return. That same standard should apply to gross motor instability. There should be no loophole or exception, because the reality is that, when such loopholes or exceptions exist, the team physicians and/or the UNCs seem to always find a way to exploit them.

79 responses to “The “gross motor instability” loophole must be closed, immediately

  1. This is a great opportunity for the NFLPA to overcome years of gross ineptitude and inadequate leadership. Make this a priority, lawyer up, defend your dues paying members. Create significant changes in player safety and while you’re at it, you might even get to expose some teams for extremely shady and borderline negligent / criminal behavior. Not a good look for the league (seems like a recurring topic.)

  2. They should apply the same ‘drunk guys in a bar’ qualifier they use on penalties. If 10 drunk guys in a bar all say “that dude got his bell rung”, then he probably doesn’t need to go back in.

  3. Not anyone on these boards can truthfully say Tua had a concussion the game before! No one! The revisionist history on this and sudden appearance of a zillion mini-MDs is ridiculous. Just because you are woozy for a few seconds does not mean you had concussion. He passed the protocol as the system dictates. None of you can say what happened during his assessment. Just stop.

  4. When Tua stood up on Sunday and his legs got rubbery, was anyone in their right mind saying “Oh, back injury!”? No. And some folks always want to blame the player – “he said he was fine”. This lets the NFL, their protocols and the medical staff off the hook.

    Players have a mindset that if they’re not able to play, they might lose their job. That needs to change, too. However, ultimately, the player – and his safety – is under the responsibilities of the NFL and medical staff. Shrugging and saying “he wanted to be out there” is incredibly irresponsible and disingenuous.

    The Dolphins made a bad call to let him back on the field on Sunday, and now we’ll see what, if anything, changes in the league because of this.

  5. If you can’t pass the “50 drunks in a bar” test, it should be an automatic no-go. There wasn’t a person watching what happened last Sunday who didn’t go “that was a concussion” and “wtf” when he came back later.

  6. My best to Tua. What happened last night was downright terrifying. It reminded me that they’re all just human beings-like you and I-getting paid to play a game. They are so much more than athletes and entertainers.

  7. Number one thing about the NFL and owners they simply do not care about the health of its players at any time, they are meat to be used push the ratings and product on the field hence dollars in the owners pocket. Tua exciting, Teddy the knee injury story has been rehashed a few to may times and he is a below average QB that people don’t want to watch.

  8. Serious question. Did Tua look like a player who had suffered a concussion 4 days earlier last night before the injury?

  9. At some point you have to trust the doctors to do their job. They did that Sunday and cleared him to play. What happened last night had nothing to do with Sunday, if the doctors were correct in their assessment on Thursday. He was evaluated through the week and cleared. What else do you want to happen?

  10. There is lots of blame to go around the League the Teams, The Sport in General but also the Players . If Tua really wanted to stay out Sunday and Thursday he could have said I can’t go back in. I have to think he was begging to go back and play. The NHL is even worse. Until Crosby finally pushed back and said I’m taking MONTHS off to get my brain healed.

  11. I haven’t seen much about it…

    But that hit was dirty.

    That would have been flagged for unnecessary roughness 25 years ago…much less today.

    How it wasn’t called it beyond me.

  12. Time for the league offices at Park Ave to step up and take away another first rounder to send a message!

    It’s disgusting how they have handled Tua’s concussions – if they put him back on the field within the next month, it would be malpractice.

  13. I don’t always agree with your assessments but this one is 100% spot on! Bravo – well said.

  14. Easy to say this, but in a SB game in the 4th qtr no one is going to accept pulling Mahomes or some other star player from the game just because you think he might be injured.

  15. That sack would have knocked out any perfectly healthy athlete. Everyone playing doctor on the broadcast were out of line. Should it be investigated? Absolutely, but jumping to conclusions with no evidence just causes confusion and hyperbole to jump ahead of the facts.

  16. I thought the sack was excessively vicious. Tua’s head was deliberately smashed into the ground. Tupou should be suspended for a long time.

  17. The gross motor instability loophole is designed to allow players who screw up a ankle to get it taped and go back in. People need to be more proactive on pulling these hyper competitive people out when they get their bell rung. But half the ankle injuries (solved with tape) would bench players if they didn’t have that “loophole”

  18. I feared for Steve Youngs life on the hit that ended his career.

    That was more than 20 years ago.

    Forgive me if I don’t think the NFLs efforts are sincere. And equal measure of scorn for the Players Union, who has too many desperate members to take a real stand.

  19. here’s the dealeo…. even if he was pulled on Sunday, he still would have cleared on Monday and played on Thursday.

  20. Tua’s done for the season/borderline career. Miami rolled the dice — hoping to get him through this game, and then would have 10-days to recover.

    So many guilty parties. We know this organization has been dirty for years. And it put the entire league in jeopardy by allowing Tua to play min this game. So desperate to win the division, so desperate to stay undefeated. If I own that team, run that organization or coach those players I have blood on my hands. And the doctors who signed-off on Tua — and the doctors who let him fly home last night. He could have bleeding of the brain that no one can see without an MRI (which he’s getting today, but in Miami). Just pathetic the way this kid is being treated.

    Everyone needs to be punished — HARD. Then close your loopholes.

  21. Look we all saw he had a concussion last week. What the NFL did in denying this was a concussion was equal to what the line in Jaws was when the medical examiner said to Martin regarding the first shark attack:
    Examiner: Well, I think, uh, possibly, uh, yes a boating accident. A
    boat –
    Martin: That’s not what you told me over the phone.
    Medical Examiner: I was wrong. We’ll have to amend our reports.
    Martin: And you’ll stand by that?
    Medical Examiner: I’ll stand by it.

  22. I will say we have come a long way as a society that used to glorify guys coming back and playing dizzy in a game. I feel the overall sentiment towards him playing the remainder of last week and Thursday night was to exercise caution. I think as a society, we have grown up a little bit over the years and realize that players,coaches and doctors need to exercise caution over the will of the player. 20-25 years ago, that may not have been the case and would have questioned Tua’s toughness.

  23. Tua proved how tough he was when he came back in against the Bills, but he is not built for this, and yesterday came back and bit him because of it. Im glad he’s alright, but we likely won’t ever know how directly this has impacted him, unlike Muhammad Ali’s last fight; Tua has a long way to go on the road of healing, if only his coach, team physicians, and team owner cared as much about him as they do winning games

  24. Closing this ‘loophole’ would make the problem worse. You would be taking the decision out of the hands of the doctors and put it on the refs. Now, if a ref has ANY doubt about a players head, he sends them to the tent knowing that player will return if he was wrong. If that same ref now thinks by sending that player off he is essentially ejecting him, then if they have any doubt the player might not be concussed the ref would be reluctant to send him off. I’d rather have the doctor make that decision. The concussion tests should be harder to pass. They are a joke now.

  25. The league doesnt care about the players we all know that. All about the mighty dollar signs for them and social justice after the fact. Prayers up for Tua! I hope he’s okay and can make a full recovery soon. Phins please don’t put him back in until he;s fully healed.

  26. So, what you are all sayng is if the Sunday hit never took place, then after last night’s hit, Tua would have got up like nothing happened and called the next play.

  27. Players want to play. They know how to hide concussion symptoms- whether they are encouraged by the team to do so or not. If a guy has a headache on Tuesday and he wants to play Thursday, he’s not saying a word. If that’s the only symptom, no amount of doctors will be able to detect it.

  28. njeffrey says:
    September 30, 2022 at 10:13 am
    There is lots of blame to go around the League the Teams, The Sport in General but also the Players . If Tua really wanted to stay out Sunday and Thursday he could have said I can’t go back in.
    ========================

    1000% wrong.

    The entire thing about a concussion is your brain’s injured. You can’t make good decisions.

    Read stories from past NFL players who played most of an entire game and didn’t remember a thing later because they were concussed.

  29. nite2al says:
    September 30, 2022 at 9:53 am
    Not anyone on these boards can truthfully say Tua had a concussion the game before! No one! The revisionist history on this and sudden appearance of a zillion mini-MDs is ridiculous. Just because you are woozy for a few seconds does not mean you had concussion. He passed the protocol as the system dictates. None of you can say what happened during his assessment. Just stop.
    ____________________________________________________

    Because we all watch football, we have all seen what sustaining a concussion looks like. Some look like not much at all, and then there are the helmet to helmet, and the ones like what we saw on Sunday. Tua’s head bounced off the turf really hard. He got up, wobbled, then staggered to the point where team mates had to walk him to the locker room. If that was not a concussion, then what is? How do any of us know that he passed the protocol? Tua may have begged to go back in and no one had the sense to take his helmet away from him. Does it have to look as horrible as it did last night to take away all doubt? Some guys need to be protected from themselves, and it didn’t happen on Sunday. Some head coaches don’t put their foot down and say “NO” when they need to. The loophole has to go. Look at where Tua is now.

  30. I suffered a really bad concussion last October from an MMA practice. Took a kick to the head on a Tuesday morning around 8am which sparked me. Somehow, I was able to get into my car, drive home, and go to work. I felt “fine” for the first 4-6 hours of my day. Then over the next 2-3 days things started to get ‘foggy’, until my doctor encouraged me to head to the ER on day 6 to get an evaluation for a potential brain bleed [thankfully there was none]. Point being – no one really understands the brain, and there’s plenty of instances of people suffering a concussion where the symptoms don’t fully creep up on them until days later. The fact that Tua took a huge bump on a Sunday and was staggering around, and playing on a Thursday night is borderline criminal. You really do NOT know the full extent of a potential head injury until at a week has gone by. I fear the Dolphins medical staff have done some irrevocable harm to this young man.

  31. agreed on the protocol change but heavily disagree with overreacting is better than under reacting. If you overreact on everything the baseline will become ridiculous, like in life when we overreact. To critically assess would be the best outcome.

  32. Ridiculous to look back to the game before and say “we knew it”. I suffer from a back injury I’ve had since 1996 and I STILL get wobbly on occasions and sometimes lasting for days. One little pop in my low back from twisting just right (or more accurately, just wrong) and I can barely move legs at all. Besides that – we see players get “stingers” all the time, and we’ve all experienced a good bump on the funny bone, those too can cause ‘Gross Motor Instability’.

  33. McDaniel needs to get more criticism for starting Tua. He easily could have started Bridgewater given the short turnaround and the mishandling of the concussion protocol last Sunday.

  34. 5 days ago it was a back bruise. I’m sure it’s just a stinger to his elbow this time. Let teams control their false narratives. We’re all just dumb fans.

  35. Jason McCourty, on Good Morning Football, had a lot to say about this. He said that other people need to step up. Loved ones and friends need to tell the player to take some time to heal.

    “I know that if I had gone through what Tua did on Sunday, there is no way that my wife would let me go back in. She’d be like…..’I don’t give a hoot what the coaches and docs say”

  36. That the team didn’t insist Tua take Thursday off and make the call for him? It means they don’t care if he’s doinked, they are happy to move on from him. Just like the Browns last year with Mayfield. Winning TODAY is the only thing that matters to rich owners and these bodies aren’t humans to them.

    Mayfield should have shut it down and his ego got in the way. Had he shut it down, he’d be playing on a very good Browns team, instead, he’s in Carolina.

    Tua got a brain injury and I wonder how much it affected his choice to continue to play. That’s the horror of brain injuries: You may not be able to MAKE an informed choice. The league needs to dictate to the teams far more caution because one day, they WILL be held liable.

    But until the players realize playing injured is costing them more $$$ than not playing, things won’t change.

  37. He was whipped to the ground pretty viciously by that defender that sure didn’t need to be done to bring him down , but blame the NFL when it’s players hurting other players , 👍

  38. nite2al says:
    September 30, 2022 at 9:53 am
    Not anyone on these boards can truthfully say Tua had a concussion the game before! No one! The revisionist history on this and sudden appearance of a zillion mini-MDs is ridiculous. Just because you are woozy for a few seconds does not mean you had concussion. He passed the protocol as the system dictates. None of you can say what happened during his assessment. Just stop.

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  39. Even my dog could see that Tua had a concussion last Sunday. He didn’t trip or have back issues. He took a huge hit to the head and was wobbly. A player that exhibits those symptoms after an obvious hit to the head should not be allowed to play for at least 2 weeks, regardless of what the tests show.

  40. This is way too many people pretending to be outraged about a guys health who decided a long time ago that he himself did not care about it. Apparently nobody is willing to admit how many times they’ve re-watched Napoleon Kaufman and Joe Theisman get killed. Football is not a contact sport. It is a violent collision sport and whether any of us admit it or not, that a big part of why we love it. Tua will be fine and if he isn’t he will still have been paid more handsomely than most of us for his trauma. Sorry Tua, but nobody spends half this much time and energy on making work safe when there is less money involved such as a factory worker.

  41. Yes, football is a violent, collision sport. But once a player shows symptoms of a concussion, the need to be taken from the game for at least2 weeks. What happened with Tua was avoidable….if only someone…anyone had cared.

  42. RGIII got rushed back into a game, his knee exploded, and he was never the same. Soon out of the league. I don’t want to know what the brain equivalent of that might be.

    99% of the time, your QB is your most important player, so I get the natural reaction to get him back out there, but if this guy comes out of the hospital with lasting effects and/or isn’t the same player, the Dolphins should be taken to the woodshed. What a stupid move to put a guy out there who clearly had some level of brain injury only 4 days prior.

  43. “None of you can say what happened during his assessment.” Using your own logic, neither can you. You can’t say he DIDN’T have a concussion. And given the available visual evidence from last Sunday and the fact he suffered another head trauma on Thursday, it’s more than likely that he did sustain a concussion last Sunday. Moreover, what do you have to gain by arguing that he didn’t have a concussion last Sunday? Is your team’s win/loss record so important that you ignore the health and safety of your team’s franchise QB?

  44. Probably time for Congress to intervene, as they had to with baseball and steroids.

  45. Very unlucky that Tua had to play a Thursday night game a few days after that hit in the Bills game. They should have come up with some excuse to keep him out of last nights game.

  46. Tua was all smiles and hitting dimes until he got hurt. It happens. It’s called football. Now he has ten days to rest before he dissects the Jets.

  47. When does personal responsibility come in? Players are paid handsomely to play pro football. They are also adults. They are surrounded and monitored by a small army of medical professionals. Are all you amateur MDs saying that Tua does not have the cognitive ability to decide if he can, or even should, play? Are you inferring that the Dolphins coaches and medical staff are either incompetent, uncaring, or both? It appears that many of you are arguing against the basic premise of football (or any contact sport) altogether. If you don’t have the stomach for it, don’t watch. Football is not for everyone, and life equals risk. Act accordingly and live with the consequences of your own decisions.

  48. I agree with everything said but there’s one problem, the injury we just witnessed happened on Thursday, not Sunday. Even if they ruled him out of Sundays game, he still would have passed all protocols and played Thursday so this injury would have happened anyway. I mean it’s great we want to protect players and all but in a violent game like football, injuries happen and protocols wouldn’t have changed anything about this one.

  49. “When does personal responsibility come in?”

    Brain injuries are NOT like other injuries. We know that brain injuries don’t completely heal, and that overtime, enough concussions will result in CTE………basically turning people into vegetables.

    When a play shows sign of being woozy after taking a hit to the head, he should not play for atleast2weeks, regardless of the tests.

  50. ghostofnitschke says:
    Are all you amateur MDs saying that Tua does not have the cognitive ability to decide if he can, or even should, play? Are you inferring that the Dolphins coaches and medical staff are either incompetent, uncaring, or both?
    ———–
    Yes, that is exactly what people are inferring. The medical staff is “incompetent, uncaring, or both”

  51. I’m not a doctor nor did I stay in a Holiday Inn Express last night, so while I thought he looked like he had a concussion last Sunday, the independent doctor said he didn’t. Maybe the NFL and NFLPA should investigate how and why that idenpendent doctor said he was fine. They were supposed to be the untouchable buffer that took these decisions out of the hands of players and teams.

  52. “If you don’t have the stomach for it, don’t watch.” You are missing the point. It’s not about us. It’s about the players getting mush brain because they are the guy. They are the franchise QB or the star Defensive players or the stud RB etc. These are guys that will play the most intense contact sport they can. They choose to keep going. The teams want those players to keep going. The league wants them to keep going. Literally everyone wants them to keep playing. So, it becomes an issue of doing what’s right, regardless of what all the interested parties want. Why? Because of the concussion settlement. This multi-billion dollar industry is on the hook and MUST protect their future by forcing players and teams to take concussions seriously. The more they ignore concussions, the more likely they’ll be on the receiving end of further lawsuits. The more they ignore concussions, the more Junior Seau’s and Dave Duerson’s there will be. If you want to keep watching or playing this sport, you NEED to take concussions seriously.

  53. The only loophole is the NFL and NFLPA claiming they care about player safety yet have teams play on a Thursday after playing the previous Sunday!

  54. The point in having an “Unaffiliated Neurotrauma Consultant” is to have an unbiased expert who isn’t beholden to the team make a decision regarding concussions and head injuries. It’s irrelevant what 50 drunk sports bloggers in a bar think. Really – zero relevance. Or do they now need two Unaffiliated Neurotrauma Consultants, or maybe add a union rep to the process? Maybe a TV analyst? Does anybody else need to be consulted?

  55. nite2al says:
    September 30, 2022 at 9:53 am
    Just because you are woozy for a few seconds does not mean you had concussion.
    ———-
    Definition: a concussion is a brain injury that results in temporary loss of normal brain function. So yeah, “being woozy for a few seconds” (and it was longer than that) does mean he had a concussion.

  56. Dr. David Chou was interviewed on SiriusXM’s Pro Football channel and said there are thirty physicians and specialists that the NFL employs on the sidelines for each NFL game. Each team has a neurological expert or physician assigned to them and there is one upstairs in the booth. It is the decision of THE HEAD TRAINER of the team whether or not a player is cleared to return to the field. He said it is very unlikely that a trainer will allow a player to return to the field if the NFL specialist or physician believes he should ruled out. They both will come to a mutual agreement. He said it’s very difficult for a player to “fake” his way into passing a concussion evaluation, but that some concussions may not show symptoms until days after the trauma. He also said Mac Jones will NOT be playing Sunday. He heard Jones received a second opinion on his high ankle sprain and was contemplating surgery.

  57. If a wristwatch can detect a car crash, we all know that similar technology can be incorporated into a helmet and wirelessly monitored on the sideline.The NFLPA should advocate for a solution that removes the game time emotions of players, coaches, owners, medical staffs, UNC, the League, and others whose financial gains come ate the expense of compromised health and safety. In my line of work we have a saying, iIF YOU DON’T MEASURE IT YOU CAN’T CONTROL IT!

  58. ite2al says:
    September 30, 2022 at 9:53 am
    Not anyone on these boards can truthfully say Tua had a concussion the game before! No one! The revisionist history on this and sudden appearance of a zillion mini-MDs is ridiculous. Just because you are woozy for a few seconds does not mean you had concussion. He passed the protocol as the system dictates. None of you can say what happened during his assessment. Just stop.

    —————————

    Lol, I can say it, and feel pretty truthful as I do. Any revisionist history here would be your own attempts to tell everyone that saw it that they didn’t see it.

  59. It wasn’t a dirty hit, but Tua should not have been allowed to return on Sunday or to play last night. Caring people should have told Tua to take a couple of weeks off, at least.

    Head injuries are not like body injuries. Once there is sufficient brain damage, the player’s life is over. Tua should consider retirement. One more big hit to the head could kill him.

  60. kenmasters34 says:
    September 30, 2022 at 12:45 pm
    Very unlucky that Tua had to play a Thursday night game a few days after that hit in the Bills game. They should have come up with some excuse to keep him out of last nights game.

    ———————-

    Player health and safety is a pretty good excuse all on its own.

  61. The NFL in the last two weeks has demonstrated the absurdity of their sport. First, the NFL changed the Pro Bowl from its sport of tackle football to a game of flag football that has few similarities to NFL football. So, the NFL admitted that the players should not risk unnecessary injuries in a meaningless game.

    That brings up an ethical and moral point. Is the NFL implying that in its regular season and playoff it’s OK for players to risk injury because they are getting paid good money? So, somewhere between the Pro Bowl and the regular season there is a point, defined by dollars, where it is permissible to ask players to play in the face of all the violence and possible career ending, life altering bodily harm, what the NFL might call the possibility of a necessary injury?

    There are too many injuries in the NFL. There is no way to effectively prevent injuries. some of which could be life threatening, and the NFL doesn’t care because the sport is not about a leather oblate spheroid, it’s about money, plain and simple. You can say that players play at their own volition, so why not ask them to play their game in the Pro Bowl? Oh, yeah, I forgot. It’s a meaningless game.

  62. I think the best outcome would be to introduce a second examination the next day preferably by an unaffiliated doctor. I’ve had a few concussions and pulled my back a couple of times; from what I saw in the video I’d be willing to bet dollars to doughnuts he was concussed Sunday based on the way he looked. Either the medical staff missed it or didn’t enforce the protocol, but I have little to no doubt he was concussed. The biggest issue is that it’s up to the patient to report the symptoms and the patients have incentive to lie about them.

  63. bengal4573 says:
    September 30, 2022 at 1:13 pm
    Anyone who thinks that hit was dirty does not know a thing about the rules of football

    ———————-

    I have not heard anyone say that either hit on Tua was dirty. His concussion came when his head hit the ground on Sunday and was aggravated when it hit the ground again last night. If anyone is looking to blame someone for a hit then blame the ground.

  64. Any player would have had a concussion on that tackle. When the tackler grabbed Tua’s belt to whip him down, the player does not have the ability to brace his fall. Similar to a horse collar.

  65. I played sports and have had a concussion. What we saw on Sunday with Tua falling after getting up was grounds to prevent him from playing the rest of the game. And a coach who is truly concerned about his players should not have allowed him to play four days afterwards. It is not whether he qualified for a technical conclusion of a concussion. There was enough visual evidence to conclude something was not right and to protect the player. What we saw here was professional malfeasance of the highest order and threatening the safety of a player’s long term health. Let the player whine – a coach has a charge – a professional responsibility – and is charged with protecting his team’s players. To err on the side of caution may be an over reaction to some, but to do what was done is to err on the side of winning a game and to ignore the player’s health. This coach should be fired immediately.

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