Multiple concussions like Dolphins QB Tua Tagovailoa’s increase chances of long-term health issues
September 15, 2024
When Miami Dolphins quarterback Tua Tagovailoa collided headfirst with Buffalo Bills safety Damar Hamlin during Thursday night’s football game, it was immediately apparent to medical experts that Tagovailoa had suffered a serious concussion.
Knocked down on the field and lying on his back, Tagovailoa’s right arm extended up into the air as the fingers on his hand curled, a reflex known as the fencing position that happens after a significant brain injury. It was the third diagnosed concussion of his NFL career after two back-to-back concussions in 2022.
Experts say repeated head injuries can increase the risk for long-term health problems, such as chronic traumatic encephalopathy, or CTE, a neurodegenerative disorder that is associated with changes in mood, behavior and cognition, and has been diagnosed in hundreds of NFL players after their deaths. But precisely who goes on to have CTE or other long-term health issues after a head collision is somewhat of a mystery.
Tua Tagovailoa walks off the field with training staff after a concussion on Thursday.
“We know that repetitive concussions have been shown to be associated with an increased risk of cognitive impairment later in life,” said Steve Rowson, an associate professor of biomedical engineering at Virginia Tech and the director of the Virginia Tech Helmet Lab.
“But not everyone who has repetitive concussions develop brain health problems later in life,” Rowson said. “Only a fraction of those people do, and we don’t know why it’s those people.”
Contributing to the confusion: Concussions are often difficult to diagnose, and many are overlooked, said Dr. Dan Daneshvar, chief of the division of brain injury rehabilitation at Harvard Medical School.
A concussion is defined as a mild traumatic brain injury from a blow to the head or the body that causes the brain to rapidly rattle back and forth, causing symptoms that may include double vision, confusion, trouble concentrating and memory issues. Signs of a concussion range from stumbling and vomiting to loss of consciousness in extreme cases.
Those signs and symptoms are a key part of a diagnosis: If two people sustain head trauma of equal force but only one experiences symptoms or shows signs of a concussion, the other is considered to have had a nonconcussive hit, Daneshvar said.
However they are classified, the multiple head injuries add up. Research from the Boston University CTE Center based on postmortem examinations of former football players’ brains shows that repeated head impacts appear to be the chief risk factor for CTE. Meanwhile, a 2023 study in the journal Nature Communications found that the most reliable predictor of CTE later in life was the cumulative force of the head blows to players during their careers, not the number of concussions they had sustained.
“What we’re finding is, when it comes to the long-term problems associated with these hits to the head, it doesn’t seem to matter whether that hit caused symptoms or not,” said Daneshvar, who was the lead author of the study. “What seems to matter more is the total amount of head injury burden you got over your life.”
CTE can be catastrophic to mental health. It is believed to have played a role in the suicides of numerous football players, including Junior Seau; Dave Duerson; Ray Easterling; and Aaron Hernandez, all of whom were later found to have CTE.
