Two concussions don’t always add up to second impact syndrome

CNN  — 

The NFL has been thrust again into the concussion debate after Miami Dolphins quarterback Tua Tagovailoa took two huge hits simply 4 days aside.

This time, the controversy includes whether or not Tagovailoa was appropriately cleared to play, with some followers involved he was prone to a situation referred to as second impact syndrome.

On Sunday, Tagovailoa left a recreation within the second quarter after a success from the Buffalo Payments’ Matt Milano precipitated him to fall backward and hit his helmet on the turf. On his approach again to the road of scrimmage, Tagovailoa stumbled and fell.

NFL Community reporter Ian Rapoport stated Tagovailoa was checked for a concussion and cleared, and he got here again onto the sphere within the third quarter.

In a postgame information convention Sunday, Tagovailoa defined it felt as if he had hyperextended his again.

“My again form of locked up on me. However for essentially the most half, I’m good. Handed no matter concussion protocol they’d,” he stated.

On Thursday, Tagovailoa was again within the lineup towards the Cincinnati Bengals. Throughout the second quarter, he was sacked by defensive lineman Josh Tupou and lay immobile for a number of minutes earlier than being taken off the sphere in a stretcher and despatched to a hospital for analysis.

The Dolphins reported Tagovailoa was identified with a concussion on the hospital however cleared to fly again residence with the remainder of his group. On Friday, head coach Mike McDaniel stated Tagovailoa is following the NFL’s concussion protocol, with no clear timeline of when he’ll return to the sphere.

A concussion is a mind harm which occurs after a success to the top causes the mind to transfer forwards and backwards contained in the cranium. However even after the organ itself stops shaking, there can nonetheless be modifications within the mind.

Neuroscientist Julie Stamm, a scientific assistant professor within the Division of Kinesiology on the College of Wisconsin-Madison, describes it as a cascade of chemical occasions. “It takes time. Every of those metabolites and chemical substances within the mind has a special trajectory in how they get better,” she stated.

She identified it may usually take 10 to 14 days after a concussion for the mind to get again to its baseline situation.

Stamm has not handled or evaluated Tagovailoa however famous, primarily based on what she noticed of Sunday’s recreation towards the Payments, it is rather doable he had a concussion.

“He initially grabbed his helmet and shook his head. That could be a clear signal that you simply’re attempting to shake the cobwebs,” she noticed.

Watching him fall was significantly regarding. “It didn’t appear like it was his again that precipitated him to fall down. It appeared like he simply misplaced steadiness, after which his teammates are attempting to maintain him up.”

The group acknowledged it adopted the concussion protocols, and Tagovailoa was cleared to return to the sport.

Later, McDaniel advised reporters, “Tua went out with a decrease again. He actually obtained bent again on a quarterback sneak earlier. … His legs obtained wobbly as a result of his again was free. As he described it, his decrease again was like Gumby.”

However Stamm acknowledged even when somebody doesn’t discover signs, they’ll nonetheless have a mind harm. “It’s doable that he might have felt higher after, so he might not have felt like he had signs anymore.”

Earlier than Thursday’s recreation, social media lit up about Tagovailoa beginning regardless of his harm from Sunday. However after Thursday’s hit, many followers started to counsel Tagovailoa might have second impact syndrome.

“What we at the moment consider second impact syndrome to be is a second blow to the top or second concussion prior to the decision of a primary one. And that may end up in uncontrolled swelling of the mind,” explainedSteven Broglio, director of the College of Michigan’s Concussion Heart. He has additionally not been concerned in Tagovailoa’s care.

Broglio stated to consider your cranium like a field, along with your mind contained in the field. Within the case of second impact syndrome, the second hit compresses the field, and parts of the mind controlling very important features like respiration and coronary heart price can cease working.

Stamm stated the modifications occur very quickly and might lead to everlasting mind harm and even dying.

However each Broglio and Stamm confused second impact syndrome on this sense could be very uncommon, and occurs usually amongst youthful athletes.

“It is a half we don’t fairly perceive, however it tends to be solely in youthful athletes; so center college or highschool,” Broglio stated.

Even when Tagovailoa had been concussed in Sunday’s recreation, what occurred Thursday night time wouldn’t be second impact syndrome within the conventional sense, Broglio emphasised. “If someone had true mind swelling and probably mind herniation via the underside of the cranium, he wouldn’t be getting out right this moment.”

However even withoutbrain swelling, a possible second concussion may make restoration worse, Stamm added.

“When somebody has a second concussion earlier than they’ve healed from the primary one, we regularly see worse signs in contrast to the primary one. These signs may be extra extreme. The signs have a tendency to last more. The restoration is far slower,” she stated.

Of best concern to Stamm is instantly after Thursday’s hit, Tagovailoa’s arms had been stiff and splayed, a posture referred to as the fencing response.

“That was one thing that jumped out at me instantly,” she recounted. “At any time when you’ve got a posturing like that, it suggests an harm that’s probably involving the mind stem.”

McDaniel admitted after the sport “it was a scary second. … That was an emotional second that’s not a part of the deal that anybody indicators up for, regardless that you recognize it’s a risk in soccer to have one thing that you’ve to be taken off on a stretcher.”

Tagovailoa issued a press release on Twitter on Friday, which learn, “I’m feeling a lot better and targeted on recovering so I can get again out on the sphere with my teammates.”

The NFL Gamers Affiliation is conducting an investigation into whether or not the Miami Dolphins violated concussion protocols in figuring out Tagovailoa’s readiness to play.