After weeks of the NFL’s concussion protocol taking Dolphins quarterbacks out of games, limiting what they can do in practice and even going through revisions because of Tua Tagovailoa’s two hits to the head in five days, it’s a fair question to ask: Why is Pittsburgh’s Kenny Pickett accelerating through concussion protocol quicker than Teddy Bridgewater?
The Steelers visit the Dolphins in a prime-time matchup on Sunday night, igniting the comparison, as Pickett is expected to start.
Obviously, Tagovailoa’s journey through protocol was much different, so that wouldn’t be a fair comparison to make. He suffered a serious concussion on Sept. 29 against the Bengals. It left him unconscious, as he recalled, and had him taken away on a stretcher, strapped to a backboard.
But Bridgewater entered protocol on Oct. 9 at the New York Jets only because a spotter at MetLife Stadium deemed he stumbled, a sign of ataxia, after taking a hit from Sauce Gardner on the opening play, although no video confirms said stumble. Dolphins coach Mike McDaniel said after that game Bridgewater didn’t show any concussion symptoms. Because of the league and Players Association’s update to concussion protocol a day earlier, Bridgewater had to be taken out of the game and be treated in protocol the following week as if he had a concussion.
That process saw Bridgewater restricted to conditioning work on the side of practice the Wednesday that followed, listed officially as a non-participant on the injury report. He then went through drills on a limited basis on Thursday before increasing his workload to full participation that Friday.
Pickett, who cleared concussion protocol Friday, took a hit from Buccaneers linebacker Devin White on Sunday that caused his head to hit the ground from whiplash in the third quarter of the Steelers’ win. By Wednesday’s practice, the first of the week, he was already allowed to participate fully. It was expected after Steelers coach Mike Tomlin said Tuesday that would be the case, and Pickett again practiced in full on Thursday before Friday’s clearance.
Why the disparity?
“Each player and each concussion is unique, and there is no set time-frame for return to participation,” a league spokesperson told the South Florida Sun Sentinel in an email. “Team medical staff consider the player’s current concussive injury, as well as past exposures and medical history, family history and future risk in managing a player’s care.”
Given the factors the league considers, one can surmise Bridgewater’s concussion history played a role in his longer timeline. Bridgewater’s Dec. 19 concussion last year with the Broncos kept him out for the final three games of the season. He also sustained one earlier that season, which he returned from for the following week’s game. Bridgewater had one other concussion in his career, in 2015 with the Vikings, also getting cleared to return the following week.
The league does not comment on specific players’ injuries and neither team will detail specifics of their quarterback’s recovery.
Bridgewater’s limitations in practice early last week were noted by McDaniel as the reason why he didn’t start over third-string quarterback Skylar Thompson in last Sunday’s loss to the Vikings. Bridgewater, while Tagovailoa was held out, still relieved Thompson when the rookie left with a thumb injury.
Regardless of factors in play, Pickett’s rapid return is still alarming. According to Dr. David Chao, via Pittsburgh sports talk radio station 93.7 The Fan, of 39 concussions in the NFL this year, Pickett is the first player to return to full practice three days later. Some speculate the rookie didn’t actually sustain a concussion against the Buccaneers, but the Steelers announced he did Sunday.
“That’s not for me to discuss what has happened on somebody else’s team,” McDaniel said Friday. “Philosophically, I would never venture to try to be an expert on that.
“If you’ve seen our injury report, there’s enough for us to worry about. I’ll let the Steelers worry about the Steelers.”
NFL players clearing concussion protocol go through a five-step process to return to action. Clearance for full participation in practice, the fifth and final phase, is subject to the same approval by an unaffiliated doctor that has been heavily noted in all concussion protocol conversations in recent weeks.
“If, as part of a player’s progress through the five-step process, he is cleared for full participation by his club physician, he then must be seen by an Independent Neurological Consultant (INC), jointly approved by the NFL and NFLPA,” the league spokesperson wrote to the Sentinel. “If the INC confirms the club physician’s conclusion that the player’s concussion has resolved, he may return to contact practice or play in an NFL game.”
Bridgewater, last Sunday, refused to answer whether he experienced concussion symptoms on or following Oct. 9 against the Jets, but McDaniel, speaking at MetLife Stadium that day, said he did not. He nonetheless went through protocol because of the revision made the day before the game.
The five-phase protocol goes as follows with the player gradually increasing his activity: symptom-limited activity, aerobic exercise, football-specific exercise, club-based non-contact training drills, full football activity/clearance. Clubs generally don’t detail the specific step a player is in. Presumably, being listed on the injury report as a full practice participant means the player reached Phase 5, but a potential inconsistency with quarterbacks as opposed to other positions is they aren’t contacted in practice anyway, wearing red jerseys to remind teammates not to hit them.
Bridgewater cleared protocol from his unique situation on Oct. 15, six days from entering it. Tagovailoa was cleared the same day, so it took him 16 days from the Sept. 29 concussion that sent him to the hospital. Again, different players recover differently. Dolphins tight end Cethan Carter suffered a concussion in the Sept. 11 opener on a kickoff collision. He did not return to practice in any capacity in four weeks that followed and, ultimately, was placed on injured reserve on Oct. 8, putting him out at least another four weeks from that point.
The protocol change by the league and union was sparked by Tagovailoa’s injury scare on Sept. 25 against the Buffalo Bills, days before the ugly scene in Cincinnati. That Sunday, he took a similar but lighter hit to the head against the ground. Tagovailoa grabbed at his helmet, shook off the cobwebs and stumbled upon getting up to walk it off just ahead of the first half’s two-minute warning.
While he cleared concussion protocol at halftime to return for the second half — and correctly, under the letter of the law, according to the Players Association investigation — the union’s ruling was that his clearance did not match the intent of the regulations.
If a similar stumble was exhibited now, Tagovailoa, like Bridgewater was against the Jets, would automatically be ruled out of a game and enter protocol.