Bengals' Burrow had previous 'head injury,' ex-QB Smith avoided concussion protocol

Oct. 6 (UPI) -- Cincinnati Bengals quarterback Joe Burrow and former QB Alex Smith are among the players to recently speak out about experiences with head injuries and NFL protocol amid a probe into Dolphins QB Tua Tagovailoa's recent concussion.

Burrow has never been listed on an injury report with a head injury designation -- outside of a throat issue last year -- during his three-year NFL career. He told reporters Wednesday that he "definitely" has had "some kind of head injury" while playing in the league.

"Stuff like that happens all the time," Burrow said. "I've never had a headache the next day from a concussion. But I've had games, high school, college, NFL, that maybe I don't remember the rest of the game, but I don't have any side effects other than that.

"So I don't know if you would call that a concussion or not. But definitely some kind of head injury, for sure."

Tagovailoa sustained his concussion in the first half of the Dolphins' loss to Burrow's Bengals on Sept. 29 in Cincinnati. He was taken to a local hospital, but released that night and traveled back to Miami with teammates.

Tagovailoa also hit his head four days before that injury, but cleared the NFL's concussion protocol and was allowed to return to that Sept. 25 game against the Buffalo Bills. He was later designated with a "back injury" from that hit.

The NFL and players union are investigating the process behind Tagovailoa clearing the protocol amid his absence from the field. A league source told UPI on Saturday that the investigation resulted in the dismissal of an unaffiliated neurotrauma consultant, who was involved in evaluating Tagovailoa for a concussion Sept. 25.

Burrow said Wednesday he reached out to Tagovailoa after last week's game. The Bengals quarterback said it was a "scary moment," adding that NFL players know what they "signed up for, but whenever something like that happens, it makes you take a step back and think."

"I'm glad he's OK," Burrow said. "I haven't talked to him about when he will be back, but all the signs point to him being healthy going forward. There shouldn't be any long-lasting effects, and I'm happy for that."

Burrow said that if he feels like he has a concussion, he won't return to the playing field. He also said that he doesn't think league and players union can do much to avoid potentially concussed players returning to games if they withhold revealing symptoms during the protocol.

Alex Smith, who retired in 2021 after 16 seasons in the NFL, said he was among players who withheld admitting he had concussion symptoms so he could remain in games. Smith made the comments during an appearance Monday on the ESPN Daily podcast with Pablo Torres.

Smith said he hit his head twice while he was Kansas City Chiefs quarterback during a 2016 game against the Indianapolis Colts. He left the game and was evaluated for a concussion, but was allowed to return.

He told Torre on Monday that he lost consciousness during the game and had a concussion, but withheld details about how he was feeling so he could return to the game.

"Without a doubt, I withheld [information]," Smith said. "You are withholding, You aren't telling the full truth. ... I knew I had been compromised."

Smith later hit his head a second time in that game and said he passed the protocol for a second time, but did not return to the game.

Smith said he had two concussions in the NFL, with only one "documented case." He said his first concussion led to him "losing his starting job" in 2012, when Colin Kaepernick took over as the San Francisco 49ers' quarterback. He admitted that he was thinking about that moment when he went into the protocol in 2016.

The league and union announced Saturday it had agreed to "modifications" of the concussion protocol to enhance player safety, citing the Tagovailoa situation.

Those changes will address the use of the term "gross motor instability." Under current protocol guidelines, players can return to games if the neurotrauma consultant and team doctor determine that the gross motor instability is not caused from a neurological issue.

Tagovailoa wobbled, lost his balance and collapsed to the ground after he was hit in the Dolphins' Week 3 win over the Bills, before he returned to that game. At the time, that movement was not considered a trigger for immediate removal, based on the concussion protocol.

Sources told NFL Network that the protocol update, if formally approved by the league and union, will rule out players if they exhibit any form of gross motor instability.

The NFL concussion protocol was developed by a board of independent and NFL-affiliated physicians and scientists, including advisers for the players union.

Trainers, spotters, the team doctor, NFL game officials, coaches, teammates and unaffiliated neurotrauma consultants can initiate the in-game protocol.

Tagovailoa remains out indefinitely. The Dolphins will start backup quarterback Teddy Bridgewater in Week 5. The Dolphins and the NFL have been heavily criticized by former and current players and fans on social media for the Tagovailoa situation.

"At this point in time, he's in the protocol, and it's all about the only thing it's about and that's the health of the human being," Dolphins coach Mike McDaniel told reporters Wednesday. "It's a change in routine for him, and he loves football and loves being around his teammates.

"It's another example of us having to have honest and forthright communication with the medical staff. He'll be around as long as it doesn't adversely affect him as best possible," McDaniel said.

He's a captain of this team and we want him to be present as much as he can, but not at any sort of cost to his process, getting himself healthy, and going through that procedure. So that will be really case-by-case."

The Dolphins (3-1) will face the New York Jets (2-2) at 1 p.m. EDT Sunday at MetLife Stadium in East Rutherford, N.J.