Miami Dolphins quarterback Tua Tagovailoa lays on the ground after colliding with a Bills defender during a Thursday night game.

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Miami Dolphins quarterback Tua Tagovailoa lays on the ground after colliding with a Bills defender during a Thursday night game. / Getty Images

It was a routine run for a first down, the kind that quarterbacks do every week in the National Football League.

But Tua Tagovailoa of the Miami Dolphins leaned headfirst into the tackle, and the impact against the defender's chest sent his head sharply to the left. Afterward, he collapsed to the ground, with his right fist balled and raised into the air in what appeared to be a telltale sign of brain injury.

Later during the Thursday-night game, the Miami Dolphins made it official: Tagovailoa had suffered a concussion, the latest for the 26-year-old whose career had already come to be defined by his worrying history of brain injury.

Now, Tagovailoa's concussion has prompted a dramatic response by fans and former players alike who have urged him to retire — a reflection of a growing awareness among the American public of the risks of the long-term brain damage that can follow hits to the head. Even a current coach has called for him to retire.

"I'll be honest, I'd tell him to retire. It's not worth it," said Antonio Pierce, the head coach of the Las Vegas Raiders, speaking at a press conference Friday. "I just think at some point, he's going to live longer than he's going to play football. Take care of your family."

Across broadcast and social media, former players and fans alike shared the same sentiment. "If I'm him, at this point, I'm seriously considering retiring from football. If that was my son, I'd be like, 'It might be time.' This stuff is not what you play around with," said Tony Gonzalez, a Hall of Fame tight end for the Kansas City Chiefs and the Atlanta Falcons, speaking after the game as an analyst on Amazon Prime's broadcast.

"Really hope Tua is ok, but he’s gotta seriously think about shutting it [down]," said Shannon Sharpe, the former Denver Broncos tight end. "His concussions are getting worse and worse and he’s a young man with his entire life ahead of him."

Concussions and repeated blows to the head are key risk factors in long-term brain injuries, including chronic traumatic encephalopathy, or CTE, a serious condition that can cause early dementia and death.

"There is no magic number of concussions to require retirement," said Chris Nowinski, a former football player and professional wrestler who later pursued neuroscience and now heads the Concussion Legacy Foundation.

"It all depends on how he recovers from this one, but having too many concussions can lead to chronic symptoms and mental health disorders," Nowinski continued, writing on the social media site X. "He's in a very tough spot."

A small number of NFL players have left the sport early over concerns about their neurological health, including the Carolina Panthers All-Pro linebacker Luke Kuechly and the San Francisco 49ers linebacker Chris Borland, who retired after only one season in the NFL.

"With Tua, there's the added pressure of being the star of the franchise, the player that they're building around," Borland told NPR in 2022. "It's vital that players are better protected because, if left to their own devices, for a hundred different incentives, we would do anything to get back on the field."

Tagovailoa walked off the field under his own power after sustaining a concussion during Thursday night's game against the Buffalo Bills.

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Tagovailoa walked off the field under his own power after sustaining a concussion during Thursday night's game against the Buffalo Bills. / Getty Images

In 2022, the NFL revised its concussion evaluation protocol after Tagovailoa was allowed to re-enter a game after sustaining what appeared to be a head injury when he was cleared by medical evaluation. In another game just four days later, he hit his head again, this time with a formal diagnosis of concussion. Weeks later, he sustained yet another concussion and missed the rest of the season.

After that, he consulted doctors and family about whether to continue playing. In a podcast interview last month, Tagovailoa said some family members, especially his mother, had asked him to consider quitting.

"It was just brought up here and there, like, 'I don't think you should continue to play and whatnot, but we'll always support what you want to do,'" he told The Dan Le Batard Show with Stugotz podcast. "I get it. I got kids too, now, and you can understand why the mothers are the way they are."

But he decided to stick with football. Ahead of the following season, Tagovailoa devoted his offseason to become less vulnerable to concussions. He took jiu jitsu classes and trained in how to roll his body when falling, rather than allowing his head to hit the turf.

The 2023 season that followed was the best of his career. He led the league in passing yards and steered the Dolphins to an 11-6 record, their most wins since 2008. In July, he was rewarded with a $212 million contract extension.

Now, should he choose to retire, how much of that compensation he will receive will depend on whether he is medically cleared to return to football.

If he is cleared to play but retires anyway, Tagovailoa will forgo $124 million. If he is medically forced into retirement, he will collect that money, according to Spotrac, a service that tracks professional sports contracts.

After the hit during Thursday's game, Tagovailoa walked off the field without assistance, and the Dolphins reported that he was able to speak with medical staff in the locker room.

On Friday, head coach Mike McDaniel declined to speculate about a timeline for Tagovailoa's return. "The best thing I can do is not try to assess what this even means from a football standpoint," McDaniel said. "Trying to meet [timelines], trying to assess what this means for playing — this is heavy stuff."

As of Friday afternoon, Tagovailoa had not commented publicly on his options.