Tuanigamanuolepola 'Tua' Tagovailoa is the most polarizing player, in terms of injury risk, in the entire NFL this year. Tua, from Hawaii, and of Samoan descent, just turned 22 years old. He was reportedly infatuated with football ever since he was a small child. He has always seemed to be gifted, being able to throw the ball much farther than his peers, even in Pop Warner, at the age of eight.
Tua's grandfather was reportedly his main inspiration, and he would discuss football with him nearly every day. After his passing in 2014, Tua decided to continue to play in honor of him.
In his first year at Honolulu's primary high school, St. Louis, where former Heisman Trophy winner Marcus Mariota also attended, Tua put up impressive numbers, passing for 33 touchdowns over 2,500 yards and only three interceptions.
Mariota mentored Tua while they were growing up together in Hawaii. Tua's father reportedly disciplined him using a belt every single time he threw an interception, unorthodox but effective.
With each subsequent season in high school, Tua continued to thrive, and eventually joined the 'Elite 11' roster, as one of the top high school quarterbacks in the nation, and was named MVP of the squad. He was named a four-star recruit in 2017, and the top-ranked prospect in the state of Hawaii. Tua reportedly had 17 college scholarships but eventually chose Alabama.
Interestingly, Tua grew up (throwing) right-handed. However, his father trained him to throw the ball left-handed at a very young age. As we know, throwing a football left-handed is not very common.
Tua started his freshman season at Alabama as the backup to Jalen Hurts. Still, due to the dominating performances by the team, Tua ended up playing in several games that season. In the 2018 National Championship Game, Tua replaced Hurts in the second half due to ineffectiveness by Hurts.
Tua threw the game-winning touchdown pass in overtime to defeat the Georgia Bulldogs and was named the offensive MVP of the game. His ascension to elite QB had begun.
Tua led Alabama to an impressive 2018 season as he won both the Walter Camp Award as well as the Maxwell Award for the top player in college football, only finishing second to Kyler Murray in the Heisman Trophy award. Tua also led Alabama to their 4th consecutive National Championship appearance, but unfortunately lost to Clemson.
By this time, Hurts knew his time at the top in Alabama had come to an end, and he transferred to Oklahoma. Tua's reign continued, and his 2019 season again was quite impressive, but his season ended disappointingly. Despite missing several games during the season with multiple injuries, a significant hip injury in a game versus Mississippi State ended up being season-ending.
Tua underwent surgery, and his future was in flux. Would a severe hip injury prevent him from going to the NFL in 2020? Tua rolled the dice and decided to enter the 2020 NFL Draft. Despite multiple red flags with his hip, the Miami Dolphins took the risk and drafted him with the 5th overall pick.
For Tagliovailova, joining a rare left-handed quarterback club makes present difficulties for an NFL team, especially the offensive line. With the substantial majority of quarterbacks being right-handed, their blindspot is usually over their left shoulder. Therefore the left side of the O-line is often the most important, particularly the left tackle.
Since Tua is left-handed, this shifts everything to the right side. Strong support from the right side of the line is vital for him to be effective, and most importantly, for him to stay healthy. A lefty QB can be successful and have been. Ken Stabler, Jim Zorn, Boomer Esiason, Steve Young, Mark Brunell, Michael Vick, and Tim Tebow all demonstrated there is a possibility for success.
To make matters worse, the offensive line in Miami is rebuilding. There will be three new starters at minimum. Miami chose Austin Jackson in the first round, Robert Hunt in the second, and Ereck Flowers was signed as a free agent from Washington. Ted Karras arrives from New England to start at center to replace Daniel Kilgore. Overall, this group is a bottom half blocking unit.
There was additional controversy surrounding Tua primarily because he had just suffered a very significant injury that required surgery, and he was not able to participate at the NFL combine because of medical clearance. The majority of the NFL's medical teams were not able to personally evaluate him, instead of having to rely on previous medical reports and evaluations.
Unfortunately, Tua has struggled to stay healthy in his short football career. While any information on specific injuries in high school has been hard to come by, Tua had his fair share of injuries in college. Let's review them.
In October 2018, he suffered a sprained knee, but reportedly never required surgery despite reinjuring it several more times over the next couple of weeks. Then the next month, November 2018, he suffered a quad injury, likely a contusion secondary to a direct hit on his left quad.
The next month, December, Tua suffered a high-ankle sprain during the SEC championship game. Typically these take about 4 to 6 weeks to heal properly. But instead of taking the standard approach and being conservative, he did the opposite and underwent surgery to have what is known as a 'TightRope' procedure. To learn more about this procedure, click here.
This aggressiveness is very unorthodox, in my opinion, unless the injury was so severe and unstable that it required stabilization. While I have not reviewed the records, I suspect that the main goal is to have Tua ready to play in the next football game 12 days later instead of following routine protocol.
Usually, without surgery, and sometimes even with surgery, most athletes would never be able to return and be active on the football field in less than three weeks. We saw several NFL players this past season attempt to return earlier than they should have, only to be ineffective, including Alvin Kamara (maybe Saquon Barkley too?).
In October 2019, Tua suffered a high-ankle sprain of the opposite ankle. Is he injury prone? Rather than waiting and taking a traditional conservative approach with rest, and rehabilitation, no again, Tua was very aggressive and underwent the same 'TightRope' procedure the next morning after the game.
By the age of 21, he had already suffered two significant ankle injuries, both 'requiring' surgery, tweaked his knee, quadriceps, and required surgery on a broken finger. There is a possibility he suffered a fractured wrist in one of the spring games and, as a result, missed a significant amount of time, but the details are unclear.
The scary part about this story is that we haven't even gotten to the most severe and essential injury yet.
In November of 2019, just one week after making a return from his most recent ankle procedure, Tua suffered a gruesome injury where he was tackled by two opposing players, causing him to both fracture and dislocate his right hip simultaneously. This specific hip injury can be severe. Sometimes life-threatening. Sometimes permanently debilitating. Two days later, Tua underwent hip surgery, which likely included reinforcement of the socket of the hip as well as stabilization to prevent re-dislocation. Reportedly Dr. Chip Routt, a world-renowned hip fracture/dislocation specialist, an orthopedic trauma surgeon in Houston, completed the surgery.
Despite being only 22 years old, it's pretty evident that Tua has not been able to stay healthy. He has suffered a myriad of injuries that are very concerning to his long-term health. What good is he if he's always injured? Let's specifically discuss this hip injury.
I have spoken with several orthopedic hip surgeons, most with over 20 years of surgical experience each. The collective agreement amongst them is that Tua will develop significant arthritis. Post-traumatic osteoarthritis is the most common long-term complication of a hip dislocation, evidence supports this, with up to an 88% chance with complex fractures like Tua had. The question is no longer 'if' he will suffer arthritis, but the better question is 'when.'
Additionally there is concern for avascular necrosis, which is loss of blow-flow to the head of the femur, causing it to crumble and collapse (this is likely what happened to Bo Jackson). Lesser common but still possible complications include something known as heterotopic ossification, where extra bone forms, sciatic nerve injury/entrapment can also occur. I would not be surprised if Tua suffers from a decreased range of motion in this hip secondary to this trauma.
Tua is likely to have sustained a large amount of cartilage damage, secondary to the sheer amount of trauma that caused the hip not only to fracture but also to dislocate, which is not only irreversible but also detrimental. The injury will likely affect his ability to shift, pivot, and he will be at increased risk for future hip injuries secondary to this previous one.
There is a chance he could run away from a would-be tackler and attempt to slide only to re-dislocate the hip. While this fracture/dislocation injury is not unheard of in the NFL, no offensive player has ever suffered the injury and returned to effectiveness on the field. Will Tua be the first?
The risk in not being able to fully evaluate his hip, secondary to the pandemic, but also being willing to risk a prominent injury-riddled player for such a high draft capital is surprising to me. The medical team/doctors of the Miami Dolphins were reportedly not able to personally evaluate Tua before they drafted him. His talent, vision, elusiveness, 'touch,' and arm strength is elite and without question. If Tua did not suffer this significant hip injury, he had a high chance of being drafted number one overall.
After the initial injury, there was a real possibility that Tua would never play football again. Such a crazy spectrum. The fact that he is going to play and be drafted at a high pick is impressive.
I believe the Miami Dolphins were the only team, due to their collection of high draft picks between this year and next, as well as the state of the group, that could take the risk of drafting him. The number of picks for the next two seasons allowed them to bring in a high-risk athlete without affecting their plans long-term if he does not pan out. However, with high risk comes high reward.
How risky is he going into the 2020 season from a health perspective? His health status appears to be as ideal as possible, as his rehab is going well, thanks to elite medical staff, as well as his young age, but it is unclear how much he's tested this hip.
In a redraft league, I do not think he should be selected in the first ten rounds, as there are much safer quarterbacks with higher-upside and less risk.
As of right now, he is not even the starting quarterback of the Miami Dolphins, but that may change. As for dynasty leagues, this is a tricky question. Quarterbacks hold a lot more value in the long run in dynasty leagues, in my opinion, compared to say a running back that may only have one or two solid seasons before getting replaced. Imagine anticipating how good Patrick Mahomes would be before his emergence, and be able to get him for cheap?
Unfortunately, with Tua, you will likely have to pay a premium because of his impressive track record, collective talents, and as well as his notoriety. He will be the second QB off the board in a dynasty redraft league (rookie drafts), which I think is an appropriate spot for him. Would I draft him? It depends on the state of my team and the cost, probably not.
How effective will he be for the next two years? On a rebuilding Miami Dolphins team with some reliable weapons (Devante Parker, Preston Williams, Mike Gesicki, Jordan Howard, and Matt Breida) with an upgraded line, Tua has a chance to make some noise. Still, it's unclear if he's able to stay healthy for long stretches.
It's apparent that he's talented, but unfortunately, he also seems to be injury-prone. Someone who has already had surgery on both ankles, hip, and suffered injuries to his finger, knee, and possibly wrist by the age of 22 is not exactly a picture of perfect health.
Sports Injury Predictor does not have any data on Tua's chance of injury in 2020 since he is a rookie. If they did calculate it, I suspect it would be quite high. Tua is one of the highest-risk players in the NFL in 2020. His name is up there with Brandin Cooks and Derrius Guice.
He could be one hit away from a significant injury. I (Dr. Morse) am not overly concerned about his hip at least for the next couple of years, but given the severity of the injury, it's tough to tell. The best bet is to let someone else worry about his ability to stay healthy. For the cost, I will take someone with a similar upside but much less risk.
It is difficult to project Tagovailoa opening the gates as a Week 1 starter for the Dolphins. In fact, if Miami has a strong season, he may not see the field until they are out of the playoffs. Ryan Fitzpatrick can lead this team and he is a successful quarterback. Keep Tua off your roster unless you are drafting a dynasty league, in a 2 QB league, or he manages to start the season as the Dolphins’ QB.
Injury Risk: High. 7.5/10.
|Projected Missed||Probability of injury per game ?||Probablity of injury in the season ?|
|Nov 16, 2019||Inguinal Hip Strain||Tagovailoa suffered a dislocated right hip in the second quarter vs. Mississippi State and underwent successful surgery. He missed the rest of the season.|
|Oct 19, 2019||Pedal Ankle (high) Sprain Grade 3||Tagovailoa injured his right ankle during Alabama's win over Tennessee. He underwent a successful tight-rope procedure and missed one game|
|Dec 1, 2018||Pedal Ankle (high) Sprain Grade 3||Tagovailoa suffered a left ankle injury against Georgia in the SEC Championship Game vs. Georgia. He underwent surgery to repair his ankle.|
|Nov 10, 2018||Leg Quad Strain||Tagovailoa suffered a quad injury late in the third quarter during the game against Mississippi State. He was available for the next game vs. the Citadel|
|Oct 13, 2018||Knee Patella Sprain||Tagovailoa tweaked his knee after sliding on a play in the third quarter during the Missouri game on Oct. 13. He was available for the next game|
|Mar 20, 2018||Hand Finger Fracture||Tagovailoa suffered an injury to his left throwing hand when he hit his hand on a lineman’s helmet. He underwent surgery|