Alabama quarterback Tua Tagovailoa is no stranger to the limelight. Since walking off the bench in 2018 and leading Alabama to a comeback victory for it’s 22nd National Championship, he has been in Top 10 NFL draft talks. Touted for his dual-threat capabilities, accuracy, and experience in high pressure games at an NFL level he rightly deserves such praise. However, with such high pressure comes an equal high risk for injury.

Since his 2018 National Championship game he has been plagued with injuries. In his career that spanned three years he had 5 notable reported injuries :

March 2018: Broken left index finger. (Surgery; No games missed)

October 2018: Sprained right knee (No games missed)

December 2018: Left high ankle sprain (Tightrope surgery; no games missed)

October 2019: Right high ankle sprain (Tightrope surgery; 1 game missed)

November 2019: Dislocated right hip with posterior acetabular wall fracture ( surgery; missed final 3.5 games)

Injury Analysis:

The left index finger fracture is of no great concern. Being that it is on his throwing hand it may pose greater impact initially, but it is a common injury in quarterbacks and has not shown any lingering problems.

His right knee sprain has little information on the extent of the injury. Reported as a sprain following the game against Arkansas it was significant enough that it required him to wear a hinged brace with medial and lateral support. He re-injured the knee the following game against Missouri and continued to wear the brace from then on.

In the timeline of Tua’s injuries his overall decline began with his right knee injury. If you think of the lower extremities like a chain, when one link is weakened it puts greater stress on the adjacent links. Being the mobile QB that Tua is, the risk of injury can be higher and although initially it was his left ankle that was injured, a change in a players gait and throwing stance has a bilateral impact.

The most concerning of his notable injuries are the bilateral ankle and right hip injuries. All of which required surgery. His most recent hip injury was the hardest to watch. Immediate flashbacks of Bo Jackson’s career ending run came to mind. Based on reports then and now Tua escaped the feared avascular necrosis that can result from such an injury, although it does not lessen the severity of it. This type of injury is rare, the mechanism requires a great force and is seen usually in motor vehicle accidents.

What is most concerning to me is his return to play following both high ankle injuries. The surgery performed on Tua’s high ankles is known as the Sydesmosis Tightrope Implantation. Arthrex is the developer of this surgery. On their website orthopedic surgeon Steve Martin, MD who works with elite athletes discusses his rehab protocol with patients returning to “full agility and sports specific activities at 12 – 14 weeks.” Tua returned to play in 28 days following his left ankle surgery and 21 days following his right…

Let’s break it down. Tua’s ankle and hip injuries were caused by contact. Tua returned to play quickly following both ankle surgeries and most likely should have been taken out of the Mississippi State game prior to his hip injury.Following both ankle surgeries he was unable to endure more than 2 games at the end of the 2018 and 2019 seasons. His injuries played a major factor in his final two seasons and have raised questions on his durability, the impact on his throwing mechanics, and if he is mentally prepared

Mechanics:

High ankle sprains occur when the foot is forcibly rotated outward and upward causing a separation of the tibia and fibula. In Tua’s case his right ankle is placed most in this position as he takes his first step and drives back from the line. His left ankle is placed most in this position at the end of the drop back prior to shifting his weight forward from left to right as he releases. Here is an example of Tua’s throw mechanics in the 2017 season.

Now compare the above video to one of his recent pro-day leaks. Watch his right leg as he drops back, it seems to lag and something seems off. He does not transfer his weight as much from left to right and has less rotation through his right hip. He seems to be generating more power off his back leg. Given that he has an injury history of his right hip, knee, and ankle I would continue to pay more attention to his ability to place his right foot, stabilize, and transfer weight forward and how it impacts his power and accuracy.

Draft Outlook:

The Miami Herald independently confirmed one wrist fracture, but it is still unclear which wrist, what bone, and during which physical… Without this context it is probably safe to say this is a smokescreen. Mike Lombardi has a history of this when he reported injury concerns about Sony Michel. Describing someone as “brittle” is foolish and is a poor description for weak bones. As discussed above we should be weary of lax ligaments, but also of how much mental toll recovering from 5 notable injuries in less than 2 years has placed on Tua. Only a season removed from Andrew Luck’s retirement it is most likely still fresh in many NFL teams minds. Combine this with pre-draft physicals being discontinued this year he will be considered more of a risk and could fall out of top ten.

However, due to the volatility of the QB position many NFL teams are willing to take the risk. Injuries aside, Tua has shown great confidence, and has the release and accuracy to make most throws. Worst case scenario is he continues to return to play quickly and he starts year 1. Best case scenario he goes to a team that can protect him and he is allowed to further heal, strengthen, and improve his poise in the pocket.

Dynasty Outlook:

Tua’s injuries worry me a lot. My background in athletic training and physical therapy inherently give me an injury bias, but I’m not going to take the risk. In my professional opinion Tua is not 100%. If you have the depth to wait and see then by all means go for it, but to me there are better options with less injury history and risk.