Tua Tagovailoa, the early favorite to be the No. 1 pick in the 2020 NFL draft, has a decision to make. The Alabama junior quarterback is out for the season after he injured his hip in mid-November, and he might have played his final college game. He has been passed by LSU's Joe Burrow in the QB rankings of ESPN NFL draft experts Mel Kiper Jr. and Todd McShay. And he faces an uncertain rehab for a unique injury.
What exactly is this injury, and what is the timeline? When does he have to decide about entering the NFL draft? And how high could he go if he forgoes his final season of eligibility?
With help from ESPN injury analyst Stephania Bell, college football reporter Alex Scarborough and NFL reporter Kevin Seifert, plus insight from Kiper and McShay, we have answers about what's next for Tagovailoa:
OK, what happened to Tagovailoa?
Scarborough: Let's set the scene: It's Saturday, Nov. 16, and Alabama is winning big late in the first half on the road against Mississippi State. Coach Nick Saban is ready to pull Tagovailoa, but the quarterback says he wants in for one last drive, and Saban obliges.
Three plays later, Tagovailoa rolls to his left, extending the play, and just as he throws the ball away, two defenders land on him. He falls awkwardly, his knee driven into the ground, causing his hip to dislocate and fracture the posterior wall. He also breaks his nose and suffers a concussion. He gets carted off the field and flown to a Birmingham hospital, and he eventually has surgery with a specialist in Houston on Nov. 18.
And what have his doctors said about the prognosis?
Scarborough: From the moment the team's orthopedic surgeon, Dr. Lyle Cain, addressed the hip injury, he has insisted that Tagovailoa will make a "full recovery." In fact, that exact phrase has appeared in three separate statements released through the university.
What exactly is this injury?
Bell: It's a right hip dislocation and posterior wall fracture. The hip joint is composed of the "ball" portion (the round head of the femur, or thigh bone) and the "socket" portion (the deep, saucer-shaped acetabulum, which is part of the pelvis). The joint is inherently stable and requires a great deal of force to disrupt, but a high-energy impact in just the right direction can cause the ball to move out of position relative to the socket, resulting in a dislocation.
In Tagovailoa's case, falling hard on his knee (the far end of the femur) with his hip flexed, compounded by the weight of defenders falling on him, created a high-energy impact that forced the hip out of position. Unfortunately, on the way out, the ball of the femur struck the rim of the socket, causing a fracture of the back (posterior) wall.
Tua carted off field after taking big hit
Alabama QB Tua Tagovailoa is carted off the field in the second quarter after throwing downfield and taking a big hit.
It's also important to note the impact of Tagovailoa's severe nasal fracture. According to Jeff Allen, Alabama's associate athletic director for sports medicine, Tagovailoa complained only about his face when Allen arrived at the quarterback's side. Allen said the bleeding from Tagovailoa's nose was "as severe and profuse as I've seen." Allen was immediately concerned there might be additional facial fractures. Between the hip dislocation and the nasal bleeding and suspected fractures, the medical staff triaged Tagovailoa's acute injury management just as they might after a severe motor vehicle crash. Tagovailoa's hip was put back in place within minutes at the stadium and the facial bleeding was slowed. He was then transported to St. Vincent's Hospital in Birmingham for further evaluation and ultimately traveled to Houston for surgery.
Less than 48 hours after suffering the injury on the field, Tagovailoa underwent surgery with hip specialist Dr. Chip Routt at Hermann-Memorial Medical Center. As soon as Routt repaired the posterior wall fracture, Dr. Tang Ho arrived to the operating room and repaired Tagovailoa's nasal fracture. The entire process lasted approximately four and a half hours.
Have any other football players had the same injury?
Bell: It is hard to know for certain whether there have been any collegiate or professional football players who have suffered the exact same combination of injuries, as they are rare occurrences and not all injury details are public knowledge.
In December 2015, Patriots running back LeGarrette Blount reportedly chipped a bone in his hip. He returned the following season to play in all 16 games. Former Ravens tight end Dennis Pitta suffered a hip fracture/dislocation in July 2013, but returned later that season as a part of the team's Super Bowl run. He reinjured his hip in 2014, underwent another surgery and sat out 2015, but returned to lead all NFL tight ends in receptions in 2016. Pitta then injured his hip a third time in June 2017, forcing him to retire.
There are so many possible nuances to each specific injury configuration that it is fair to assume that Tagovailoa's injury is unique. And no, we can't compare this injury to Bo Jackson's.
That said, there is one recent case that is comparable, and it involved another Alabama player. It was in the BCS national title game after the 2011 season, when linebacker C.J. Mosley picked off a pass from LSU's Jordan Jefferson and was injured on the tackle.
Allen noted that Mosley's hip dislocation was obvious when the medical staff arrived on the field based on the awkward positioning of his leg. Mosley's dislocation was put back in place on the field by Dr. Cain. Unlike Tagovailoa, Mosley did not require surgery, but he did require months of careful rehabilitation. It's worth noting that Mosley's injury happened in January and he was back on the field in full capacity that summer for Alabama's workouts. He went on to be picked in the first round of the 2014 NFL draft.
Is there any worry that Tagovailoa might not be the same athletically?
Bell: Tagovailoa is expected to make a full recovery given the quick reduction of the hip dislocation and the subsequent timely surgical care, which means he should return to full strength. It is critical, however, that Tagovailoa follow the post-operative guidelines, including what could be most challenging: rest. As the fracture heals in the early phase, it is essential not to overload the hip, making the first six weeks of rehab particularly tough for an athlete who constantly wants to push himself.
"This isn't something that I can rush," Tagovailoa said last week. "If I want to play to my full potential, I know I can't just come back and play on it as if it were my ankle. I think a lot of that has to go into my decision-making, too, as to whether I stay or leave."
As he moves forward, there will be serial imaging studies to ensure that the healing progresses. Rehab will gradually involve progressive strengthening, range of motion and ultimately football activity. Allen, having worked with Mosley, knows what it takes for an athlete to return to a high level after this type of hip injury. Allen also has worked with Tagovailoa following two ankle surgeries and notes his work ethic and upbeat attitude as additional reasons to believe in his ability to return to pre-injury form.
What is Tagovailoa doing in the meantime?
Scarborough: Tagovailoa returned to Tuscaloosa five days after his surgery in Houston, even attending Alabama's final home game. He sat on a golf cart during that game and, a week later, traveled to Auburn for the final game of the regular season, this time forgoing the golf cart for crutches.
He has been rehabbing every day since the surgery but isn't expected to begin weight-bearing activities until the end of this month. In another month and a half, he should be able to begin athletic activity again. By the spring, he is expected to begin throwing.
Tua: Being here uplifts my spirits
Tua Tagovailoa thanks everyone from the Alabama fans to his parents as he recovers from hip surgery, and says supporting his team from the sidelines has been uplifting.
Let's switch gears here. Is there much history of QBs getting hurt but still being drafted in the first round?
Seifert: It has happened. Probably the most notable example was Oklahoma quarterback Sam Bradford, who twice injured his shoulder during his final college season in 2009. The second instance required season-ending surgery. Bradford was unable to throw at the 2010 NFL combine, but the St. Louis Rams still drafted him No. 1 overall.
He struggled through an injury-ravaged career that included two ACL tears, but played nine seasons for four different teams.
When does Tagovailoa have to decide whether he'll enter the draft?
Seifert: The deadline for underclassmen to declare for the NFL's April draft is Jan. 20. The league will send a full list of those players to teams by Jan. 24.
Is there any chance he might return for his senior season?
Scarborough: Absolutely. Tagovailoa told ESPN recently that he's going to weigh the decision carefully and could make up his mind anytime between now and the deadline to enter the draft.
"If I come back, the risk is, what if I get hurt again?" he said. "But the reward could be maybe I jump back to the top of the charts, the boards for all these teams."
Tagovailoa also said he'd be tempted to enter the draft if he were considered a top-10 or top-15 pick instead of returning to school for his senior season.
"I think that'd be tough to pass up," he said. "But there's a lot more to it than that in some aspects."
He could either return and play his senior season in 2020, proving he's healthy again, or he could make use of a redshirt year and not risk reinjury and instead sit out while continuing to use Alabama's facilities.
What's Bama's plan to replace him if he leaves?
Scarborough: It might have been a blessing in disguise that Mac Jones got some much-needed experience this season in relief of Tagovailoa. The redshirt sophomore started three games -- the only three starts of his career -- against Western Carolina, Arkansas and Auburn, throwing a combined 10 touchdowns and two interceptions. But he's no shoo-in for the starting job long-term.
Tagovailoa's younger brother, freshman Taulia, is a former four-star recruit who played some this past season. And Paul Tyson, the freshman and great-grandson of Paul "Bear" Bryant, will have a say as well. What's more, the No. 1-rated dual-threat quarterback in the 2020 class, Bryce Young, is expected on campus soon.
OK, so what other dates should we know for him?
Seifert: If Tagovailoa enters the draft, teams will get a chance to talk to him at the NFL combine, which starts Feb. 24 in Indianapolis. Not all top quarterbacks work out there -- Kyler Murray, the eventual No. 1 pick in 2019, skipped workouts -- but medical evaluations and interviews with team officials are always on the schedule.
Alabama will likely hold its annual pro day in mid-March. If Tagovailoa has started a throwing program by then, scouts could get a closer look at his progress. It will already be a well-attended event based on the Crimson Tide's other top prospects in the 2020 class.
The draft begins April 23 in Las Vegas.
Let's talk Tagovailoa as an NFL prospect: What makes him special?
McShay: Tagovailoa has elite accuracy at all three levels, but particularly when throwing downfield. He has a smooth delivery, fast eyes and good arm strength. And the 6-foot-1, 218-pound lefty also does a great job anticipating and leading his receivers into the ball with high-end touch.
But will he regain the twitchiness and suddenness that stood out before his injury? Tagovailoa keeps his feet aligned with his eyes as he moves quickly and smoothly through his progressions and then is sudden in his release. Whether he is still effective in that area will be really important.
His final 2019 numbers are impressive and back up what evaluators see in his game: 2,840 passing yards, 33 touchdown passes, three interceptions, 71.4% completion percentage, 11.3 yards per attempt and a 94.5 Total QBR.
How much will his injury history hurt his draft stock?
Kiper: This injury makes Tagovailoa the biggest wild card in the class -- if he enters the draft -- and he'll be the hot topic through April. He has also suffered left and right high-ankle sprains in the past year, plus a sprained knee he suffered last season. These are concerning injuries, and teams are going to do their homework over the next few months to see how he's progressing from his hip surgery.
That makes Tagovailoa's stock complicated, because teams will want their own doctors to evaluate Tagovailoa's medical reports, and they'll have to weigh whether they want to use a valuable pick on a quarterback who might not be able to work out for them. If you're a general manager, do you trust Tagovailoa's tape and trust that he'll recover to be your franchise quarterback? It's easier said than done, because your job is on the line if the pick doesn't pan out.
With all that being said, Tagovailoa is going to go earlier than people think right now, as long as he doesn't have any setbacks in his rehab.
And where do you have him ranked now?
Kiper: He's still No. 3 on my Big Board, the second-ranked quarterback behind LSU's Joe Burrow. Tagovailoa is the best pure passer in this class, and he has all of the physical and mental traits that teams look for as the face of their franchise. He'd be fighting neck-and-neck with Burrow if not for the injury, and even then, I'm not dropping him much.
Saban: We hate that Tua got injured
Nick Saban discusses his decision to play Tua Tagovailoa vs. Mississippi State after the QB exited the game with an injury.
McShay: I'm a little more cautious right now. I have him at No. 12 in my latest top 32 rankings, behind Burrow (No. 2) but ahead of Oregon's Justin Herbert among quarterbacks. If healthy, he's still my QB1, though, even over Burrow. Expect his ranking to fluctuate plenty over the coming months as we continue to learn more about his recovery.
Make your predictions: Will Tagovailoa be picked in Round 1?
McShay: Yes, I still have him as a first-rounder. Remember, NFL teams will want to capitalize on the fifth-year option that comes with a Day 1 selection. And there are plenty of teams, at both ends of the first round, that need a quarterback. But again, it's very early, and there is still a lot we don't know.
Kiper: Barring a setback, there's no question in my mind that he will be a first-round pick. He's too gifted. Now, could he drop to the middle of Round 1? Absolutely. And some lucky team -- how about Miami, which has two extra picks? -- is going to get its guy.