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

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

But Miami Dolphins tight end Tua Tagovailoa plunged headfirst into the tackle, and the impact against the defender’s chest sent his head flying sharply to the left, before collapsing to the ground with his right fist clenched and raised in the air, a telltale sign of a brain injury.

Later during the game on Thursday night, the Miami Dolphins made it official: Tagovailoa had suffered a concussion, the last for the 26-year-old, whose career had already been ruined by his disturbing history of brain injuries.

Now, Tagovailoa’s concussion has sparked dramatic reactions from both fans and former players, who have called for him to retire, reflecting a growing awareness among the American public of the risks of long-term brain damage that can occur after blows to the head.

“If I were him, I’d be seriously thinking about quitting football right now. If that were my son, I’d say, ‘Maybe it’s time.’ You don’t mess around with stuff like that,” Tony Gonzalez, a Hall of Fame tight end for the Kansas City Chiefs and Atlanta Falcons, said after the game as an analyst on the Amazon Prime broadcast.

On social media, former players and fans shared the same opinion. “He needs to retire because of his health concerns about longevity,” wrote Dez Bryantthe retired Dallas Cowboys wide receiver.

“I really hope Tua is OK, but he needs to seriously consider retiring,” said former Denver Broncos tight end Shannon Sharpe. “His concussions are getting worse and he’s a young man with his whole life ahead of him.”

Concussions and repeated blows to the head are important risk factors for long-term brain injuries, including chronic traumatic encephalopathy (CTE), a serious disease that can lead to early dementia and death.

“There is no magic number of concussions that requires retirement from the sport,” says Chris Nowinski, a former football player and professional wrestler who later turned to neuroscience and now heads the Concussion Legacy Foundation.

“It all depends on how he recovers, but too many concussions can lead to chronic symptoms and mental disorders,” Nowinski continuedhe wrote on the social media site X. “He is in a very difficult situation.”

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

“With Tua, there’s the added pressure of being the star of the franchise, the player they build their team around,” Borland told NPR in 2022. “It’s critical that players are better protected because if you left them to their own devices, we’d do anything for a hundred different incentives to get back on the field.”

Tagovailoa left the field under his own power after suffering a concussion during Thursday night’s game against the Buffalo Bills.

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In 2022, the NFL revised its concussion evaluation protocol after Tagovailoa was allowed to play in a game after suffering a head injury that was deemed non-harmful after medical evaluation. In another game just four days later, he hit his head again, this time with an official diagnosis of a concussion. Weeks later, he suffered another concussion and missed the rest of the season.

Before the 2023 season, Tagovailoa had spent his offseason working on becoming less susceptible to concussions, taking jiu-jitsu classes and practicing how to roll his body when falling instead of hitting his head on the turf.

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

Should he decide to end his career, the amount of compensation will depend on whether he is cleared to return to football for medical reasons.

If he is allowed to play again but still retires, Tagovailoa will give up $124 million. If he has to retire for medical reasons, he will receive that money. according to Spotraca service that tracks contracts in professional sports.

After the hit during Thursday’s game, Tagovailoa left the field unassisted and the Dolphins reported that he was able to speak with medical staff in the locker room.

On Friday, head coach Mike McDaniel would not speculate on a timetable for Tagovailoa’s return. “The best thing I can do is not even try to judge what that even means from a football perspective,” McDaniel said. “Trying to meet (timelines), trying to estimate what that means for playing — that’s tough stuff.”

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