Tagovailoa suffered another undetected head impact during the Dolphins' Christmas Day game against the Green Bay Packers in December 2022. He remained on the field, but his play deteriorated sharply and he threw three second-half interceptions before the concussion was diagnosed days later. The cumulative damage forced him to miss the Dolphins' playoff game against Buffalo, and he later acknowledged that he had seriously considered retirement after discussions with his family, particularly his mother. He instead trained in jiu-jitsu during the offseason to learn safer falling techniques and returned to lead the NFL in passing yards in 2023. The controversy resurfaced with greater force in September 2024, when he suffered his third diagnosed NFL concussion after lowering his head into the forearm of Bills safety Damar Hamlin; once again, his arms displayed a fencing response. A previously undisclosed 2019 concussion at Alabama, suffered alongside a season-ending hip injury, brought his documented total to four over five years. Figures including Raiders coach Antonio Pierce, Hall of Fame tight end Tony Gonzalez, and concussion researcher Christopher Nowinski urged him to consider his long-term health, while others emphasized his autonomy and medical clearance. The debate became inseparable from the NFL's broader CTE crisis: postmortem research had found CTE in a large proportion of examined former players, yet the condition remains difficult to diagnose in living athletes. Tagovailoa ultimately returned six weeks after the 2024 injury, even as critics argued that his lucrative four-year, $212.4 million extension created enormous financial pressure around the decision; voluntary retirement was reported to threaten roughly $124 million in future earnings, whereas a qualifying medical retirement could preserve the contract's value.
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