Just after Tua Tagovailoa’s head forcefully struck the field, his hands contorted in involuntary spasms. While he stayed down, the stark silence of the more than 60,000 fans inside Paycor Stadium in Cincinnati and the consternation on the faces of the players who formed a semicircle around him struck a grim reminder of the sport’s inherent risk.

Tagovailoa’s terrifying injury became the subject of wide scrutiny over the vulnerable position the 24-year-old Miami Dolphins quarterback was put in after an eerily similar scene in a game against the Buffalo Bills unfolded just four days earlier, when an on-site neurotrauma consultant and the team’s physician cleared the quarterback to finish the game.

There has been much fallout since. The independent neurosurgeon has been fired, and the NFL and NFLPA revamped concussion protocols. But the devastating incident once again thrust concerns about whether a team’s needs — like a quarterback finishing a game — are deemed more important than that player’s well-being.

It is a constant tension, unique to professional sports — whether it’s a terrifying collision that leaves a player in severe distress while millions watch at home, or a dispute over just how injured a player is and how the injury should be treated.

It’s an agreement that sits at the center of a fundamental conflict within the way athlete injuries are diagnosed and treated across professional sports — where, bound by contract and lucrative investments, an athlete is both an individual and a commodity.

The player sells their ability to play as well as possible, for as long as possible, to the team. The team sees its return through the player’s performance — with a genuine interest in keeping that asset healthy and in the game.

There is alignment in that mutual exchange. But in the end, which side’s interest carries the most weight? And what factors, really, play into the decisions made by team physicians who, by definition, grapple with divided loyalties?

Tagovailoa’s injury led to public outcry and almost instant internal reform of the NFL and NFLPA concussion protocol. But previous conflicts — less shocking in nature — show that the answer almost always leans toward the team and not the individual.

Disputes over how his injured quadriceps would be treated led to Kawhi Leonard’s frayed relationship with the San Antonio Spurs.

When NHL forward Jack Eichel returned to the KeyBank Center in Buffalo for the first time as a member of the Vegas Golden Knights last spring, he was met with a passionate chorus of boos every time he touched the puck.