For its part, the NFL has taken heat for its attitude, with accusations that it, like the tobacco industry denying a link between smoking and cancer, supported bogus science to hide the role of football in permanent brain damage. Recently, the NFL has been more forthcoming about brain injury inflicted on the field and has even agreed to support scientific studies, pledging $1 million to a research center in Boston.
Congress has also gotten into the act and attitudes are changing. The league is creating new rules concerning the time interval between a concussion and a return to play and an acceptable amount of cerebral bell ringing before an athlete has to retire. New helmet designs are on the drawing board. I am not sanguine that such maneuvers will really protect the head from the mayhem, but something is better than nothing.
Leading the charge in this reform movement has been a brave group of outspoken neurologists and neuropathologists for whom a connection between a career in football and dementia later in life is, to make a terrible pun, a no-brainer. These physicians saw unequivocal clinical and pathological evidence of brain damage and acted smartly and decisively.
What is the chance of developing arthritis that would make me have a heart-to-heart talk with the athlete and tell him it’s time to say no?
When it comes to musculoskeletal injury resulting from sports, however, the medical profession has at best an ambivalent attitude even if the connection with eventual arthritis is so abundantly clear. There is simply no question that playing football at any level virtually guarantees a serious injury to joint, muscle, or bone. Fractures, dislocations, and joint blowouts mark just about every career, and many of these injuries culminate in severe lifelong arthritis.
The most common form of injury-related arthritis is osteoarthritis (OA) or degenerative joint disease. While common in the older population, arthritis is not inevitable. Its frequency in the elderly should not minimize its significance when it strikes decades earlier than expected.
Watch any gathering of former athletes at a pregame or half-time celebration to honor old-timers. These former hulks limp, shuffle, or get pushed around in wheelchairs because of the sorry state of their joints. If there were X-rays of the limbs of these former players, the joints would look either crushed or shine brightly with titanium replacements. Indeed, degenerative arthritis is three to five times more common in pro football players than men of the same age, with the impact greatest on men younger than age 60.
