Whenever I see a 30- or 40-year-old person with serious OA, one of the first questions I ask is “Did you play sports?” Almost always, the answer is yes.
In my practice, I see countless patients who attribute their pain directly and unequivocally to their participation in sports. Nevertheless, they keep at it, repetitively hurting themselves despite the prophylactic dose of ibuprofen, an arm brace, or running shoes with rubbers of four colors or densities to dissipate shock or prevent too much pronation.
“What can I do?” these patients asked plaintively about relieving their pain. “Stop. Take a rest,” I say, and they look at me in disbelief or pique, wondering how someone supposed to be an expert is just so plain dumb. They act as if my request for respite is tantamount to genetic rewiring or a sex-change operation.
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A Path to Victory?
As in the case of reducing neurological damage from football, I can see many ways to lessen the impact of football on bones and joints. To be fair, these strategies would need support from solid research, and I would encourage a major initiative to study the frequency of football-related arthritis and its long-term course, including the effects of surgery, either positive or negative. Research takes time but, to get started now, I would suggest some modest steps that seem eminently reasonable: independent assessment of player injury by impartial evaluators, not team physicians; limitations on the number of joint injections or surgical procedures in a player’s career; restriction on the use of pain killers, whether given systemically or injected in the joint, before the game; and increase in the time interval after surgery before a return to practice or playing.
At the high school level, I would add an education program on the dangers of sports just as I would educate young people about the hazards of smoking, unprotected sex, or driving under the influence of alcohol or drugs. Programs of education are enormously difficult to implement but, with the unquestioned dangers or participation in collision sports, young people and their families should be told honestly about the risks to make a more informed decision.
