Is There Life After Football? (20 page)

Right now, I wouldn't be able to have a job where I had to lift a lot. I even have a problem with the job that I'm in now [enrollment advisor for an online university]. It requires me to sit in front of the computer, calling students all day, leaning, switching between different program screens, typing, leaning forward a lot. . . . Now, after the surgery, the pain has intensified in a different area, and now I still can't sit down for more than like an hour at a time. I have to stand up and walk around. So, it is affecting me being able to sit down for periods of time without my shoulder and arm going numb and having sharp nerve pain in my back.
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There are hundreds of others in the same boat, relatively young men unable to sit or stand for more than an hour at a time, literally hobbled in their attempts to hold down routine jobs.

This spells financial disaster for some former players, but some may get relief from the NFL concussion settlement. Flying quietly under the radar, however, is another remedy thousands of former players are seeking through the State of California worker's compensation law. Under California statutes, players who played as few as one game in the state are allowed to pursue injury-related disability claims. Claimants are evaluated by doctors and, if they're judged to be disabled, they may receive financial compensation as well as medical-care benefits. Most players who stick around the league for several years eventually play a game in California, so the state has become the “disability venue of choice” for retired athletes in recent years, with thousands of former NFL players filing claims.

By some estimates, former NFL players could recoup as much as $1 billion by way of nearly 4,000 workers' compensation claims pending in California. Hundreds of players have been awarded disability benefits by going through the entire hearings process, but it's clear that players are taking a “fast track” similar to that pursued in the concussion settlement: take substantial, quick settlements while foregoing more lucrative payoffs that would involve extended time and possible litigation. If a player presents a legitimate case for football-related injury and subsequent disability, he's entitled to a cash disability award plus an award of lifetime medical care related to the injury. Cases are adjudicated by an administrative judge, not a jury. Winning cases have typically resulted in permanent disability awards ranging from $40,000 to $100,000, paid over six years, plus the lifetime medical-care award. The vast majority of former NFL claimants, however, opt for cash settlements between $150,000 and $250,000, but without the medical insurance. That means trading lifetime medical care for more money right now. While the settlements are substantial, realistically, the up-front money won't cover the expenses associated with the long-term medical and surgical needs of many former players.
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For some, it's a hard choice. It's not easy to forego a six-figure cash settlement when there are bills to pay, but a knee replacement in today's medical market can cost between $23,000 and $70,000. A hip can
run anywhere from $10,000 to $150,000, with most hospitals charging in the $50,000 to $100,000 range.
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As a result of his football injuries and 13 subsequent major surgeries, Dave Pear, for example, has run up medical bills in excess of $600,000.
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Like aches and pains, the financial consequences of NFL injuries may be slow to emerge, but they can be devastating. “Vested” players are currently covered by NFL insurance for five years after retirement (see
Appendix 2
for a summary of retirement benefits), but that short window doesn't accommodate the sorts of problems and expenses that emerge several years after retirement. Non-vested players get no NFL health care coverage (and there are probably more former players who were never vested than those who are currently covered).
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On top of that, many players can't purchase adequate insurance because of “preexisting conditions.” In general, vested former players are a bit better off than men in the general population. Ninety-two percent of vested ex-players aged 50 to 64 have health insurance, compared to 85 percent of all men in that age range. Ninety-one percent of younger ex-players (30–49) are insured, verses 78 percent of their age peers in the general population. The difference, according to the NFL Player Care study, is likely to be due to former players purchasing their own privately administered insurance.
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The long-term financial ramifications of football injuries aren't the only lifestyle changers. While a notable percentage of them end up at least partially disabled, for some players, the disability really is “total.” About four percent of ex-players report needing help from others to deal with personal care needs such as eating, bathing, or dressing themselves (about twice the rate of the comparable general population). Around seven percent need help with everyday household chores, conducting business, shopping, and getting around town (again about twice the rate of non-NFL peers). Perhaps most chillingly, former players are over five times more likely than other men their age to suffer from dementia.
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For some, encroaching dependency is mainly the result of more or less typical aging. But for others, deteriorating bodies and brains wreak havoc
on lives of much younger men, as well as the lives of their families and loved ones. Some of the stories are heartrending.

In 2012,
Sports Illustrated
published a cover story titled “The Other Half of the Story.”
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It presented a moving saga of wives and loved ones who endure the burden of caring for players who've suffered severe injuries—primarily head trauma—and the pain of watching the men they love slip away. It's a painful account of once fit, powerful, and mentally vibrant men in the ostensible primes of their lives losing control of their bodies, memories, and mental faculties. It's a chilling portrait of descent into dependency: grown men needing to be treated like children. But it's also the depressing story of what NFL
families
lose to the ravages of injury. Not only do they lose their men, but they give up their own lives and freedom. Wives and girlfriends must monitor their men at every turn; watch them so they don't wander off and get lost; call the police to search the neighborhoods when they do; keep their loved ones out of the bathroom where they might mistake a razor for a toothbrush; help them with the most basic of hygiene and toilet needs. As former players' conditions render them more and more childlike, wives become progressively like mothers of infants, setting aside their jobs, social circles, and personal time to tend to their men. The toll on
their
lives is almost as great as the price paid by their injured players.

Drug abuse is another collateral consequence of injury. Sometimes players turn to drugs for respite from the pain. Given their injuries, it's not surprising that former NFL players have long histories of heavy over-the-counter and prescription drug use. It's hard to find a player who hasn't relied on painkillers of one sort or another. Players pop over-the-counter analgesics such as acetaminophen and ibuprofen like candy. Under the supervision of medical personnel, they frequently use more potent painkillers—opioids which include morphine, codeine, hydro-codone (Vicodin), and oxycodone (Percocet). Some players and former players report excessively self-medicating, sometimes with legitimate prescriptions, sometimes without. Often such drug use begins as treatment for pain due to injury, but escalates into escapist, if not recreational,
drug use, and even addiction.
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It's almost inevitable, according to former linebacker Keith McCants: “They are going to shoot you up with morphine after the game, give you cortisone during the game, whatever it takes to get you back out there on the field. And that is with each and every NFL team. So when an athlete ends up on drugs, they don't ask him why or how did they do it. They know damn well how it happened.”
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Mark Schlereth, former offensive lineman and veteran of over two dozen major surgeries, is well known for his willingness to tolerate pain and persevere through injury. His approach to pain management was simple, yet comprehensive. “I've done it all,” he says. “I would strap a dog turd to it if I thought that would make me feel better. I'd do whatever I have to do. Have I had Toradol shots? Yes. Have I abused anti-inflammatories? Yes. Have I used painkillers? Yes. Have I got shot up with painkillers and Xylocaine and different things to numb areas so I can play? Yes.”
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Reliance upon—indeed, the abuse of—painkillers has at least two significant ramifications for life after football. First, it increases the likelihood of players damaging their already compromised bodies by masking signals that more harm is being done. Toradol is just the latest in a long line of painkillers used to “shoot them up and get them back on the field.” It is a non-steroidal, non-narcotic anti-inflammatory drug often used to manage postoperative pain. While it isn't addictive, the drug is considered dangerous enough that it's banned in some European countries. Kidney damage and gastrointestinal bleeding are possible side effects, while as an anticoagulant, it may also exacerbate the effects of concussions. But its primary danger for NFL players lies in its ability to deaden feeling, inhibiting a player's ability to sense pain and injury. A player can hurt himself and not even notice.

A recent
Washington Post
study found that 50 percent of players who retired in the 1990s or later reported using Toradol during their playing days. About 70 percent of players who got out of the game after 2000 said they used the drug. The
Post
reports that in 2000, 28 of 30 teams used Toradol injections on game days, averaging 15 pregame injections per team. The drug works fast; an intramuscular injection can quell pain
within ten minutes. And it lasts for a full game, with a half life of over six hours. As former defensive end Tyoka Jackson puts it, “Once you get your first one, you realize, wow, you can play pretty pain-free for the entire game. . . . Whatever's ailing you, you don't feel.”
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Nearly 80 percent of former players using Toradol said they took the drug as a masking agent, intended to dull the pain they
expected
to feel during games. They used the drug to manage
anticipated
pain, not necessarily to deal with something that already hurt.
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Either way, those using Toradol could injure, or reinjure, themselves and not realize it until well after the fact. Perhaps this is how so many players survived their 20,000-car-crash careers. But it may also be part of the reason they were in those crashes in the first place.

Whether or not drug abuse is inevitable, reliance upon pain medication can become habitual if not addictive. NFL players use painkillers at a much higher rate than the general population, according to research conducted at the Washington University School of Medicine in St. Louis. The study found that seven percent of the former players were currently using painkilling opioid drugs. That's more than four times the rate of opioid use in the general population. More than half of players used opioids during their NFL careers, and 71 percent reported “misusing” the drugs. That is, they used the medication for a different reason or in a different way than it was prescribed, or they may have painkillers that were prescribed for someone else. Fifteen percent of those who misused opioids during their careers continued to misuse after they retired, according to the study. One retired player reported taking up to 1,000 Vicodin tablets per month. Another said he might take 100 pills per day and spend more than $1,000 per week on painkillers.
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While there is no systematic evidence that former NFL players are more frequently involved in illicit drug use than members of the general population, strong medication—often with perception altering properties—is a way of life of many players long after their playing days are done.

Players may also try to mask pain through alcohol use. While there's no certain causal linkage, former players are 10–15 percentage points
more likely to have ever been drinkers or to currently drink than are their non-playing counterparts. Rates of heavy and binge drinking, however, are only slightly higher among former players than among the general population. Only about ten percent of former players include themselves in these categories, although self-reports of heavy drinking show rates among former players to be twice those of non-players.
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Taken together, the collateral consequences of injury add up to a depressing picture—literally. About one in four former players has either been diagnosed with depression or experienced major depressive symptoms. On a battery of lifetime depression screening measures, former players consistently report symptoms at higher levels than their age peers in the general population. While they are no more likely to report symptoms “at the current time,” former players are more likely than age peers to have experienced a wide variety of problems, across the board, with the greatest discrepancies coming among men aged 30–49.
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Players who have at least three concussions are three times more likely to become clinically depressed later in life than are players without concussions. And players with at least three concussions are five times more likely to be diagnosed with early signs of dementia.
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Given the prevalence of head injuries, that adds up to a lot of depressed ex-players.
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Most former players live with chronic pain, yet they stoically embrace their fate. They feel it, acknowledge it, accept it. They wear their surgical scars as badges of honor, seldom regretting the sacrifices they've made and the pain they bear. A mere glimpse into a recent Green Bay Packers Alumni Weekend is telling. Health concerns dominate nearly every conversation among veterans from as far back as the 1950s to those who recently retired.
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We heard numerous variations on the following exchange: