Professional Athletes and Personal Responsibility for Health

[Disclaimer: I am not involved in this, and the views expressed here are entirely my own.]

Concussions and Performance Enhancing Drugs (PEDs) have been the dominant subject of concern in the sports world recently, and for good reason, but I would like to highlight an often overlooked and more general problem.  Our athletes are rewarded for pushing their bodies to the brink to accomplish majestic feats, requiring physical perfection.  We laud playing through injuries to succeed at the pinnacle of sport, or recovering from injuries at super human speeds, only to return those bodies to the brutal punishment of competition.[1]  With these pressures, Concussions and PEDs can be viewed as mere symptoms of a culture that runs from the fans to the teams to the players themselves, asking them to sacrifice their bodies, sometimes, to the detriment of their long-term health.  In this new age of awareness about player health, we should be asking: Are athletes making properly informed rational choices about their health?  Or are there situations where neither the players nor their teams are properly incentivized to protect long-term player health due to the culture described above?

Some recent stories have exemplified the culture:

Kobe Bryant recently called for his teammate, Dwight Howard, to play through a painful torn labrum to help the struggling Los Angeles Lakers.   “We don’t have time for [Howard’s shoulder] to heal,” Bryant said in a much publicized interview.  While much of this was likely overblown, media and fan sentiment largely sided with Bryant, and Howard was derided as selfish for acting in his best interests, even after responding that [Kobe] is “not a doctor.”

It was revealed in December that the NFL asks players to sign a waiver, before receiving Toradol shots to relieve pain, which lists the major risks of the drug, and refers the players to Toradol’s Wikipedia page.  The NFL Players’ Association said it will file a grievance against the use of this waiver to escape liability from the drug, for which potential side effects include long-term kidney, liver, or gastrointestinal problems.  Complicating the matter, though, is that the waiver was a response to the players balking at the NFL’s attempts to restrict the use of the drug.  It has been claimed that Toradol, which has already been at the center of a lawsuit filed against the NFL in 2011 by former players for allegedly worsening concussions, was being used “prophylactically” by football players, as well as by many baseball players.[2]

These types of stories abound, when athletes are forced to choose between their long-term health and the short-term competitive pressures placed upon them by themselves, their fellow players, teams, and fans.  Another example is the series of injuries to Washington Redskins rookie quarterback Robert Griffin III that culminated in a surgery to repair both the LCL and ACL in his right knee.[3]  The injury led to questions about his and his coach’s decision to let him play, [4] as well as, whether he was properly cleared by doctors when he first suffered a knee sprain and returned to play weeks earlier.  Additionally, there is the fascinating story of Royce White, the recently drafted basketball player who has refused to play citing differences with his team, the Houston Rockets, over how to manage a serious anxiety disorder.  While the dispute was recently resolved, it included White requesting that “his own personal psychiatrist decide when he’s mentally fit to play.”

While White most likely was not granted his request, although his fear of flying is being accommodated, his suggestion may not be as outlandish as it has been treated in the media.  We will never be able to stop athletes from pushing their bodies to the limits, and we do not want to, but if players, teams, and the leagues really wish to protect long-term player health and well-being, it is time to address scenarios fraught with short-term incentives and pressures.  For example, maybe each team should have an independent representative, akin to the independent neurological consultants recently announced by the NFL, to – at a minimum – ensure that players are adequately informed about risks of taking certain drugs and playing through injuries, and also review team health protocols.  Like with concussions, there may be situations which warrant giving these representatives the authority to remove the decision to play, practice, or be treated from the hands of the players and the team.  It is time to talk about alleviating the most perverse incentives, or removing those decisions altogether, for the sake of the long-term health of athletes.