April 06, 2015 - Dr. David Chao
Monday Morning MD: Why Athletes Struggle in Retirement
This is not another alarmist concussion piece. It is my attempt to humanize professional athletes and explain what they may be going through from my medical and insider’s perspective. The end of any career is always hard. A professional musician who can no longer play music will struggle. A sportswriter who can’t write anymore will have to adjust. A lifelong police officer entering retirement will have transition issues. A career military officer entering civilian life will have to adapt. NFL players are no different; they are human too. I am not discounting any role chronic traumatic encephalopathy may play. I am simply pointing out the humanistic and well-being factors that I have observed as a physician. The retirement adjustment issue really hit home for me last week as I read Nick Hardwick’s Finding Myself piece penned for The Player’s Tribune. I know the longtime Chargers center and his family well and he always struck me as someone who was well grounded and very intelligent. He was a team leader, players union representative, had his life planned and anticipated retirement. He is not in financial trouble of having any other personal issues. Maybe I am too close to the situation but I never thought he would have any transition issues. The good news is Nick is fine as he has a great wife and two awesome little boys. But reading the piece made me think. If this guy has to “find himself”, then the retirement issue is even larger than I had ever imagined. I have witnessed plenty of players struggle with their identity post football. The average fan might think: “get over it, you got paid well to play a game”. The reality is that in order to succeed, most of these athletes had to define themselves as a football players and dedicate fully to their craft. When that goes away, a void inevitably exists. My observation shows players that defined themselves as a father, husband or son first don’t seem to struggle as much with after-football life. A person who happens to play professional football seems to have a much easier transition than someone whose life was defined as a football player. Imagine doing something you are passionate about for over half your life and all of your adult life, then quitting and never being able to do it again. Add to that, you are in your 20s or 30s and have your whole life ahead of you. Everyone needs a purpose in life. When your focus is on one thing for so long and that one purpose is gone, it is easy to feel rudderless. As Nick points out, retirement sets an easy trap to fall into. The adrenaline rush of the game, the strict regime of football and the irreplaceable camaraderie of teammates make football unique. In a much smaller way, I experienced post-football transition after 17 years as a NFL team physician. However, my adjustment was much easier as I always had my private practice during and after my NFL career. Being newly married for the first time and having twins also gave me tremendous focus and purpose. Finally, my media exploits allowed me an easy continued connection to football and in many ways excite me more as I had become accustomed to the NFL medical routine but I am still learning everyday on the media side. My situation is not nearly the same circumstance but being a NFL team doc was my job, not who I was. Team physician wasn’t even my full time job as I always had my private practice too. The better comparison would be if I lost my ability to be a doctor. My advice to NFL players is to be dedicated to your career but to always define yourself as someone who plays football and not only as a football player. Don’t limit yourself to being just a football player and the inevitable end of your career will be an easier transition. As much as we idolize and glorify NFL players, lets remember they are human. MMMD 1: Tom Brady violates contract? The Super Bowl winning quarterback was on vacation with his supermodel wife when he posted a Facebook video of himself jumping off a Costa Rican cliff. The question was asked if this violated his contract. The standard contract does have language that prevents engaging in dangerous activity. In my experience, this is very loosely enforced. Teams rarely investigate off-season injuries or enforce the restrictions. If a team did, it really signals the end of the player/team relationship. Since clubs rarely enforce the clause on players who aren’t the Super Bowl MVP, there is little chance the Patriots even entertained invoking the contract. MMMD 2: How did Aaron Hernandez avoid testing positive for marijuana? Testimony during the murder trial made it clear that the former Patriots tight end smoked pot regularly. How did Hernandez never test positive or be suspended if the NFL drug program has random testing? Performance enhancing drugs are tested randomly throughout the season. The separate substances of abuse test is conducted once a year prior to the start of the season in a defined time period and thus could be avoided. The NFLPA even issues a warning to players a month before the testing window as cannabis can remain in the body for up to 30 days. Outside of a few well-publicized cases including Josh Gordon and previously Ricky Williams, this is how almost 1700 men with an average age of 26 rarely test positive for recreational drug use. MMMD 3: Combines do test for substances of abuse Randy Gregory, a projected first-round draft pick, tested positive for marijuana in Indianapolis. It was already known that he tested positive for pot twice while at Nebraska so his cannabis use is not new information. Why it is news is that he now enters the NFL in Stage 1 of the program. This means his free strike is gone and will be subjected to year round testing. Since pot can be detected for up to 30 days after use, if he continues to smoke, he will inevitably be caught. The next positive test results in suspension. It will be interesting to see how teams factor that into their draft selection process as he likely will drop out of his projected spot in the top 10. MMMD 4: Current helmet sensors not reliable to detect concussions The NFL had placed accelerometers in some helmets during the last two seasons. The data was found to be unreliable and the program was cancelled. Please don’t scream NFL conspiracy here. The Head, Neck & Spine Committee member speaking out in favor of stopping the sensor study is also an outspoken concussion critic that co-founded the Boston University CTE center. Right now, the technology is not accurate in measuring the forces unless it is a direct hit. Tangential, rotational and off-center hits do no register well. Hopefully, a more reliable sensor system will be developed soon. MMMD 5: Sammy Watkins hip surgery The Buffalo star rookie receiver injured his hip in Week 13 and finished the season. Off-season hip scope was announced last week. The good news is this surgery could make Watkins even better as hip flexibility is vital to a receiver’s fluidity. The bad news, if he had a labral repair as suspected, he is likely to miss much of OTAs and mini-camp as a new offense is installed. A labral trimming would allow him to return for the off-season workouts. MMMD 6: USC reaches settlement with former player over Toradol use Armond Armstead sued the school and doctors blaming Toradol for a 2011 heart attack. He missed his senior season, went undrafted, played one year in the CFL, was signed by the Patriots but has never played in a NFL game. A confidential settlement was reached to avoid pending trial. Whether one believes Toradol is dangerous or not, there is no theory that ketorolac (generic name) can cause continued “clotting issues”. If anything, Toradol is an anti-inflammatory that thins the blood. MMMD 7: Veteran Combine players signed To date, the first ever Veteran Combine resulted in nine player signings. That certainly is a positive given a rookie friendly CBA. The real question is whether any of these players will make the opening roster. Right now they are signed to the 90-man roster, That is a long way from making the final 53-man list. Good luck to the veterans. Follow David on Twitter: @profootballdoc Dr. David Chao is a former NFL head team physician with 17 years of sideline, locker and training room experience. He currently has a successful orthopedic/sports medicine practice in San Diego.