As an orthopedic surgeon specializing in sports medicine, how do you see football impacting athletes’ health?
As a Sports Medicine Orthopedic Surgeon, I work with NFL players, as well as college and high school football players. In my work with these players and in my research, we have discovered that football, at all levels, causes lasting damage to the athletes’ bodies, which may disable them for the rest of their lives. While concussions have become well known in football, the damage to the rest of the football player’s body has largely remained a secret.
In my recently published research in the American Journal of Sports Medicine, I analyzed the total injury impairment on 50 NFL players that I have treated. I found that on average, more than 1/3 of their body is permanently impaired by the end of their career. This means that for the rest of their lives, they will wake up every morning in pain, and in many cases they may have difficulty walking, or even holding a job. In almost all cases, the athletes will need multiple orthopedic surgeries in years to come to treat the damage they sustained during their playing years.
While this damage is dramatic in NFL players, it is just as significant for high school and college football players. The damage may be compounded by the old football adage, ’play through the pain’. Parents of children who play football can protect their children with injury prevention protocols, and with early diagnosis and treatment of orthopedic injuries. The football players themselves can reduce permanent impairment by resisting the advice to ‘play through the pain’, and rather take care of their bodies for the long-term.
What are the most common football injuries that you see? Are you seeing any trends?
While concussions have become well known in football, the damage to the rest of the football player’s body has largely remained a secret. In fact, the damage to the rest of the body is probably more significant, in more players, than concussions. Many players attempt to play through the pain, doing further damage to their bodies. In many cases, musculoskeletal injuries go undiagnosed, or misdiagnosed. When this occurs, minor injuries can become major injuries, with long-term consequences for the player.
Some of the most commonly misdiagnosed football injuries today are hip injuries, which have been a particular focus of my football research. Tears of the labrum, cartilage, or ligaments in the hip are extraordinarily common in a collision sport like football. In another research study which I recently published in the American Journal of Sports Medicine, I found that 89% of NFL players who had been sidelined by hip pain actually had an undiagnosed tear of the labrum. Unfortunately, many of these injuries are initially misdiagnosed as ‘hip flexor strains’ or ‘groin pulls’. We have discovered that early diagnosis of these injuries can allow for arthroscopic repair. With an outpatient surgery, done through tiny keyhole incisions, we can use a camera inside the joint to repair the damaged structure, and get the athlete back on the field.
What do you hear athletes or parents of young athletes say about football and players’ health/safety?
For nearly a century, football culture traditionally embraced advice such as ‘play through the pain’. Now that the long-term consequences of ignored injuries are being discovered, athletes and their parents are fighting back against that culture. They are realizing that if they ignore injuries, they may lead to permanent pain, disability, or arthritis. Boys who play sports may be more than 7x more likely to need a joint replacement than boys who do not participate in sports. These frightening statistics have led athletes, and their parents, to fight for early diagnosis and treatment.
One of the most important trends in football has been the discovery of labral tears in the hip, one of the most commonly undiagnosed football injuries. Like so many other injuries, these are best treated when recognized early. With immediate diagnosis, they can generally be fixed with an arthroscopic surgery.
As a father, would you let your son play football? Why or Why not?
I would think very carefully about it. I love the game of football, as well as all the life lessons that young boys can learn from team sports. However, I would be concerned about the long-term effects of football injuries on my son’s body and mind. If he did choose to play football, I would advise him that whenever he suffers an injury, he should see an orthopedic surgeon who specializes in football medicine and in the specific injury he has sustained. With early diagnosis and treatment, I would hope to avoid some of the long-term consequences of these injuries.
With regard to player safety, do you think attitudes are changing about football? How so?
For nearly a century, football culture traditionally embraced advice, such as ‘play through the pain’ or ‘suck it up’. Now that the long-term consequences of ignored injuries are being discovered, athletes and their parents are fighting back against that culture. They are realizing that if they ignore injuries, they may lead to permanent pain, disability, or arthritis. Boys who play sports may be more than 7x more likely to need a joint replacement than boys who do not participate in sports. These frightening statistics have led athletes, and their parents, to fight for early diagnosis and treatment.
In addition, attention is being shifted to the rules of the game. It is my hope that by the time my children are considering playing football, the rules will have been refined to better protect the athletes.
Dr. Domb is a nationally recognized orthopaedic surgeon specializing in sports medicine and arthroscopic surgery of the hip, shoulder and knee. A noted pioneer in advanced new techniques in hip arthroscopy, he delivers innovative treatments for patients with hip injuries such as impingement and labral tears. Dr. Domb is also an expert in arthroscopic surgery of the shoulder and knee, adept in specialized techniques including arthroscopic rotator cuff repair and all-inside ACL reconstruction.