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Jerome Bettis: Here's Why NFL Stars Are Quitting Young

Kavitha A. Davidson is a former Bloomberg View columnist.
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The recent trend of NFL players retiring early is an understandable result of increased awareness around the mental and physical toll football takes on players. In decades past, long-term injury was seen as a necessary price of admission for those few lucky enough to make it to the pros. Now, a Hall of Famer is working to teach players that they do have more control over the game's consequences to their bodies.

"I was at the end of my rope from a physical standpoint," former Steelers running back Jerome Bettis told me in an interview earlier this week. "I couldn't do the things I could do when I was younger. Football is ultimately a young man's sport." Bettis, who retired at the age of 33 in 2006 after winning a Super Bowl, is today raising awareness about ways to treat injuries, maintaining that it isn't necessarily a given that athletes must live their post-retirement life in chronic pain. 

As Bettis noted, after his 13 years in the NFL, "good health is relative." He's constantly dealing with residual pain from his injuries -- he had knee surgery in 2001 -- but he has come to realize that with the right knowledge and treatment, athletes can mitigate some of these side effects. It's a bit of a shift from the stance he took in his 2007 autobiography, where he described being treated by team doctors in 2000 for a number of injuries, including his knee, in the days leading up to a game:

Even with the limited practice schedule, my knee would swell. So every Saturday a team doctor would come in and drain the knee. The needle was as long and thick as a No. 2 pencil. Think about that for a minute. Then the doctor would extract all sorts of pus, blood, and little pieces of cartilage.

Yeah, it hurt. Damn right it did. But if I wanted to play, that's what I had to do. Pain is part of the game. It's as much a part of the game as the crowds or the Miller Lite commercials or the TV cameras. If you can't endure pain, you can't play in the NFL.

Today Bettis acknowledges that "there's a certain price that you pay for playing this game," and that it's on players to decide whether that price is worth it. But he also says that there's a considerable knowledge gap for players to make truly informed decisions about their health, and that things might have been different for him had he known what he knows now.

"We as players have to own some of the responsibility for not asking the question, 'Hey, what's the ramifications of this 10 years from now?' " he said, referring to short-term treatments and the various injections team doctors administer. "That's a question that I didn't ask, and something I tell young players today to ask."

I've been critical of team doctors in the past. Many players don't retain their own personal physicians, the assumption among athletes being "that the health-care provider has an obligation to you," Bettis said. While I maintain it's necessary for employees to remain skeptical of doctors who receive their paychecks from their employer, Bettis for the most part trusts these doctors and instead shifts the responsibility to the union to guide players on how to properly address their health. The NFL Players Association needs "to present questions that need to be asked, long-term issues that can come up and can be averted if the questions are asked," he said.

Bettis's interest here isn't just that of a former player: He has formed a partnership with Stryker Orthopaedics, a medical devices firm specializing in joint replacement, which approached Bettis to be a spokesperson and speak out about joint pain and mobility issues. An avid golfer, Bettis will be taking his message, and Stryker's, to PGA Tour events. He says too many others are unable to do "things we take for granted, like getting out of a golf cart, or kneeling down for a putt." 

In a 2013 Washington Post poll, 89 percent of former NFL players reported feeling aches and pains on a daily basis. More than half reported either never having a joint replacement or being advised by a doctor that they would need one. (A 2009 University of Michigan study found that more than 28 percent of former players underwent joint replacement.) Nearly a third said they were discouraged by their team from seeking second opinions from personal physicians, while 47 percent felt team doctors prioritized the interests of the team.

Most of the attention surrounding the NFL's health crisis surrounds long-term brain damage. Bettis isn't addressing that in this partnership, though he did tell SI Now that had he known the risks of concussions, he would have altered his running style. That said, joint and muscle pain are also a perennial concern, and fall in line with the league's inability to take care of players more than five years after retirement -- a failure that largely rests on the union's shoulders. While Bettis couldn't speak to the state of union affairs today, he said when he was in the league, "there was very little done in terms of education about pain and medicine by the NFLPA."

Bettis thinks the new exodus of players before they turn 30 -- Calvin Johnson, Marshawn Lynch, Jerod Mayo, Chris Borland -- should worry the NFL. "They have to figure out how they find a happy medium between health and a product that American people want to watch," he told the Huffington Post. And it doesn't just reflect injury and concussion fears; as former Packers tight end Jermichael Finley has noted, many lower-salaried players have simply decided that the risks aren't worth staying in a league that undervalues them.

On the other hand, Bettis told me that the increasing salaries on the higher end of the spectrum give players the freedom to decide to retire on their own terms. "These guys are making a lot more money than football players ever made, and it's providing some financial security, so players don't have to play," he said. "They can walk away from the game and be secure."

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

To contact the author of this story:
Kavitha A. Davidson at kdavidson19@bloomberg.net

To contact the editor responsible for this story:
Tobin Harshaw at tharshaw@bloomberg.net