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NFL players struggle with a lifetime of disability and pain

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    NFL players struggle with a lifetime of disability and pain

    The Wrecking Yard

    As they limp into the sunset, retired NFL players struggle with the game's grim legacy: a lifetime of disability and pain

    By William Nack, Special Reporting by Lester Munson
    Issue date: May 7, 2001

    When I came to my first NFL camp, it was like I was a tall, cold can of beer. They popped the top, and all that energy and desire and ability poured out. I gave of myself with the same passion that I had in high school and college. When I was empty, when I had no more to give, they just crumpled me up and threw me on the garbage heap. Then they grabbed another new can and popped him open, and he flowed out until he was empty.

    --CURT MARSH, NFL lineman 1981-86

    They are the wincing, hobbling wounded: the men who played professional football, a notoriously joint-shearing, disk-popping, nerve-numbing exercise that has grown only more dangerous since Curt Marsh last crashed into a defensive lineman as a Los Angeles Raider.

    "If you go to a retired players' convention, there are older retirees who walk around like Maryland crabs," says Miki Yaras-Davis, director of benefits for the NFL Players Association. "It's an orthopedic surgeon's dream. I'm surprised the doctors aren't standing outside the door handing out their cards. Hardly one [former player] you see doesn't need a hip replacement. Everybody comes out of pro football with some injury. It's only the degree that separates them." A 1990 Ball State study, commissioned by the NFLPA and covering the previous 50 years of league history, revealed that among 870 former players responding to a survey, 65% had suffered a "major injury" while playing--that is, an injury that either required surgery or forced them to miss at least eight games. The study also reported that the percentage of players incurring such injuries had increased alarmingly: from 42% before 1959 to 72% in the 1980s, after many stadiums had switched from grass to artificial turf. Two of every three former players disclosed that their football injuries had limited their ability to participate in sports and other recreation in retirement, and more than half of them also had a curtailed ability to do physical labor. Of those who played during the '70s and '80s, nearly half (50% and 48%, respectively) reported that they had retired because of injury -- up from 30% in the years before 1959.

    There's little doubt, based on a follow-up survey in 1994 and on considerable anecdotal evidence, that injuries in the NFL are becoming more serious and frequent as the colliding bodies grow bigger and stronger. The 300-pound-plus Sira-goosed lineman, a rarity 40 years ago, is today as common as the soccer-style kicker. James Andrews, a leading orthopedic surgeon who has been operating on pro football players for almost 30 years, sees a correlation between the worsening of injuries and the size and power of the modern player.

    In fact, Andrews, who works out of the HealthSouth Medical Center in Birmingham, is witnessing the rise of a phenomenon that was almost unheard of only 15 years ago.

    "The incidence of serious, noncontact knee injuries is much higher than it used to be," he says. Artificial turf is only part of the problem. "These athletes are bigger, stronger and running faster, and they're tearing up knees from cutting, changing direction on a dime," Andrews says. "In fact, the incidence of anterior cruciate ligament injuries is higher from noncontact than contact. I've seen guys get significant injuries just falling on the football. It's like a big tree falling."

    Indeed, among the most notable casualties of noncontact incidents are two gifted running backs: Jamal Anderson and Ki-Jana Carter. Anderson, of the Atlanta Falcons, missed all but two games in 1999 after tearing the ACL in his right knee during a Monday Night Football game on artificial turf; his foot got snagged in the rug, and Anderson went one way as his popping knee went another.

    Carter, the top pick in the 1995 draft, tore his left ACL in his rookie year by simply "twisting" the knee, says Andrews. The former Penn State star was cut by the Cincinnati Bengals last June and hasn't been picked up by another team.

    As for the New Age tyrannosaurs battling in the trenches, they have become so large and powerful that injuries have risen alarmingly in their hand-to-hand combat. "They are exerting forces strong enough to dislocate their elbows and shoulders forward and backward," Andrews says. "With the blocking techniques we're seeing, there's an increased incidence of offensive linemen's shoulders being dislocated."

    Some players have quit rather than court more pain. A teary-eyed John Elway, claiming he still had a passion for the game at age 38, retired two years ago because his body could no longer take the punishment. Minnesota Vikings running back Robert Smith, 28, an unrestricted free agent at the height of his game, astounded the NFL in February by retiring without explanation, turning his back on what was expected to be a lively bidding war, with offers likely to exceed $ 30 million for five years. Smith had already had three knee surgeries, and while his agent, Neil Cornrich, denied that the on-the-job pounding played any part in the running back's decision to leave the game, Smith had implied as much to reporters. (Another running back, Curtis Enis, retired last week at 24 because of a degenerative condition in his left knee. Enis, the No. 5 pick in the 1998 draft, tore a ligament in that knee during his rookie season, with the Chicago Bears.)

    No matter how young they are when they retire, a great many NFL players face a visit in middle age from that most pernicious of postfootball afflictions, degenerative arthritis. An athlete who suffers an injury to a major weight-bearing joint, such as the hip or knee, is five to seven times more likely to develop degenerative arthritis than an average member of the population. Repeated pounding and jarring of the joints -- even in the absence of injury -- all but guarantee that former players will be caught in the ganglia of serious and chronic pain. The 1994 NFLPA-Ball State survey said that arthritis is the most commonly reported health problem among retired players, affecting 47% of respondents.

    "A lot of ex-players with terribly arthritic spines say, 'But I never had a back injury!'" Andrews says. "That doesn't matter. There's no way to heal those cartilage lesions. They heal with scar tissue and are never as good again. What you end up with is a bunch of ex-NFL players, in their 40s and 50s, who shouldn't have arthritis but have degenerated knees and need total replacement done at an early age."

    This, then, is not about a few casualties wandering off the playing field into retirement, their bells rung and still chiming in their heads, but rather about a whole society of broken men hounded through their lives by pain and injury, and all the psychological problems that often attend them.

    Johnny Unitas once owned the most dangerous right arm in the NFL. Today he barely has use of the hand attached to it. Unitas, who is considered by many to be the greatest field general to play the game, is still paying for a hit he took more than three decades ago as a Baltimore Colt. That day in 1968, Unitas was drawing back his arm to throw a pass when a Dallas Cowboy mashed the inside of his elbow. Unitas came back to play again--the arm seemed fine up through his retirement in 1974 -- but by the mid-1990s he was having problems with the nerves that controlled his hand and fingers. He lost strength and feeling in the hand and became unable to rotate the thumb back and grasp objects. The symptoms only got worse. Now Unitas cannot close the hand that made Raymond Berry famous.

    Unitas's two knee replacements work perfectly well -- cartilage and ligaments in the right knee were torn in a collision with two Bears in 1963, while the left wore out from years of favoring the right -- but when he plays golf, which is about all the exercise he can get with those knees, he has to use his left hand to close the fingers of his gloved right hand around the grip, then strap the hand to the shaft with a Velcro strip. He goes through this tedium on every shot. "I do it putting, too," says Johnny U, who's 68.

    Forty years ago Unitas was the toughest and smartest quarterback in the game, calling the plays and running the show in a way that inspired both fear and awe among teammates and opponents alike. Mentally, he always seemed a step ahead of everyone else. If a situation looked ripe for a pass, Unitas would signal a run; if it called for a run, he'd throw a pass. If it called for a pass and his opponents, trying to outguess him, set up for a run, he'd throw. Unitas perfected the two-minute drill, and no one since -- not Montana, not Elway -- has run it better.

    Setting an NFL record that seems as unassailable as Joe DiMaggio's 56-game hitting streak, Unitas threw a touchdown pass in 47 consecutive games between 1956 and 1960. In the years since, only Dan Marino has come anywhere close to that mark, throwing scoring passes in 30 straight games from 1985 to '87.

    Unitas has demanded disability compensation from the league but says he has been turned down for various reasons, among them that he didn't apply by age 55 -- though his right hand didn't fail him until he was 60 -- and that the league pays him a pension of $ 4,000 a month. The NFL adds that, in its opinion, Unitas is not "totally and permanently disabled."

    Meanwhile, of that magical hand that spun footballs like strands of gold, Unitas says, "I have no strength in the fingers. I can't use a hammer or saw around the house. I can't button buttons. I can't use zippers. Very difficult to tie shoes.

    I can't brush my teeth with it, because I can't hold a brush. I can't hold a fork with the right hand. I can't pick this phone up. You give me a full cup of coffee, and I can't hold it. I can't comb my hair."

    Bill Stanfill never thought it would come to this. Never conceived, through all his years as a rampaging defensive end for the Miami Dolphins, that he would be reduced to what he is now. Never imagined that at 54, he would be navigating his house in Georgia with a metal walker--step-shuffle, step-shuffle -- as he recovered from hip-replacement surgery. Or still feeling the consequences of that near-fatal injury he suffered when, during a preseason game against the Bengals in 1975, he cracked heads with teammate Vern Den Herder and almost severed his spinal cord between vertebrae C-4 and C-3.

    It was like nothing he had ever felt. "I'd had stingers, but this was entirely different," Stanfill recalls. "I just numbed up. Could not move my arms or feel myself breathing." Stanfill had subluxed the joint in his cervical spine; that is, a disk and the surrounding bone had slipped nearly far enough to damage the cord. Stanfill would never be the same player again, and by the end of the next year he would be out of football. Two decades later, in the mid-'90s, the disks began herniating, and he has had four vertebrae fused in his cervical spine.

    "I can't tip my head back at all," says Stanfill, an avid bird hunter, "so I can't shoot dove anymore. I feel like I swallowed a Viagra pill and it got stuck in my throat. My neck is stiff as hell. The neurosurgeons have told me that if another disk goes [in my cervical spine], I will be totally disabled."

    Stanfill was an old-fashioned football gladiator, a 6'5 1/2", 255-pound country boy who won the Outland Trophy, as the college game's best interior lineman, in his senior year at Georgia; helped Miami win two Super Bowls, after the 1972 and '73 seasons; and was named to four Pro Bowls. He relished the battle in the trenches, mano a mano. "All I wanted to do was play," he says.

    All those wars left all those scars, however, and not only to his spine. In late January, while sitting next to the fireplace in his five-bedroom redbrick house outside Albany, Ga., Stanfill pointed out a glass jar sitting on the mantel. At the bottom of the jar, immersed in a clear solution, was a mysterious white ball. "I'm gonna see if I can donate it for auction," he said. "'Who wants a piece of Bill Stanfill?' That's part of me. The price I paid for playing pro football."

    It was the ball of his left hip, and it had been sawed off his skeleton three weeks earlier. Stanfill had been suffering from avascular necrosis (AVN) -- in which blood circulation is cut off to the hip bone, causing it to die -- because of repeated trauma and, possibly, repeated injection of the anti-inflammatory drug cortisone when he was in pro ball. ("I was like a pincushion," he says.) Stanfill sells agricultural real estate, but he has worked little since March 2000, when a disk in his lower back ruptured. Doctors have told him that his right hip also has AVN and will have to be replaced.

    Stanfill's football days have left him a physical wreck, making him wonder what his life will be like in five years. Still, he expresses neither rancor nor self-pity. "Just wish I'd made some of the money they're making today," he says wryly. "It would make this a lot easier to live with."

    Earl Campbell has a dazzling assortment of rings that were given to him in honor of his storied accomplishments as a college and pro running back: the Heisman Trophy ring, the NFL Rookie of the Year ring, one MVP ring (though he was MVP three times) and the NFL Hall of Fame ring, but he wears none of them because of arthritis in both his hands, the ones that he used to push away pursuing tacklers. "Jim Brown and I were the best at the stiff-arm," says Campbell. "Now I can barely close my left fist -- the arthritis and the soreness and the pain."

    Campbell was a complete force as a running back, fast enough to turn the corner and race upfield, strong enough to crash through the line. He always seemed to be running out of his clothes; it was as if he invented the tear-away jersey.

    The abiding memory of Campbell is that of a man charging down the field with three defenders clinging to his back. It was easy to imagine him in the end zone dressed in nothing more than his jockstrap and shoulder pads, standing there with a quizzical smile on his face and various large bodies scattered behind him, each clutching a remnant of his uniform. As his Houston Oilers coach, Bum Phillips, said, "Earl Campbell may not be in a class by himself, but whatever class he's in, it doesn't take long to call roll."

    Now 46 and the owner of a barbecue restaurant and a sausage-making business in Austin, Campbell winces at more than his swollen digits. His knees and back ache ceaselessly. He also has a condition called drop foot: As a result of nerve damage to his legs, he cannot raise the front of his feet when he lifts them off the ground to take a step. The feet flop along loosely when he walks. To use the bathroom upstairs from his home office, Campbell -- unable to grip with his hands or bend his knees--must lean his forearms on the railings and drag himself up the eight or 10 steps. The process is as painful to watch as it must be for Campbell to complete.

    "I realize that every time you get something in life, you've got to give up something," he says. He likes to hunt deer and wild boar in south Texas, and he is reminded of what he gave the game whenever he is home on the range.

    "Sometimes it gets to the point that I can't stand the pain, like when I've got to walk a lot," he says. "Thank God I'm with people who understand me: 'Take all the time you need.' It's embarrassing when I've got to hop onto the back of a pickup and I need help. Or I need help climbing into deer blinds.

    "Sometimes I tell my wife, 'Shoot, if I knew it was going to hurt like this, I don't know if I'd have [played football].' It's a hell of a price to pay."

    For most NFL players, especially linemen, weight training is as much a part of the daily regimen as stretching exercises--and the weight room works its own form of wickedness. Hoisting iron, players rupture the patella tendons in their knees, put enormous strain on their lower backs and cause ligament injuries to the lumbar spine. They even damage their shoulders by doing something the joint was not designed to do: bench-pressing huge weights.

    Joe Jacoby, a former Washington Redskins offensive lineman, was a habitue of the Skins' weight room, squat lifting his afternoons away. He dare not lift weights anymore, for fear it will accelerate the deterioration of his ankles, knees, wrists, elbows and back. Jacoby still feels the echoes of years spent snatching iron and leaning his sequoia body into snot-blowing defensive linemen who drove shuddering forces down his spine and onto his lower joints.

    At 6'7", 305 pounds, Jacoby was a giant among the Hogs, a 13-year veteran who retired in 1993, the year he collapsed in his bathroom at home and could not get up. "My lower back went out," he says. "I dropped to my knees on the floor. The pain was that sharp. I crawled out of the bathroom to the bed." Like Stanfill, imbued with the ethic to play in pain, Jacoby played again later that year.

    Then, against the Kansas City Chiefs, his back went out again. He ended up spending three days in a hospital.

    "I never wanted to go out that way," says Jacoby, 41. "I wanted to keep playing, even though I was hurting. I felt like I was letting down the team. You've been brought up that way since high school. It's ingrained in you. I had a wife. I had a family. A business I was starting. But I kept hearing those little things in the back of my mind: You're letting your team down." He was in traction, shot up with cortisone, when the thought finally struck him: I can't keep doing this. I have a life to live after this.

    Jacoby had blown out his left knee earlier in his career, when his leg got wrenched in a pileup during a field goal attempt. "The kneecap was way over on the side of the knee," he recalls. "I still hear the crunching and popping."

    Another old wound--vintage for linemen, who are forever getting their fingers caught and dislocated in face masks and shoulder pads--is the busted knuckle on Jacoby's wedding-band finger, as gnarled as a tree root. He has won many wagers in bars, claiming he can get the ring over that knuckle. His wife, Irene, had the band made with a clasp, so he can take it off like a bracelet.

    Jacoby owns an auto dealership in Warrenton, Va. He and Irene had the sinks in the kitchen and master bathroom of their house installed higher than normal, "so he doesn't have to bend down," she says. He often walks about sockless in loafers. "It's too painful for him to bend over and put on socks or lace up shoes," Irene says.

    Jacoby walks stiffly on his damaged ankles, but he endures the discomforts with stoic grace. He still remembers vividly the pounding he took year after year, through 170 games, including four Super Bowls--a career that left him unable to do any exercise other than walking. "Some days the back gets unbearable," he says. "It's really deep in the lower back and goes down to my left buttock and hamstring. Sometimes it gets so bad it hurts my nuts. There's pain down my left leg now. My left foot has been numb for two months. The bone's pressing on the nerve. Too many years of abuse, using the back to block."

    Like so many other hobbled former players, Jacoby says he would do it all again if he had the chance. He knew what he was getting into. "Football players know the risk and the consequences," he says. "They know they will pay for it later in life. If they don't, they are misleading themselves."

    As much as Jacoby has gone through, he looks fortunate when compared with Chris Washington. Only 39, Washington seems old beyond his years. He was an NFL linebacker for seven seasons, most of them with the Tampa Bay Buccaneers, and he has had 21 operations. He suffers from severe arthritis in both knees--he has had six surgeries on the right, five on the left--and his right thigh and calf are atrophying. He endures his days with help from a pharmacopia in a kitchen cabinet: one pill for sleep, two for pain (including double-strength codeine) and two to reduce inflammation.

    Washington was a zealous weightlifter, but now his home looks like a Gold's Gym after closing, with everything racked and idle: the stationary bike, the treadmill, the stair-climber and tons of barbells. He won't use any of them for fear of inflaming his diseased joints. Not only is he virtually crippled by ailing knees, but he also suffers hand tremors from pinched nerves; he shakes too much to fasten a necklace around his wife's neck. Although he has upper arms like ham shanks, he experiences periodic loss of strength in the right one and has back spasms as well. Washington carries his 10-month-old daughter, Taylor, in a Snugli, but not simply for convenience. He fears he will be seized by a shooting pain in his back or arm or suffer the sudden collapse of a knee and drop her -- or, worse, fall on her.

    Washington, who has worked as an insurance salesman and a data-entry clerk after retiring from the NFL in 1992, has been unable to hold a job since 1996. He draws disability payments to help support his family and is seeing his worst fears slide before his eyes. "Not being able to run around and play with my daughter," he says, giving one example. "I tried coaching [as a volunteer at the high school level], but my body couldn't take it; I can't stay on my feet that long. What kind of an example am I setting for kids if I'm walking around with a cane? I don't go to a lot of NFL functions. I would like to hang out with those guys, but I don't want them to see me like this."

    None of this comes in the tone of a complaint. Washington wishes only that when he played he had known more about what he was doing to his body and had taken better care of it. He wishes that he had not allowed himself to be shot up with painkillers and cortisone so he could play hurt. Like the other former players who have been down that tortuous road, he assumes his share of the blame. "It was my choice to do what I did," he says. "I guess I didn't expect to be in this kind of shape."

    Nor did Harry Carson, for 13 years a crushing, headfirst inside linebacker of the New York Giants. Carson's injury is to a human organ that is still little understood. By his own count he suffered at least 15 concussions while playing pro football, from 1976 to '88, and he is afflicted by what Yaras-Davis, of the NFLPA, believes is one of the most common and troublesome maladies among former players: postconcussion syndrome, which is marked by headaches, forgetfulness, blurred vision and difficulty tracking mentally.

    Former Cowboys quarterback Troy Aikman and former San Francisco 49ers quarterback Steve Young, each of whom has suffered repeated bell-ringers on the field, are the players most closely associated with concussions. Carson, however, was one of the first former players to go public with the debilitating aftershocks of concussions, in an attempt to broaden understanding of the problem. Carson had his share of other injuries, but none quite as stunning as the concussion he suffered in 1985 when he crashed head-on into his favorite opponent, Redskins fullback John Riggins. "It was pretty much my power against his power," Carson says. "I remember hitting John and going back to the huddle ... everything faded to black. I was literally out on my feet."

    Carson would find that such blows had long-term effects. In 1991, three years after he retired, he wrote in his journal, "I don't think as clearly as I used to. Nor is my speech, diction, selection of vocabulary as good as it used to be, and I don't know why." As a TV broadcaster with the MSG Network in New York City, he would occasionally misspeak. "I would mispronounce words and lose my train of thought," he says. "Things would happen, and I'd think I was going crazy. I'd go to the store to get something and forget what."

    Like Yaras-Davis, Carson believes the syndrome is far more common than is generally thought. "One problem is that a lot of players who suffer from it have no clue what they're dealing with," says Carson, who still appears on a weekly show, Giants GamePlan, for MSG. "I've talked to players I've played with and against. Once I went public with this concussion thing, they were looking at me as being sort of brain-damaged, drooling and all this stuff. But it is an injury just like one to your knee or hip."

    What ails Curt Marsh is far less elusive. The 41-year-old former offensive lineman for the Raiders could serve as a poster boy for crippled veterans who ache in all the usual NFL places: neck, back, knees, hips, ankles. Bone by bone, Marsh's body is gradually being replaced. He has had more than 20 operations, including one in '96 to replace his left hip, which had developed AVN, and he expects soon to undergo surgery to replace his right hip, which also has been damaged by AVN.

    Like Stanfill, Marsh allowed team doctors to shoot him up repeatedly with painkillers and cortisone. By the time he retired, after seven years in the league, Marsh had a scoped knee, bulging disks and a right ankle that had been destroyed when the Raiders' team physician, Robert Rosenfeld, who died in 1994, apparently misdiagnosed and mistreated a broken talus bone. By 1994, after the 13th operation on it, the ankle was a hopeless ruin, and doctors cut off Marsh's leg eight inches below the knee.

    Marsh is not shy about being an amputee. While attending a 1998 hearing of the California Senate's Industrial Relations Committee in Sacramento, Marsh, all 350 pounds of him, heard one agitated senator, Ross Johnson of Irvine, excoriate pro athletes who had taken advantage of the state's generous workers' compensation laws by filing their claims there, even if they lived in other states and had played only road games in California. Johnson, backing a bill that would have limited workers' comp payments for pro athletes, declared that he was "outraged" that "professional athletes, who earn huge sums of money, wind up abusing a system that was created for the benefit of average working men and women."

    Moments later Marsh, in a move as memorable as any he ever made with the Raiders, pounced on Johnson, saying he was "offended" to see athletes being treated "as if they were a piece of meat" because they were well paid for their labors. "And that makes [what happens to them] O.K.? That really bothers me. We have families that go through the pain. We have ... "

    Here Marsh reached both hands down to his right leg, pressed a button on the side of his black boot and, to gasps from the audience, removed the prosthesis from his stump and raised it in the air. "Fact of the matter is, you cannot pay me enough money to make this worth my while," he said, holding the boot aloft.

    "This is a real issue Seventy times a game you run into a human being as big as you are. They say that's like a traffic accident What is that, 1,400 traffic accidents a year? And we're gonna say it's O.K. because we pay 'em a lot of money... but they don't deserve to get the same thing that we give everyone else?"

    The bill was never enacted.

    For all that he has been through, Marsh is remarkably free of bitterness, even though he believes his amputation was the result of poor medical care. "I'm not looking for pity," he says. "That's just the way it is." For him and for countless other veterans of pro football's trench warfare.

    A whole battalion of Curt Marshes and Chris Washingtons and Earl Campbells is out there, enough to fill an NFL Old Soldiers' Home, doddering arthritically around the grounds. Busted knees, numb and bulbous ankles, sawed-off hips and all.

    Issue date: May 7, 2001

    Johnny Unitas died yesterday. Baltimore and the sporting world will never forget him.

    Proofread carefully to see if you any words out.