Over the last couple of weeks football players in both the NFL, notably Chris Borland of the San Francisco 49ers, and NCAA have announced their retirement due to concussion and other injury related concerns. While the media chooses to anoint these as isolated incidents I believe that it is likely that more of these retirements will be occurring as more and more risks of these injuries, particularly concussions are identified. As Athletic Trainers we must remain informed on these risks and be able to sift through the research for the best evidence because it is likely that we are involved in these difficult conversations with athletes when they are trying to make these decisions.
In professional sports the decision to make often includes weighing millions of dollars versus continually putting one’s body at risk. While of course the player’s family, front office staff, coaching staff will likely be involved in the decision, the athlete may look to us to provide informed advice. We have the most contact on a daily basis with these players in the medical aspect of sports, so they are going to value our opinion. It is not our role to make the decision for them, but rather give them the best information based upon an evidenced-based approach to their particular case.
This evidence-based approach should involve our knowledge of clinical outcomes for players that have suffered similar injuries in the past, the current highest level of evidence published on the topic, and the patient’s own values. If an injury does not have great clinical outcomes we have a professional responsibility to let our patient’s know what they are facing and what risks lie ahead if they continue sport participation. We also need to continue to seek out new evidence to provide not only the best patient care, but the best information possible when trying to help make a life altering decision such as this. The patient’s own values are one of the most overlooked aspects in this process. For example, many have chosen to criticize Derrick Rose over his comments saying he would rather be able to attend business meeting and play with his kids later in life than risk further damage to his knee, but those are his values and they must be respected.
In the end we have responsibility to our patients to provide the best care possible and if that involves informing them that they could be doing potentially irreparable damage to their body at 25 then we have a professional obligation to do so. We must continue to remain independent from the team that is paying them and make sure that we are not pressured into telling a patient something that we do not believe, betraying our own values and ethics. Our goal is not to try to end someone’s career or take away potential earnings, but we cannot allow these athletes to continue to put themselves at harm without giving them the best information possible from a medical perspective.
Justin Police, LAT, ATC
In professional sports the decision to make often includes weighing millions of dollars versus continually putting one’s body at risk. While of course the player’s family, front office staff, coaching staff will likely be involved in the decision, the athlete may look to us to provide informed advice. We have the most contact on a daily basis with these players in the medical aspect of sports, so they are going to value our opinion. It is not our role to make the decision for them, but rather give them the best information based upon an evidenced-based approach to their particular case.
This evidence-based approach should involve our knowledge of clinical outcomes for players that have suffered similar injuries in the past, the current highest level of evidence published on the topic, and the patient’s own values. If an injury does not have great clinical outcomes we have a professional responsibility to let our patient’s know what they are facing and what risks lie ahead if they continue sport participation. We also need to continue to seek out new evidence to provide not only the best patient care, but the best information possible when trying to help make a life altering decision such as this. The patient’s own values are one of the most overlooked aspects in this process. For example, many have chosen to criticize Derrick Rose over his comments saying he would rather be able to attend business meeting and play with his kids later in life than risk further damage to his knee, but those are his values and they must be respected.
In the end we have responsibility to our patients to provide the best care possible and if that involves informing them that they could be doing potentially irreparable damage to their body at 25 then we have a professional obligation to do so. We must continue to remain independent from the team that is paying them and make sure that we are not pressured into telling a patient something that we do not believe, betraying our own values and ethics. Our goal is not to try to end someone’s career or take away potential earnings, but we cannot allow these athletes to continue to put themselves at harm without giving them the best information possible from a medical perspective.
Justin Police, LAT, ATC
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