Neuro Athletes,
The NFL and NFLPA have still failed to meaningfully address one of the principal legal and ethical issues concerning player health: the conflicted structure in which club medical staff provide services to both players and the clubs.
I love football but sometimes I wish I didn’t. Most people involved with football are aware of the risks associated with playing a collision sport. It is widely reported that every head-to-head collision generates imperceptible “sub-concussions,” slowly damaging the brain without the victim suffering the symptoms of an acute trauma. This means many players are being injured on almost every play they are involved with 🤯
The Football Players Health Study (a research initiative composed of several ongoing studies examining the health and wellbeing of NFL players) at Harvard University released a set of legal and ethical recommendations to address a series of structural factors that affect NFL player health. such as;
The Structural Conflict of Interest in Club Medical Staff
Wearable Technologies and Biospecimen Collection
Behavioral and Mental Health .
Transitioning out of the NFL
What did the NFL do about it?
The NFL and NFLPA made meaningful progress on a wide range of issues affecting NFL player health in the 2020 CBA.
In particular, the addition of:
A Behavioral Health Specialist
Mental Health and Wellness Team
Joint Behavioral Health Committee which should help players better cope with the very important but often less visible challenges of a career in the NFL
Pain Management Specialist and Prescription Drug Monitoring Program
New rules will protect player privacy in the rapidly developing area of biotechnologies
An identified and increased focus on assisting players with transitioning out of the NFL
Stricter certification requirements for club support staff
Tweaks to squad size rules which could help to protect players with concussions from the pressure to return to the field too soon
As discussed at length in Section III.A of the written review which you can find here, the NFL and NFLPA have still failed to meaningfully address one of the principal legal and ethical issues concerning player health – the conflicted structure in which club medical staff provide services to both players and the clubs.
NFL players typically receive care from two sets of professionals: club athletic trainers and club doctors. Club doctors diagnose and treat players for a variety of ailments, physical and mental, while making recommendations to the player concerning those ailments. At the same time they have obligations to the club, namely to inform and advise clubs about the health status of players.
While players and clubs share an interest in player health—both of them want players to be healthy so they can play at peak performance—there are several areas where their interests can diverge, and the divergence presents legal and ethical challenges.
As explained in Protecting and Promoting:
“Club doctors are clearly fundamental to protecting and promoting player health. Yet given the various roles just described, it is evident that they face an inherent structural conflict of interest. This is not a moral judgment about them as competent professionals or devoted individuals, but rather a simple fact of the current organizational structure of their position in which they simultaneously perform at least two roles that are not necessarily compatible”
Chapter 2 of Protecting and Promoting recommends a comprehensive plan to restructure the club doctor’s relationship in order to extinguish some of the conflicts. In short, the report recommends that player care and treatment be provided by one set of medical professionals, appointed by a joint committee with representation from both the NFL and NFLPA, and evaluation of players for a club’s business purposes should be done by separate medical personnel.
Opinions from Thought Leaders
So what is a player is meant to do, when their life is on the line, they feel vulnerable, they're riddled with injuries, and they want the advice and guidance from someone who is not attached to their team or club?
They seek out external coaches who can help guide them in all areas of performance, health, and longevity. However, there seems to be a push and pull between health and performance for elite athletes. Meaning if an athlete is to perform at their highest level, then health and longevity needs to take a backseat.
The coaching profession is ever changing. Coaches at each level of competition need to know more than just the Xs and the O's in order to be successful. As the primary individuals tasked with developing athletes from average to elite, they are challenged with not understanding how to optimise an athlete and get them to the NFL while also maintaining their health and well being for the long term.
I recruited @Alan_Couzens and @PratikxPatel to the podcast, who are both high level well respected coaches. Alan coaches endurance athletes and uses the latest in science to optimise both performance and longevity.
Ptraik is the assistant coach at the New York Giants. He also serves as the director of performance, nutrition and is the assistant Strength and Conditioning coach.
You can listen to the full episode here.
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