Getting Back to Work in the NFL

| | Utilization Review

getting back to work in the nfl

Professional athletes are a unique type of patient. They are paid a lot of money to play, which places practitioners under significant pressure to speed up the functional restoration process. However, returning athletes to the field before they have made full recoveries is detrimental to them in the long term.

The Story of Rob Gronkowski

During the 2011 AFC Championship Game, New England Patriots tight end Rob Gronkowski suffered a high ankle sprain. In most professions, Gronkowski’s injury would be reason to take time off and seek appropriate treatment before returning to work. This is known as functional restoration, treating patients so they may safely return to work after injury.

While most patients want functional restoration to be speedy, professional athletes want the process to be faster than is possible. Medical practitioners face pressure from two sources when treating injured athletes. The athlete’s team may reduce its chance of winning and possibly lose income when a key player is out of the game, so they want to minimize his downtime. Similarly, the player himself understands that the longer he is unable to play, the harder it becomes for him to return and capitalize on his return – athletes are acutely aware of the limited lifespans of their careers. As a result, practitioners try to get athletes back in the game as soon as they can – sometimes, too soon.

Rather than taking the necessary time to recover, Gronkowski continued playing, even participating in the Super Bowl, which the Patriots ended up losing. Fans and commentators pointed out that Gronkowski was clearly not in condition to play, as his performance in the Super Bowl was far below his standards. The injury appeared to be the source of Gronkowski’s struggles on the field.

A post-season MRI showed that Gronkowski’s decision to keep playing exacerbated his injury. The sprain had developed into strained ligaments and required surgery. What should have been a relatively minor injury became something with longer lasting repercussions.

What Happens When We Rush Functional Restoration?

Gronkowski’s story is not unique in the NFL. According to a survey conducted by the Washington Post, 47 percent of football players believe that team doctors placed the interests of the team above the health of individual players. This means that a significant portion of injured players were allowed back on the field when they should have been recovering. 90 percent of the players surveyed said they played while injured during their career.

When functional restoration is rushed, treatments fail and injuries worsen. Gronkowski’s sprain required surgery after he failed to take the necessary time to recover. Many current and former football players experience chronic and severe pain as a result of improperly rushed recoveries. Nearly nine in ten retired football players suffer pain on a daily basis, according to the Washington Post, and 91 percent of these former players believe football is responsible for their lifelong injuries.

The repercussions of rushed functional restoration for professional athletes can help us make decisions about functional restoration for other patients. Returning patients to work before they are fully healed often results in further damage, which prolongs treatment overall and harms the patient in the long term.

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Zenia Cortes, MD, Orthopedic Surgeon

Dr. Zenia Cortes brings her combined expertise in sports and orthopaedic medicine to UniMed Direct, along with insights from her experience in peer and utilization review.

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