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The Health Status of Retired American Football Players

Super Bowl III Revisited

Stephen J. Nicholas, MD, James A. Nicholas, MD, Calvin Nicholas, MD, Jennifer R. Diecchio and Malachy P. McHugh, PhD^*

From the Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, New York, New York

^* Address correspondence to Malachy P McHugh, PhD, Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, 130 East 77^th Street, New York, NY 10021 (e-mail: mchugh{at}nismat.org).

Background: Despite a perception that retired professional football players have poor health, there are little supporting data.

Hypothesis: Retired football players have poor health compared with age-matched population norms.

Study Design: Cross-sectional study; Level of evidence, 4.

Methods: Thirty-six of 41 members of the 1969 Super Bowl winning team were contacted 35 years after that event (3 were deceased, and no contact information was available for 2). Players completed an SF-36 health survey and a medical history and football-specific questionnaire. Each player’s football-related injury history before 1969 was documented from medical records. It was estimated that there was 80% power to detect a 10% difference in physical and mental health scores between the retired football players (age, 62 ± 3 y) and population norms (n = 741) at an alpha level of 0.05.

Results: SF-36 scores for physical and mental health were not different from age-matched norms (physical health P = .69; mental health P = .49). The most prevalent medical conditions were arthritis (24 of 36 players), hypertension (13 of 36 players), and chronic low back pain (13 of 36 players). SF-36 physical health scores were 21% lower in players with arthritis (P < .01) and back pain (P < .05) compared with the other players. Physical health scores were 19% above normal for players without arthritis (P < .01) and not different from normal for players with arthritis (6% lower; P = .6). Four of 8 players who had major ligamentous injuries to the knee before 1969 had total knee arthroplasty in the intervening years, compared with 3 of the remaining 28 players (P < .05). The men played professional football for 8.3 ± 3.8 years, and 33 players (94%) reported having had "very fulfilling" (n = 24) or "somewhat fulfilling" (n = 9) careers.

Conclusion: These professional football players had long and fulfilling careers with no apparent long-term detrimental effects on physical or mental health scores despite a high prevalence of arthritis.

Key Words: SF-36 • arthritis • National Football League • arthroplasty