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By Lori Shridhare
May 1, 2023

Football Players Health Study Enters Next Phase

Research program will continue to explore football’s lifelong effects on former players

The Football Players Health Study at Harvard University has received five years of new funding through the National League Players Association (NFLPA) to continue comprehensive research on the health of former NFL players.

Since its launch in 2014, the study has conducted numerous sub-studies examining the spectrum of health conditions and injuries sustained by players, as well as the social, ethical and legal aspects that can affect player health.

These include research into cardiovascular health, brain and cognitive health, musculoskeletal conditions and chronic pain, sleep disorders, hormonal dysfunction, weight gain, health equity and race, mobility, social networks, and law and ethics.

Since its inception, the Football Players Health Study has advanced more than 20 novel treatment interventions to various forms of translation and produced three commercial ventures to date, and investigators have authored and co-authored more than 70 peer-reviewed publications.

Recent publications included an analysis of early aging among former NFL players and a paper on the potential link between concussion and hypertension.

The study includes both in-person evaluations and player surveys. Study participants have included individuals ranging in age from 24 to 89 years who had various positions and signed contracts with the league between 1960 and 2013. On average, study participants played seven seasons in the NFL.

The In-Person Assessment arm of the study, led by Aaron Baggish, a Harvard Medical School associate professor of medicine, involved 17 co-investigators conducting head-to-toe assessments of more than 100 former NFL players for nearly three years. Players underwent a battery of tests to examine a range of conditions.

Future work

In this next phase, the research program will explore an early aging hypothesis based on evidence that has emerged from prior work. The study will focus on aging and longevity, the connection of heart health to brain health, and a biospecimen repository.
Additionally, a series of new research projects will be developed based on data from the three-year In-Person Assessment Study of former players. Several other initiatives will involve collaborations with other institutions, including the Morehouse School of Medicine.

Since the beginning of the study, input from former players and their families has guided the research program. New information from the player community and their families will continue to inform the study’s direction.

“The lack of independent, credible and visionary medical research for NFL players in the early 2000’s was a problem we sought to remedy in the 2011 Collective Bargaining Agreement,” said DeMaurice “De” Smith, executive director of the NFLPA.

“After a comprehensive review process, we formed our collaboration with Harvard Medical School. The power of the players to dedicate resources specifically directed at improving their health and safety has? changed the landscape,” Smith said.

“It is our pleasure to recommit to the Football Players Health Study, the most advanced and comprehensive research program that has already led to discoveries which have improved the well-being of our players,” he added.

“Building upon a solid foundation of research, as well as input from the former player community, we are now well poised to advance our knowledge of the complexities former NFL players face as we continue the next step of this critical work,” said Ross Zafonte, the Earle P. and Ida S. Charlton Professor of Physical Medicine and Rehabilitation and head of the Department of Physical Medicine and Rehabilitation at Spaulding Rehabilitation Hospital and principal investigator of the Football Players Health Study at Harvard.

“Our commitment to the player community is to continue to both refine our understanding of the conditions and injury patterns that have been studied for decades, but just as important, to elucidate those areas of knowledge that have not yet been studied. These are the gaps we are most interested in filling, and which will benefit former players the most,” Zafonte said.

Investigating lifelong health effects on football players

To date, investigators have accumulated a wealth of evidence on the various health effects that a lifelong football career can have on an individual.

Additionally, evidence has emerged about the specific ways in which certain playing positions can affect an individual’s long-term risk for injury and disease.

Some of the broad themes that have emerged from the study thus far are around brain and cardiac health. For example, the complexity of brain and neuro-cognitive health among former NFL players demands a more nuanced understanding of symptoms in order to avoid misdiagnoses that often cause undue stress to the former player community.

At the same time, cardiovascular disease, the leading cause of death among former NFL players, is often overlooked, understudied and can be overshadowed by the assumption that brain health is paramount. In fact, cardiovascular and brain function are not only critically important individually but also closely intertwined, the investigators have found.

Longitudinal efforts in research play a critical role in discovering the interwoven complexities that uniquely impact each player following a playing career, even a brief one.

The study team regularly shares with study participants key takeaways from its latest research findings in the form of concrete tips for healthy living, prevention and prompt diagnosis.

The NFL Players Association continually works to enhance the safety of the NFL workplace while pursuing innovative methods to improve the health of our members,” said Sean Sansiveri, the NFLPA’s general counsel & head of business affairs who also leads the union’s health, safety and medical research initiatives.

“Scientific advancements, and a greater understanding of the issues that affect the health and safety of players, are paramount to the advancement of player welfare. To that end, the NFLPA remains committed to supporting innovative approaches to diagnosing, treating, and preventing injuries and illnesses in active, former, and future players,” Sansiveri said.

While concussion and head injury are of paramount concern, the study examines all aspects of player health across the life span. Former players can find important resources to support their health in this section of the study’s website.

The NFLPA has no role in the design and conduct of any study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of manuscripts; and the decisions to submit the manuscript for publication.

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