NFL trust looks out for former players

Approximately 20,000 athletes have played in the NFL since its inception.  Despite this relatively small number, many of these men are among the most severely injured in sports.

Football is a high-velocity, collision sport.  Success is based on the ability to resist injury and tolerate pain.  Many of the injuries incurred while playing become chronic and lead to lifelong debility.  Although many injuries are orthopedic, an increasing number of traumatic brain injuries and psychiatric problems are emerging.

Sadly, little has been done to support these former football players and their families.  Some have moved into other professions that provide health benefits.  Others have been left to find entitlement programs where health care is limited and preventive care is non-existent.

Fortunately, in the most recent collective bargaining agreement, active NFL players negotiated for approximately $200 million to be set aside for the ongoing health care of former players.  The program through which this is administered, currently known as “The Trust,” has become much more than a health program.

“The Trust is a set of resources, programs and services designed to provide former players with the support, skills and tools to help ensure success off the field and in life after football,” states Bahati VanPelt, executive director of The Trust.

The Trust consists of six pillars that address brain and body, career, education, finances, personal interaction and lifestyle.  The brain and body pillar utilizes national health centers at the Cleveland Clinic, Tulane University and the University of North Carolina.

“I received the most comprehensive medical evaluation I have had since playing in the NFL,” reports former player, Bernard Whittington.

The Trust is a unique program.  Establishing a system of care for former players by active players sends an important message to skeptical sports fans that it’s not always about the money.

Genomics could hold the key to improved athletic performance

Genomics is a scientific discipline that may have significant impact on the future of athletics at all levels.

The human body consists of approximately 50 trillion cells.  Each cell contains a nucleus with 46 pairs of chromosomes.  Half of these are maternal, the other half paternal.  Chromosomes are made of DNA and a gene is a distinct section of DNA that determines particular characteristics such as hair color, height and eye color.  Some genes increase the likelihood of developing diseases like cancer, hemophilia and Alzheimer’s.

The human genome is the complete set of genetic information for humans.  Mapping the human genome remains the “holy grail” of genetics.  Caenorhabditis elegans (C. elegans) is a tiny worm.  It is also the first multicellular organism whose entire genome has been mapped. 

Considering it takes only three days to mature from birth to adulthood and the entire lifecycle is only two weeks, C. elegans provides an excellent opportunity for scientific study.  It can be studied under a variety of conditions and cellular damage assessed.  More importantly, these studies can provide a key to how an organism can adapt.

“When dealing with stress, human metabolism must adjust and this results in fatigue and diminished concentration.  Experiments have shown that C. elegans can be acclimated to heat and stress,” states Dr. Elaine Lee, assistant professor of kinesiology at the University of Connecticut and a leading genetics researcher.

Stress includes conditions such as heat, dehydration, illness, infection, inadequate sleep and poor diet.  These can all result in cell damage.  The cumulative effect not only results in poor athletic performance but also leaves athletes vulnerable to more severe injury.

Genomics can lead to information on how organisms adapt to stress.  The correct balance of aerobic and resistive exercise, along with proper diet, can lead to resistance to illness as well as improved athletic performance.

Interestingly, the key to these breakthroughs may depend on genetic studies performed on a worm that is just one millimeter in size.

Professional athletes not immune to strokes

A stroke is the result of a blockage or a tear in a blood vessel that brings blood to the brain.  Among the last people expected to suffer a stroke are professional athletes.

On Jan. 29, Kris Letang, a National Hockey League defenseman for the Pittsburgh Penguins, developed unremitting symptoms of dizziness and nausea.  A thorough medical work-up revealed his symptoms to be the result of a stroke.  Further evaluation discovered a patent foramen ovale (PFO).

PFO is a hole between the upper two chambers of the heart called the atria.  The hole is the result of incomplete closure of a wall that forms between these two structures in the developing fetus.  A PFO is estimated to be found in between 25 and 40 percent of adults.

Obviously, not everyone with a PFO suffers a stroke and in fact, there are no typical symptoms of a PFO.  Nevertheless, Kris Letang has joined a growing list of athletes who have suffered strokes associated with a PFO.  Among the most notable members of this group is Teddy Bruschi.

Letang is expected to make a full recovery and return to hockey in six weeks thanks to quick action and his good health. The controversy is whether the PFO should be repaired.

“Studies looked at closure of PFOs as a means of reducing recurrent stroke and it did not make a difference,” states Dr. Anita Kelsey, a cardiologist and director of the Women’s Heart Program at St. Francis Hospital.  These studies compared closure to medical treatment with blood thinners.

Athletes’ hearts undergo large shifts in pressure during competition and workouts.  It is also unwise for contact sports athletes to be on blood thinning medications. These factors favor surgical repair.

In summary, there is no definitive direction for treatment of PFOs in athletes. More detailed studies in this population are necessary.

Dr. Alessi is an on-air contributor for ESPN and can be reached at