Parry…has written an excellent volume on the 'debilitating paradox' of popular spectator sports: that 'the overwhelming desire to attain the heightened fitness' required of an elite athlete leads children and adults to pain, injuries, and 'disability, addictions, and even premature deaths...' [It is] a highly detailed work that should be read by athletes, managers, and sports administrators at all levels.
Harold J Bursztajn, MD: neuro-psychiatric expert and Associate Professor, Harvard Medical School
John Parry has written a wonderfully readable tour de force… on the dangers of athletic …competition... [T]here is an all too steep and slippery slope from narcisistic to neurological injury.... A must read for … experts…fans, athletes and parents.
Ken Reed, Sports Policy Director, League of Fans & Author of How We Can Save Sports: A Game Plan (2015)
The Athlete's Dilemma ... builds a compelling case that numerous health-related crises are impacting our athletes... due to a combination of a laissez-faire approach to the sports industry... and win-at-all-costs and profit-at-all-costs ethos. The result is ... indeed pathological.
Fred Bowen, Washington Post Sports Columnist for Kids
John Parry asks [important] questions about our favorite spectator sports.... Questions about injuries, concussions and how professional athletes and big-time college players are treated... They are important questions that fans should think about even when they are cheering.
Mark H Anshel, Professor Emeritus, Middle Tennessee State University. Author of In Praise of Failure: The Value of Overcoming Mistakes in Sports and Life (2016)
John Parry has written an insightful and revealing expose about [the]… treatment of athletes during and after their sports career[s]… Parry does an excellent job of exposing… [the] costs and consequences to … athlete’s short-term and long-term health. ”
Sports provide people around the globe with unmatched entertainment, from the ecstasy of victory to the agony of defeat. Unfortunately, agony in sports goes well beyond athletes losing games or competitions. Playing with serious injuries, the abuse of medications, use of performance-enhancing substances, and other health-related pathologies have become cruel reminders that being a professional, collegiate, or elite amateur athlete can be as dangerous as it is lucrative and ego fulfilling.
The Athlete’s Dilemma: Sacrificing Health for Wealth and Fame (Rowman & Littlefield, June 2017) examines health-related pathologies in our most popular spectator sports: football, baseball, basketball, soccer, hockey, Olympic competitions, tennis, and golf. These pathologies include: concussions, related brain traumas, and CTE; misuse of pain-killing and performance-enhancing drugs; and other debilitating physical and mental impairments. The book is written for a general audience with illustrative examples involving star and superstar athletes and many different teams. It is informed by legal, health, mental health, and disability perspectives.
Football has engendered the most health-related controversies and scandals in American sports, in large part because it is so popular. Moreover, football remains unsurpassed in promoting violence and a culture of unhealthy attitudes and practices. Nevertheless, all of our major spectator sports, both domestically and internationally, incubate these unhealthy practices for elite athletes, as well as the millions of children who try to emulate those athletes.
Most of the worst health-related dysfunctions are in spectator sports run by cartels: the NFL, NCAA, MLB, IOC, FIFA, NBA, NHL, MLS, PGA, WADA, ITF, and IAAF. Too often these powerful sports conglomerates both encourage and ignore health pathologies in the pursuit of revenues, wealth, and victories. In the United States, sports cartels can do this with relative impunity because they are largely beyond the reach of our federal and state governments. Within this monitoring and enforcement vacuum, the health of elite athletes—and those who hope to become elite—has been placed in jeopardy.
From former football, hockey, and female soccer players not being able to walk normally or think rationally, to Olympic athletes and baseball players using toxic pain-killers and performance-enhancing substances, The Athlete’s Dilemma provides broad perspectives on serious health risks prevalent in spectator sports, both domestically and internationally, and specifies steps that can be taken to substantially reduce those risks. Accessibly written, yet carefully researched, this book will be of interest to sports fans, athletes, health professionals, academics, lawyers, and policymakers.
The Athlete's Dilemma has four major parts. Part I addresses athletes playing with pain, playing injured, and using drugs to mask pain and injuries. It examines the ethic that real athletes—both men and women—should play hurt, including famous examples of professional athletes who have glorified that ethic. Part I also focuses on conflicts of interest and other ethical breaches in team medical care, especially the cavalier dispensing of powerful pain-killing drugs with dangerous side-effects including addictions.
Part II focuses on performance-enhancing substances and elite athletes who are looking for a perceived edge over their competition, or just hoping to stay on a level playing field with their competitors. This part begins with a description of legal performance-enhancements that are readily available. That is followed with chapters on the use of illicit and illegal substances by well-known athletes in baseball, football, cycling, swimming, track and field, biathlon, and tennis. A separate chapter covers the state-sponsored doping scandal involving Russian Olympic athletes. Part II concludes with recommendations on how to address sports doping from a public health perspective.
Part III addresses debilitating physical and mental impairments to current and former elite athletes. It begins with sports-related injuries and conditions and their social implications, including the cautionary tale of what happened to boxing. That is followed by chapters detailing: the long saga of concussions, brain traumas, and deliberate injuries in football; concussion litigation against the NFL on behalf of former players; and calls to ban tackle football, especially for children. Additional chapters cover: concussion litigation against the NHL and NCAA football; brain traumas to female athletes, especially in soccer and ice hockey; and severe injuries sustained by players and fans in professional baseball.
Part IV presents the major factors that explain why elite athletes—and those aspiring to be elite—are willing to sacrifice their health. This begins with a discussion of how “performance-risk-rewards” and the pursuit of profits and revenues seriously diminish the health of athletes. That is followed by prominent examples of how such dysfunctions have manifested themselves in sports, such as: the growing danger of serious arm injuries to elite baseball pitchers and catchers; devastating injuries sustained by professional football players; the absence of comprehensive health care and related benefits for intercollegiate athletes; and how the mental health of elite athletes has been undermined by secrecy, stereotypes, and discrimination.
The Athlete's Dilemma concludes with three recommendations. First, Congress should encourage expansion of the collective bargaining structures found in America’s four major professional team sports to encompass all professional and intercollegiate sports doing business in United States. Second, a national commission should be created to promulgate sports-related health standards to protect current and former athletes. Third, there should be independent judicial oversight in the form of a federal magistrate court to ensure that the sports cartels and player unions conscientiously implement these standards on behalf of their athletes.
John Weston Parry
John Weston Parry is a writer, lawyer, and host of sportpatholgies.com. He was the director of the American Bar Association’s Commission on Disability Rights (1982-2012) and editor/editor-in-chief of the Mental and Physical Disability Law Reporter (1979-2011). He has written numerous law-related books and articles focusing on disability, mental health, individual rights, and diversity. These include Mental Disability, Violence, Future Dangerousness: Myths Behind the Presumption of Guilt (Rowman & Littlefield, October 2013). He also is a recipient of the Manfred Guttmacher Award from the American Psychiatric Association and the American Academy of Psychiatry and Law.
The Athlete's Dilemma is the first in a proposed series of books on sports pathologies.
Athlete's Dilemma: Table of Contents
PAIN, INJURIES, DRUGS, AND TEAM DOCTORS
Chapter 1: Real Men Play Hurt
Chapter 2: Teammates, Coaches, Fans, and Other Unhealthy Influences
Chapter 3: RG III’s Painful Stay in Washington
Chapter 4: The Pitfalls of Team-Directed Medical Care
PERFORMANCE ENHANCING SUBSTANCES:
THE PERILOUS SEARCH FOR THE HOLY GRAIL
Chapter 5: Performance-Enhancing Measures: The Good, Bad, and the Ugly
Chapter 6: Baseball’s Tarnished Legacy
Chapter 7: Football’s Brazen Lack of Compliance
Chapter 8: Cycling, Olympic Sports, and the WADA
Chapter 9: The Laissez-Faire Approach to Doping in Tennis
Chapter 10: The IOC, WADA, IAAF, and State-Sponsored Doping In Russia
Chapter 11: Regulating PED’s To Promote Athletes’ Health
PHYSICAL AND MENTAL IMPAIRMENTS
Chapter 12: A Litany of Sport-Related Impairments
Chapter 13: Football Concussions in the NFL: Myths, Deceptions, Denials, and Lies
Chapter 14: Concussion Lawsuits Filed Against the NFL
Chapter 15: Football’s Unholy Trinity: Brain Traumas, Bounties, and Deliberate Injuries
Chapter 16: Children Playing Football: The NFL’s Achilles Heel
Chapter 17: Following Suit: Concussions in the NHL and NCAA Football
Chapter 18: Concussion Concerns for Female Athletes
Chapter 19: Brain and Other Severe Injuries in Baseball
WHY ELITE ATHLETES SACRIFICE THEIR HEALTH
Chapter 20: Performance-Risk Rewards Undermine Health
Chapter 21: Arm Injuries to Elite Young Pitchers in Baseball
Chapter 22: Football Injuries in the NFL and College
Chapter 23: The NCAA Provides Woefully Inadequate Health Care for Its Student-Athletes
Chapter 24: Stigma, Stereotypes, and Secrecy Undermine Athletes’ Mental Health
Protecting Athletes’ Health in Cartel-Governed Sports
Ken Reed Sports Policy Director for Ralph Nader’s League of Fans and author of How We Can Save Sports: A Game Plan (2015) interviews John Weston Parry about The Athlete’s Dilemma: Sacrificing Health for Wealth and Fame (Rowman & Littlefield, June 2017), sportpathologies.com, and the topic for his next book: unregulated sports cartels. Much of that interview is reprinted below.
Reed: Most of your career has been in mental and physical disability law. What spurred you to write The Athlete’s Dilemma: Sacrificing Heath for Wealth and Fame?
Parry: My impetus for writing The Athlete’s Dilemma: Sacrificing Health for Wealth and Fame (Rowman & Littlefield, June 16, 2017) was an opportunity to focus on pathologies in sports using the professional expertise I had developed as a lawyer, writer, editor, and advocate immersed in issues involving mental and physical disability law, disability rights, and diversity. I felt I brought unique perspectives to these topics.
Reed: Your website title is SportPathologies.com. That’s an interesting title for a sports-based website. What’s the genesis of that name -- in particular, the use of the word pathology?
Parry: As I learned at Columbia School of Public Health, pathology examines the causes, origins, and nature of diseases as they affect the human body and mind. The more common meaning of the term, however, focuses on sharp deviations from what is normal, expected, or healthy.
Pathologies have developed or evolved in American sports, especially where they have been played at an elite level. There is a culture and locker room atmosphere that, like a disease, penetrates and compromises the ideals of sports. Sport pathologies are often precipitated, or made worse, by money and the pursuit of profits and publicity. There also is an underlying recklessness and malevolence that is associated with the obsession to win.
Everywhere one looks in our most popular spectator sports, there are serious injuries and life-long impairments, drug problems and addictions, cheating using performance-enhancing substances, and a culture that values playing with pain and injuries more than promoting a lifetime of health and mental health. Many sports teach athletes how to incapacitate their opponents and to cheat as much as the enforcement of the rules will allow, as long as the perpetrators or their teams are not penalized too severely when they are caught. That is what winners are often expected to do in order to be the best. And once most elite athletes can no longer perform, they are left to deal with any physical and mental impairments and addictions they may have sustained without any meaningful organizational support.
Thus, pathologies struck me as an apt way to describe what is happening to athletes playing sports at an elite level or just trying to become elite.
Reed: Some of the sports pathologies you examine in your book include athletes being pushed to play in pain, the use of performance-enhancing drugs, brain trauma and concussions, the proliferation of arm injuries to youth baseball pitchers, and inadequate health care for college athletes. What do you think is the number one sport pathology in the country today?
Parry: Trying to determine which health-related sport pathology is the worst or most prevalent in this country is almost beside the point. Sports pathologies tend to be connected to a number of similar causes that play out differently depending on the sport. It also depends on whether one is looking at this broad subject area from a micro or macro level.
On a micro level, arguably concussions and brain traumas are the most disturbing because athletes of all ages and levels of competition in many different sports—not just football and hockey—are at risk for life-altering impairments and a diminution of their cognitive abilities. Moreover, until recently the level of awareness of the seriousness of this problem was appallingly low. In fact, many of the leagues and sports organizations that govern professional, intercollegiate, Olympic, and even youth sports ignored and deliberately minimized the dangers, which has meant that adequate prevention, treatment, and rehabilitation were much less likely to occur.
On a macro level, I think the one factor uniting all of these health-related pathologies is the role of our unregulated sports cartels. They allow such abuses and transgressions to occur with very little intervention unless profits are at risk. Whether it is the NFL, NHL, NCAA, MLB, IOC, FIFA, or one of the many other cartels in sports, the cover-ups, deceptions, and public relations rationalizations can be mind-numbing. These pathologies are made worse because our favorite spectator sports escape the legal and legislative scrutiny that most—but not all—other businesses expect to receive. Sports are run much like the stock market or mortgage industry, which is to say the best one can expect is “buyer beware,” including the reality that much of the information necessary to make informed decisions is likely to be hidden from view. This is fundamentally against the public interest.
Reed: Do you see a common root cause linking the various sports pathologies you discuss in your book?
Parry: There does not appear to be a “common root cause” that unites health and other pathologies in sports. That said, the obsession with personal profits—both in sports and in society—is a factor, which more than any other seems to push us towards unhealthy and morally questionable decisions and outcomes. In addition, that obsession tends to help drive the almost as damaging win-at-any cost ethos because winners are likely to make more money and be awarded more opportunities in life. When one adds fact-deprived publicity and self-serving organizational information, which fuels the pursuit of profits in sports, pathologies are almost inevitable.
Nonetheless, the obsessions with money, publicity, and winning would never create the social problems they do if it were not for the fact that the leagues and organizations that run our favorite sports are unregulated cartels. This unchecked organizational power structure, when combined with the relentless pursuit of money, publicity, and winning, incubate and often produce unhealthy, corrupt, and bad behaviors.
Reed: Which sport pathology that you write about poses the biggest threat to athletes – young and old?
Parry: The biggest threat to athletes, young and old—unregulated sports cartels—is also the threat that can be rectified most easily, at least theoretically. Unfortunately, the practical obstacles are more complex and demanding.
On my website/blog Sportpathologies.com, there is a separate page devoted to “cartels,” which emphasizes their dominant role in the sports world. Cartels are the biggest threat because they have caused the most damage to elite athletes, young and old and those aspiring to become elite. They have encouraged their own athletes to take unnecessary risks, act recklessly, engage in bad behaviors, and place winning over good sportsmanship and fair play. Indirectly, they also have encouraged non-elite athletes to do the same, which we have seen in many youth sports programs where academics are short-changed and injuries and the potential for long-term impairments are too easily dismissed.
When our favorite spectator sports are consumed with making more money, increasing wealth, generating favorable publicity, and winning at any cost, important community values—including the health of the athletes and obtaining the truth—becomes blurred. Not too long ago, the New York Times ran the results of its investigation of youth programs, which revealed that too many of these organizations were being run by unscrupulous profiteers. These individuals grab money for themselves either directly by illegal or illicit means, or indirectly by pushing talented athletes towards prep schools, colleges, or the pros and then receive some sort of pay-off for doing so.
The fact that the sports cartels and youth programs are largely unregulated, and scholastic and college programs are regulated poorly and granted far too much latitude, has created a vacuum in which athletes, especially those who participate in sports that generate the most income, are drawn to and socialized by the pursuit of profits, wins, publicity, scholarships, and the accumulation of wealth. This happens at the expense of just having fun and promoting the educational and community values that athletics are supposed to embody.
Reed: What do you think is the genesis of the “real athletes play through pain” mentality prevalent in sports at all levels?
Parry: I think there are a number of factors that contribute to the “real athletes play through pain” cultural imperative. Its genesis, however, is difficult to pinpoint. My feeling is that it is a restatement of the larger historical reality that soldiers and laborers, as well as Olympic athletes, were expected to endure a great deal of pain and discomfort before they were allowed to complain or seek relief, either by stopping what they were doing or obtaining treatment. This began to change substantially towards the middle of the Twentieth Century.
Elite athletes, however—who tend to view themselves as superior physical beings—and their fans, believe athletes should be better-able to withstand pain than other people. They also profit by creating this perception. While this cultural attitude derives from a male-centered perspective, since—until 1950 or so—a vast majority of soldiers, laborers, and athletes were men, the attitude has grown to include more female athletes as girls and women have had more opportunities to compete.
Reed: What is your goal with SportPathologies.com and your sports-oriented books?
Parry: Fundamentally I am a writer. I love the process of writing. It gives me joy and satisfaction and I suspect it will extend the quality of my life. It is different from work. So having the opportunity to write about sports in books and articles and on my website/blog Sportpathologies.com, utilizing my special expertise, is more than enough motivation for me to continue on this self-fulfilling path.
That said, it would be nice to inform and entertain a cadre of readers, as well as to make a difference in the lives of athletes, young and old, by helping to create a sports environment that is healthier and ultimately more worthwhile, not only for athletes, but also for society. I realize that in the current political environment anyone who promotes more government scrutiny and regulation of any business activity is going to be frustrated. At the time I was submitting The Athlete’s Dilemma to my editors in the fall of 2016, it appeared as if the push for more regulation of sports would be a reasonable political objective. I still believe that relatively soon, but not for several years, it will become reasonable again. In the meantime, I will focus on my website/blog and next book, which is likely to be about sports cartels doing business in the United States.