Using the NFL as a case study, Jamie Klinger examines the troubling intersection of professional sports, human rights, and health. Despite reforms like concussion research and advanced safety gear, the NFL struggles to balance its pursuit of profit with player well-being. Klinger examines how the league’s failure to adequately protect players, both on and off the field, violates fundamental human rights under the Convention on the Rights of Persons with Disabilities and argues that the United States and NFL has a responsibility to enforce stronger protections for athletes.
On 12 September 2024, Miami Dolphins Quarterback Tua Tagovailoa suffered a hit that began to dominate the conversation surrounding professional athletes’ health. The 26-year-old was hit headfirst during a tackle which resulted in his third concussion while playing for the National Football League (NFL). The NFL has stated they will not influence Tagovailoa’s potential retirement. NFL Chief Medical Officer Dr Allen Sills emphasised patient autonomy in this matter, saying: “Ultimately […] patients make decisions” regarding their careers.
The relationship between the NFL and the health of its players is complex. In 2016, the NFL and other NFL-associated American football leagues settled a class action lawsuit after players alleged that the NFL was aware of the sport’s health risks, particularly degenerative brain disease, and did not take adequate measures to inform or protect players. But players love the game –often to an extreme extent. When Buffalo Bills Safety Damar Hamlin suffered cardiac arrest and required CPR during a televised game, the first question he asked when he awoke in the hospital was if the Bills won. While the NFL and players alike claim health is of the highest priority, the behaviour of both suggests that is not the case. In 2023, NFL teams made $13 billion from merchandising, licensing, sponsorship, and league media and $3 billion from ticket revenue, with the most popular team earning the most. With this model, a significant portion of NFL profits rests with player and game popularity, which injuries disrupt. This push and pull between the health of the players and big, profitable wins defines the league-player relationship.
The NFL, teams, and the NFL Players Association have tried to reduce injuries during gameplay. Rule changes, concussion research, and helmet improvements have led to concussion rates falling 24 per cent since 2023 and lower extremity strains decreasing by 27 per cent since 2021. One of these reforms that has made headlines is the introduction of optional Guardian Caps to games. The Cap has a softshell helmet that disperses impact and has led to a 46 per cent reduction in concussions. Out of 1,696 active players, only eight players are currently wearing GuardianCaps during this football season. Many claim they are too ugly to wear.
Such reforms, however, do not prevent players with concussions or other injuries from returning to gameplay despite health concerns, a widespread issue within professional sports. When asked why he didn’t retire after numerous severe concussions, Marc Savard, a former professional ice hockey player, explained hockey “was [his] entire identity.” To give up on a lifelong dream would be unthinkable, even when the future health prospects are bleak.
In a study of 202 brains of former football players, nearly 90 per cent suffered from chronic traumatic encephalopathy (CTE), a traumatic brain disease caused by repetitive hits to the head. Common symptoms of the disease range from headaches and short-term memory loss to aggressive tendencies, language difficulties, paranoia, and depression. CTE is not exclusive to football; players of any sport with regular head hits can and do develop the disease. As there are currently no scans or fluid tests that can identify the tau protein deposition that causes CTE in a living patient, the disease can only be definitively diagnosed post-mortem, creating challenges for treating suspected patients.
Those who suffer from degenerative brain disease following their athletic careers are not likely to receive leading care despite promises by the league. Since its launch in 2017, the NFL concussion settlement, which is meant to provide money for care to players suffering from dementia, has rejected 1,100 claims. Raising the settlement threshold definition of dementia, the inaccessibility of network-approved doctors, and long wait times for reports have made it difficult for players to get the money they need. Instead, “players are dying while waiting for their benefits,” only to be found to have severe CTE post-mortem.
Often, these issues are brushed aside as a hazard of the game. Players are educated on the risks, and many choose to return to gameplay despite health concerns; any injuries sustained are an occupational hazard. But leagues are not without responsibilities to their players. The inability to consistently provide adequate safety measures and remedies following grave injuries is a violation of players’ human rights, specifically under the Convention on the Rights of Persons with Disabilities.
This may at first appear unrelated: how could professional athletes, who must be at the pinnacle of health to perform, have any relation to the rights of the disabled? It is undeniable that the rate of disability players experience after their careers is shocking and, as demonstrated, disability resources remain elusive. This is a violation of Article 10 of the Convention which affirms the “inherent right to life and […] its effective enjoyment by persons with disabilities on an equal basis to others.”
The NFL’s class action settlement malpractice also violates Article 25 of the Convention, which affirms: “the right to the enjoyment of the highest attainable standard of health without discrimination.” Under this article, the provision of local,disability-specific, high-quality health care is required. Opposingly, the current plan requires players to wait months and potentially travel hundreds of miles to receive a diagnosis that could be overruled by settlement review doctors, leaving them with no access to care. Moreover, Articles 26 (onhabitation and rehabilitation) and 30 (on participation in cultural life, recreation, leisure, and sport) are violated by the settlement’s insistence that players reach a debilitating level of disability before receiving aid. By not enforcing these practices with the settlement, the US government violated its obligations as a signatory to the Convention, which requires the US “to refrain in good faith from acts that would defeat the object and purpose of the treaty.”
Another crucial document related to protecting the human rights of injured athletes is the revised International Charter of Physical Education, Physical Activity and Sport adopted by UNESCO in 2015. Its Article 9 affirms that safety and risk management are necessary provisions in sports play, with Article 9(2) emphasizing that healthy gameplay “require[s] that all stakeholders seek to rid physical education, physical activity and sport of practices that limit or harm participants.” The NFL does partially satisfy this requirement with its reforms, but limited use of the Guardian Cap demonstrates that efforts do not go far enough. Players have the autonomy to decide to play despite the risks, but the leagues must ensure that players wear the highest level of safety gear while doing so. That the US government has not enforced these protective practices is a human rights abuse. Although, the NFL is a private company, “a State may be responsible for the effects of the conduct of private parties, if it failed to take necessary measures to prevent those effects” according to the draft articles on Responsibility of States for Internationally Wrongful Acts (2001). As the United States is a member of UNESCO, remedying these abuses is paramount.
NFL players will never be perfectly safe. There will always be a risk of injury during games and such risk is part of what makes games so exciting. Nothing, however, is exciting about asking players to risk the rest of their lives in service of a sport. Kyle Granson, a tight end for the IndianapolisColts, wears a Guardian Cap because: “no matter how dumb it looks, it doesn’t matter in the long term,” explaining that he would like: “to remember [his wedding] first dance 30 years from now […] [his] first kid’s steps […] be there at their first day of school.” Articles 7(b) and 12 of the International Covenant on Economic, Social, and Cultural Rights affirm the right to: “the highest attainable standard of physical and mental health” via “safe and healthy working conditions.” When did athletes become the exception?
All articles posted on this blog give the views of the author(s), and not the position of the Department of Sociology, LSE Human Rights, nor of the London School of Economics and Political Science.
Image credit: Chris Chow
