PRO FOOTBALL; Painkillers a Quiet Fact of Life in the N.F.L.
By MIKE FREEMAN
Published: January 31, 2002
Kurt Warner's ribs remain the talk of the town. Warner, the St. Louis Rams' quarterback, says that the ribs he bruised in the playoffs against Green Bay are feeling better. But they are still quite sore, and there remains a possibility he will take a painkilling injection before playing against the New England Patriots Sunday in Super Bowl XXXVI.
''We'll see how it goes, but hopefully it won't come to that,'' Warner said on Tuesday.
Warner's situation, and that of Pittsburgh running back Jerome Bettis, who had an adverse reaction to a painkilling shot only minutes before a playoff game two weeks ago, is calling attention to the use of such medication in the National Football League.
Many players say that the use of pain-numbing shots is pervasive in pro football, the most violent of American professional sports.
The demand for the shots is so widespread that it might be hard to field teams to play on a typical Sunday, much less a Super Bowl game, without them.
Pain is an unspoken but constant presence in the sport, and painkilling injections allow players to function when their bodies want to shut down.
''Football is a rough game,'' Rams cornerback Dexter McCleon said. ''These shots are a necessity. If it wasn't for these shots, a lot of guys, I mean hundreds of guys, wouldn't be able to play every week. I would say half the teams in football wouldn't have enough guys to play on Sunday if it wasn't for those needles.''
Team doctors and trainers generally consider the use of painkilling drugs to be safe.
But there are potential dangers. Since injections or oral medication can mask pain, a player sometimes runs the risk of further injury.
''One danger is you are numbing a body part that if a player takes a blow there he could do further damage without knowing it,'' Ronnie Barnes, the Giants' trainer, said. ''Pain tells you to stop. If you can't feel the pain, that's a danger.''
Repeated shots can sometimes delay the healing process, trainers and players said. There can also be complications associated with an injection. Bettis was unable to play on Jan. 20 after he was given two shots of a local anesthetic called Marcain to mask pain he anticipated from a groin injury that had kept him out of the lineup for weeks. One shot leaked underneath a nerve, causing his leg to go numb.
Several Rams and Patriots said they were concerned that players resort too often to painkilling drugs because of pressure from their teams and teammates to play at all costs.
Sometimes the pressure is also self-induced, they said.
''There are times when it's safer for players to just sit and rest an injury for two weeks instead of getting shot up,'' said Patriots fullback Marc Edwards, who said he had never taken a painkilling injection. ''But there's too much pressure on guys to get back on the field. So they take risks and get the shots.''
Patriots safety Lawyer Milloy said: ''In general I don't like taking shots. But they are a necessary evil. If you don't do whatever it takes to play, you feel like you let your teammates down. They might also look at you like you're a wimp.''
The N.F.L. says teams are required to keep records of all prescription medications administered to players, including painkillers like Toradol, which is injected, and Vicodin, which is taken in pills. The N.F.L. says it monitors those records.
The league has no specific policy on injections, saying it is a matter between players and team doctors. The Players Association has not commented on the subject.
Three trainers estimated that 70 percent of current N.F.L. players have received at least one painkilling shot during their careers and that perhaps 50 percent have been given more than one. Wayne Gandy, the Steelers' offensive tackle, said this month that about half of his team's 53-man roster took painkilling shots each week.
''I can't imagine one player in this league who plays in the trenches not ever needing to take a shot,'' Rams linebacker London Fletcher said. ''It's basically impossible.''
Barnes, the Giants' trainer, said, ''It's difficult to say what percentage of N.F.L. players have taken painkilling injections, but I can't sit here and say it's a small number.''
Some Rams and Patriots said they expected a handful of teammates to get injections before the championship game on Sunday.
Patriots quarterback Tom Brady may be among them, should he need an injection for pain in his sprained left ankle, a Patriots official said today.
Painkilling injections are not new in the N.F.L. John Elway, the former Denver quarterback, received painkilling shots for injured ribs. Philadelphia Eagles running back Duce Staley got them for a painful hernia. Brian Mitchell, the Eagles' kick returner, got a shot to numb pain from a heel injury.
Troy Aikman, the retired Dallas Cowboys quarterback, once took eight painkilling shots for a herniated disk. Quarterback Trent Dilfer took eight painkilling injections over several days for a shoulder injury when he played for Tampa Bay in 1997.
In 1974, the Hall of Fame linebacker **** Butkus of the Bears sued his team, contending that repeated cortisone injections had harmed his long-term health. The Bears paid Butkus $600,000 in a settlement.
Barnes said one of the most common painkilling drugs now in use is Toradol, an anti-inflammatory that is injected.
''That is the only medicine I will allow trainers to use on me,'' Patriots linebacker Bryan Cox said. ''A lot of the others are bad news, because they can become addictive.''
Players typically receive injections on the day of games to enable them to play despite pain. After games or after practices, they are usually given oral prescription medicine to numb pain, and some players have become addicted to the pills. Green Bay quarterback Brett Favre was treated for an addiction to Vicodin several years ago.
Sometimes, too, a needle can be inserted improperly. In 1999 San Francisco tight end Greg Clark said a shot intended to ease the pain from five rib fractures accidentally punctured a lung.
At the time, he said, ''The thing that's hard as an athlete is sometimes you get so used to playing in pain and dealing with pain that sometimes you're not sure where to draw the line of where it's too serious to play.''
Some players endure the shots despite a fear of them.
''That needle hurts like heck,'' Fletcher said. ''When it goes in, I look away and hope it goes to the right place.''
The potential risks are among the reasons Warner does not want to take a shot before playing on Sunday. He said last week that the injection he took before playing the Eagles in the National Football Conference championship game was the first of his career.
''I don't like to do that,'' he said. ''I do not want to do that.''
