Health issues in American football

There a number of issues relating to public awareness and health aspects of American football. Since the invention of the game, it has seen a higher injury and death rate than any other major American professional sport. Due to the game's popularity, several universities have been criticized for allegedly valuing wins and losses above the educational welfare of the student-athletes. The extent of steroid use also has some controversy attached to it.

Steroids

Recent attitudes toward and awareness of steroid use are also evolving, spurred on by the recent (and highly publicized) baseball steroid scandals. Bill Romanowski, a former player for the San Francisco 49ers, Philadelphia Eagles, Denver Broncos, and Oakland Raiders, recently admitted that he had used steroids while in the National Football League (NFL). Because the use of steroids is an unfair competitive advantage, they are banned by the NFL, which randomly tests all its players for steroids and penalizes those who are caught.

Injuries

Despite the helmets and heavy padding worn by all players on the field, injuries are common in football. An "Injury Report" section is ubiquitous in American newspapers' sports sections, detailing, for each injured player on each team, his injury and the amount of time he is expected to be out. Twice-weekly during the season (Wednesdays and Fridays), all NFL teams must report the status of their injured players, or be subject to a fine from the league. The standard severity descriptions are "out" (will not play in the coming game); "doubtful" (25% chance of playing); "questionable" (50% chance of playing); or "probable" (75% chance of playing). Note that teams occasionally manipulate their injury reports, minimizing or maximizing the extent of a player's injury, as an attempt to strategically deny their upcoming opponents a clear picture of the team's health. Similar systems are in place for most major American sports.

The NFL has a roster limit of 53 players per team during the season; 45 of which dress for a game plus an "emergency quarterback" who only plays if all the quarterbacks on the 45-man roster are out of the game. Players who are injured are frequently among the eight that do not dress. If it becomes certain that a player will not play for the rest of the season, the team may put him on the "Injured Reserve" list and replace the player on the roster.

An average of about eight players die each year in the United States as a result of injuries received in games at all levels. Concussions are common, with an estimated 40,000 suffered every year among high school players [1]. The National Football League now collects benchmark measures of awareness for each player, which can be used during a game to judge whether he has been concussed.

Injuries sustained by football players often are permanent. Many former football players experience pain, sometimes severe, that lasts for the rest of their lives. Many players require surgery, even multiple surgeries, for injuries experienced years earlier.

Newspaper reporters who have interviewed former football players who are crippled or in pain as a result of their former sport find that a player will never (or virtually never) express regret over his choice of career. The players often state that the thrill of playing football was worth the price of a lifetime of subsequent pain.

Deaths and long-term disability attributed to illegal use of anabolic steroids have become a new factor in this picture, starting in about the 1990s.

Instances of heat-related death, especially during professional practice sessions, have begun receiving press attention in the decade of the 2000s, and led to new standards intended to respond cautiously to possible danger signs that traditionally had been ignored. There is also the prospect that conventional first-aid technique has been in error, and an apparatus to circumvent this: apparently efforts to cool an overheated patient quickly, by wetting a large fraction of the body, are misguided, with the sudden chilling of the skin causing the body to reduce superficial circulation, and making that chilling near the surface ineffective at cooling the core of the body and thus the brain. A device suitable for professional teams has been developed, that provides for rapid cooling of small areas of skin where large blood vessels are near the surface, and is proposed as a means of cooling the blood quickly without evoking the reflex of isolating the body surface from the core.

Certain rule changes have been implemented in an attempt to reduce the number of more serious injuries. An example of this is the illegal "crackback block", when a blocker positioned wide blocks back towards where the ball was snapped. These blocks are infamous for causing severe leg injuries. Another rule recently implemented is that a defender can't dive a quarterback's legs while bringing him down. Thie rule has been colloquially referred to as the "Carson Palmer" rule, after he was injured from such a contact in the 2005 NFL season.