Information, Symptoms, Treatments and Resources


Is Football Too Dangerous and Violent for Universities to Sponsor?




Jacob (Jake) S. Stueve, MD played college football (tight end) at the University of Missouri on a full athletic scholarship. He finished his football career in 1998 when he was selected Academic All-American (first team). Jake graduated from the MU School of Medicine and the Thomas Jefferson University Orthopedic Surgery Residency. While there he received the Cotler-Marone Award for Leadership Excellence. He remained to take a Fellowship in shoulder and elbow surgery. Dr. Stueve now practices in the Metropolitan Kansas City Area. Missouri Medicine asked him to share his college football experience from the perspective of a player and physician.



August in mid-Missouri, even fifteen years after I last buckled my MU chinstrap, still conjures up a sense of anticipation and dread. Despite my love of playing football I hated the grueling two-a-day practices. Each August, college football players across America begin preparation for their upcoming season by practicing twice daily. For me that meant enduring the heat, humidity, and slogging through practice after practice in shoes water logged from the previous day’s perspiration. Most of us have special abilities. One of mine is profuse sweating. I sweat to the extent that I regularly lost 10 to 15 pounds during two-a-days. I often needed intravenous saline fluid boluses and oral hydration of about 320 ounces of water and PowerAde daily.

The necessity for a fluid bolus was preceded by a practice ending with unrelenting cramping. Multiple trainers would attempt to stretch my contacted muscle only to have its antagonist cramp. The following day, feeling awful, I was mentally and physically challenged in meetings and on the field. During football camp my junior year, I hoped my most recent dehydration episode would not interfere with a very different mental exercise. That year I checked out of Missouri University Hospital re-hydrated at sunset to drive to Kansas City for a restless night prior to taking the Medical College Admission Test (MCAT) the next day. Of course, it was the team’s only day without practice during the week.


The College Life of the Student Athlete

During my time as a division one college player there was no question football-related activities were the top priority. Academics and personal obligations all needed to be scheduled outside of team activities. During football season a rigorous pre-med class schedule, team meetings and practice left me very little free time. My typical day would begin on campus for class at 7:30 a.m. Most mornings I attended two to four lectures. All class work had to be scheduled before noon to accommodate football activities. Any downtime between classes was usually spent in the training room receiving treatment for injuries. If you were on the injury list, which for me might as well have been a permanently reserved spot, morning treatment was required.

Morning would end with a rushed lunch prior to spending the remainder of my day at the football facility. Once there preparation would begin by getting my ankles taped for practice and squeezing in another round of injury therapy. Next, meetings would commence with players expected to be dressed for practice except for cleats, shoulder pads, and helmets. During these meetings, plays and strategies would be outlined for the week’s game plan. The opponent’s personnel and tendencies would be reviewed and expectations discussed. Techniques for assignments were detailed. Once the meeting concluded, we had few minutes to put on cleats, gather our pads and get out on the field.


Practice Makes Perfect

Once on the field, walk-throughs would expand on the meeting previews. Walk-throughs allowed more repetitions to review assignments and techniques prior to full speed practice. Full speed practice would then ensue consisting of 22 five-minute scripted periods. Every second was planned and the practice was expected to complete all intended tasks. Practice would start with individual position drills followed by group work (i.e. offensive line and tight-ends together, quarterbacks and receivers, etc.) and lastly full team. There was an emphasis on ‘toughness’ and at least two practices a week would be fully padded and “live.” “Live” meant football like game day except that the ball carrier was not (usually) taken to the ground. These practices left me almost as sore as a Saturday game. Eventually we would review the practice tape. Afterwards, it was time to clean up and go to the dining hall. Following dinner I finally returned home, usually around 7 p.m. Freshmen and any player in danger of losing eligibility for academic reasons were required to attend two hours of study hall.


Keeping Your Grades Up

Academics were taken seriously within the MU football program. We were often reminded that academics were the primary reason for being at MU. Though true for most students, and paid plenty of lip service by the athletic department, I cynically always knew for some players and coaches, grades were a necessary evil to maintain football eligibility. There are many resources available for student-athletes to help their studies. There is an entire wing of the athletic facility devoted to academics. This includes a library, computer lab, and study room. Tutors are mandatory for first semester freshman and anyone struggling or who might benefit. As long as players maintained a sufficient GPA, tutors were not mandatory after the freshman year. An additional study area was located on campus and attendance there between classes was required for freshmen and athletes with academic difficulties.

The coaches also policed study hall and class attendance. Coaches would turn up randomly on campus to check class attendance. Skipping class or study hall was punishable by extra conditioning, even suspension. I was the only football player in the majority of my pre-med classes so I was seldom a target for attendance audit. Because of my course load I was an anomaly within the athletic academic community. I still remember my coach asking in all earnestness during my first collegiate semester, “Are you sure these are the classes you want to take? I can’t even pronounce half of these. You know your parents aren’t here now - you can decide to major in whatever you would like.” Despite his skepticism, he remained supportive of my academic schedule. He even allowed me to take a chemistry course that resulted in my absence from some Monday pre-practice meetings. The academic support staff also went to extra effort to help me obtain information regarding applying to medical school and take the necessary pre-requisite courses. Nevertheless I did not create a typical medical school resume with research, employment and/or volunteer hours within the medical field. I did get an unwanted first person experience in sports medicine due to my inability to avoid injury.


Keeping Athletes Healthy and Healing Their Inevitable Injuries

Health care for student athletes at Mizzou is state-of-the-art. The MU facility has whirlpools, ultrasound, Transcutaneous Electrical Nerve Stimulation units, exercise equipment galore, etc., in numbers sufficient to treat multiple athletes simultaneously. The Tigers’ training room at the MU athletic facility is better equipped than even the most modern physical therapy centers I send my patients to now. Team doctors are also available to evaluate injuries, illness and prescribe timely treatment. Unfortunately, I utilized medical-surgical-rehabilitative services way too often. My compendium of significant injuries included a fractured scaphoid, ruptured medial collateral ligament with patellar dislocation, anterior shoulder dislocation with recurrent anterior instability, and lastly posterior shoulder dislocation with recurrent posterior instability. All told I netted nine months in a thumb spica cast (luckily one perk was biweekly cast changes) for my slow healing scaphoid, one knee surgery, and two shoulder surgeries. Luckily, due to the skill of the physicians and training staff, I only missed eight games during my career (sophomore year following the knee injury). Knowing what I know now, I may someday regret that I was patched up only to endure more wear, tear and injury. As I shall discuss later, it appears that ex-football players are more prone to a variety of frequently severe health problems.


Would I Do It All Over Again?

Yes! Even after all the punishment and injuries I do not believe there is a better game on earth. Part of me will always yearn for one more chance to strap on the pads and run through or over an opposing player. I have always enjoyed the complexities of football. This includes complex plays run from multiple formations within an ever-changing game strategy. However reductively speaking, at its fundamental core football relies rather simply on each player, in one way or another, beating the opponent facing him across the line of scrimmage.

College football is now dominated by conference re-alignment, bowls versus playoff, considering paying “student-athletes” to play, and the emerging science of the consequences of repetitive head injuries and the violent nature of the gridiron. With age, my extensive experience in orthopedic surgery and as the father of three sons, I am re-assessing my opinion of football in general and college and professional football in particular.


Are the Costs of Football Too Dear of a Price To Pay?

During my playing career, I could not fathom a better deal than to have a “full ride” scholarship to play football at my great state university while chasing my second dream of becoming a physician like my grandfather and uncle. [Editor’s note: Dr. Stueve’s sister is a general surgeon and his two cousins an ophthalmologist and obstetrician-gynecologist.] How could life be any better? The only thing I every envied in other MU students was their extra free time.

My scholarship compensation, coupled with my parent’s support and encouragement, was all I needed. I felt I was enjoying university life to its fullest. I now feel, with broadcast money to universities skyrocketing, coaching and athletic administration compensation soaring that the student-athlete is getting a raw deal.

Football scholarships, indeed all athletic scholarships, do allow some individuals the opportunity to attend colleges that would not otherwise be available to them based on their financial need or their below general student entry level high school grades, ACT or SAT scores. A very tiny few will go on to professional sports where they may become multi-millionaires.


Share the Wealth with the Athlete and the University Educational/Research Mission

What does a football scholarship provide? It covers room and board in campus housing or enough to cover shared off campus rent and utilities. It does not include spending money. Spending money has to be obtained from parents. A year round side job is out of the question due to NCAA regulations. If the regulations were changed the student athlete does not have time for work during the school year and summer practice season. Many of my teammates did not get financial support from home. They required additional grants or loans to afford weekly expenses.

The above scenario is fundamentally flawed and unfair when colleges and universities are reaping increasing profits from hundreds of thousands of dollars to hundreds of millions of dollars from the efforts of their student-athletes. I don’t believe college athletes should be compensated like professionals. However, a few thousand dollars a year to pay for laundry, clothing, incidentals, and to enjoy a night on the town every so often without needing a tax-payer funded grant or loan would be fair and reasonable. Five hundred dollars a month to every scholarship athlete at major conference universities would be a small slice of the athletic department budget. It might reduce the illegal money flowing to players from coaches, alumni and recruiters that has sullied college football’s reputation. In a system built for education, it should not be difficult to justify or rationalize player stipends, especially when the head football coach often earns many times what the University President does.

Across the entire country major universities with multi-million dollar revenues continue to maneuver to create even greater profits through conference re-alignment, football playoffs, and additional games. We know universities exist to educate, provide services and conduct research. How much of this football generated money flows back into the educational budget and how much into student loans, scholarships and grants? How do these revenues benefit the student athletes who power this money machine? We are told it is for the good of the university and the student-athlete. To modify Rod Tidwell’s (Jerry Maguire) famous quote, “Show THEM the money.”


Late Injuries From a Career in College-Professional Football

I am now paying a physical price for my football career. I have traumatic degenerative joint disease which may get much worse as I age. More attention is being directed toward the ramifications of the physicality football places on its participants after their careers conclude. Former National Football League players are suing owners to receive increased compensation in retirement in part to deal with their health care expenditures. Repetitive head trauma has also garnered the spotlight of the national media, especially with the suicides of high profile players and the mounting evidence that multiple concussions may result in increased rates of mental illness.

It seems logical to me that slamming your head into other big men might not be a healthy proposition. As players continue to become heavier, faster, and stronger the force of their collisions increases. Even with modern football helmets the padding does not fully protect the brain from the acceleration-deceleration that occurs during these violent collisions. Hopefully as more data is collected rule changes and equipment improvements will result in better protection for football players at all levels.


What I Tell Patients and My Own Boys About Football Participation

My current conclusions are not based on any scientific analysis, but on my own experiences on and off the field. Since the vast majority of football players never play beyond the high school level, where collisions are not as violent, most will not need to worry about chronic brain injury. The single biggest problem is recognizing concussions when they occur and keeping the player off the field until they fully recover. High schools in Missouri and Kansas now require a physician independent from the team to clear athletes to return after a concussion. Part of the problem is challenging the ‘macho, tough guy’ mentality the coaches still teach football players. The alleged monetary “bounty” paid by NFL coaches for injuring an opponent is reprehensible and must be eliminated.

Based on the current evidence available and subject to change in the future, I will still allow my kids to play if they desire. Statistically, riding their bike through the neighborhood is more likely to result in a life altering injury than organized football. Football has provided me with experiences and lifetime friendships that are priceless. Knowing all I know today including my injuries, I would still go back and play college football all over again.


Jacob (Jake) Stueve, MD practices at Orthopaedic and Sports Medicine Consultants in Leawood, Kansas and was an Academic All American football player at the University of Missouri. 


Published December 10, 2012.


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Editor's note: This article is part of a special series brought to you by Missouri Medicine, the Medical Journal of the Missouri State Medical Association (MSMA). MedHelp, Missouri Medicine, and MSMA are collaborating to educate and empower health consumers by making the latest scientific studies and medical research available to the public. Learn more about MSMA and see more from Missouri Medicine.

This article was originally published in the September/October 2012 issue of Missiouri Medicine.

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