As a long-time football fan, and as a sports medicine orthopedic surgeon, I have always believed that NFL players deserve guaranteed contracts, especially given the high rates of injuries. While I still think the argument has merits, I thought it would be worthwhile to discuss the pros and cons of NFL guaranteed contracts for my latest newspaper column.

NFL players playing through injuries

On Sunday, I received an email from a producer at a major media company. She explained that she would like to interview me to discuss NFL players playing through injury. The premise was that teams, and their coaches and doctors, supposedly pressure the athletes into playing hurt. But she emphasized that the show would also like to show how the athletes themselves play hurt due to pride and a sense of obligation.

Minutes later, I watched replays of Cincinnati Bengals quarterback Joe Burrow, the top pick in last year’s NFL Draft, suffering a serious knee injury that could keep him out of football for 12 months or more.

Whether or not you believe teams push players to take the field injured, putting them at higher risk for further injuries and long-term physical disability, or you believe that players willingly play through injuries, it’s hard to argue the risk of physical harm is enormous.

Given that risk, should the NFL and its team owners fully guarantee the contracts of its players for injuries suffered while playing the sport?

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Should the NFL guarantee contracts for injuries?

Of the four major pro sports leagues in the U.S., the NFL is the one which largely avoids guaranteed contracts. Major League Baseball guarantees players’ salaries completely. Other than occasional buyouts, the NHL guarantees them as well. The vast majority of NBA contracts are guaranteed. And the NFL’s lack of guaranteed contracts persists despite bringing in over $15 billion in revenue in 2019, according to Statista.

One could argue that the NFL should be the league most willing to pay players even if they get hurt. After all, injuries are far more common in football than other major sports. According to the Football Players Health Study at Harvard University, the NFL has ten times more injuries per game than the next closest professional league. In fact, the authors of the study found that “the estimated mean number of injuries suffered per game in the NFL is approximately 4.9 times higher than the sum of those other leagues.”

Without question, NFL athletes get paid a lot of money to play a game for a living. But consider the fact that the average NFL career lasts 3.3 years, according to the NFL Players’ Association. Over three-quarters of players go broke within three years of retirement.

Should NFL players have guaranteed contracts in case of injuries?

The slow move toward guaranteed contracts in the NFL

While most NFL players don’t have fully guaranteed contracts, we have seen more movement toward them in recent years. In 2018, Minnesota Vikings quarterback Kirk Cousins signed a fully guaranteed three-year, $84 million contract. Russell Wilson and Patrick Mahomes recently signed deals with large amounts guaranteed. But most of the non-star players can be cut after an injury and not receive any of the money remaining on their contracts.

Three types of contract guarantees in the NFL

NFL contracts have three types of guarantees: skill, cap, and injury guarantees. I’m interested here only in the financial security of players after they get hurt, so I’m addressing injury guarantees. A player with a contract fully guaranteed for injury could suffer a football injury, fail to pass a physical performed by the team doctor, and still be paid his full salary if the team were to release him.

For a team owner, players are assets. If a player performs well on the field and brings the team a championship, he is worth more to the franchise. But he could also suffer a career-ending injury on the very next play, and he becomes worthless to the team.

Such a view might be cynical, but guaranteed contracts shift the financial risk of injury to the owners. As it stands now, players who already accept the risk of serious harm just by stepping on the field also accept the risk of losing future income from those injuries.

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The arguments against injury guarantees

The arguments against injury guarantees are simple. There are far more players in the NFL than the other leagues – four times more than the NBA, for example. Injured players could lose their motivation to play, theoretically sitting out of games they could otherwise play in.

And it’s worth noting that, according to the Harvard study, the NFL offers health-related benefits that many other pro leagues don’t, including severance pay, long-term care insurance, and the Former Player Life Improvement Plan.

Will we see guaranteed contracts in the NFL soon?

I don’t see the NFL guaranteeing the contracts of every player for injuries suffered any time soon. If it did happen, I’d expect owners to simply offer lower salaries and shorter contracts. Whether that’s a good deal for the players, especially for those who aren’t elite quarterbacks, is up for debate.

Note: A modified version of this article appears as my sports medicine column for the November 25, 2020 issue of The Post and Courier.