One player defied his team and had surgery on his damaged shoulder. Another blamed his club for not spotting a rare form of cancer sooner. Still another, according to media reports, disputed his team’s assertion that his concussion symptoms had abated.
The players — former Jets guard Kelechi Osemele, Washington Redskins tackle Trent Williams and Cincinnati Bengals tackle Cordy Glenn — had very different ailments. But what they had in common was a willingness to question their employers over how their injuries were handled, and all of them appear to have paid a financial price.
The N.F.L. has for generations been built on the backs of players willing to sacrifice their long-term health for a paycheck, and perhaps no position group accepts repeated injury more stoically than offensive linemen. Now a small number of players are, in effect, putting their long-term well-being over paychecks and speaking up in defense of their health, spurred on by a few advancements.
With the digitization of medical records, players have access to information about their conditions at their fingertips. Players are using their hard-fought right to seek second opinions, as guaranteed in the collective bargaining agreement. Social media and 24-hour sports news have given players platforms on which to speak out and challenge the spin on their reasons for sitting out.
According to the N.F.L. Players Association, the union has filed about 40 medical grievances on behalf of players in the past two years. A union spokesman said that number had generally declined because teams had been settling with players more often to avoid grievances.
“This is the age of empowerment, they feel emboldened, and you’ll see more and more veterans standing up for themselves,” said James Acho, a lawyer who has represented retired N.F.L. players for nearly 20 years.
This season’s public medical spats come months after the former Indianapolis Colts quarterback Andrew Luck went on national television to announce he was retiring from football because of the wear and tear on his body, and the desire to take care of his long-term health.
“I haven’t been able to live the life I want to live,” Luck said during his farewell. “It’s taken the joy out of this game. The only way forward for me is to remove myself from football and this cycle I’ve been in.”
To be sure, Luck as well as Osemele, Williams and Glenn presumably have the wherewithal to absorb the consequences of speaking out. All of them have made tens of millions of dollars and have played at a level that should ensure their place in the league. It is far harder for rookies, free agents and walk-ons with less secure futures to follow the same course of action.
The Bengals won’t confirm reports that they have fined Glenn $200,000 for sitting out, referring to the ongoing friction as “an internal disciplinary matter.” But the fact that clubs have pushed aside top-flight players like Osemele and Williams — outright releasing Osemele from his $21.9 million contract and electing not to pay Williams the remaining $5.1 million on his — is a fresh reminder that players speak out at their peril.
This reality is likely to harden the N.F.L. Players Association’s opposition to proposals by team owners to extend the regular season to 17 games, scaled back from their original push for 18, which the players contend would increase their risk of injury. The teams, meanwhile, say the decision to add games would increase revenue that could be split among all parties.
In a league of 2,000 players, the details of most cases are never publicly disclosed. Many players accept the diagnoses of their team doctors with little pushback.
Those who doubt their diagnosis or want to be reassured they are taking the right path can seek second opinions. The union provides players with a list of doctors available for second opinions, and the team pays for those visits.
According to the collective bargaining agreement signed in 2011, players can seek a second opinion but must notify the team in advance and share the second opinion with the club. Players can follow the diagnosis of the second doctor, “but only after consulting with the club physician and giving due consideration to his recommendations.”
This is where conflict can arise. Last month, Osemele ended a public showdown with the Jets when he had season-ending surgery to repair a torn labrum in his right shoulder even though the team did not authorize the procedure. The Jets, whose doctors had determined that Osemele was well enough to play, released him. The N.F.L.P.A. is expected to file a grievance on Osemele’s behalf.
“We felt like this was the best decision for the organization and the team in regards to our decision,” Jets General Manager Joe Douglas said after Osemele was released. “One thing that I will clarify: The safety and well-being of all our players is paramount.”
In Washington, Williams blamed team doctors for not more quickly acknowledging his concerns about a growth on his scalp that turned out to be a cancerous tumor that required surgery. Williams has sat out most of this season partly because of a salary dispute, but also because he was unable to comfortably wear a helmet.
Last week, the team put Williams on the non-football injury list and said he would not play this season.
Williams has asked the N.F.L.P.A. not to seek legal action against the team, presumably because he wants to move on. But DeMaurice Smith, the executive president of the union, accused the Washington franchise of a “disinformation campaign” and leaking Williams’s medical records. He also questioned the loyalty of the team’s physicians.
“Doctors have an ethical obligation to treat our men as patients first regardless of where their check comes from,” Smith said last week.
Team doctors push back at the characterization that they put the needs of their employers ahead of those of the players. Dr. Leigh Ann Curl, an orthopedic surgeon and team doctor for the Baltimore Ravens for 20 years, said that “medicine is complicated and for any specific set of problems, you may get a difference in opinion for what the best treatment is.”
Curl, who is the president of the N.F.L. Physicians Society, said she routinely helps players seek a second opinion. Some players, she said, prefer to use doctors they know or who have a particular specialty.
“If they choose to work with another doctor, that’s not a threat to me,” she said. “It’s not as clandestine or adversarial as you might think.”
While players must share the second opinion they receive with their team doctors, Curl said she wanted to make sure that second diagnosis was credible. “Maybe they come back with something that doesn’t really make a lot of sense,” she said, adding that a third opinion is sometimes sought.
But where there is no common ground, as in Osemele’s case, players see no choice but to be advocates for themselves.
“A lot of guys play through injuries,” Osemele said in October. “But once it stops working and it doesn’t do anything for you anymore, then you’re at the point of ‘What do I do now?’ Do I take Vicodin? Where is the line? How much should a player play through pain?”
Danielle Allentuck contributed reporting.