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Truth about players playing injured

Hines Ward's recent comments about teammate Ben Roethlisberger shed some light on the attitude most NFL players have regarding injuries, team doctors and concussions. My guess is that attitude would confuse and surprise most fans that don't really understand the business of the NFL and the internal and external pressure to play. Allow me to explain the prevailing thought process among most NFL players when it comes to some of the issues that Ward raised.

Most players attempt to play primarily for selfish reasons. Football players are conditioned since the day they first start playing to believe that playing with pain or injury is expected. To be successful as a football player one has to have significant physical and mental toughness. Playing with a physical malady of some kind is the ultimate demonstration that an athlete possesses both qualities. At least that is what the players believe.

The decision of whether or not to play through pain or an injury of some kind is enhanced in the NFL by an overwhelming sense of fear -- that if you are unable to get out on the field, somebody else will seize your role and ultimately your job and livelihood. In a sport in which most of the combatants have little to no job security to begin with, being unable to compete for whatever reason gives the team an easy excuse to move on to the next body. And yes, I meant body, because that is exactly what NFL players are. There is a sign in the New England Patriots training room that says "Durability is more important than Ability," and they mean it.

That inherent lack of job security is a major factor in whether or not to play with an injury. It really isn't that complicated. Established stars with big-money guaranteed contacts, such as Roethlisberger and Cardinals quarterback Kurt Warner, can afford to sit out a game if they have symptoms of some kind later in the week. Guys lower on the totem pole do not have that luxury. They play because they realize how valuable these jobs are. That's also why you don't hear a whole lot about backup linebackers who make their living on special teams sitting out games because of some mild, post-concussion symptoms later in the week.

Playing for your teammates is a concern as well. Football is a violent sport in which many players are charged with keeping others free from harm. That's serious stuff. Whether it is the running back picking up the blitzer or the offensive guard blasting the nose tackle who is bending the center backwards with a bull rush, there is an understanding that the guys wearing the same colored uniforms will have each other's back. That goes beyond money or job security.

Along with that brotherhood is a sense of responsibility to play through pain because of the understanding that your teammates would do the same. One year in the NFL I started on an offensive line in which three guys, including myself, had surgery after the season for one thing or another. One of the two who didn't have surgery had missed parts of several games with a torn oblique yet still tried to play through the injury. The fifth member of the line, however, refused to play through a couple of minor injuries on multiple occasions. As a result he never really fit in with the rest of the group and was somewhat ostracized. The message was loud and clear as far as we were concerned: he could not be trusted to do the things the rest of us were willing to do for each other. And yes, as far as offensive lines go, I do believe that one bad apple can spoil the bunch.

That means doing whatever it takes to get on the field. Whether the reasoning is purely one of self-interest and survival or one of obligation to others, the pressure to play is constant. It's important to note that I don't necessarily blame the team doctors and trainers, though I certainly think sometimes they could be a little more forthcoming with information.

Players, likewise, could be more open about how they really feel. If I had a dollar every time an injured player in pain said he was "good" or "fine" when the team's medical staff asked them how he felt, I would be a very rich man. The propensity for being less than truthful in order to play is what Ward was alluding to with his comments and something Warner also spoke about earlier this week.

The thing most fans don't really recognize is that players don't curry any favor with their coaches or front office by doing the "smart" thing and sitting out a practice or a game when they are injured. A missed practice or game because of an injury is every bit as bad as actually having a bad play or game in the coaching staff's book. Maybe even worse. Consider it a bad mark that goes on your permanent record. Forever.

In fact, even playing through an injury isn't really rewarded. I learned early in my career that being in the training room receiving treatment for any type of physical ailment is frowned upon. Now, if you truly need assistance in order to play, that is somewhat acceptable. Anything outside of that, your career is much better served if nobody ever knows anything about the pain you are experiencing because the team can and will, on occasion, hold that injury against you down the line, even if you gut it out and play.

Concussions are a whole separate issue. The NFL and its players are at a critical juncture as it relates to head issues and the recent rash of concussions. How they are being treated now versus before bears that out. That is one reason Ward and other veterans are somewhat confused. They have seen this thing come full circle right before their very eyes.

Players used to almost always play the next week after suffering a concussion and, in fact, often would return in the very same game. There are so many different levels of concussions that it is hard for some to truly understand the difference between "seeing stars" or being knocked a little "silly" to being rendered completely unconscious like Eagles RB Brian Westbrook was earlier this year against the Redskins.

I have never been diagnosed with a concussion, but I can think of at least three times during my career when I am pretty sure I suffered some sort of low grade brain trauma. On every occasion I was woozy for several seconds after the play and I distinctly recall thinking the collision was different. I was never knocked out on any of those plays, so I just kind of recovered in time for the next play, even though things may have been a bit hazy. I also never told the trainers or doctors about those episodes, which, of course, is the reason I was never officially diagnosed with a mild concussion.

Complicating matters is that unlike a torn ACL or a broken arm, there is simply nothing visual for a player or his teammates to see that confirms the severity of the injury. There is no brace or cast for a head trauma and I think that contributes to the mindset of the "50 percent" of the Steelers who thought Roethlisberger should have played, according to Ward. They saw Big Ben practice and to them he looked and acted fine all week. Then, the day before the game, all of a sudden they are told he won't be playing. Even if the doctors shut down the Steelers signal caller, there are clearly guys in the Steelers locker room who felt like Roethlisberger should have just said "fine" or "good" when the medical staff asked him how he was feeling.

After all, that is the NFL players' way.

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