The price of success

Shaq's back, but at what long-term cost?

Shaquille O’Neal is back. You can tell by the way he’s getting 30 and 10 again. The way he’s leaving backboards shaking after dunks. The way he’s bouncing on the balls of his feet and flexing his biceps.

It's enough to make you think he's back on anti-inflammatory medication. While Shaq denied Tuesday he was again using the painkillers because of his sore knee and toe, it's impossible to know for sure becuase he says different things at different times. Just before his recent hot spell, Shaq admitted he just wasn’t able to play at a high level without them.

"I’m going to just have to get back on the medicine and hope it doesn’t mess me up on the inside," he said last month.

It’s a seldom-discussed aspect of being an NBA star. Play an 82-game season, sometimes five games in a week, and you’re going to get some aches and pains. For players like O’Neal, anti-inflammatory drugs -- from over-the-counter aspirin to prescription brands like Indocin -- can be needed just to get out of bed each morning.

But ever since the high-profile cases of Sean Elliott and Alonzo Mourning -- both of whom had their playing careers cut short because of kidney disease -- many NBA players have begun to question the wisdom of taking such drugs. While considered safe for the vast majority of people, medical experts say prolonged use at excessive levels may lead to some forms of kidney problems.

Although there is no evidence of a direct link in the cases of either Elliott or Mourning, both players said they had used anti-inflammatories and believe it might have contributed to their conditions. As a result, some NBA players around the league have become reluctant or unwilling to take them.

"You do think about it," veteran Bulls guard Fred Hoiberg said. "On the one hand, it’s your job. On the other hand, there might be long-term effects. ... I’ve got twins on the way. I want to be around to see them grow up."

For Shaq, the decision has become something of an issue in L.A. While he has taken prescription painkillers such as Naprosyn, Orudis and Indocin for years, he says they sometimes leave him with a queasy stomach. He also admits the Mourning situation concerns him.

Citing those fears, Shaq last month said he would no longer take Indocin, which he had been using to alleviate pain in his sore knee and surgically repaired big toe. Instead he chose to sit out three games, including a showdown with Yao Ming and the Rockets. Many L.A. fans were angry.

Even Lakers coach Phil Jackson seemed unsympathetic. At one point, Jackson chided Shaq, suggesting he had a case of "Ming-itis." Talk-radio hosts pointed out Shaq’s $24 million annual salary -- and Kobe Bryant’s decision to play through his own knee pain -- and accused him of being selfish.

For old-school types like Jackson, downing anti-inflammatories is just a part of the NBA job description, like showing up for practice and tucking in your jersey. During his playing days in the 1960s and '70s, players popped them like candy. "I took them all the time," Bucks coach George Karl said. "I wanted to play."

Today’s pro athletes are better educated -- and better compensated. With millions of dollars in the bank, they understandably might not be as willing to take long-term health risks.

On a recent episode of Fox’s Best Damn Sports Show, former NBA star John Salley talked about his own experience with painkillers and urged Shaq, for his long-term health, not to take them. Former NFL star Michael Irvin disagreed, saying the risk was minimal. Former Mets pitcher Ron Darling played it down the middle, though he did blame anti-inflammatories for a severe case of stomach problems he experienced one spring.

Three pro athletes. Three different opinions. It’s like that in a lot of NBA locker rooms these days.

Do players such as Shaq, who are paid millions in guaranteed contracts, owe it to their teams to do what it takes (within reason) to stay on the court? After all, there is no clear evidence that such anti-inflammatories cause kidney damage. And what is acceptable risk for a pro athlete, anyway?

For now, it doesn’t matter. Shaq is back on the court, and the Lakers are riding high once again. But if he had continued to play at sub-par level while staying off the medicine -- and L.A.’s quest for a four-peat had failed -- he would have heard about it from fans, media and maybe some in his own organization.

In other words, he would have had a headache that no amount of aspirin could have cured.

Marty Burns covers pro basketball for SI.com. Click here to send Marty a question or comment.

 

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