Health risk?

NBA players worried about anti-inflammatory impact

Players across the NBA are nervous -- but not about facing up to the Los Angeles Lakers' destiny, pending roster cuts or even financial investments gone south.

No, what suddenly has them worried is the long-term impact of anti-inflammatory drugs, the pills many players pop to get through a game or practice, to deal with the aches and pain of a season-long grind. The pills some of them abuse.

With Alonzo Mourning, the Miami Heat’s all-star center, out indefinitely because of a kidney ailment -- the same disease that caused San Antonio Spurs swingman Sean Elliott to require a kidney transplant and eventually factored into his retirement -- talk is rampant around the NBA about a possible connection to prolonged use of these anti-inflammatories.

An important disclaimer here: No direct medical link has been made between anti-inflammatory medicines and kidney disease, particularly in the cases involving Elliot and Mourning. Still, a players union official describes a “epidemic of concern" among players.

Dr. Domenic Sica, a consultant to the NBA Players Association, says the answer as to why two well-known players contracted kidney disease is -- for now -- “bad luck."

But word has Shaquille O’Neal so fearful that he stopped taking an anti-inflammatory drug to cope with a painful toe ailment. Former NBA players Larry Johnson and Luc Longley quit taking anti-inflammatories late in their careers because of the accompanying stomach distress. Milwaukee Bucks All-Star guard Ray Allen has complained of similar side effects. Purvis Short, a union official and former NBA player, claims to have heard from others reporting side effects.

“A lot of times guys have been using [anti-inflammatory drugs] every day since college," says Atlanta Hawks All-Star forward Shareef Abdur-Rahim. “Now, after what happened with Sean Elliott and with Alonzo, guys are asking questions."

What is the usage pattern? Nobody knows, but the players union and those close to the league say you can only go by perception, which is that a fair number of NBA players ingest the medicine on an almost routine basis.

From his experience, Abdur-Rahim suggests about three-quarters of NBA players use anti-inflammatories to cope with pain, saying: “Among the guys really playing big-time minutes, there is something -- Advil, Motrin, Aleve or whatever. Playing a lot of minutes your body takes a toll. Guys take things to recover. And it does help you recover."

That’s the Catch-22 situation. The anti-inflammatory drugs, from over-the-counter medicine like ibuprofen and aspirin to prescription drugs, help dull the strains and bruises that are a daily burden to NBA players and other athletes. So if you’re worried about a starting job or playing time, you probably do whatever it takes to stay on the court. But at what price?

Medical experts say using the drugs short-term in recommended dosage shouldn’t lead to kidney disease, but the effects of long-term usage remain a mystery to researchers.

Common sense, however, suggests habitual ingestion over a lengthy period isn’t a smart thing. Nor is exceeding the recommended dosage, which is suspected to be the case with some NBA players.

“The effect of long-term usage is something doctors worry about, because the drugs are so darn popular," says Dr. William Henrich, chairman of the Department of Medicine at the University of Maryland School of Medicine. “Most of the time when you take these drugs the No. 1 side effect is your stomach gets upset. If you get by that, you do put yourself at some risk for a kidney reaction of one type or another. So people need to be cautious. The recommendation is that individuals take them at the lowest dose for the shortest amount of time."

To its credit, the union is trying to guide its members. The NBAPA brought in a team of medical experts to specifically discuss anti-inflammatory medicines and kidney disease at a medical symposium for players in June and during a rookie orientation program last month. Next, the union plans to set up an advisory panel of doctors across the country to offer a second opinion for players, possibly providing blood level and kidney screening.

“The anti-inflam use is real [among players]," says Sica, a professor of medicine and pharmacology at Virginia Commonwealth University. “Most players tell you that it is available to them in the training room. I tell the players to be careful about what they’re taking, for how long and the amount. And if they use more than the recommended amount, then talk to someone. Maybe not just to your team doctor or your trainer. You can’t just self-medicate. Get someone who is objective and outside the loop."

No one is calling a hard foul here, daring to charge team doctors with not protecting the players' best interest. It’s just that team medical staff can’t escape the inherent conflict of interest when it comes to advising pro athletes.

“My initiative is to get players better able to take care of themselves," says Sica. "Not to say that they don’t have a health care network within the team, but they have to do a little better job on their own.’’

Mike Fish is a senior writer for CNNSI.com.

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