The ALS diagnosis of former Tennessee Titans running back Chris Johnson has sent shockwaves through the NFL community and beyond. 

Johnson’s Monday appearance on Good Morning America revealed how quickly the disease has progressed in roughly a year since his diagnosis, and the images shook fans, former teammates, and media members across the sports world. 

Myself included. 

Whether you’re a Titans fan or media, had him carry your fantasy team nearly two decades ago, or simply admired one of the most electric players of his era, the news has been difficult to process.

As more voices have emerged in recent days discussing the 2021 study of the connection between ALS and professional football, one statistic keeps resurfacing: NFL players are four times as likely to develop ALS than the general male population in this country. 

That is a staggering number. The baseline odds for men developing ALS over a lifetime fall between 1-in-350 and 1-in-400, with most diagnoses occurring between the ages of 55 and 75. Diagnoses under age 40 remain extremely rare in the general population, yet the NFL has produced a troubling cluster of exactly those cases.

“CJ2K” is one of them. So is his former Titans teammate Tim Shaw, who has been living with ALS after his own diagnosis. Those two players shared a Tennessee locker room from 2010 to 2012, a three-season window that produced two ALS cases.

Steve Gleason, the former New Orleans Saints safety, has lived with ALS for 15 years after being diagnosed under 40. The same is true for O.J. Brigance, a Baltimore Ravens Super Bowl champ who has battled the disease for two decades.

Dr. Andrews on the state of ALS research

Dr. Jinsy Andrews of NYU Langone Health, who specializes in ALS research, joined A to Z Sports Nashville’s Easton Freeze on YouTube late last week for an extensive interview. 

The conversation covered what researchers know about ALS, what they don’t, how the disease connects to CTE research in the NFL, and how funding from the league, government agencies, and the private sector has contributed to progress.

Dr. Andrews also discussed how ALS may share connections with other neurological diseases that are more commonly understood, including Parkinson’s, Alzheimer’s, and MS, suggesting that unlocking a breakthrough in one of these four diseases could help accelerate progress on the others.

ALS Doctor’s Message to Football Parents and Players

At the end of the interview, Freeze asked the question so many people have been thinking about since Johnson’s diagnosis became public: 

What is the message for parents who have children playing football or other contact sports? What about adults who played those sports themselves? Should they be worried about ALS?

“Being physically active is really important for our overall health and even for our brain health,” Andrews says. “But when we identify risk factors like playing football, we have to really understand what is it about playing football that causes the nerves to degenerate and lead to ALS?”

“We’ve come a long way in just concussion management, right? Kids in high school, when they get a blow and they get knocked out, they get pulled out until they are screened and they’re evaluated and they’re allowed and cleared to go back to playing.” 

“Once we understand what it is about playing football that leads to this risk of ALS, we can alter what we do or how we intervene when players are playing contact sports, so that we can protect them and keep them healthier for longer. So that includes physical interventions, medical interventions, maybe even pharmaceutical interventions to help protect the nerves.”

The hope is that similar progress can be made around nerve injuries and the overexertion of muscles and mitochondria that comes with years of physical contact. I think about how common “stingers” are in football. A player takes an awkward hit, their neck tightens up, their arm goes fuzzy or feels like it fell asleep for a few moments. They shake it off and go back in. Those moments happen at every level of the sport, and the long-term consequences remain poorly understood.

If researchers can continue uncovering answers about what happens to the body during those nerve injuries the way the medical community has advanced its understanding of concussions, better equipment and better protocols could follow. Those protections would trickle up and down the entire sport.

Football provides genuine value through teamwork, leadership, athleticism, and the simple benefit of being active. The goal is to protect quality of life while still enjoying what these sports offer. We, as a society, NEED continued research, continued funding, and a willingness to change how the game handles injuries we don’t even fully understand… yet. 

I’m just thinking ahead,” Andrews continued. “It’s not about just stopping football altogether, but understanding what it is specifically that raised this risk. Was it the number of years they played, was it their age, was it something about the number of times they took hits, and did they complain? There are nuances to this than just simply playing football.”