The Cost of Playing Through Pain in the NHL

[00:00:00]The hip tore in game five. The groin tore with it. Ryan Kesler played all seven games of the Stanley Cup final.

[00:00:08]1,01 games. One silver medal. One drug that almost killed him long after the final whistle. The drug was called Tordol.

[00:00:18]>> But it's my belief that people taking high doses of Tordol on a chronic basis before vigorous exercise are putting themselves at serious risk. By the end of this, you'll understand why some of the toughest men in hockey quietly fell apart after they retired.

[00:00:34]>> It's terrible. And and that was all because I wasn't made aware of what this drug could could potentially do to me.

[00:00:42]>> Leavonia, Michigan, a kid who skated before he could ride a bike. Ryan Kesler was drafted 23rd overall by the Vancouver Conucks in 2003. And for the next 15 years, he built a reputation that had nothing to do with skill alone.

[00:00:56]skill most teams can find. What Vancouver got was something harder to replace. A center who killed penalties, won faceoffs, shut down the other team's best line, and then went to the front of the net and put the puck in. A two-way force. The kind of player coaches talk about in closed rooms when they talk about winning. In 2011, he won the Selki Trophy as the best defensive forward in the league. That same season, he scored 41 goals, both in the same year. And neither of those things is what people remember most about him. The hip problems didn't start late. They started early. January 2007, he was 22 years old. Three seasons into his career. Torn labram. That's the cartilage that keeps the ball and socket stable. Once it tears, you can rehab around it, but you cannot fix it without surgery. He had the surgery. Then he came back and kept playing. Four years later, the 2011 playoffs. Vancouver was built for a championship that year. Kesler was the engine. In the second round against Nashville, he carried that team on his back. In the Western Conference final against the San Jose Sharks, game five, something gave a tear in his groin, a tear in his hip labum. Two injuries that should end a postseason at the same time on the same shift. He didn't miss a game. He played all seven of the Stanley Cup final against the Boston Bruins. He managed one assist in that series.

[00:02:27]Vancouver lost game seven at home. A week later, the league gave him the selki. About 6 weeks later, he was back on an operating table getting his hip put back together. This is where the myth took hold. Not the award, not the 41 goals, the image of a guy playing through two tears because the alternative sitting out wasn't something he could imagine doing. He once told the Canucks medical staff to cut his broken finger off so he could keep playing in a playoff series. He said it like a joke.

[00:02:56]He also said years later he would have done it. That's who he was. And in his own words from the TSN report that eventually blew this whole story open, "For me, I only knew one position and it was full out and full gear." It's easy to hear a line like that and admire it.

[00:03:13]That's the point. The whole system runs on that admiration. And nobody asks the question that actually matters. How many guys in how many locker rooms right now are doing exactly what Kesler was doing?

[00:03:26]And what happens to them 5 years after the last game, 10 years after the last game, when the cheering stops and the body finally sends the bill? But stop here for a second because the story so far is one you've heard before. Tough guy, torn up, played anyway. If that's where it ended, nobody would have made a documentary in 2020. The story didn't end there because of one specific drug.

[00:03:52]A drug most fans have never heard of. A drug most players don't understand either. Tordol. The generic name is couturlac. It's a non-steroidal anti-inflammatory, an insaid. Same drug class as ibuprofen, but nothing like it in strength. Toridol is what you get in a hospital after surgery. when the next step up is morphine. It was developed by a Stanford chemist named Robert Greenhouse who spent 17 years creating it. He designed it to be as potent as morphine without being an opioid. He succeeded. Pain is a signal. Your body is telling you to stop. Toridol doesn't fix the damage. It mutes the signal. You still have the tear, the inflammation, the damage. You just can't feel it. So, you escape. You take the hit. Your body is screaming and you can't hear it.

[00:04:44]You're borrowing against a debt you don't know you're opening. The FDA put a boxed warning on Toridol. A boxed warning is the strongest warning the agency issues. One step short of pulling a drug off the market. The warning says in plain language that total use combining injection and pills is not to exceed 5 days. Not 5 days per injury, not 5 days per season, 5 days ever in one stretch. After that, the risk of gastrointestinal bleeding, ulceration, and perforation climbs sharply. The drug's own inventor put it this way. It was never meant to be used for more than 5 days at a time. Ryan Kesler took it for years. And here's where the story stops being about one player. TSN's Rick Westhead spent a year on this investigation. He spoke to player agents across the league. Multiple agents told him the same thing. They have clients, current NHL players, who take toridol before every regular season game, before every playoff game, as a preventative measure. Not because they're hurt that day, because they expect to be hurt by the third period and they don't want to feel it when it happens. That is not one player making a bad decision. That's the infrastructure. Trainers who prepare the injections. Team doctors who write the prescriptions. Locker rooms where a needle is as routine as the tape on a stick. An entire professional culture organized around the idea that the human body can be overridden night after night for 82 games plus playoffs for 15 years with a drug that was approved for 5 days. Kesler is 31 years old, still playing now for the Anaheim Ducks, who had traded for him the year before. He starts feeling something new, not the hip pain, something in his gut. The diagnosis comes back, colitis, chronic inflammation of the colon. His doctors trace it directly to the years of toridol. Four years later, in the fall of 2019, he got a second diagnosis on top of the first, Crohn's disease.

[00:06:54]another inflammatory bowel condition.

[00:06:57]Lifelong, incurable. By this point, he's already stopped playing. The damage kept compounding after he'd put the skates away. What colitis and Crohn's actually mean is not something a broadcast graphic can convey. Kesler to ESPN in September 2020, "I had holes in my colon and ulcers. His intestines would spasm.

[00:07:19]He was going to the bathroom 30 to 40 times a day. When he did, it was pure blood.

[00:07:25]>> It ate holes in my colon and ulcers and basically my whole intestines went into spasm. You know, it's it's very unpleasant. You got to go to the bathroom. I was going 30, 40 times a day during playoffs. And he said all of it came from not being told what the drug could do to him. Go back to that FDA label. In the precautions section, there's a specific line. NSAIDs should be given with care to patients with inflammatory bowel disease because the drug can make it worse. The medical community has known this for decades. It wasn't obscure science. It was printed on the box. So the question was never whether the league knew the risks of Toridol. The information was publicly available in pharmarmacology on the packaging and in the medical literature for decades. The question is how long they were willing to pretend the risk was the players to carry. Here's what Kesler says about his own experience inside that system. I never knew what it could do to me. That line is worth sitting with. He isn't saying he was reckless. He's saying he trusted the people who handed him the needle to tell him what it was. And they didn't. Team trainers, team doctors, the medical staff whose job is literally to protect the player. None of them sat him down and walked him through what this drug would do to him after his career was over. That's not a hypothetical anymore.

[00:08:45]His career ended on March 6th, 2019. His last game was against the St. Louis Blues. He tried to come back. Both hips failed. He had resurfacing surgery on the right side in May 2019. On the left in February 2021, he was 34 years old.

[00:09:03]Before we get to what Kesler did next, we need to be clear about the system that produced him because blaming one teen doctor misses the point. The pressure to play through injury doesn't come from one person in a hockey organization. It comes from everyone at once. It comes from the coach who needs you on the ice tonight. It comes from the teammate who's covering your shifts when you're out. It comes from the general manager watching your contract clock. It comes from the rookie in the miners who's been called up and is skating around in your warm-up jersey.

[00:09:35]It comes from the fan base that will cheer a player who takes a puck to the face and finishes the shift and will turn on a player who sits out with an injury that doesn't show up on camera.

[00:09:46]The entire machine is calibrated to reward one thing, availability. A player who doesn't play isn't a player. Kesler described it simply.

[00:09:56]>> I never wanted to hurt the team, so I knew I had to play. And >> that's not toughness talking. That's the job description. and fellow former NHL defenseman Kyle Quincy, who appeared in that same TSN documentary, put the job security side of it better than anyone.

[00:10:13]>> You're a prospect, then you're a project, then you're a suspect.

[00:10:17]>> That's the window. Every player knows it. If you can't play, someone else will. And when you come back, your spot might not be. So, you take the shot. You play the shift. You worry about the consequences later. Later came for Kesler. In September 2020, he sat down with Rick Westhead and TSN for a report called The Problem of Pain. Not for sympathy. It'd already been out of the league for over a year. He did it because nobody in authority was saying what he was saying, and he was tired of waiting. The cost of what he gave the game is paid now, every day in his own home. After treatments, he sleeps for 2 days. If he tries to do something active with his kids, he pays for it the next day. In his words, >> it got so bad that they would stop asking to to go out and throw the ball with him.

[00:11:07]>> They stopped asking because they already knew the answer. He spoke up because of who was coming behind him. There is an 18-year-old right now somewhere in an AHL locker room who got called up for his first NHL game this week. Somewhere between the morning skate and the opening faceoff, a trainer is going to hand him something and tell him it's routine. It's what everyone uses. It'll get him through the game. Nobody will hand him a pharmacology textbook. Nobody will walk him through what 15 years of this does to his gut. He's going to take it. He's going to play. And if he's good enough to stay, he'll take it again and again for as many years as his body holds up. That's the system Kesler is trying to put a crack in. That's why he went on camera. And that leaves the rest of us, the people watching, the ones who filled the buildings, who bought the jerseys, who clipped the highlight of him playing through two tears in the 2011 conference final and shared it around as proof of what hockey is supposed to look like. We've watched these men bleed on the ice, and we've called it heart. We've called it warrior culture. We've called it a compliment.

[00:12:14]But what do we call it when the cost doesn't show up on the ice? when it doesn't show up in the press conference or the postgame interview or the retirement ceremony. When it shows up 5 years later in a hospital bed, in a diagnosis, in a father sitting on a couch watching his kids play from a distance because his body won't let him join them. That's the cost of playing through pain. And the bill doesn't come when the game ends. It comes when everything else does. Drop a comment. If you were 22 years old and someone handed you a shot that could end your pain tonight and your career tomorrow, what would you do? If this one hits home, a super thanks means a lot and it helps these stories keep coming. And hit subscribe. The next one goes somewhere you won't see coming.