Football With A Pacemaker: Be Guarded

American football is a popular sport in the USA both professionally and as a pastime.

Granted, I personally have never played the sport, but I can absolutely see the appeal of it: it builds a sense of camaraderie, is a fun social activity, and is just an enjoyable sport all around. Following that logic, it makes sense why so many choose to play the game, regardless of their cardiovascular condition.

As such, it is an excellent sport to help one’s physical, mental, and social well-being.

However, as we have discussed with other sports, sometimes some extra caution is needed if you have a cardiovascular device like a pacemaker.

Does this problem also pertain to American football and pacemakers?

Before you grab your helmet and rush out onto the field, let’s take a deeper dive into this question.

The article, American‐Style Football and Cardiovascular Health, by Kim et al. acknowledges the popularity of the sport, “American‐style football (ASF) is the most popular organized team sport in the United States, with ≈1 million high school, 70 000 collegiate, and 2000 professional participants annually” (Kim et al., 2018). However, despite its popularity and how “youthful competitive athletes are classically regarded as the paradigm of health and vitality, uncertainties surrounding the long‐term health implications of ASF participation have recently become a topic of considerable interest and controversy. Specifically, concerns about the impact of ASF participation on cardiovascular and neurocognitive health have generated lively debates in the scientific literature, in the mainstream media, and within governing bodies that oversee ASF rules and regulations” (Kim et al., 2018). Therefore there is an established reason to investigate this matter despite the presume health of the athletes.

Tn terms of cardiovascular disease, “a growing body of observational data documents associations among large body mass, early life hypertension, and subclinical pathologic cardiovascular phenotypes in ASF athletes. In addition, epidemiologic outcomes data from former professional ASF athletes suggest accelerated cardiovascular mortality among former lineman‐position players. The precise relationship between early life ASF participation and subsequent cardiovascular health remains incompletely understood; however, multiple lines of evidence suggest that ASF participation may impart increased risk for the development of cardiovascular disease” (Kim et al., 2018). That being said, there is clear concern for the cardiovascular health of those playing American football for even those with generally healthy hearts. But the results are still unclear.

It is clear that playing or not playing football even with a healthy heart is necessarily good for the organ if it is taken too far. This is why the article also quotes Vince Lombardi, “To achieve success, whatever the job we have, we must pay a price” (Kim et al., 2018). It is true that there is always a risk to achieve success, especially if it involves something we love. However, considering this, the question must be asked: what risks do someone with pacemaker take when they play American football? Is it even worth taking?

It’s complicated.

The article, Recovering From A Pacemaker Implantation by NHS Inform says very clearly, “if you play contact sports, such as football or rugby, it’s important to avoid collisions. You may want to wear a protective pad. Check with your cardiologist before taking part in extremely energetic activities” (NHS inform, 2024). So, the road toward playing football with a pacemaker is not necessarily straightforward due to the nature of the sport itself.

However, it should be remembered that this statement is not a direct “no” as to whether or not someone with a pacemaker can participate in the sport. Rather, it advises caution and provides a list of factors to considered before picking up the ball.

The article highlights how the primary danger to the pacemaker is a potential impact at the site that could damage or dislodge the device. This should be avoided at all costs.

So, before playing American football, one must consider safety. It might be a good idea to consider playing casually rather than professionally. Ideally, the game could take place at a park or an open area instead of a stadium. This less intense environment may be better for both your cardiovascular health and your pacemaker as it theoretically reduces stress and the likeness of being run into while playing. It kills two birds with one stone.

However, should one be collided into during the game, there must be some level of protection to mitigate the impact. The article mentioned a ‘pad’ but, I, personally, recommend more than that. For optimal protection, I would suggest that one wears at least a padded vest below some sort of harder plastic guard. Since the biggest concern is damage to the site itself, once this area is protected, then it should be ok for one to play the game with significantly less fear.

It is very important to remember, however, that in such a high contact sport like American football, the risk can be lessened but that does not mean it is erased. There is always some level of danger of collision and device damage to this game if you have a pacemaker. So, I do advise caution.

However, don’t take my word for it. Whether or not you play a sport, especially a risky one like American football, should be discussed between yourself and your medical professional. This is because one’s cardiovascular health needs to be strong enough to handle the physical requirements of the sport long before the pacemaker and its protection should even be considered.

Once these three things are accounted for then feel free to join in the fun! But please, do so with care.

Personally, as a child, I wanted to play football but always had to sit out. However, while my pacemaker was a concern, the primary barrier keeping me from the field was the very real danger of excess bruising from the blood thinners due to the mechanical heart valves.

That doesn’t mean I don’t enjoy watching the game from time to time. I can see why many love the sport and how someone could feel deeply passionate for a game even if they have a pacemaker.

So, if you do love American football and you have taken all the necessary precautions especially after talking to your doctor about it, then I wish you the best of luck.

So, while American football is on the more dangerous side of the spectrum of sports we’ve discussed so far, this does not necessarily mean people with pacemaker’s can’t play it. We just need to be more cautious.

Before you put on your helmet and run onto the field, check with your doctor first, ideally play in an open area, and absolutely wear one or more layers of chest protection.

Tune in on Wednesday for the long awaited article about White Tea and CVD.

Keep ticking, my friends!

What topics about CVD or pacemakers would you like to learn more about?

Let me know.

Reference List:

Kim, J.H., Zafonte, R., Pascuale‐Leon, A., Nadler, L.M., Weisskopf, M., Speizer, F.E., Taylor, H.A. and Baggish, A.L. (2018). American‐Style Football and Cardiovascular Health. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, [online] 7(8). doi:https://doi.org/10.1161/JAHA.118.008620.

NHS inform. (2024). Recovering From A Pacemaker Implantation . [online] Available at: https://www.nhsinform.scot/tests-and-treatments/surgical-procedures/pacemaker-implantation/recovering-from-a-pacemaker-implantation/.

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