Joe Namath's NFL Knee Brace (Photo courtesy of Pro Football Hall of Fame).
Joe Namath’s knee brace looks like a medieval torture tool. In actuality, it was the first knee brace worn by someone in the NFL. Believe it or not, in a sport that is hard on joints, there was no way to support or protect the knee before the 1960s in football. Let’s talk knees and Namath.
The History of Knee Braces
Unlike other historical football topics (I cover many here), the history of the knee brace does not go back far.
Dr. Robert McDavid is often credited with being the inventor of the knee brace in 1967. That same year, with the help of brace professional Jack Castiglia and sports physician Dr. James Nicholas, Joe Namath was fitted with the infamous knee brace pictured above.
Braces had become fairly common in the league by 1970. They were a popular commodity in a league where bum knees could end your career. Surgeries were less refined, physical therapy to strengthen the knee was poorly understood, and protection (before the brace) was nonexistent.
Knee Surgeries in the 1960s
It was hard to get an official diagnosis of Namath’s actual knee injuries. His college knee issue was described as “twisted” and severely swollen, but one source identified him as having an untreated ACL tear. We’ll discuss the history of the ACL surgery here.
The Early ACL Surgery
Orthopedic surgeon Dr. Russell Warren was quoted saying: “In the 1960’s and 1970’s, ACL injuries were often missed diagnostically, treated relatively poorly, or not treated at all. Physicians didn’t know enough about the ligament. In fact, there was an ongoing debate in the field as to whether the ACL played a significant role in the knee and whether to fix it at all.”
According to Dr. Warren, the status quo was for the player to play through an ACL injury. The destabilized knee would put extra strain on the meniscus; they would tear those; the meniscus would be removed; and then they would have horrible arthritis.
In the 1970s, hospitals that do thousands of ACL surgeries now would be doing less than 10. The failure rate was high. Doctors would try to repair the ACL or replace it with a different material. In modern days, doctors do ACL grafts, completely replacing the ligament with the graft.
ACL Surgery Prognosis
Arthroscopy entered the scene in the 1980s, which helped the success of the ACL surgery immensely. At that point, doctors could cut a small hole in the surgery area and use little lighted cameras in tubes to see things. This was instead of cutting the knee wide open, which made healing harder and allowed infection to set in.
Post-operatively, things have improved as well. For example, we understand the knee joint better and have better-informed physical therapy. In the 1970s, the knee was cast for six to seven weeks. As a result, the ACL would be loose and wouldn’t stabilize the knee. When the cast was removed, everything would be weak and stiff in the joint.
It must have been that much scarier to be a football player in the 1970s, knowing that a bad joint could mean the end of a career. Knee replacements had poor success rates until the 1980s. Many players in the NFL with bum knees wouldn’t live long enough to have a successful knee replacement.
Joe Namath’s Knees
We have reason to believe that Joe Namath had an ACL tear and a posterior cruciate ligament injury. As mentioned previously, it’s really hard to determine exactly what injuries were sustained and what surgeries were performed, so there’s significant guesswork involved with examining his injuries.
The quarterback was treated by famous orthopedic surgeon Dr. James Nicholas during his playing career. Nicholas was the team doctor for the New York Jets after being recruited by a former patient who founded the team. Namath was lucky (maybe) that he had Dr. Nicholas’s help to keep gimping down the field for 12 seasons with the Jets.
Surgery 1 and 2
Namath was signed in 1965 by the Jets, already with a three-time injured right knee. A few weeks later, Nicholas got to slicing and dicing. Namath was said to have “repaired” ligament and cartilage damage. As we know now, repairing a torn ligament is mostly fruitless in the knee. “Reconstruction” is the way to go, by grafting another tendon harvested within the body to replace it.
By 1966, Nicholas was back working on the right knee. This time, he pulled more cartilage and bone fragments. Cartilage can break down and become painful with injury, which is benefited by removal. However, the cartilage is also the “padding” in the knee that allows the joint to “glide” and avoids bone-on-bone contact. Bone fragments are also fairly common to have and remove. A recipe for arthritis.
Surgery 3 and 4
Surgeries 3 and 4 were on Joe Namath’s left knee. He was said to have repaired tendons, cartilage, and ligament damage the first time around in 1968. In 1971, Namath’s knee was sliced open again for the repair of ligament damage. This appears to be for the repair of his PCL in his left knee. The ACL and PCL are some of the most commonly injured ligaments in the knee.
In Dr. Nicholas’s 1970 book, he was already describing Joe Namath as having the knees of a 70-year-old man.
Doctor and Player
Joe Namath had infinite faith in his team doctor, telling the New York Times in 1971, “After four operations I have complete confidence in him. If he tells me to play, I play; if he says I should retire, I retire.”
Namath had a history of poor health preservation skills. He had his fourth surgery due to an injury he sustained while attempting to tackle a linebacker who speared his knee with his helmet during a pre-season game. When the quarterback was asked why he played such a dangerous game in a meaningless game, he was quoted as saying, “It’s the only way I know how to play.”
Apparently Nicholas didn’t tell him to stop playing because Namath had to have his knees drained at games during halftime from 1972 on.
“Do No Harm”
We won’t get too much into this topic here, but I can’t help but call his team doctor’s integrity into question. The Hippocratic Oath requires a doctor to “do no harm.” Continuing to do surgeries and play an athlete who has implicit trust in you after you said he had the knees of a 70-year-old could be interpreted as harm.
There are many team doctors who could be called to the carpet for putting the needs of the team and their reputation before the quality (and, debatably, duration) of their patients’ lives. Obviously, there is some self-sacrifice involved with being an athlete, but at some point, lines must be drawn. Especially since doctors know better and have specific training that most people can’t fully grasp.
Again, we will avoid topics like team doctors intentionally holding back information from their players that would better inform the patients about long-term consequences. The feeling of betrayal from former players towards their doctors and the general mistrust of team doctors today exist for a reason.
Thankfully, Joe Namath was young enough to benefit from knee-replacement surgery at 49 years old. He was in pain for nearly 30 years before getting the surgery in 1992. His concussions and cognitive decline are also topics for another day.
