Football is one of the most violent sports in the world – a fact that is both its downfall and allure. As players, we are acutely aware of the risks we take every time we step on to the field. And if we aren’t, it’s often a chosen ignorance, a conscious decision to embrace the reckless freedom that the sport demands. I don’t know a single teammate from my career in the NFL or college who doesn’t suffer daily pain from their playing days. Yet, that pain often brings back memories of treasured moments – the locker room camaraderie, the weight room grind and the battles on the field. In the NFL, these injuries can feel like medals of honor, testaments to having survived a game that those who have not played it cannot truly fathom. Despite the suffering, most of us continue to play the game we love while we still can, accepting the consequences of the life we’ve chosen. Few regret it, though some do. And tragically, some lose their lives too soon because of it. But what happens when the risk finally outweighs the reward?

The recent discussion around the health of Miami Dolphins quarterback Tua Tagovailoa have reopened a familiar debate: when is it time for a player to walk away? After his third documented concussion in two years, many in the football world urged Tua to retire, to “shut it down”. People point out that he has already made $73m – enough to set up the 26-year-old and his family for life. Why risk his health for a job that could kill him? But walking away isn’t a simple choice; it’s a deeply personal reckoning that goes beyond the physical.

The focus on health and money alone misses the bigger picture. Players sacrifice far more than just their bodies to stay in the game; we also give up parts of our humanity and identity. From an early age, we’re taught that success in sports demands immense sacrifice – giving up social engagements, relationships and hobbies – all for the greater good of the team. And while putting our bodies on the line is significant, it’s often the least of our worries. Over time, this lifestyle frays our mental health in ways we can’t always comprehend. The blunt truth is that we players are constantly deteriorating inside, our minds affected in ways beyond our control.

I know this struggle first-hand. In 2019, I became the first NFL player to come out as bisexual, a decision that weighed heavily on me for years. My identity was something I had to suppress to fit the rigid mold that football demands. The strain wasn’t just around my sexuality. Playing during the Colin Kaepernick era, I had to make a choice every game: kneel in protest against social injustice or protect my fragile spot on the roster. For many players, the fear of being labeled a “distraction” keeps them silent, leading them to hide their true selves to avoid jeopardizing their careers. These pressures compound the already immense sacrifices we make, eroding parts of who we are.

So when people urge Tua to walk away, they’re not just asking him to consider his health; they’re asking him to confront the entirety of what football has meant to him. Do you give up a sport that you have given up so much else for? This isn’t merely about avoiding further injury; it’s about grappling with what leaving the game means for one’s sense of self.

Now Tua faces a decision: continue playing or walk away. To outsiders, this might seem straightforward, but it’s far more complicated. Unlike Tom Brady’s return from retirement, Tua’s departure would be an admission – not just to himself, but to the world – that he isn’t mentally or cognitively well enough to play the most cerebral position in football. It’s an irreversible step with a heavy emotional toll.

For many of us, football becomes more than a job; it’s our identity. We’ve invested everything into it – our time, youth, health, and even our sense of self. Walking away means losing a piece of who we are. While stepping away could mean a safer life, it also means confronting an uncertain future and acknowledging that the game may have taken more from us than we’re ready to admit. Who’s to say that a life without the game, even if safer, will be more fulfilling? Is that truly a choice at all?

When I was a college player at Purdue University, the great Mike Alstott returned to his alma mater to speak with the team and share his hard-earned wisdom. Alstott, known as one of the fiercest runners at both the college and professional levels, embodied the bruiser mentality – a player who took forever to go down and never stayed down for long. He was the kind of athlete who didn’t know when enough was enough. While he gave us plenty of valuable advice that day, one statement has stayed with me: “All athletes die twice – once when your career is over, and once when your life is over.”

Now, in what feels like my second or third act of life, removed from football and having mourned the loss of my football self, his words have never felt more true. I see it in my former teammates, some of whom are still grieving their first death, years after leaving the game. When I look at Tua’s situation, I can’t help but wonder: If you could choose your first death, would you? Or would you do everything in your power to keep fighting and keep living?

The outpouring of concern for Tua is heartening, but framing his decision as merely one of personal responsibility misses the profound internal conflict players face. Walking away isn’t just about avoiding further injury; it’s about confronting the reality of a life without football. It forces a player to ask, often at a young age: What does my life mean to me without this sport? Can I be whole without this part of myself?

Yet, it’s also important to acknowledge that leaving football can open doors to new beginnings. Some players find fulfillment in new careers, advocacy work, or personal growth. This path can lead to a healthier, safer life, but the transition is fraught with uncertainty and emotional turmoil, making the decision even more complicated.

In the end, the choice to leave football is intensely personal, weighed down by factors only those who have lived it can truly understand. And even then, brain injuries occupy their own complex realm, which require difficult decisions. Tua’s story reminds us that the sacrifices players make for this sport are not just measured in concussions or broken bones. They are measured in the fragments of ourselves that we give up to play the game we love. And sometimes, the hardest part is deciding when enough is enough.

• RK Russell is a former NFL player for the Dallas Cowboys and Tampa Bay Buccaneers.

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