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More than one in three former professional footballers over 40 years old suffer from knee cartilage damage amid concerns active players are risking their long-term health or are unaware of the lasting effects of serious knee injuries.

A FIFPro study among 400 active and 900 former professional footballers indicated that 35 percent of ex-players above 40 are suffering from knee osteoarthritis (a degenerative joint disease). That compares to 8 to 13% of the general population in the same age group.

Footballers are 2.5 times more likely to suffer from knee osteoarthritis with every severe knee injury or knee surgery they had during their career.

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“I know some old players who cannot even walk. They are cripples,” Pontus Kamark told FIFPro. The 48-year old Swedish World Cup veteran quit when he was 32 after three cruciate ligament surgeries. “My doctor noticed that my knee cartilage was almost gone. He advised me to stop.”

Only two months earlier Kamark had declined an invitation for Sweden’s 2002 World Cup squad because he did not feel fit enough. “I took the doctor’s advice. I considered my future health and wanted to be active, play ice hockey, tennis and golf for the rest of my life.”

Kamark, who played at IFK Goteborg and Leicester City, is still very active, but he said some of his peers have not been so lucky. Hakan Lindman, who played for Malmo and Anderlecht “has two plastic knees and can barely walk.”

 Pontus Kamark playing for Sweden against England in 1998

Dr. Vincent Gouttebarge, FIFPro’s Chief Medical Officer, said club medical staff need to do more during a player’s career to prevent osteoarthritis in later life. Gouttebarge also suggests after-career consultation would help players strengthen their knees by following a healthy lifestyle and a fitness program.

“The results of the study are a confirmation that there are often serious, long term effects from knee injuries,” Gouttebarge said. “This is the first research into knee osteoarthritis that includes active players and it gives us a clear picture of how cartilage damage evolves.”

Malmo defender Rasmus Bengtsson coped with knee problems for a year before opting for surgery. “The last six months I played with huge pain. First I took painkillers, later on I had cortisone injections. When these did not help anymore we decided on the operation,” the Sweden international player told FIFPro. The meniscus was removed from his left knee. Cartilage was already gone. His recovery took ten months.

“Maybe if we had done the operation immediately the recovery could have been easier and faster.”

The 31-year old Bengtsson said his knee joint is “bone to bone”. He especially experiences pain after playing on hard artificial pitches. “If I get the same problem again, I will think about my future. I don’t want to destroy my body, I want to play football with my kid.”

Bengtsson played with pain because he had just joined Malmo and wanted to prove himself. “When you are young or moving to a new club, it would be helpful if physios hold you back when you are not fit. It is very difficult for a player to say that he does not want to play.”


Steven Lenhart, a former MLS champion with Columbus Crew, agrees with Bengtsson. “At one point my knee got weaker and weaker, but as a player you don’t want to listen to your body, you want to play. When somebody would have told me, your knee is going to be f***** when you are older, then I would have said but I feel okay now.”

Lenhart had to quit in 2016 after five meniscus surgeries on his right knee. “The first injury just happened, but after the second and third it becomes preventable.”

The 31-year old former striker thinks that it is helpful that former players who dealt with similar injuries share advice or talk about their current health status. “Players make their own decision, but you have to give them tools to listen to their body. They must not feel so much expectation to play when they are injured.”


About the players:

Pontus Kamark: 48 years, professional footballer (defender) from 1985 until 2002 at among others IFK Goteborg and Leicester City. Won 5 league titles with IFK. 57 caps for Sweden and bronze medal at 1994 World Cup.

Rasmus Bengtsson: 31 years, professional footballer (defender) since 2006 for among others Hertha Berlin and FC Twente. Won 2 league titles with his current club Malmo. Four caps for Sweden.

Steven Lenhart: 31 years, professional footballer (striker) from 2008 until 2016 at Columbus Crew and San Jose Earthquakes. Won MLS title with Columbus.


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