This story appears in ESPN The Magazine’s Feb. 29 Analytics of the NBA Body Issue.
Larry Bird, legendary Indiana Pacers coach, was once so consumed by heart palpitations during a game against the Bulls that he wasn’t even sure what play his team was running. The familiar symptoms of his atrial fibrillation – profuse sweating, nausea, and dizziness – threatened to overwhelm him on the sideline. This wasn’t a new experience for Bird; during his playing days, these episodes would force him to lie down and nap for hours to avoid losing consciousness. But this time, in the heat of a crucial game, rest was not an option.
Bird, diagnosed with atrial fibrillation in 1995, was known for his aversion to medication, often skipping his prescribed pills. His condition, an abnormal heartbeat caused by chaotic electrical signals in the heart’s upper chambers, could be managed with medication, exercise, and diet – treatments Bird was reluctant to consistently follow. His somewhat fatalistic outlook on life played a role in this reluctance. “You don’t see many 7-footers walking around at the age of 75,” Bird, standing at 6-foot-9, often told his wife, a statement she disliked. He acknowledged the exceptions but held a general belief that big men like him don’t live as long.
Bird’s sentiment, though seemingly macabre, is shared by many NBA giants. There’s a pervasive belief among these athletes that their extraordinary size and the physical demands of their careers lead to premature deterioration and shorter lifespans. The idea that “the bigger they are, the younger they fall” resonates within the NBA community. But is there any truth to this notion?
Moses Malone, a figure synonymous with punctuality, was uncharacteristically late one Sunday morning. His friend and former teammate, Calvin Murphy, was puzzled when Malone missed their 6 a.m. breakfast before a charity golf tournament in Norfolk, Virginia. Malone, a Petersburg native and a regular at the annual event, had attended a comedy show the previous night and made plans to meet Murphy in the morning. Just hours before, around 2 a.m., Malone, aged 60, had told Murphy he was tired and bid him goodnight with the parting words, “Don’t be late.”
But Malone was late, and his phone went unanswered. Tournament organizers sent Sandra White, an event coordinator, to check on him while Murphy headed to the golf course. White’s knock at Malone’s door went unanswered. Security was summoned, and upon forcing entry, they discovered Malone deceased in his bed, eyes open.
The news of Malone’s passing reached NBA referee Tony Brothers at the golf course, who then informed Murphy. Murphy, overwhelmed with grief, collapsed. “I just blacked out,” Murphy recounted, struggling to comprehend the sudden loss of his seemingly healthy friend.
Just seventeen days prior, Darryl Dawkins, another NBA center known for his powerful dunks, had also died of a heart attack at 58. Like Malone, Dawkins had no known prior health issues. These sudden deaths, along with others in the NBA community, sparked concern and introspection among players and veterans alike. Within a seven-month period, the NBA lost Anthony Mason, Christian Welp, and Jack Haley to heart-related deaths, all under 60, and Jerome Kersey, 52, died from a pulmonary thromboembolism. Current players like LaMarcus Aldridge, Jeff Green, and Channing Frye have also faced heart issues. Fred Hoiberg, now a coach, had his playing career cut short by a heart condition and underwent open-heart surgery. Eddy Curry was hospitalized with an irregular heartbeat at just 22.
However, the health concerns for NBA big men extend beyond cardiac issues. John “Hot Rod” Williams, a 6-foot-11 power forward, passed away at 53 due to complications from prostate cancer. Manute Bol retired at 36 due to rheumatism and died at 47 from acute kidney failure. Kareem Abdul-Jabbar underwent quadruple bypass surgery at 68 and had previously battled blood cancer.
Then there is Bill Walton, the legendary 6-11 center, whose struggles with debilitating back pain led him to contemplate suicide at 56 in 2008. Walton, who chronicled his journey in his book “Back From the Dead,” estimates he has undergone 37 surgeries, including multiple ankle fusion surgeries. “When you are in that never-ending cycle of pain, it puts you in a space of darkness, sadness and overwhelming depression,” Walton explained. He described the progression of his despair, from fear of death to a desire for it, and finally to the grim reality of living with constant pain.
In 2009, Walton underwent an extensive 8½-hour spinal fusion surgery, requiring a complex framework of bolts, titanium rods, and a metal cage to reconstruct his back. Now, he advocates for athletes to take a proactive approach to their health. “We athletes are our own worst enemies,” Walton asserts. “We don’t listen to our bodies, we don’t listen to our doctors. We don’t realize until later in life that health is everything. Without it, you’ve got nothing.”
Evolutionarily, extreme height may not be advantageous for longevity. The rarity of 7-footers underscores this point. In fact, 17 percent of 7-footers in the United States have played in the NBA, highlighting their statistical anomaly. This scarcity has also limited research into the correlation between extreme height and lifespan.
Despite the limited specific research on 7-footers, studies on height and lifespan generally suggest that being taller is not beneficial for longevity. Research from the University of Tromso in Norway linked increased height to a 2.6 times higher risk of potentially fatal blood clots in men over 6 feet. Another study in the Journal of Epidemiology and Community Health found a correlation between increased height and a greater risk of most cancers. A study of Finnish athletes in Medicine and Science in Sports and Exercise found that cross-country skiers, significantly shorter than basketball players, lived almost seven years longer. Furthermore, researchers at the University of Hawaii Kuakini Medical Center and the U.S. Veterans Affairs found that shorter men are more likely to possess an enhanced version of the FOXO3 gene, associated with stress resistance and longevity.
Thomas Samaras, founder of Reventropy Associates, argues that smaller body size is linked to greater longevity and reduced risk of age-related chronic diseases. His 2012 study in Biodemography and Social Biology on Sardinian men demonstrated a better survival rate for shorter individuals. Another study he cited showed that Spanish men lost 0.7 years of longevity for every centimeter of height above average. Samaras attributes these findings to factors such as taller individuals having trillions more cells, increasing cancer risk, and a higher likelihood of hypertension, atrial fibrillation, blood clots, and lower heart efficiency.
Bill Walton doesn’t need scientific studies to understand these risks. Looking back at his 1986 Celtics championship team, he notes the heart attacks suffered by his backcourt teammates, Dennis Johnson and Danny Ainge. Johnson tragically died at 52, while Ainge survived a heart attack at 50. Coupled with Kevin McHale’s foot problems and Bird’s and Walton’s own health battles, the core of this legendary team has faced significant health challenges post-retirement.
Larry Bird believes that the intensity of play and physical exertion during their careers might contribute to these issues, especially for big men. He points to Moses Malone as an example of a player who competed fiercely. Bird speculates that the strain of high-level performance builds up the heart, and when that intensity ceases, the heart is left in a vulnerable state. Bird himself is limited in his current physical activity due to his condition.
Joe Rogowski, executive director of sports medicine and research for the National Basketball Players Association, acknowledges emerging trends from preliminary research on former NBA players suggesting health differences compared to the general population. The NBA and NBPA have initiated joint health screenings for retired players in response to the deaths of Dawkins and Malone. The first screening, held in Houston, transformed the Toyota Center into a temporary clinic, offering various health assessments. Approximately 25 former players participated, undergoing tests for diabetes, high cholesterol, heart abnormalities, carotid artery issues, and sleep apnea, among other conditions.
Kevin Loder, a former NBA player and vice president of the Houston chapter of the Retired Players Association, emphasizes the urgency of addressing these health concerns. His own screening revealed alarmingly high glucose and cholesterol levels and dangerously thick blood. Dr. Manuel Reyes, a cardiologist and advisor to the union, reported finding “dramatically uncontrolled” hypertension, undiagnosed diabetes, and atrial fibrillation among the screened players. The screenings also included tests for Marfan syndrome, a potentially fatal connective tissue disorder.
Dr. Andrea Natale, another cardiologist advising the union, points to genetic predisposition, obesity, sleep apnea, and hypertension as risk factors for heart abnormalities in NBA players. He notes that while arrhythmia typically manifests in the general population in older age, athletes may experience it earlier, potentially in their 40s and 50s.
Hall of Famer Bob Lanier expressed shock and fear regarding the recent deaths and acknowledged his own struggles with mobility and pain from his NBA career. He highlights the lack of advanced sports science, analytics, and player care during his era, contributing to long-term physical consequences. Lanier reflects on the cessation of exercise post-retirement due to joint pain and the reluctance to undergo procedures like knee replacements.
Bill Walton, drawing from his own experience with chronic pain and recovery, now counsels others facing similar struggles. He advocates for proactive health management and emphasizes the importance of listening to one’s body and seeking medical advice. He worries about his fellow players and encourages them to prioritize their health.
Rogowski mentioned that future health screenings would expand to include orthopedics. Moses Malone had participated in a previous screening in Houston and learned of heart concerns. Loder recalls Malone mentioning heart fibrillation at that time and seeking further consultation, though the outcome remained unclear before his sudden death.
Lanier and Loder continue to mourn Malone and grapple with the broader question of NBA player health and longevity. Lanier, echoing Bird’s sentiment, wonders how many NBA big men reach the age of 75, expressing his own desire to be among them.
