A promising career cut short, former Pittsburgh Steelers S Ryan Watts medically retired this past offseason following a neck injury he sustained at the end of the 2024 preseason. Though Watts is able to live a normal life, he and Steelers team doctor David Okonkwo explained why playing football could no longer be part of his future.
Watts walked through the injury and hit that changed his life.
“I couldn’t move my legs,” Watts said on The Athlete Spine podcast in an episode that aired Wednesday. “My arms not at all. My arms ended up going in a fight or flight position. So I was really just stuck. And I was just laying on the floor just thinking ‘Oh my gosh, am I paralyzed?'”
The hit occurred at the literal end of the preseason. With 1:39 left in the Steelers’ final exhibition game, Watts went to make a tackle, but was pushed from behind and fell head-first into the runner.
Scary as the injury looked, one that invoked memories of Ryan Shazier’s, Okonkwo quickly realized the injuries weren’t the same.
“Principally this was a spinal-cord neuropraxia,” he said. “And we were able to ascertain very quickly that Ryan was having recovery of function. Because I am a neurosurgeon there on the sideline, and the Steelers are unique in the NFL that the Steelers have their neurosurgeon travel with the team.
“We’re in Detroit, this happens on the road and I’m there and this is what I do for a living. And I was able to figure out very quickly that he didn’t have an unstable neck injury and that he was recovering quite rapidly with restoration of function.”
The Steelers and city of Pittsburgh have been at the forefront of head and neck injuries. It was Dr. Bennet Omalu who first discovered CTE while conducting Mike Webster’s autopsy, a game-changing revelation that better illustrated the danger of concussions and the need to prevent and mitigate them. Pittsburgh is regarded as having some of the best doctors in the field with notable names like Dale Earnhardt Jr. flying to the city specifically to see its doctors after suffering multiple concussions.
Okonkwo’s evaluation allowed Watts to walk off the field. Despite initial numbness in his arm, the prognosis on Watts was positive with the team believing he could eventually return to football. More tests, however, changed that outlook.
“We get back to Pittsburgh. CT scans and MRIs and as Ryan said, that’s when the picture started to get a little murkier” Okonkwo said. “Because this was a combination of congenital spinal stenosis and also a disc bulge at C3-4, where that was the principal site of spinal cord compression. So we had an opportunity at that point to leverage time. To see what was gonna happen with the natural history of his sensory manifestations, etc. Eventually, we got to the point where it became clear that there was one ongoing symptom.”
Watts detailed moving his head in a certain position would send a painful “shock” down his arm and leg. Initially hoping the feeling would go away, the pain continued, and Watts soon brought it to the team’s attention. That was the surgery associated with the photos Watts sent out this past winter, showing him back in the hospital undergoing another procedure. Per the show’s notes, Watts officially underwent an “anterior cervical discectomy fusion at C3-4.”
The surgery stopped the sensation from happening. But the underlying stenosis couldn’t be cured, leading doctors to tell Watts he couldn’t safely return to football.
“The surgery wasn’t going to address the multi-level congenital spinal stenosis,” Okonkwo said. “That was ultimately something we couldn’t overcome to create safety for the game of football for Ryan.”
The stenosis diagnosis led Watts to officially retire in late April. General manager Omar Khan released a statement, noting the team would help him transition into his post-playing career. Initially wanting to coach, Watts has found a new passion in medical sales.
“I feel like I can play football,” Watts said. “I feel like I can go play football or do anything, but I know I can’t. So that’s the thing. But I feel a lot better. I don’t have any of those lingering issues.”
Before his injury, Watts impressed as a rookie making the switch from college cornerback to safety. He may have made the Steelers’ 53-man roster and if not, definitely their practice squad. Unfortunately, he’ll never get to find that out. But his great health is most important and the Steelers have seemingly offered strong support every step of the way.
