Abstract for: Modeling the “Surgical Trap”: A Community-Based System Dynamics Approach to Chronic Pain in Former NFL Players

Chronic pain in retired NFL players is managed through surgery and medication, but these interventions often worsen long-term outcomes. Repeated surgeries accumulate irreversible structural damage, medication builds tolerance while eroding social relationships, and high-effort coping compounds the pain signal. These are interconnected feedback loops, not isolated clinical problems. We apply community-based system dynamics to model the full retirement transition and identify leverage points for holistic intervention. We conducted CBSD workshops with former NFL players who had previously completed Goal-Directed Resilience Training. Participants constructed causal loop diagrams from their own experience. A crosswalk matrix maps specific player quotes to model feedback loops, providing an auditable chain from participant voice to equation. The CLDs were formalized into a stock-and-flow simulation in Stella Architect over a 12-year post-career horizon. Preliminary loop dominance analysis shows the Surgical Quick Fix loop accounts for 82% of model behavior by year 12. The system is organized around the surgery-pain cycle, with pharmacological coping contributing an additional 11%. Simulation runs indicate that shifting from biomedical intervention toward psychosocial engagement improves the cohort's Best Life Score even though raw physical trauma remains permanently high. The model separates physical damage from the experience of suffering, allowing us to test psychosocial interventions without claiming to reverse structural injury. Next steps include participant validation of simulation output, calibration against the Harvard Football Players Health Study, and development of an interactive interface where retirees can test their own post-career strategies. The crosswalk matrix method may transfer to other CBSD applications. Generative AI was used to refine the clarity and concision of the abstract.