In July of 2014, more than 4,500 retired professional football players came forward claiming the NFL had misled them about the risks for concussion. U.S. District Judge Anita Brody presided over the case, eventually ruling the league’s initial settlement offer of $870 million wasn’t enough. The NFL needed a formula, and it got one.

Meanwhile, professional wrestling, another sport couched in the spectacle of beefed-up men slamming their bodies together, still waits for a formula of its own. The sport is notorious for robbing athletes before their 55th birthdays, issuing loosely enforced guidelines on steroid use yet demanding peak physical health every time wrestlers step, slide, or jump into the ring. Now, two ex-athletes have stepped forward to sue World Wrestling Entertainment, or WWE, for the traumatic brain injuries they sustained as wrestlers.

Two Kinds Of Pressure

The lawsuit comes on behalf of Vito LoGrasso, 50, and Evan Singleton, 22, who both allege the WWE has sustained its success through “selling violence” and neglecting the ex-athletes’ “numerous” concussions. “Under the guise of providing ‘entertainment,’ WWE has, for decades, subjected its wrestlers to extreme physical brutality that it knew, or should have known” causes a raft of injuries, which includes brain damage, the lawsuit said. LoGrasso claims to suffer from “serious neurological damage,” which includes memory loss, depression, and anxiety. Singleton battles tremors, convulsion, and an “impaired ability to reason.”

Pile drivers and choke slams, however staged they are, aren’t the only things putting athletes at risk. According to the data, the greatest threat to a professional wrestler after he retires is a heart attack. Between 1997 and 2004, more than 65 wrestlers out of the active pool of 1,000 died. Twenty-five were from heart attacks — a rate that soars past the average for people that age. In USA Today’s 2004 investigation of pro wrestling heart attacks, five of the 25 autopsies showed signs of steroid use, with a dozen more examiners pointing to the use of painkillers, cocaine, and other drugs.

Pro wrestling, like just about every sport in America, formally bans performance-enhancing drugs. In its Talent Wellness Program, the WWE spells out a laundry list of substances that athletes are prohibited from using on a non-medical basis, including testosterone, Human Growth Hormone, methadone, pseudoephedrine, certain sleep aids, anti-estrogen drugs, and many others with unpronounceable titles. But if you ask the wrestlers themselves, the issue ends up being less about legality and more about practicality. And sidelining injuries just aren’t practical.

“There was a joke: If you did not test positive for steroids, you were fired,” former wrestler and broadcaster Bruno Sammartino told the St. Louis Post-Dispatch in 1991. Even 24 years later, many of the same issues rise to the surface. Last November, former WWE superstar CM Punk (real name Phil Brooks) spoke out for the first time since his January departure from the organization. On a recent episode of the podcast The Art of Wrestling, Brooks explained the constant tension between him and the medical staff in regards to having a clean bill of health.

“I got a concussion in the Royal Rumble. I knew I had a concussion. Everyone knew I had a concussion,” he said. But after passing a concussion test “with flying colors” and being told to get in the ring, Brooks bristled. “I was like so your test is worthless. I’m not going out in the f------ ring like a two-week rookie to run the ropes in front of everybody. Let’s just call it [a concussion] now.”

Not Football

LoGrasso, Singleton, and Brooks don’t have history on their side. Heart attacks claimed the lives of Randy “Macho Man” Savage at age 58; James “The Ultimate Warrior” Hellwig at 54; Raymond Traylor Jr. aka “Big Boss Man” at 41; and Davy Boy Smith, better known as the British Bulldog, at just 39. Chris Benoit, famed Canadian pro wrestler, died at 40, and when examiners looked at his brain they said it looked like that of an 85-year-old man with Alzheimer’s.

The WWE denies the claim that LoGrasso’s and Singleton’s injuries can be traced back to the organization’s negligence. Through Brooks’s allegations up to the present, the WWE has stood by its company doctors, issuing a statement to Yahoo! last November saying it “takes the health and wellness of its talent very seriously and has a comprehensive Talent Wellness Program that is led by one of the most well-respected physicians in the country, Dr. Joseph Maroon.”

Admittedly, football has some of the same problems. Traumatic brain injury stands as the football player’s greatest lifelong risk, and one disease in particular: chronic traumatic encephalopathy (CTE). It results from thousands of sub-concussive blows to the head, which over time degrade the brain tissue. Unfortunately, CTE can only be discovered after an athlete has died. To earn compensation, he must show signs of some other related affliction, like concussion or dementia.

Despite these similarities, football still has only one-twentieth the death rate before age 45 as professional wrestling, USA Today found. Unlike football’s diverse on-field army, there are no positions in wrestling. No weight classes like its Olympic counterpart. Professional wrestling, of the performance-art variety, is an industry of maximalism. It’s the biggest and the strongest sacrificing their bodies until it’s the biggest and whoever’s still left.

Flatline

The problem of life-ending injuries in football runs perpendicular to that of professional wrestling, based on how much wrestler’s injuries are popularized. It’s not entirely unforgivable: Football is a much, much larger sport and revenue-producer, at all levels, than wrestling. It should make sense that head injuries get more airplay, such as an official government program run by the Centers for Disease Control and Prevention, called Heads Up, and wrestling doesn’t.

Instead, wrestling is the silent killer. Showmanship and grit trump quality of life at a far greater percentage than helmet-crashing tackles. Big hits are only part of the equation in football. Devastating injuries, even melodramatic ones, are at the heart of what make wrestling entertaining. They are its pulse — until eventually, inevitably, it stops.