As the surgeries piled up and the doctors kept coming back with worse news, Ben Bywater began looking for a way to save his career.
The BYU senior linebacker knew the nerve that runs from his brain to his shoulder wouldn’t grow back in time for the football season. He injured himself during a game on Sept. 23, 2023, when he lowered his shoulder on a tackle and the hit essentially obliterated the nerve. In the months after, he saw specialists at the Mayo Clinic and in California to help coax it back to life.
But when those treatments moved too slowly, Bywater asked NFL players for faster solutions.
They provided a potentially risky alternative: a stem cell injection in Tijuana, Mexico.
The science was unproven. The risk of infection, and other side effects, was high. But in February, Bywater traveled out of the country to get the work done on his shoulder. He hoped the stem cells would “stimulate muscle, get blood flow” and then help the nerve heal quicker.
Some coaches on BYU’s staff said they knew of Bywater’s international medical trip and supported his efforts to get back on the field — even those that may not have been tested.
Now, almost eight months later, Bywater’s college career is over. The stem-cell treatment failed. The nerve hasn’t fully regenerated. His shoulder, by his estimation, is 50% strength of where it should be.
And even though Bywater’s nerve may have never healed, doctors who spoke to The Salt Lake Tribune said, the procedure is a concerning one that is attracting more and more athletes who are lured out of the country by the false promises and a lack of guidance.
“There’s no data to suggest that [it works] at all,” said Leonard Zon, a Harvard Medical School professor and the director of the stem cell program at Boston Children’s Hospital.
“What happens is these companies are selling people hope and charging a lot of money for it. It’s very similar to the old snake oil. … It leads to them going to a foreign country, also sometimes in the United States, and getting treatments that are not really sanctioned, not under a clinical trial, and ending up with massive problems.”
How Bywater got there
Bywater didn’t start with stem-cell treatment as his first option.
After he sustained the injury, he went down the surgery route like most expected. As the doctors explained it, the nerve in his shoulder was directly impacted during the tackle he made in a game against Kansas last year.
“When I hit that shoulder, it hit the nerve connecting my brain to my arm,” Bywater said. “The connection from my brain to my arm is impeded by that nerve and it swelled up. So it’s like a traffic jam on that nerve that my arm is not getting 100% function.”
The doctors could do the surgery, but they could not regrow the nerve itself. It would take time, they said, for the nerve to grow and eventually connect the two entities again.
In the meantime, Bywater worked with BYU’s team doctors and outside specialists in the United States to help the rehab process. He went to Minnesota to work with the Mayo Clinic, one of the top hospitals in the world for orthopedic and shoulder injuries.
After that, he saw Neal ElAttrache in California. He is the Los Angeles Rams team doctor and works with several high-profile athletes. He performed Jets quarterback Aaron Rodgers’ Achilles surgery.
“I was getting surgery at the same time as — they can’t say — but like, big names, you know, A-list celebrity names,” Bywater said.
But nothing worked. BYU linebackers coach Justin Ena said he was getting updates weekly, sometimes daily, about Bywater’s status and the different doctors he saw.
“He was going to the Mayo Clinic three or four times during the whole process, making sure that the nerves were connecting and firing,” Ena said. “And when he came back, it was always kind of bad news.”
(LM Otero | AP) BYU linebacker Ben Bywater speaks to reporters during the Big 12 college football media days in Arlington, Texas, Wednesday, July 12, 2023.
And that is when Ena said Mexico came up, as a last-ditch effort, to save the linebacker’s career.
Bywater had been talking to some NFL players who had done stem cell treatments in the past in Mexico. He said they swore by it. He wanted to give it a chance. Ena heard him out, even if it came with a risk.
Many doctors, however, remain dubious of the idea.
“These stem cells offered in Mexico are not proven to work or be safe,” said Paul Knoepfler, a doctor who specializes in stem cell research at UC Davis. “Even so, we see a lot of pro athletes going down there for ‘treatments.’ ... Sometimes what is being injected is not even living stem cells but just junk like dead cells or living cells that are not stem cells. Sometimes the material is not even sterile so people get infections. It’s a real mess.”
Zon said the procedure can be done in two ways. Either the clinic will inject “mesenchymal” stem cells, which are fatty tissue cells that grow in a dish. They are injected around the damaged nerve and they serve as “supportive cells that are meant to stimulate the growth of the neuron.” That would be the most common way.
The other way is to inject the neuron itself and “hope it synapses, or connects, to the place where it’s supposed to go,” Zon said.
Neither procedures is approved by the U.S. Food and Drug Administration. There are many trials with mesenchymal cells in the US, but the practice has not been approved.
“Some of them are responsible [trails], many of them are not,” Zon said.
The only mainstream, approved use of stem cells in the United States, at the moment, is for blood transplants.
(Rick Egan | The Salt Lake Tribune) Linebacker Ben Bywater, on day 1 of fall camp, on Thursday, Aug. 4, 2022.
Still, Bywater proceeded. He said he chose a clinic in Mexico as a matter of cost — not an issue of an unproven science.
“It’s cheaper and that’s the guy I knew,” he said. “They do it in the U.S., too.”
Knoepfler estimated there are more than 1,000 stem cell clinics in the U.S., though he believes the government has been too slow to shut them down.
Ena said he was aware of the Mexico trip and held out hope it could work. But he knew it was an experimental treatment.
“He would do the stem cells going down to Mexico. And we were hoping that would come to fruition,” he said. “It’s kind of a newer treatment. I mean, stem cells, you usually have to go international.”
BYU head coach Kalani Sitake said he was not part of the decision to send Bywater to Mexico, and was aware of how potentially dangerous the treatment could be.
“I don’t know anything about that,” he said. “I’m not a health professional. I don’t know if that’s even my position to say anything. I don’t know the requirements for surgeries and all that stuff. I just know there is a lot of technology and a lot of options out there. But it is not my place to speak on that. Probably talk to our doctors. I’m not equipped enough to even answer those questions.”
The risks and consequences
(Trent Nelson | The Salt Lake Tribune) East Carolina Pirates running back Keaton Mitchell (2) runs from Brigham Young Cougars linebacker Ben Bywater (2) as BYU hosts East Carolina, NCAA football in Provo on Friday, Oct. 28, 2022.
Zon said this isn’t the first time he’s heard of a football player going across the border for potentially dangerous treatments. And he understands how Bywater could latch onto the treatment, especially if nobody cautioned him against it.
He said “stem cell tourism” has become increasingly common as clinics in foreign countries promise to be a one-stop-shop to fix diseases. For example, there are around 10 stem cell clinics in Tijuana alone. One clinic, called Stem Cell Mexico, promises to fix 16 different issues.
That included everything from multiple sclerosis to Alzheimer’s to a spinal cord injury.
“People start going on the clinic website, and they see, ‘Oh, I can fix my disease.’ But they’ve also listed 100 other diseases they’ll fix.’” he said. “That’s probably the number one way I know the site is not worth going to, whether the company’s not worth going to or not. Because if they’re listing, ‘I can cure your Alzheimer’s at the same time as cure your football injury.’ You know, that’s just too much.’’
Still, he said hope is powerful. And when people run out of FDA-approved options, they will take risks they shouldn’t.
In May, three Americans came back from a stem cell clinic in Mexico with a strain of infections that could lead to leprosy and tuberculosis, USA Today reported.
Beyond that, Zon said there is no standard in these clinics for how stem cells are grown. That can lead to infection as well.
“In these clinics where there’s poor oversight, anything can happen,” he said, noting he founded the International Society for Stem Cell research, in part, to help combat some stem cell tourism.
He has seen extreme horror stories. In Florida, one clinic tried to perform a stem cell injection in both eyes of a patient. The patient ended up going blind.
“It just illustrates how patients, athletes, everybody has a hope that these things would work,” Zon said. “So they end up somehow getting convinced that this is the right thing for them. I’m particularly worried about what we call stem cell tourism.”
In Bywater’s case, it was the NFL players who pushed him into doing it. BYU’s medical staff, and his position coach, did not interject.
Bywater saw stem cells as just another way to treat his injury. He equated it to working out in some ways.
“You’re working out, trying to do some stem right?” he said. “You’re trying to stimulate the muscles. Any time you can stimulate muscle, get blood flow, that’s the way. And then it’s just time [to heal].”
At the moment, Bywater said he could still be two years away from the nerve fully growing back.
And only time will tell if he can return to football.
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