Injuries are an ever present part of sports. The threat of injury is something that every athlete must live with as a hazard of the job. Certain injuries have become ingrained in the psyche of sports fans and have left indelible images of gruesome scenes in their minds. These injuries have signaled the end of some athlete’s careers, while others have managed to recover and take the field of play again. Regardless of their ability to return, the damage suffered at the hands and feet of their opposition serves as a permanent reminder of the dangers of sport.

Some injuries on this list have led to sports taking up revolutionary approaches in order to prevent them from happening again. These changes have come in the form of equipment alterations, new schemes of protection, and promoting increased awareness among athletes. The impact from some of these injuries continue to influence decisions made by front office executives and individual players. They serve as a brutal reminder that a career as a professional athlete is short and can be over in an instant.

As athletes become bigger, faster, and stronger, the impacts that take place on the field of play increase in severity. The human body can only endure so much stress before succumbing to its physical limitations. The following injuries have turned the stomachs of announcers, fans, and fellow athletes. A few of these injuries have sadly led to death. No athlete expects to die in the course of their occupation, but several have paid the ultimate price for their sports. This list is not for the faint of heart.

20 20. Tyrone Prothro

Tyrone Prothro developed a reputation for making spectacular catches in his college football career. He was in the middle of a promising junior season at the University of Alabama, when his career was suddenly ended during a play in the end zone against the Florida Gators. Prothro leapt to catch a pass from Brodie Croyle, but was denied another spectacular catch because a defender had rolled up on his leg. He suffered fractures of both his tibia and fibula and despite efforts to rehabilitate, was never able to resume his football career. Prothro now works as a bank teller in Tuscaloosa.

19 19. Borje Salming

Borje Salming is one of the most prolific defensemen in Toronto Maple Leafs history, with a career that spanned four decades. In a game between the Leafs and Detroit Red Wings in 1986, Salming was knocked to the ice in front of the net. Gerard Gallant’s skate sliced the face of the Swedish defenseman, causing a gash that required over 200 stitches to repair. Salming was left with a Frankenstein monster-esque scar that required additional surgery. Despite the brutal injury, Salming joined the Red Wings several seasons later.

18 18. J.A. Happ

During the second inning of J.A. Happ’s start against the Tampa Bay Rays, Happ was struck in the side of the head by a line drive off the bat of Desmond Jennings. Happ collapsed to the ground and when he moved his hand, blood gushed from the wound behind his ear. Happ laid on the ground for 11 minutes before being stretchered off the field. He suffered a skull fracture, laceration behind his ear, and a knee injury because of his awkward fall. He returned to the mound later in the 2013 season and remains a pitcher in the Major Leagues.

17 17. Allan Ray

During a 2006 Big East Tournament clash between the Villanova Wildcats and the Pittsburgh Panthers, Allan Ray suffered a shocking eye injury. As Ray dove for a loose ball, he was inadvertently hit in the eye by Carl Krauser. Ray’s eye appeared to pop out of its socket and caused temporary loss of vision. Despite the appearance of a serious injury, Allan Ray returned to action less than a week later in the NCAA Tournament, without the protection of goggles. It was later determined that he had suffered only soft tissue damage. Allan Ray currently plies his trade in Liga Basket Serie A in Italy.

16 16. Wayne “Buck” Shelford

Wayne Shelford forever sealed his place in rugby lore, during the famed 1986 clash between New Zealand and France dubbed “The Battle of Nantes.” Shelford had a reputation for toughness, but took it to a new level when a French player’s stud tore his scrotum during a ruck about 20 minutes into the match. Shelford demanded that the team doctor stitch him up so he could return to play, and that is just what happened. Despite Buck’s heroics the All-Blacks suffered a 16-13 defeat in that match. New Zealand returned one year later in the first iteration of the Rugby World Cup, where they defeated France to become champions.

15 15. Marcus Lattimore

Marcus Lattimore was on his way to a spectacular junior season with the University of South Carolina Gamecocks when his season was abruptly ended in late October. A run to the left side in the second quarter against the University of Tennessee was Lattimore’s final carry in the NCAA. He was brought down by a devastating lunge at his right knee, which caused a knee dislocation and damage to several knee ligaments. Despite the injury, Lattimore declared for the NFL draft, where he was selected by the San Francisco 49ers. It has been nearly two years since the injury and surgery by Dr. James Andrews. This season, Lattimore hopes to make his NFL debut.

14 14. Shaun Livingston

Shaun Livingston’s early NBA career was full of injuries, none worse than his devastating knee injury. Early in a February game against Charlotte, Livingston ran down the left side of the court before missing a layup. While landing after the layup, Livingston’s left knee bent unnaturally causing his patella to dislocate as well as tears in his ACL, PCL, MCL, and lateral meniscus. It was a freak injury which took Livingston almost eighteen months to recover. He has since been able to resurrect his basketball career, becoming a role player for the Brooklyn Nets, which he parlayed into a 3-year, $16 million contract with the Golden State Warriors.

13 13. Paul George

Paul George was coming off a solid season with the Indiana Pacers when he was named to Team USA for the FIBA World Championship. During a televised intra-squad game, George was defending a fast break layup attempt by James Harden when his foot wedged between the basket’s stanchion and the floor. George’s momentum carried him into the photographers seated courtside and caused a compound fracture of both his tibia and fibula. He was immediately rushed into surgery and will miss the entire 2014-15 NBA season.

12 12. Anderson Silva

UFC legend Anderson Silva has dealt many devastating knockouts during his mixed martial arts career. However, his most brutal moment was a self-inflicted leg break that happened during his rematch with Chris Weidman. Weidman bested Silva in their first matchup when Silva engaged in his trademark head movement taunting. The second match ended abruptly when Silva threw a leg kick, which Weidman checked with his tree trunk legs, causing both bones in the Brazilian fighter’s lower leg to break. Despite calls for the former champ to retire, Anderson is set to fight again on January 31, 2015.

11 11. Kevin Ware

Kevin Ware was a promising sophomore guard on the University of Louisville Cardinals basketball team when he suffered a gruesome compound fracture of his lower leg. The guard was attempting to block a shot in Louisville’s Elite Eight matchup against Duke, when he fell awkwardly in front of the Louisville bench. His teammates recoiled and shouted in terror as Ware’s tibia was exposed in front of the national television audience. Ware was tended to on the court before being rushed into surgery, where doctors inserted a metal rod into his tibia. Louisville went on to win the National Championship, which they dedicated to him. Ware eventually returned to the court, but ultimately redshirted the following season before transferring to Georgia State.

10 10. Joe Theismann

Few moments have had such a lasting impact on the NFL as Joe Theismann’s leg break suffered at the hands of Lawrence Taylor. Theismann takes the snap and hands off to John Riggins who laterals it back to Theismann, setting up a classic flea-flicker. Theismann is contained in the pocket, stepping forward, before the fearsome LT takes him down. A pile on top of the downed quarterback causes Theismann’s leg to twist and fold underneath the pile of bodies. After a loud snap, Taylor leaps from the pile, immediately signaling for Washington medical staff to attend to their quarterback. The moment had a lasting impact on the NFL because it prioritized a team’s need for quarterback protection, especially from the quarterback’s blindside. The compound fracture of Theismann’s lower leg forced him into retirement at the age of 36.

9 9. Willis McGahee

Willis McGahee was an integral part of the Miami Hurricanes team that nearly went undefeated for two consecutive seasons. In the 2003 Fiesta Bowl against Ohio State, they sought to become repeat National Champions. That changed in the 4th quarter when McGahee caught a screen pass and was cut down by a Will Allen tackle to his knee. McGahee’s knee bent backwards causing tears of his ACL, MCL, and PCL. Allen made a throat slashing gesture following the play, while McGahee writhed in pain. In Allen's defense, he had no idea that he was injured while celebrating. Prior to the game, McGahee took out a $2.5 million insurance policy which would be paid if his NFL career was put in jeopardy. Despite having the policy, he refused to collect and was drafted by the Buffalo Bills. He went on to have a successful NFL career that included two Pro Bowl appearances.

8 8. Steve Moore

Steve Moore was the victim of one of the most brutal cheap shots in NHL history. Late in a 3rd period matchup with the Vancouver Canucks, Moore's life would change when he was struck in the back of the head by Todd Bertuzzi. Earlier that season, Moore had delivered a devastating, yet fair, check to Marcus Naslund. The next matchup between Moore’s Avalanche and the Canucks occurred without incident. In the following matchup, Moore fought Matt Cooke in a fairly even scrap. In the late stages of that game, which was dominated by Colorado, Bertuzzi sought to provoke a fight with Moore and was rebuffed as the score was 5-0.

Moore attempted to skate away from Bertuzzi, but he was struck by a devastating right hook to the back of the head by Bertuzzi and bulldogged to the ground. Moore’s teammates raced to avenge their teammate, but the damage had been done. Moore suffered three fractured vertebrae and a severe concussion as a result of the cheap shot. Bertuzzi was suspended for 20 games. Moore sued Bertuzzi in a civil lawsuit initially seeking $68 million. The lawsuit was settled out of court in an undisclosed settlement. Steve Moore never played another game.

7 7. Richard Zednik

During a 2008 game between the Florida Panthers and Buffalo Sabers, Richard Zednik’s neck was cut by teammate Olli Jokinen’s skate. Zednik quickly raced over to the Panthers bench where he was met by trainer, Dave Zenobi. Medical staff attended to him in the locker room and he underwent surgery later that evening. Despite losing an estimated 5 units of blood, doctors said Zednik’s life was not in immediate danger because his carotid artery had not been entirely severed. He missed the remainder of the season, but was able to return to NHL action the following fall.

6 6. Clint Malarchuk

Clint Malarchuk’s nearly 20-year career in professional hockey is remembered for a single moment during a game with his Buffalo Sabers and the St. Louis Blues. Skaters Uwe Krupp and Steve Tuttle became entangled and crashed into Malarchuk, when Tuttle’s skate sliced the neck of Malarchuk, severing his carotid artery. As blood poured onto the ice, Sabres trainer and Vietnam medic Jim Pizzutelli, pinched off the artery. Doctors then applied pressure to Malarchuk’s collar bone to prevent exsanguination as he was rushed to a local hospital, where he was stabilized. In true hockey fashion, Malarchuk joked with doctors to get him back for the third period. He suffered from post-traumatic stress disorder as a result of the accident.

5 5. Mike Utley

Mike Utley’s life was changed during the 4th quarter of a 1991 game between the Detroit Lions and Los Angeles Rams. While Utley was engaged with defensive lineman David Rocker, he lost his balance and was driven head first into the ground. He suffered two fractured cervical vertebrae and was left paralyzed from the chest down. As he left the field, he flashed a thumbs up sign to the crowd, which later became the symbol of his charitable organization, the Mike Utley Foundation. He has recovered almost complete use of his upper body and remains dedicated to finding a cure for spinal cord injuries.

4 4. Eric LeGrand

Eric LeGrand’s life changed instantly as he tore down the field on kickoff coverage during the 4th quarter of a game between Rutgers and Army. LeGrand collided with the ball carrier with his head down and remained motionless for several minutes. He received credit for the tackle, but had to be carted off of the field. It was later revealed that LeGrand had fractured two cervical vertebrae, which left him paralyzed below the neck. After months of dedication and rehab, LeGrand regained movement in his shoulders and feeling in his body. In July 2011, he posted a picture on Twitter of his standing with the support of a metal frame. He was signed to a ceremonial contract by the Tampa Bay Buccanneers. LeGrand was able to complete his studies at Rutgers, earning a degree in labor relations, and spoke at his graduation ceremony.

3 3. Dale Earnhardt – NASCAR

Dale Earnhardt was a legend in NASCAR racing, earning the nickname “The Intimidator” for his tenacity on and off the track. During the 2001 Daytona 500, Earnhardt’s son, Dale Jr., was in second place as the race was coming to a close, with Dale Sr. blocking opposing racers repeatedly. In the race’s final lap, Dale Earnhardt slammed into the outside wall of turn 3 at over 150 mph as he attempted to block another passing attempt by Sterling Marlin. Dale Sr. was rushed to the hospital, but was pronounced dead later that day. An autopsy stated that he had died immediately upon impact of blunt force trauma. As a result of this crash, the HANS (Head and Neck Restraint System) device is now required equipment for all NASCAR drivers.

2 2. Bill Masterton

While in his first season with the expansion Minnesota North Stars in 1968, Bill Masterton paid the ultimate price for his sport. Masterton skated at full speed toward the Oakland Seals defense and was met with a check by Larry Cahan and Ron Harris. The hit sent Masterton flying backwards and caused him to land on his head. Like the vast majority of players during the era, Masterton was not wearing a helmet. He bled from his ears, mouth and nose while trainers rushed to help him.

At the hospital, surgeons did not dare to operate because of the severity of the injury. Masterton died 30 hours later without ever regaining consciousness. His death contributed to the league mandating helmets for incoming players in the 1979-80 season. The NHL honors his legacy by awarding the Bill Masterton trophy for the player who “best exemplifies the qualities of perseverance, sportsmanship, and dedication to hockey.”

1 1. Ray Chapman

Ray Chapman remains the only player to have ever died of injuries suffered because of being hit by a pitch. The incident occurred during an August 16, 1920 game between the Cleveland Indians and the New York Yankees at the Polo Grounds. Pitcher Carl Mays delivered the pitch, with his typical submarine delivery, which struck Chapman near the ear without Chapman attempting to move to avoid the pitch. According to accounts the impact sounded similar to it hitting a bat, which caused Mays to throw the ball to first base for the out. Chapman took a few staggering steps before collapsing as blood poured out of his ear. He died twelve hours later of a depressed skull fracture. The incident led to baseball banning the “spit ball” the following season.