Over the credits, we see numerous magazines and newspaper articles from the 80’s, all of which feature Randy "The Ram" Rccvcvbinson, a major star. We then flash forward twenty years, where Randy is getting ready for a professional wrestling match in a small local auditorium. He interacts with the other wrestlers backstage, most of whom are much younger than he is (Randy is acknowledged to be in his 50’s). After the show Randy is given a meager payday, as the promoter claims the gate was smaller than expected. The promoter then proposes a 20th anniversary rematch with his most notable opponent, the Ayatollah, which sold out Madison Square Garden in the 80’s. Randy agrees, hoping this kind of high-profile match could help him get back to the top.
Randy goes home to find he has been locked out of his trailer for not paying his rent. He takes pain medication and falls asleep in the back of his van (a Dodge Ram). The next day he goes to work, loading boxes at a supermarket. At night he goes to a strip club where he has taken a liking to an older stripper named Cassidy (Marisa Tomei). Randy nearly gets in a fight with several young men who are making fun of Cassidy’s age.
We see Randy going through his training rituals, which includes bleaching his hair blond, getting tanned and shaving his body. To maintain a chiseled physique at his age, Randy also buys and injects large amounts of steroids and then works out feverishly. His next match is a particularly brutal "hardcore" match, in which Randy and his opponent (real life wrestler Dylan Summers, a.k.a. Necro Butcher) use various weapons on each other, including thumbtacks, staple guns, barbed wire and glass. Randy suffers numerous gashes, includes a deep cut on his chest from the barbed wire. Post-match, Randy is treated by a doctor backstage, but collapses soon after.
Randy wakes up in a hospital to learn that he suffered a severe heart attack, necessitating a bypass operation. His doctor warns Randy that unless he cuts out the steroids and stops wrestling, his life could be in danger. Randy follows the doctor’s advice, giving up his pills and even canceling all of his upcoming matches. He takes longer hours at the supermarket to make ends meet. Faced with his mortality, he goes to the strip club, tells Cassidy about his heart attack, and she breaks one of her rules by agreeing to meet him outside to talk. He tells her how lonely he feels, and she suggests he try to rekindle a relationship with his daughter, Stephanie.
Randy goes to Stephanie’s home, where she refuses to have anything to do with him, cursing him out for never being there during her childhood. Randy tells Cassidy what happened; she offers to help Randy find a present for Stephanie. They go to a vintage shop and buy Stephanie a jacket, and Randy convinces Cassidy to have a beer with him. They talk, and Randy eventually kisses her. At first she fully embraces him, but then suddenly pushes him away, not wanting to break her rule of no contact with customers.
Randy goes to see Stephanie and gives her his gifts. Stephanie reluctantly agrees to spend the afternoon with him. They walk by the boardwalk, talk, and Randy confesses that he has not been a good father. But with his career finished, he wants to have the relationship with his daughter he never had. Stephanie warms to him, thinks he might be trying to be a good father, and agrees to meet him for dinner that weekend.
A few days later Randy goes to a convention to sign memorabilia for fans, and sees several old wrestlers, many of whom are disabled or wrecks. Randy leaves, and goes to the strip club to talk to Cassidy about their embrace, but she says it was a mistake and blows him off, saying that he is nothing but a customer. Randy insults her and is thrown out of the club. He then goes to a wrestling show as a spectator, where he clearly misses being in the ring. After the show he goes out with the other wrestlers, gets drunk, and ends up doing cocaine and having sex with a female fan. He gets home, only to realize that he was supposed to be with Stephanie that night. He goes to her house in the middle of the night, where Stephanie angrily tells him he has never been and never will be a father to her. Dejected and alone, Randy goes to work the next day, where he deliberately cuts himself in the deli meat slicer, screams at his boss, and quits his job. He calls up the promoter and tells him he now wants to wrestle the canceled rematch with the Ayatollah.
As Randy is getting ready for the match, Cassidy, who has tried to apologize to Randy, arrives at the arena and finds him about to go out to the ring. She warns him that his heart could give out if he wrestles, but he shrugs it off. Randy says that the real world doesn’t care about him, and the only place he belongs is in the ring. Cassidy tells him she wants to be with him, but Randy heads to the ring as his intro music blares.
Before the match, Randy gives an emotonal speech to the crowd. As the match goes on, Randy feels his heart straining, and he can barely stand. Ayatollah realizes this and tries to end the match out of concern for Randy, but Randy refuses to stop. Randy looks into the crowd, but cannot see Cassidy, which resolves him to finish the fight in spite of his growing heart trouble. Randy fights through the pain, and slowly climbs to the top rope to deliver his signature "Ram Jam" finisher. In the final shot, he salutes the fans and leaps from the ropes.
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