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Doctors' Notes: Gaining A Medical Competitive Advantage

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Photo by Stephen Dunn/Getty Images.
Photo by Stephen Dunn/Getty Images.

There’s a part of the draft evaluation process that always reminds me of that classic scene from Jaws, the one where Quint and Hooper are swapping stories and showing off scars (“Okay, we’ll drink to our legs.”)

By the time football players have made it to the doorstep of an NFL career, they’ve all suffered their fair share of battlefield bumps and bruises. ACLs are as much a part of a prospect’s record as INTs.

Which is why every NFL team conducts a comprehensive medical evaluation of every player it is even considering bringing into the building. You have to remember, these guys are not just players to an NFL team; they’re investments, in an unforgiving economic environment. Coaches and GMs need to be comfortable that the shiny new quarterback or cornerback they’re driving off the lot isn’t damaged goods.

In the Playbook Edition of “Take Your Eye Off The Ball,” the book I had the pleasure of writing with Pat Kirwan, we included a chapter on the important role a team’s medical staff plays in the draft evaluation process. A medical eval is no different than a prospect’s 40 time at the combine or what a coach sees on game film. It’s a piece of a complex puzzle. What matters is that the doctors get their chance to weigh in, and they have to get it right just like the scouts and decision-makers all the way up the chain of command have to get it right based on their own set of criteria. The teams who utilize input from their doctors can gain a medical competitive advantage over teams whose information is either inaccurate or unheeded.

In the book, Pat recalled one such example. A Jets doctor had examined a high-profile prospect prior to the 1981 draft, looking specifically at his supposedly balky knee. The medical staff red flagged the kid, recommending that the Jets not spend the third overall pick on him. Which they didn’t. That “medical reject” now gets introduced as “Hall of Famer, Ronnie Lott.”

Think that doesn’t happen all the time? That’s why Drew Brees isn’t wearing a Dolphins uniform (which is probably why Nick Saban is winning his titles in Tuscaloosa instead of Miami).

This year’s first round is littered with the usual rash of health-related question marks. Keenan Allen’s ankle. Matt Barkley’s shoulder. Tank Carradine’s knee. A couple of surgically repaired labrums (or is that labri?) belonging to Dion Jordan and Dee Milliner.

Coaches and GMs depend on their doctors to determine whether prospects should be cleared, so that they can make their decisions with clear consciences.

Look back to the influence the white coats wielded in the 2011 draft. Da'Quan Bowers was coming off a season where he'd led the nation with 15.5 sacks, but there were concerns that his surgically repaired knee might have some degenerative issues. It was enough to scare off teams for a round and a half; Bowers went to Tampa Bay with the 51st overall pick. His knee hasn't been a problem yet, though he did miss six games in 2012 recovering from an offseason Achilles' injury.

Then there was DeMarco Murray. He left Oklahoma with an abundance of school records, including career TDs and all-purpose yards. But he also had a record of prior injuries that read like multiple choices on an anatomy exam: knee, hamstring, ankle, shoulder. No single injury was enough to concern NFL doctors the way it had with Bowers. But they did have to consider whether he might be "injury prone" (not an official medical condition, mind you, but an unfortunate box to have checked on your NFL job application). The consensus, apparently, was that Murray was not worth an early pick, and he was on the board until Dallas took him with the 71st pick. 

Were the doctors right? When he's been on the field, Murray has shown signs of the explosive player scouts dreamed he'd be. You don't break the single-game rushing record for a team whose backfield once featured Tony Dorsett and Emmitt Smith if you're not a potentially elite talent. But then he's missed nine games due to injuries over his first two seasons. Score one for the stethoscopes.

The top of this year’s draft also features some unique and unsettling medical situations, potentially affecting the draft position of some top-tier prospects. We’re not talking conditions that are merely career-endangering; the potential consequences are far more dire.

Take Star Lotulelei. Before he arrived in Indianapolis for the combine, the Utah defensive lineman was widely considered one of the top prospects in the draft. Then, he was sent home, after an electrocardiogram detected an irregularity with the left ventricle of his heart.

Nothing had happened that would cause a coach to doubt his football skills, and once he received the medical green light, he had a monster showing at Utah’s pro day. Still, it can’t be easy for a GM to hear “heart condition” and not have it factor into the equation at some point when building his draft board. What can a team doctor possibly advise in such a case? 

Or in the case of cornerback D.J. Hayden? A collision with another defensive back during a play – in practice, no less – left Hayden with a tear in his inferior vena cava. For those non-thoracic surgeons among us, that’s the vein that carries blood from the lower part of your body back to the heart. As veins go, that’s a pretty important one.

Four months after a life-saving surgical procedure, Hayden ran a 4.4 40 at Houston’s pro day. Having had his sternum cracked open recently earned him a pass on the bench press. Now, a month later, NFL.com’s Mike Mayock has Hayden as his top-rated cornerback.

But when does a team take him? How much weight does a doctor’s note carry in the wake of an incident like that?

Doctors in the NFL wouldn’t blink over the hamstring that kept Eddie Lacy from participating in drills at the combine. But they do have to think twice about signing off on the reported case of spinal stenosis suffered by Jarvis Jones, whose falling draft stock likely has something to do with that diagnosis.

It’s not just first-rounders, of course, that are subjected to some medical hand-wringing and soul-searching. Someone will take a chance on Cincinnati defensive end Walter Stewart, but how do you decide in what round it is worth the risk of picking a player with a recently diagnosed congenital abnormality in a cervical vertebra? Maybe best to pass on him in the third round, just in case? How about the fourth? Or seventh? 

What can a doctor tell a coach about Marcus Lattimore? That the three ligaments he tore in his right knee have healed as well as the ACL he tore in his left the year before? In what round would a doctor endorse a coach’s dream that Lattimore will recover the way Adrian Peterson did?

When you’re watching the draft unfold this week and you see players’ names lasting a bit longer than expected on the “best player available” list, keep in mind that it may have nothing to do with talent. In some cases, it could be doctor’s orders.