Marcus Lattimore’s moment of truth: NFL combine medical examinations
COLUMBIA — South Carolina’s team doctor and orthopedic surgeon, Jeffrey Guy, attended the 2011 NFL scouting combine as a guest of the Carolina Panthers.
NFL CombineWHEN: Today - Tuesday WHERE: Lucas Oil Stadium, Indianapolis WORKOUT SCHEDULE: Saturday (tight ends, offensive line, special teams); Sunday (quarterbacks, wide receivers, running backs); Monday (defensive linemen, linebackers); Tuesday (defensive backs)USC PARTICIPANTS: TE Justice Cunningham, LB DeVonte Holloman, OL T.J Johnson, RB Marcus Lattimore, WR Ace Sanders, DB D.J. Swearinger, DL Devin Taylor CLEMSON PARTICIPANTS: RB Andre Ellington, DL Malliciah Goodman, WR DeAndre Hopkins
Though Guy was part of an NFL program designed to educate college football’s doctors on the combine’s medical examinations, he spent part of his time talking with USC’s players who attended that combine.
“One of our kids was kind of upset about (the exams),” Guy said. “He said, ‘I feel like they’re trying to find something.’ He’s right. They are trying to find something.”
That is the combine’s overarching goal — trying to find something. With millions of dollars in draft investments at stake, the combine lets teams obtain tangible data about potential picks.
Most public attention focuses on drills, such as the 40-yard dash, which are now broadcast on live television. But for players recovering from a serious injury, like former USC running back Marcus Lattimore, the most important part of the combine is the more secretive medical exams.
“I think that would be the most fascinating thing for the NFL Network to show at the combine,” said Dr. David Geier, an orthopedic surgeon and the Medical University of South Carolina’s director of sports medicine, who attended the 2005 combine with the St. Louis Rams’ doctors.
The combine, and all of its obsessively thorough analysis of players, runs today through Tuesday in Indianapolis’ Lucas Oil Stadium. Perhaps no part of it more closely replicates a grocery store produce section than the medical exams. It is there, in a secure set of rooms not far from the on-field drills, that players are poked, prodded and questioned about their physical condition as NFL team doctors search for data of their own.
Lattimore might have been a first-round pick in April’s draft if not for the right knee injury he suffered Oct. 27 against Tennessee. In a gruesome collision, he dislocated his knee and tore three of its four ligaments. Lattimore has been rehabilitating in Pensacola, Fla., and while he has expressed optimism about his progress in media interviews, he will not participate in drills at the combine or run at USC’s pro day on March 27.
Lattimore will interview with teams at the combine, and while everyone he talks to probably will leave impressed by his mature and positive demeanor, the medical exams in Indianapolis and a check-up just before the draft are vastly more important in determining where he will be selected.
“The NFL is collectively holding its breath to see where he is,” said NFL Network analyst Mike Mayock. “If he can play next year, even if it’s the second half of the year, that will add to his value. I think a third-round grade is fair for him, because you’re going to get his most production two years down the line.”
Jury still out
So where is Lattimore in his recovery?
Jury still out
Not surprisingly, Lattimore has said he plans to play in 2013. While Guy said in December that it wasn’t impossible, he said this week that “it’s too early to tell” if it will actually happen. Famed surgeon Dr. James Andrews agreed, though he told USA Today that Lattimore is three months ahead of his rehab schedule and “twice as far along as we ever expected him to be.”
“Marcus is on schedule,” Guy said. “I never use the word ‘ahead of schedule.’ He’s doing really well, but when you talk about ligament surgery, the strength of ligaments is based on the concept of re-developing a blood supply. There’s only so much you can do (in rehab) while that’s happening.”
With assistance from Andrews, Guy performed Lattimore’s right knee operation. Guy also fixed the anterior cruciate ligament in Lattimore’s left knee in 2011, an injury he completely recovered from before hurting his right knee.
Though Guy is not directly supervising Lattimore’s current rehab, he speaks to Lattimore regularly, and Lattimore’s physical therapist sends Guy videos of the rehab process.
Guy said Lattimore is approaching the critical four-month anniversary of his Nov. 2 surgery. In the first four months, the surgical grafts in the knee take hold and blood supply ideally improves. The next two months will be when Lattimore increases his leg strength.
Because Lattimore is still in the four-month window, his running has been limited to an underwater treadmill. Moreover, Guy said, “we’re a little bit more cautious” with Lattimore’s rehab, because he tore multiple ligaments, not just an ACL.
But Lattimore has regained range of motion in his knee, and leg muscle strength. When doctors touch his knee to measure its progress “the knee feels really good,” Guy said.
“But the bottom line is, it doesn’t really matter if they feel like he’s ahead of the game,” Guy said. “The (NFL) teams themselves are going to have to make a final decision of whether or not they want him to play. These teams are not going to draft Marcus and try to hurry him back because they want to try to get him to play. There’s nobody out there right now that could tell you Marcus is going to play in 2013. The jury is out.”
Lattimore’s big day
NFL organizations are notoriously paranoid about other teams learning their inner workings. But the NFL’s medical community is more open, and that’s on full display at the combine.
Lattimore’s big day
One of the Panthers’ doctors who attended the 2011 combine with Guy was Dr. Robert B. Anderson, a renowned foot and ankle specialist. Anderson also serves as a consultant for other NFL teams. So when other team doctors noticed a foot or ankle injury during a combine exam, they poked their heads into Anderson’s room and asked his opinion.
“In general, they’re just trying to find out the status of all these kids,” Guy said. “All the politics, they let all that stuff happen at other levels.”
For Lattimore, the medical exams are scheduled to begin Thursday, with a hospital pre-exam, X-rays and MRIs on both knees. For all 333 players who attend the combine, any body part they ever significantly injured likely will receive an MRI when they arrive.
“The joke when I was Indianapolis (for the 2005 combine) is they run every MRI in town 24 hours a day for the week of the combine,” Geier said.
All players also undergo a standard physical, with blood tests and an EKG heart exam.
Then Lattimore’s serious business starts Friday, in secure exam rooms. There are five to six NFL team doctors in each room. One will examine Lattimore’s knees. The doctor will combine his observations of Lattimore’s MRIs and knees with the operation notes from Lattimore’s surgeries, and then deliver a spoken presentation about Lattimore to the other doctors. A full written report on Lattimore’s exam and injury and surgery history will be given to the doctors.
As Lattimore stands next to the presenting doctor, he will listen to the doctor detail his injuries, how long it took him to recover, who performed the surgery, even what type of graft was used. The other doctors can ask Lattimore questions about his injuries and rehab, and physically examine his knees themselves — and they will. Lattimore then heads to the next room and repeats the process until he has covered every team.
“I imagine he will get more hands put on his knee than anybody else at the combine this year,” Geier said.
All doctors can see Lattimore’s latest MRI, but scar tissue sometimes obscures post-surgery MRIs. The absence of cartilage damage on the MRI, which Guy called a “savior” because of the complications it can cause, will alleviate many concerns often associated with multiple knee ligament tears. Still, doctors will find most value in handling Lattimore’s knee, Guy said.
Guy told Lattimore doctors will want to see three things in addition to his MRI: how well developed his quadriceps and hamstring are, if he has full range of motion and if his ligaments are stable.
To measure strength, they will have him flex his upper right leg and compare it to his left leg. Because Lattimore fully recovered from his left knee injury, which Guy said is beneficial for how NFL teams will view Lattimore, doctors will bend his legs to compare range of motion. They will do the usual 15-second ligament stability check with their fingers, poking at the inside, outside, front and back of the knee.
Guy said NFL doctors obviously won’t expect Lattimore to be 100 percent, but they will want to confirm he is progressing as Andrews said he is. Then the doctors will do it all over again at the check-up exam shortly before the draft.
“It’s going to be a very important part of his process,” Guy said of Lattimore’s combine exams. “People coming out of surgery, having the medical doctors that work for the teams (examine them), it’s a big point of discovery for lots of things.”