Medical evaluation of players critical at combine
Editor's Note: Dr. Geier is Director of MUSC Sports Medicine and an orthopaedic surgeon. He writes a sports medicine column for The Post and Courier.
Of all of the workouts at the NFL Scouting Combine televised this week by the NFL Network and discussed at length by draft experts, which aspect do you think has the greatest effect on the players' draft status? The bench press? The 40-yard dash? Skills demonstrations? Interviews?
I would argue that one of the most important, if not the most important, is the medical evaluation.
The medical evaluations of players cannot be televised for confidentiality reasons. Rarely in draft coverage do the media ever talk about a player's health. But the evaluation process is a fascinating one, so let me describe it with a hypothetical player and injury history.
Player X is brought by a chaperone into one of the medical stations. This station has the orthopaedic doctors and athletic trainers for the Colts, Vikings, Patriots, Browns, Ravens and Rams. This group of doctors produces the report that contains the medical evaluation of all the players that is distributed to all the teams, although the players will have to go to other stations with the other teams' doctors and one station for assessment of medical issues such as heart or high blood pressure issues.
The player is taken into one room of the station, where one of the team doctors asks numerous questions about any and all prior injuries, surgeries, missed games and any current problems. Then the doctor performs a thorough physical examination and extensively examines the previously injured areas.
The doctor then reviews X-rays and MRIs performed on that player during the combine. Basically, if a player has ever had an injury, he gets X-rays and often MRIs of that body part. Players will often have three to four sets of X-rays and two or three MRIs. I don't know the number of MRIs done for the combine, but it must be staggering, because MRI facilities in Indianapolis perform the tests around the clock that week.
Next, the examining doctor takes the player into the station's second room to present the player to the other doctors and athletic trainers of the teams mentioned earlier.
After a very detailed medical evaluation is presented, team doctors and trainers ask more questions of the player. "Do you feel any giving out of your knee when you play? Does your knee swell often?" They might come up and examine player X themselves. Then each team's medical staff rates the player based on this information. Each team probably does it differently, but the Rams used an A-F grading scale. Player X, with a history of knee surgery and ankle sprains might be a B or B-minus. Each team has to judge for itself how risky a player is medically.
The team's scouts, coaching staff and general manager have to evaluate players based on playing ability, physical measurements and all of the combine workout results to decide who they would like to draft. They then consult with their team's doctors if the player's medical grade might make them rethink their pick.
Hypothetical GM or coach: "We really like Player X and want to take him with our first-round pick. Can he stay healthy?"
Team doctor: "I'm a little worried about his knee. He missed two games last year due to knee soreness, and his strength still hasn't completely returned from his surgery almost two years ago."
And then the team decides what decision is best.
The NFL Scouting Combine and NFL draft essentially involve speculation. Scouts look at films from a player's college games, tests to judge size, strength and athletic ability, and skills demonstrations to try to find a future All-Pro player. The team's medical staff is speculating as well. They try to predict how likely a player will be healthy and play without injury based on prior injuries. The top picks earn a lot of money, and they are needed to play right away.
For more information on football injuries and other sports medicine topics, go to Dr. Geier's blog.
