Dr. David Chao
Latest NFL News


After an offseason of speculation of who will be healthy and who will not, the PUP watch is on. The eagerly anticipated news of the week will be who is placed on the Physically Unable to Perform (PUP) list, but what does it really mean?

As previously explained, there are two types of PUP, Active (for the preseason) and Reserve (for the regular season). The other designation is Non-Football Injury (NFI) which is used for injures not occurring during NFL football, which includes collegiate injuries.

One needs to be on Active/PUP even first, if only for a day, to be eligible for Reserve/PUP . Thus, is it not the end of the world if your favorite player is placed on PUP. For example, the Jets signed Muhammad Wilkerson to a big free agent contract but fans should not freak out, rather expect his appearance on PUP initially in case his ankle doesn’t respond as expected.

It says more when a player is not on PUP than when he is. The Ravens announced six players were not ready for training camp, including Steve Smith (Achilles), Terrell Suggs (Achilles), Elvis Dumervil (foot), Breshad Perriman (“partial” ACL), Trent Richardson (knee scope, hamstring) and Jumal Rolle (Achilles). Notably absent from this PUP list was Joe Flacco coming off ACL surgery. This speaks volumes to the team’s confidence in their QB’s recovery.

The Lions placed three players (WR Corey Fuller, TE Brandon Pettigrew, T Corey Robinson) on preseason PUP. The key is not that a player begins on PUP but when he comes off.

Jordy Nelson is reportedly doing well and had almost an entire calendar year to recover from his ACL tear; however, don’t be shocked if the medically conservative Packers start him on PUP. Sometimes, it is just the team taking the precaution and leaving the worst case option of Reserve/PUP open if there is a setback.

The Cowboys reportedly will start TE Gavin Escobar on PUP after a Week 15 Achilles rupture. The Bills will undoubtedly start Shaq Lawson on Active/PUP and convert him to Reserve/PUP to save the roster spot and get him back this season after shoulder surgery in May.

There are some big names coming off injury: Jamaal Charles (ACL), Dion Lewis (ACL), Jimmy Graham (patella tendon), Thomas Rawls (ankle fracture), Sammy Watkins (Jones fracture) and Julian Edelman (Jones fracture). Don’t be surprised if many of these names at least start training camp on PUP. The key will be how long they stay on the list and unable to practice.

The annual PUP watch is on.

MMMD 1: J.J. Watt’s back surgery isn’t the issue, rehab is

Although back surgery is nothing to scoff at, the herniated disc procedure for the two-time reigning Defensive Player of the Year is relatively straightforward. The rehab of the core muscles for this injury is more unpredictable.

While it is possible that Watt will play Week 1, it is very unlikely that he will be 100% until mid-season. The Chiefs’ Dontari Poe had a similar surgery and a late July 2015 time frame and indeed returned to play Week 1 but was not himself until much later.

The disc procedure was undoubtedly in the lower lumbar spine at L5-S1 or L4-5 level meaning it affects the player’s base. In my NFL experience, it is harder for a power player like a defensive lineman to return to full effectiveness than a skill position. After all, playing on the D line is like wrestling a bear (or two).

The Texans medical staff didn’t miss the injury and Watt didn’t delay surgery. Yes he played with a herniated disc (many players do) last season; however, it likely got worse, or extruded, leading the team and player to decide to be aggressive. Pulling the trigger now on surgery assures Watt being 100% for the critical parts of the later season.

MMMD 2: Bell suspension minimal real effect on Steelers

Le’Veon Bell is still recovering from his multi-ligament knee injury. In reality, the four-game suspension will just give him more time to recover and might not really be costing additional game time. Combined PCL/MCL injuries are harder to recover from than an ACL tear.

Bell was likely to start training camp on active/PUP and work his way back in anyways. The biggest significance is that he will have to find his own rehab and workout place as he will not be allowed to be with the team during the first four weeks of the regular season. The Steelers are likely to factor in the suspension in deciding when to activate Bell. This is not illegal, as when Bell is ready to play is a subjective decision anyways.

The bigger worry for Bell is that this counts as a second strike. A third violation would mean a one-year suspension. He needs to continue on random testing and this potential jeopardy could cost him in his pending contract status.

MMMD 3: A change in stance on Jaylon Smith?

The Cowboys have always expressed confidence in their high second-round pick’s nerve recovery. Has that now changed?

Jerry Jones remained steadfast in his comments that Smith is not behind in his recovery; however, he did say “if it comes around” not when. This is the first acknowledgement from the team that it might not. Let’s all continue to hope that it does.

MMMD 4: New IR/dfr rule

The amended injured reserve-designated for return (IR/dfr) rule should benefit clubs and players. In the past, a team needed to designate the single slot with the initial roster move. Last season, the Steelers wasted their only IR/dfr slot on Maurkice Pouncey, as he was unable to return after his ankle fracture as he ended up with seven additional surgeries due to infection.

This year, teams can place players on IR and not make the decision on which player they want to return until the player is ready to come back. This removes the worry of teams of using the designation too early in case a star player gets injured later or holding the spot and wasting it in the end. It also prevents using it on the wrong player, as in the case of Pouncey. This rule change is a good improvement.

MMMD 5: NFL medical director “retires”

Elliot Pellman, the longtime Park Avenue medical voice, has been asked to step down by the commissioner. Pellman and the NFL have made their share of mistakes over time. No one is going to shed a tear in his departure.

People seem to want a “scalp”, rather than focus on a solution. Now they have Pellman’s so lets focus on fixes. Hopefully this signals a new era where the NFL, NFLPA, concussion researchers and media stop playing politics.

The bigger issue is perhaps the NFL will now be forced to have a real medical advisor. I am not at all knocking current chief health and medical advisor, Betsy Nabel. However, working on a part-time basis one day a month is hardly enough time to tackle all of the health and safety issues in the NFL. Hopefully the new medical director can have the time and resources to truly lead the NFL where it needs to go.

MMMD 6: Dennis Green passes away

One of my early experiences as a NFL team physician was with the Dennis Green coached Minnesota Vikings in 1994. I had the fortune of taking my first NFL road trip with that special team. Besides Green, there were some great coaches on that staff including Brian Billick and Tony Dungy as well as future head coach Jack Del Rio who was playing at the time. Four players on that squad, Warren Moon, Randall McDaniel, John Randle and Cris Carter, would later be inducted into the Hall of Fame. I will remember Green fondly and may he rest in peace.

MMMD 7: ProFootballDoc scorecard

When Desmond Bryant of the Browns was announced with a pectoral muscle injury, I immediately indicated it was likely a tendon tear and surgery would be needed, essentially costing him the season. Unfortunately, this has come true, but the good news is he will recover 100% for 2017.

When Muhammad Wilkerson broke his leg last season, I tweeted he would recover well and it would not have a negative effect on his pending free agency. Indeed, the Jets resigned him to a big contract as expected.

This takes the 2016 record from 10-0 to 12-0.

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Dr. David Chao
Latest NFL News


The Packers superstar made news with his comments about his 2004 anterior cruciate ligament (ACL) surgery. One of the NFL’s best and most athletic quarterbacks attributed some of his success to his cadaver donor being a “fast SOB” as he shaved almost 3/10ths of a second off his 40-yard dash time after surgery.

Known to have a unique sense of humor that even fools teammates, Rodgers comments were surely made tongue-in-cheek. It wouldn’t be the first time a player was kidding the media as Danny Trevathan joked about having someone else’s kneecap last year. In any case, Rodger’s quotes give us a good chance to separate the realities from the myths of ACL surgery.

Was Rodgers’ cadaver donor a “fast SOB”?

There would be no clear way for Rodgers to know whom the donor was. The only cadaver information typically available to the surgeon is the age, sex, cause of death and dimensions of the graft. Upon expiration, donors are screened for diseases before being deemed viable for tissue harvesting. There is no direct tissue typing or matching to the recipient. Details of the donor’s life, ethnicity, occupation or athleticism are not considered or available. In fact, Rodgers ACL graft donor could have been female.

Could someone else’s ACL make you faster post surgery?

No way the graft itself makes anyone faster. First, the actual ACL from a cadaver is never directly harvested for use due to size and geometry limitations. Commonly, the patellar tendon (with two attached bone blocks), Achilles tendon (with bone on one side) or all soft tissue grafts (like posterior tibialis tendon) are used. Second, the ACL functionally can’t make one faster. It serves to stabilize the femur to the tibia and thus actually could be said to “slow’ the knee down to prevent shifting.

Is it feasible to decrease one’s 40-yard dash time after ACL surgery?

Rodgers said he was a 4.95 (40-yard dash) guy and then ran 4.66 after ACL surgery. Yes, ACL rehab can make someone faster/quicker if the athlete was not performing maximally prior to injury. A fully trained athlete can’t be made faster; however, a sub-optimally functioning player can be helped. In fact it is possible for an uninjured player to go thru ACL rehab style training and have performance improve. I personally witnessed Philip Rivers become a better athlete after ACL surgery in 2008. I wish I could take credit for his increased speed/mobility but it was a result of his hard work with top Chargers athletic trainers. Rodgers is downplaying his own dedication to rehab post-surgery here.

How is it possible to play football for multiple years without an ACL?

Playing through an ACL tear is possible in certain circumstances. Rodgers played high school, junior college and into his time at Cal with a torn ACL. Rivers played in the 2008 AFC Championship Game six days after arthroscopic surgery with a torn ACL.

The ACL is like an internal seat belt for the knee. Just like it is possible to drive a car with the seat belt broken, one can function without the ACL. However, when racing NASCAR, your seat belt better be working, just like your ACL is needed for the aggressive running/jumping/cutting of football. Without an ACL it is playing “Russian roulette” with your knee as there can be permanent cartilage damage if the knee gives out.. Rodgers was able to play through with a brace at lower levels of competition. Rightfully, his ACL surgery was done before exiting college and advancing to the NFL.

Is cadaver the best ACL graft like Rodgers recommends?

Certainly, the cadaver ACL worked for Rodgers. However, that would not be my (or most NFL physicians’) first recommendation. Fortunately, disease transmission risk with cadaver grafts is small. Even so, autograft (own tissue) patellar tendon with bone on each end is the most popular graft choice in the NFL. Bone-tendon-bone (BTB) graft is the strongest and most likely to succeed. Cadaver can work but has the higher re-tear rate over hamstring and BTB autografts. Using cadaver leads to less post-operative soreness and makes for a quicker recovery but may not be worth the significant (up to 30% per the ACL Study Group) re-tear rate. The cadaver failure rates are highest for younger and more active patients. Remember, missing a second consecutive season likely means the end of an athlete’s career.

Why is cadaver a potentially weaker graft choice?

All ACL grafts are scaffolds for one’s own tissue to grow into. Logic would tell you that your own tissue grows best into your own tissue versus someone else’s. A graft that does not incorporate and ligamentize is doomed to failure. There is no true rejection, as that is an immunologic response and cadaver patients don’t need to take special medications like organ transplant patients. Perhaps when technology arrives to tissue type and match to donor to recipient, cadaver failure rates will improve.

Can the ACL be stronger after surgery?

After one year of recovery, my patients are twice as likely to tear the other knee ACL versus re-tearing the reconstructed ACL. This is why I recommend bracing during the first year with early return to sport. The new ACL is not truly stronger, just lower re-tear risk. No, I would not recommend prophylactic ACL surgery.

Has ACL recovery gotten faster?

It sure seems that way. Rehab techniques have improved but there is no way to speed up biology. The media with Adrian Peterson’s nine-month return to rush for 2000 yards makes it seem like early return is something new but ACL recovery has been getting faster for over a decade. Shannon McMillian returned to play international soccer 102 days after her ACL surgery and at four months played in the 2003 Women’s World Cup for USA.

What is best thing to do for an ACL tear?

Pick a surgeon you trust and not the specific technique or graft choice. There are many ACL techniques (open, double incision, single incision, medial portal technique, all-inside) and many autograft (BTB, hamstring, quad tendon, contralateral) or allograft (BTB, Achilles, posterior tib) options. Let the chef tell you what he cooks well and the best meal to order. Let the surgeon tell you the procedure he is most comfortable with and what is best for you. Don’t make a surgeon who recommends cadaver harvest a hamstring graft. In other words, when you go to Morton’s get the steak. If you want fish, go to Oceanaire. Trust the recommendation or choose a different restaurant or surgeon.

Overall the joke is on us to take Rodgers comments so literally. It is very nice of Rodgers to thank and credit his ACL donor. At least this gave us a chance to discuss some of the fact and fiction about ACL surgery and recovery.

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Danny Shimon
NFP Fresh Voices


With most NFL draft’s it’s usually the first round picks who receive much of the attention and attract most of the spotlight. Yet over the years when you go back and review successful draft classes it’s typically the “sleepers” or day three selections that make a good class turn into a great class.

With that in mind we reviewed each NFL teams draft class, per division, and attempted to point out who potentially could turn out to be that groups “sleeper”

NFC South

Atlanta Falcons – De’Vondre Campbell, OLB Minnesota 4th rd. 17th pick (#115 overall)

Head coach Dan Quinn continues to build and reshape the Falcons defense into a mold similar to what he had with Seattle by adding length and speed to his front seven.
With De’Vondre Campbell Atlanta added an athletic linebacker who possesses that aforementioned speed and terrific length. He has experience playing both the inside and outside linebacker positions. He can quickly accelerate and chase down quarterbacks and ball carriers from sideline to sideline.

Although he was asked to place his hand in the ground and rush off the edge as a Gopher, Campbell admits that pass rushing is one of his weaknesses. Which is why he has been working with former Falcon Chuck Smith in the off season to help improve his technique.

The Falcons will start Campbell off at the WILL position on their defense hoping to take advantage of his ability to run and chase down tackles.

Look for Campbell to battle fellow rookie Deion Jones and veteran Phillip Wheeler for snaps at the weak-side linebacker spot in 2016.

Carolina Panthers – Zack Sanchez, CB Oklahoma 5th rd. 2nd pick (#141 overall)

One of the more surprising moves this offseason was when the Panthers rescinded the franchise tag on All-Pro cornerback Josh Norman, allowing him to leave and sign with Washington. The move not only saw one of the league’s better corners depart but it made the cornerback position an even greater need on defense.

The Norman move coupled with veterans Charles Tillman and Bene’ Benwikere both coming off season ending injuries Carolina used the draft to load up on defensive backs, drafting a total of three with their five allotted selections.

With Zack Sanchez the Panthers get a playmaking corner whose penchant to gamble on defense can allow him to not only make plays but also get himself in trouble and beaten at times.

Both confident and cocky Sanchez is a ball hawk in the secondary finishing with 15 interceptions over his three seasons in Norman. Sanchez quick-feet allow him to plant and drive jumping routes and getting his hands on the ball.

Sanchez lack of size (5’11” 185 pounds), strength, coupled with his quickness make him an ideal candidate to play the nickel position on the Panthers defense. With his quickness and ability to cover in confined areas Sanchez should excel covering receivers in the middle of the field.

Playing inside will also present him with opportunities to get his hands on the ball and create turnovers something he excelled at in college.

New Orleans Saints – David Onyemata, DE, Manitoba (CA) 4th rd. 22nd pick (#120 overall)

Looking to improve the league’s 31st ranked defense in 2015 the Saints went north of the border to draft a raw but physically talented prospect in David Onyemata.
Onyemata, who hails from Lagos Nigeria, attended the University of Manitoba and as a senior was awarded the J.P Metras Trophy, given to the top down lineman in CIS (Canadian Interuniversity Sport) which is Canada’s equivalent to the NCAA.

Onyemata had not played football before trying out for the Bison’s prior to the start of their 2012 season.

Onyemata caught the eyes of scouts during the week long practices leading up to the East-West Shrine game. His stock really took off after he ran a 5.06 forty-time, benched 225 pounds 33 times, and vertically jumped 33 inches at Manitoba’s first ever Pro Day. Impressive athletic numbers for someone who stands 6’3” weighs 300 pounds, and possesses an 82 ¼ wingspan.

Besides his size, and strength Onyemata has good up-field quickness and is able to get after the passer. He plays with balance and displays some natural instincts for the position. His big powerful hands can jolt a lineman backwards once he plants them into their chest. Onyemata strength, and quickness allows him to be used at both the inside tackle position or outside as a defensive end.

That type of scheme versatility is one reason why Onyemata has drawn comparisons to former 10-year NFL veteran, and also a former Manitoba Bison, Israel Idonije.

The Saints will start off Onyemata on the outside as a defensive end initially, hoping to one-day pair him across from Cameron Jordan and next to first-round pick Sheldon Rankins.

Tampa Bay Buccaneers – Dan Vitale, FB Northwestern 6th rd. 22nd pick (#197 overall)

With their sixth-round pick the Buccaneers drafted themselves a “super back” in Northwesterns Dan Vitale.

As a Wildcat Vitale played a hybrid tight end/fullback position where he was asked to block as both a lead blocker, and as an inline tight end. Vitale also lined up and ran routes from the slot position as well as out of the backfield.

He has very good hands as he displayed by hauling in 135 receptions to go along with 11 touchdowns in his four-seasons at Northwestern.

Vitale, who currently is listed as a tight end on the Bucs roster, offers the team a very versatile offensive weapon who can be lined up in multiple positions and can be used in a variety of different formations.

While his game is not flashy what you do get with Vitale is a tough competitive football player who possesses high football character, and the ability to make big plays when you least expect it.

Look for Vitale to make contributions on both the offense and special teams units for the buccaneers as a rookie next season.

Danny Shimon is a graduate of Introduction to Scouting and Scouting Boot Camp. 

Follow Danny on Twitter @dshimon56



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Joe Messineo
NFP Fresh Voices


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Monday Night Football used to be a huge event. Back in the day, the Monday Night game was the best game of the week. But then again, back in the day there was no Thursday Night or Sunday Night games so it was easier for Monday Night to get the best match-up.

Some of the best games ever have been on Monday Night Football. Some memorable Monday Night games that come to mind is the 1985 Chicago Bears at Miami Dolphins game, which turned out to be the only game the Bears lost all season, and the Green Bay at Oakland game when Brett Favre had one of his best games of his career days after the death of his father.  And who can ever forget the Oakland Raiders at Seattle Seahawks game when Bo Jackson trucked Brian Bosworth on his way to the end zone. There was the Houston Oilers vs Miami Dolphins game when Earl Campbell led the Oilers to a thrilling win in the Astrodome.

Howard Cosell, Don Meredith and Frank Gifford were must-watch TV for years. Every game seemed to be a classic. I remember as a kid, the main topic of conversation at school on Tuesday was always the Monday Night Football game.

While Monday Night Football isn’t what it once was, it’s still football, so it’s still a good thing. Let’s take a look at how each week of MNF stacks up on a interest and watchability scale.

 

Week One- Pittsburgh Steelers at Washington Redskins:

Two playoff teams from last season clash in the first game of a double-header in the season opening Monday Night Football game. Important to note this game is on at 7 pm eastern time so if you’re on the west coast and have a job may be a little tricky to catch the start. Big Ben and Kirk Cousins should be a really good quarterback battle. Hopefully the progress the Skins made last year will continue and make this a competitive contest.

Watchability – 3.5 out of 5

 

Week One – Los Angeles Rams at San Francisco 49ers: This one doesn’t sound like much based on actual skill level, but the Rams and 49ers had a big rivalry back in the day when the Rams were in L.A. With the Rams back in L.A. we will see the NorCal vs SoCal rivalry possibly re-ignite once again. Since this one doesn’t start till 10pm on the east, you fantasy football fans may have to go to sleep not knowing if they won week 1.

Watchability – 3

 

Week Two- Philadelphia Eagles at Chicago Bears: This could be a good game if we get good quarterback play from Sam Bradford and Jay Cutler. But both of those guys are prone to stinking up the joint at times so this one could end up pretty bad too.

Watchability – 2.5
Week Three- Atlanta Falcons at New Orleans Saints: The Falcons and Saints always put on a good show and they really put one one when they play on Monday Night. This one should be a shootout between Matty Ice and Cool Brees. They are two NFC South rivals and both want to be the team to challenge the Panthers this year. The winner will have a leg up to do that.

Watchability – 3.5

 

Week Four- New York Giants at Minnesota Vikings: This could be fun. Teddy Bridgewater is becoming a good NFL quarterback add in stars like Adrian Peterson, Eli Manning and Odell Beckham and this thing get’s pretty interesting.

Watchability -3.5

 

Week Five- Tampa Bay Buccaneers at Carolina Panthers: This is another NFC South division rivalry game. This one is a bit more one-sided than Falcons Saints though. The Bucs may hang in there for a while but they have little chance in this one. Cam Newton is always entertaining, and seeing how Jameis Winston performs following his Rookie Of The Year rookie season is an interesting sub plot.

Watchability – 3

 

Week Six- New York Jets at Arizona Cardinals:  The Cards are always fun to watch and they seem to always play well when they are on in prime time. The Jets were surprisingly good last year as well. The Larry Fitzgerald vs Brandon Marshall matchup is worth the price of admission in itself.

Watchability – 3.5

 

Week Seven- Houston Texans at Denver Broncos: Well, come on now, this is Brock Osweiler going back to Denver! You have to watch this one. J. J. Watt is playing and you have the Super Bowl Champs at home.  Must see tv.

Watchability – 4

 

Week Eight- Minnesota Vikings at Chicago Bears: Halloween Night in the “Black and Blue” Division. If you like to watch two old rivals go at it in a good defensive game, then you’ll like this one. It might not be the prettiest game though.

Watchability – 2.5

 

Week Nine- Buffalo Bills at Seattle Seahawks: Seattle is always a great atmosphere, especially in prime time. It will be loud there, we know that for sure. The Bills are getting better, but might not be ready for this quite yet. This has blowout potential.

Watchability – 2.5

Week Ten- Cincinnati Bengals at New York Giants: This one should be fun. We know Eli Manning and Andy Dalton will put it up a lot. They might not always go to the right color jerseys though. It’s hard to say what might happen in this one. These two teams are capable of playing great and also stinking it up. Sometimes they do it both in the same game.

Watchability – 3

 

Week Eleven- Houston Texas at Oakland Raiders:   The Houston Texans are back on after only a three week absence. This time they face the Raiders in a game that might be half empty in the stands. If the Raiders announce they are leaving town by then, there might not be anyone.

Watchability – 1.5

 

Week Twelve- Green Bay Packers at Philadelphia Eagles: The Packers are always fun to watch. Aaron Rodgers is one of the best quarterbacks in the game’s history. Eagles fans make them a tough opponent to take on at home. This game has high potential, but could also end up a very one signed affair.

Watchability – 3.5

 

Week Thirteen- Indianapolis Colts at New York Jets: Joe Namath guarantees the Jets will win. Just kidding. But Andrew Luck is in the house, and with that new contract he signed in the offseason he better put up some serious numbers this year.  So this should be a good one.

Watchability – 3

 

Week Fourteen- Baltimore Ravens at New England Patriots-  This one could be a really good one if the Ravens are still in contention. When Baltimore is at their best they are one of the few teams that can go into Foxboro and win.  They won in Foxboro in the 2o09 playoffs, can The Ravens do it again? But it all really depends on how their season is shaping up leading in to this late week contest.

Watchability – 4

 

Week Fifteen- Carolina Panthers at Washington Redskins-  Cam Newton vs Kirk Cousins is a good quarterback match-up, assuming they’re both still healthy. If both of these team are in the hunt for a division title, and they really should be, then this will be surely be a good one.

Watchability – 3.5

 

Week Sixteen- Detroit Lions at Dallas Cowboys: It’s hard to say what we might have with this one. Both teams could be well out of the playoff race by then. If Tony Romo goes down to another injury this could be a real stinker, but there is always the chance that the Cowboys could be well in the hunt for the NFC East. Hard to call.

Watchability – 2.5

 

Week Seventeen- No Monday Night game.

On paper, there are definitely some good looking games on Monday Night Football, but not too many that make you really salivate. They don’t seem to get those great games like Ravens vs Steelers or Packers vs Bears or Pats vs Broncos that the Sunday Night matchup constantly gets now. Theres also a lot of teams that don’t ever make it to Monday Night spotlight.  Unlike the Thursday Night game where you can see every team play. But then again, are you really all that  sad the Titans, Jaguars, Dolphins, or Chargers aren’t on Monday Night?

 


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Dr. David Chao
Latest NFL News


Calvin Johnson created a stir with his in-depth interview this week. The recently retired Detroit Lions wide receiver spoke candidly about a wide range of topics. At one point the likely future hall of famer compared giving out pain meds to handing out candy.

The way Johnson’s interview was promoted, it seemed like the nine-year veteran was going to slam the NFL and the Lions medical staff. In reality, after watching the interview in its entirety, I don’t feel that is the case at all and agree with a majority of what Megatron said. Let’s analyze the top five highlight quotes.

“Team doctors and trainers were giving them (pain medications) out like candy.”

If Johnson was referring to the accessibility of pain medication, where players could obtain pain medication thru the team doctors, that is indeed true. NFL players do not have to go to the local retail pharmacy like the rest of the world. However, that hardly means that pain medication wasn’t controlled and medically indicated.

No formal prescriptions are written, because scripts are only needed if one is to the pharmacy. That doesn’t mean there wasn’t appropriate documentation and control. Doctors manually record each pill administered or dispensed. Team physicians chart or dictate every encounter to document medical examinations and use of medications. Players use to make fun of me for “talking to myself” into my dictaphone on game day.

Most people are not aware that each medication, narcotic or otherwise, is tracked. Teams have a mandatory quarterly drug audit where every pill is accounted for. When news of the painkiller lawsuits came out, several players jokingly asked me how come I never “hooked them up” and why pain pills were not more plentiful to them.

Johnson acknowledges that medication availability became more difficult in the later half of his career. Toradol for prophylactic use was discouraged and team doctors were no longer allowed to travel with any narcotic medication for road games. It was typical for a team athletic trainer to walk up and down an airplane aisle after a road game to pass out Advil or Tylenol, which can be considered painkillers.

“The team doctor, the team trainers, they work for the team”

This is certainly true. Keep in mind, team doctors only work for the NFL as a side job. They all have university or private practices and only a minor portion of their income is related to the team. To think that physicians would jeopardize their personal careers by knowingly mistreating players defies logic.

Johnson added “and I love ’em, you know”. “They’re some good people, you know. They want to see you do good.” I agree that a medical staff wants to return a player to the field and that goal is in alignment with players’ desires to stay in the line up.

“You can’t take Toradol and pain medicine every day”

I certainly agree with this statement. During my 17-year tenure as team physician, we never used medication on a daily basis or to get thru a practice. Toradol, a strong anti-inflammatory with pain relieving properties which is in the same category as Advil, was used sparingly. Ketorolac, the generic name, is typically limited to 20 doses over a five-day period. Players received no more than 20 doses across an entire season. Our club even performed a Toradol study that showed it was safe to be used this way and presented it at the NFL Physicians Society meetings.

On game days there may have been a line for Toradol, but players just didn’t jump into line. The use of medication was predetermined and consented. No one was forced or encouraged to take Toradol or pain pills to play. In fact, players were the ones asking for the medications. We rarely used Vicodin or other narcotics as we felt that might interfere with the mental aspects of football.

“Concussions happen”

There is no question that concussions are unavoidable in football. Johnson didn’t come out and blame the league for knowingly putting players at risk, but he described a culture that demands that players play. There is no question the culture has changed but it is far from perfect as the Case Keenum situations still occur.

Megatron missed only nine games in nine seasons and was listed on the injury reports for his ankle, knee, Achilles, shoulder, thumb, quadriceps, groin, thigh, hand, foot and back. Interestingly, Johnson was never listed for head injury, although he acknowledged he had his “fair share” of concussions. Note the second half of Johnson’s career was played with a spotter in the sky, sideline video injury review and independent neurotrauma specialists on the sideline.

“Catching the ball hurt”

I don’t doubt that Megatron played thru pain. He described getting his knee drained 12 times during one season. I have witnessed the everyday pain he spoke about.

There is no question that catching a pass with his deformed finger with a boutonniere injury would be painful. He waited until retirement to have surgery, as the long recovery would have cost him game time.

Fortunately, Johnson made over $100 million in his career, another few million wouldn’t change his life and he chose health. It does seem he had some gas left in the tank and there were other factors. He hinted at the Lions lack of winning. “If we would have been a contender, it would have been hard to let go. If the Lions could get out of their own way…”

Johnson has the most receiving yards and touchdowns for any player to never win a playoff game. His 2008 team was the only team ever to go 0-16.

For the most part, I agree with what Johnson said and I hope he makes the Hall of Fame. He harbored no grudges, made no accusations, nor pointed any fingers. There was honest dialogue from his point of view. This type of frank discussion from a players perspective only helps football and helps fans understand the game behind the scenes. Thanks for letting me share some of my reaction to his comments.

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