Top 2016 NFL Draft Medical Issues

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Draft

As draft day approaches, there is a plethora of information and mock drafts which are all affected by medical grades. I will take this opportunity to analyze the top medical issues for the 2016 draft. It is widely acknowledged that medical evaluations are an important factor in the decision making process.

All team physicians won’t agree on a player’s medical grade, just like scouts won’t necessarily agree on a player’s talent. Even though each team acts independently, a consensus on medical grade is typically reached. It is not uncommon for team medical staffs to trade information and consult with each other.

Below are my top medical issues for a few key NFL draftees. Using the format of last year’s top NFL draft medical issues column, the assessments are categorized into red, yellow and green light ratings. This is for simplicity as teams certainly utilize more sophisticated grading systems.

I have not examined any of the following players or seen their medical records. If I had, I would not be allowed to comment based on federal privacy laws (HIPAA). For these evaluations, I utilize public reports combined with my knowledge as a practicing orthopedic surgeon/sports medicine specialist, my almost two decades of experience as a head team physician and my insight from having attended 19 NFL Scouting Combines. Injured players also now commonly post video of workouts and I take that information into consideration as well. Like a traffic light, the ratings are subject to change as more facts become known with a physical examination.

RED Light issues:

Indicates a serious medical issue that should cause a team to stop and reassess. These players aren’t undraftable, but their draft position will likely be affected by the evaluation of team doctors. When a player is red flagged, it doesn’t mean he can’t play football. It just means there is an issue to cause a team to stop and pause. Usually a “red M” goes on the players draft board magnet as a reminder.  A general manager will have a long discussion with his medical staff prior to a final decision. They may need surgery, be recovering from surgery or have significant longevity issues. One or more teams will likely have taken these players off their draft boards due to medical risk while others will be willing to take a risk based on need or value.

Jaylon Smith, LB Notre Dame:

This is the tragedy of this draft. I worried about nerve injury as soon as I saw the unfortunate New Year’s Day injury. When I later saw video of Smith wearing the ankle foot orthosis (AFO) that indicated a peroneal nerve palsy existed, I predicted a “medical redshirt” year for 2016 and a tumble from top pick to a Day 3 late round flyer before his Combine medical exam. His injury is much more than an ACL tear. It also includes his lateral collateral ligament (LCL) and the posterolateral corner (PLC), which is confirmed for the first time by recent comments from his surgeon indicating “all the structures on the lateral side of his knee” were damaged. Even without the foot drop issue, this is a daunting recovery. To my knowledge, no NFL linebacker has ever played wearing an AFO. Is Smith talented enough to beat the odds and do so? Maybe, but that doesn’t mean he would still be the “generational” linebacker that he was projected to be. While it is possible the nerve could wake up, it would be beating the odds to think there would be 100% recovery. Smith has longer odds than Marcus Lattimore (not reported to have a nerve issue) who retired after two years of rehabilitation with the 49ers and never played a down. I give Smith a lot of credit for working hard and having a great attitude. The workout videos, while impressive, still show the affects of the foot drop on the left side. The use of the bungee cord dampens explosiveness and helps hide the nerve palsy, but it is still evident. I hope I am wrong and Smith beats the odds to return. He has an excellent surgeon who is optimistic of a full recovery. His doctor also happens to be the Cowboys head team physician. We will see if this gives Dallas enough confidence to select Smith before Day Three.

Myles Jack, LB University of California Los Angeles:

The worry here is not the meniscus but the articular cartilage. Putting together various reports, Jack has an osteochondral defect (osteochondritis dissecans-OCD) which involves a lack of blood to the underlying bone, thus putting the overlying cartilage at risk. This condition is congenital and not directly related to the meniscus issue. There is no question that Jack can play NFL football today. How long his knee will hold up is the question. If this piece breaks off, there is no simple surgical fix as there is a divot left in the bone surface. Results depend on the size and location of the OCD lesion. Ultimately, re-growing articular cartilage is the ‘holy grail” of orthopedics. All 32 NFL head team physicians will form their own opinions but any OCD lesion has to worry a team. Just like all scouts don’t universally agree on player evaluations, doctors each will have their own take on medical risk. Unlike Jaylon Smith, Myles Jack will still be drafted high but his knee will affect his draft stock.

Brad Sylve, CB Alabama:

Torn Achilles the day before his Pro Day and had repair surgery. Despite great speed, he still might not have been drafted pre-injury. However, now he is definitely a free agent. Sylve is unlikely to be ready for training camp, which is where he would get his reps to make a squad. He likely will have the equivalent of a medical redshirt year and try to catch on next season.

YELLOW Light issues:

Indicates a significant medical issue that needs to be taken into account. As the color indicates, a general manger needs to slow down and factor in his team’s medical assessment. As a reminder, typically a “yellow M” is placed on the players draft magnet. If two players are rated the same, it might be less risky to select the non-yellow light player.

Shaq Lawson, DE Clemson:

Was called back to medical rechecks for a shoulder issue. Lawson finally acknowledged his shoulder injury by saying it is now finally ready by sending video to all 32 teams this weekend. He claims he hurt it his freshman season where it “popped out”. Lawson played three years with a brace and claims there is no issue with it. When a shoulder dislocates and requires reduction, there is a very high chance of a labral tear. It is something he can play with in a brace. The NFL team that drafts him may have him undergo immediate surgery or choose to have him play with a brace and have surgery next offseason. I don’t believe this will completely deter suitors from drafting him but it does warrant a closer look and may affect his draft position.

Devontae Booker, RB Utah:

Suffered a torn meniscus and bone bruise. Booker said he was 70% at his Pro Day. The concern is the bone bruise as it would be unusual for the meniscus to still bother him at four plus months from surgery. Teams will have to take a closer look at the bone contusion issue before making a final decision on Booker.

Karl Joseph, Safety West Virginia:

Tore his ACL in October 2015. Seems on track for a good recovery but likely will not be ready to practice day one of training camp. Joseph may not return to full form until the middle of this coming season. Teams will have to consider his rehab progress before selecting him.

Laquon Treadwell, WR Ole Miss:

Fractured fibula and dislocated right ankle in 2014. The injuries are all healed now and he played well in 2015. Treadwell ran a somewhat slow 4.63 in the 40-yard dash which opened up questions on the ankle. It could be because he is a big physical receiver but teams will want to make sure it is not due to sequela of the ankle fracture/dislocation causing the loss of speed where perhaps there is early ankle degenerative changes.

GREEN Light issues:

Indicates a definite medical issue, but one that has healed or should have minimal long term effect. These player injuries have been evaluated by the medical staff and are a “go” as the color indicates. These players have known injuries that shouldn’t scare away a general manager.

Carson Wentz, QB North Dakota State University:

Missed second half of season with a right throwing wrist injury. By reports of the surrounding circumstances and his post-operative cast, he appears to have had a scaphoid fracture. Because it is his throwing hand, teams will have cause to take a good look. Scaphoid fractures can be problem fractures, but when diagnosed and treated quickly, they usually heal well. Assuming x-rays show the bone is healed, there should be little risk here.

Jared Goff, QB California:

Had right shoulder surgery after his freshman year. As a likely #1 pick and franchise QB, any throwing shoulder issue is always a potential concern. Goff played three more years after the surgery. The procedure was to fix a separated (not dislocated) shoulder. Technically, the procedure was to his AC joint and not his ball and socket true shoulder joint so there should be no worries here.

Scooby Wright, LB Arizona:

Had lateral meniscus tear and was scoped at the beginning of season and returned to play within a month. Subsequently suffered a foot sprain. His injury issues should be minimal at this point.

4 Responses to "Top 2016 NFL Draft Medical Issues"
  1. Jed says:

    Dr. Chao, since Jaylon Smith’s foot drop is due to nerve damage, would it be more beneficial for him to wear a foot drop e-stimulator (i.e. Bioness) during games versus a standard AFO? Would he need special clearance in order to wear something like that during a game? Is that even a practical option during game time?

  2. No special permission needed to wear and AFO. Would be difficult for LB to perform at a high level with a foot drop.

  3. Binh says:

    Dr. Chao, if Jaylon Smith nerve ever wakes up, what would be his recovery time once woken up?

  4. Jim Whitman says:

    In 2005 Eagles safety JR Reed injured this nerve, suffered foot drop due to an off the field injury. He wore the brace and did play, but was much less effective and basically bounced around the league for the next few years.

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