Monday Morning MD

2015 NFL season has begun With the start of the Scouting Combine, teams have turned the page on the 2014 season. The 2015 NFL season kicks off with the annual Indiana migration like MLB starts with spring training in Arizona/Florida.  Like baseball, hope springs eternal as all 32 teams feel they have a chance to hoist the Lombardi Trophy. Athletic trainers and other personnel have already begun their combine week as of yesterday. As a NFL team physician, I made 19 of these annual pilgrimages to Indianapolis. The dinners at St. Elmo’s (it used to be the only good restaurant in downtown but Indy has developed significantly over the years) symbolized the start of the new league year. For the medical staffs, the Super Bowl is a distant memory and last season’s clean up surgeries are usually completed by now. It seems that Combine comes earlier and earlier each year and it does. This year marks the earliest start ever as the entire schedule has once again been moved up by a day. I remember when I began participating, it was three days of medical exams across a long weekend. Now it is four days of medical exams with team doctors arriving Tuesday. The entire Combine is over a week in length and is now a NFL Network made for TV mini-series. The medical exam is what sets the Scouting Combine apart. Pro Days have watered down the combine workouts as more and more choose to skip the Indy on field evaluation for the school Pro Days. After Combine comes the tedious process of reviewing all MRI imaging studies and completing final medical grades. Often this involves meeting with team management to explain and justify the medical downgrades. Next comes college player visits to teams and often a second chance for a medical evaluation. March brings free agency physical. The medical exams don’t always go smoothly, like what happened to Oakland last year. Combine is not even limited to a week anymore. It is now “combine season”. Last year brought regional and super combines. This year there is even an inaugural Veteran’s Combine. Comprehensive physicals are not performed at the regional, super or veteran combines. The central role of the medical evaluation is what sets the main Scouting Combine apart.   MMMD 1: Todd Gurley knee exam is key The medical evaluation of Todd Gurley’s reconstructed ACL is much anticipated. Combine is likely the only chance for NFL team physicians to examine his knee. Undoubtedly, the ex-Georgia running back will not work out at Combine but his medical exam will play a large role in where he is drafted. Gurley doesn’t need to be ready today, he just needs to project to be good to go in the future. Expect him to return to medical re-checks in Indianapolis in six weeks so NFL medical staffs can monitor his progress before the draft. In 2006, cornerback Antonio Cromartie was not medically cleared at Combine but he projected well enough coming off of ACL surgery for the Chargers to select him with the 19th pick overall despite missing the entire previous season.  This hopes to be a similar situation for Gurley and the team drafting him.   MMMD 2: Peyton Manning injuries won’t end his career The quad tear that left Manning ineffective in his Divisional Playoff loss has essentially healed without surgery. The chronic neck issues have stabilized. Although his arm strength will never return to full form, injury will not end his career this offseason. As expected, Manning has informed the Broncos he is healthy.  If he doesn’t return to Denver, it will be for reasons other than his quad or neck.   MMMD 3: Bradford back with Rams? When Sam Bradford suffered a torn ACL for a second consecutive season, some felt his time in St Louis might be over. That may not be the case at all as the quarterback was consulted before the new Rams offensive coordinator was hired. With medical advances, it is now possible to recover from double ACL surgery.  The fact that Bradford is a pocket quarterback only helps his cause.   MMMD 4:  ACL better second year back In this society of immediate results, we often forget that the second season back is usually when a player coming off of ACL surgery fully recovers. The first year they can return to play but it is the next year where they typically excel. Von Miller admitted to me that although he felt good in his first year back from ACL surgery, he was not 100% and next season will be even better. “Revis Island” was a forgotten term but Darrelle Revis’ second season back from ACL surgery re-established him as a top shut down corner. His teammate, Rob Gronkowski struggled early season with his new ACL but hit his stride late season. Look for a bigger 2015 season from Gronk. Defensive tackle Henry Melton was coming off ACL surgery in his first season with Dallas. His option was not picked up and he will be a free agent again. With this being his second year back from his ACL, some team may pick up a bargain as he should have a better year than 2014.   MMMD 5: NFLPA candidates want 18 games.   In this health and safety era, the NFLPA has taken a stance against two additional regular season games. When Eric Winston was elected president last year, he said a 18 game season was dead in the water. The majority of candidates who want to be NFLPA executive director back the idea of expanded regular season.  It will be interesting to see how this all plays out in the coming month as the elections may be contentious with the feeling that the NFLPA got the worst end of the new CBA.   MMMD 6: Buffalo Bills athletic trainers named staff of the year Congrats to Bud Carpenter and his crew for being named best in the NFL for a second time.  Last year, sources coming out of the Combine had Buffalo coaches wanting to replace the athletic training staff. Last season, Chicago’s offensive coordinator gave a tearful apology for criticizing QB Jay Cutler and taking things outside the Bears family by leaking to media. I am not aware of Bills coaches apologizing to Carpenter or the team for apparently doing the same thing. I suppose the ultimate apology is the athletic training staff just won a top award and are still employed, while the former Bills coaching staff is no longer in Buffalo.   MMMD 7: A year later, things remain the same Pro Football Talk points out their February 11, 2014 and February 11, 2015 headlines are eerily similar.  Both stories chronicle the Browns owner saying his team is “not a mess with a straight face”. Often team dysfunction is manifested in other ways and can even be seen on the medical side. The 2013 handling of Robert Griffin knee issues could be attributed to flawed Washington front office dynamics. Last year, the Browns attended Combine without a qualified head team physician.  Cleveland has since hired a quality lead physician and has always had quality athletic trainers. Lets hope the rest of the Browns franchise follows suit. Follow David on Twitter: @profootballdoc Dr. David Chao is a former NFL head team physician with 17 years of sideline, locker and training room experience. He currently has a successful orthopedic/sports medicine practice in San Diego.
Dr. David Chao
Two decades of NFL team physician experience including two Super Bowls and two Pro Bowls. Providing unique perspective to injuries and the NFL sideline/locker room. Successful orthopedic surgery and sports medicine practice in Southern California.

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