Dr. John Best, aka The Old Chief, is a cardiologist who has served as team physician to the Missouri State University athletic department, and as a consultant to the KU, MU and SBU athletic departments. He has almost 40 years experience in the fields of medicine and sports medicine.
Yesterday, falling victim to the cold weather and sheer boredom, I flipped on the TV. After watching another boring Big Ten “shootout” between Michigan State and Wisconsin, I turned my attention to the NFL combine. Folks, a snoozefest! Are we Chiefs fans so desperate for our football fix that we have turned to watching time trials for QBs and offensive lineman? So caught up in the game that we are willing to listen to grown men rant and rave about young men running around in spandex onesies?
Despite the placid nature of this event, I thought this might be an opportune time to review the team physician’s role in this livestock auction. After all, more important than any speed or strength drill, more important than any psychological profile or Wonderlic test, is the client’s bill of health. When all these scouts and GMs visit Bill “the Butcher” Polian’s meat market (Lucas Oil Stadium), they’re looking to find Grade A beef with no defects.
Initially, every player has an extensive history and physical exam. During this process, prior injuries are highlighted as potential sources of chronic problems. Next, a family history is reviewed looking for inherited problems such as sickle cell trait, Marfan’s Syndrome and Idiopathic Hypertrophic Subaortic Stenosis. IHSS, Marfan’s and sickle cell trait are markers for sudden cardiac death in a young athlete. During the physical exam, special attention is also given to the spine, shoulder, elbow, hip, knee and ankle joints. Along with all the poking and prodding, range of motion is recorded for all teams to review.
A careful history of concussions and/or head trauma is then recorded. The player is asked if they’ve had any prior stingers. If the answer is yes, that question is followed up by two more: “how often did they occur?” and “how long did they last?” This may be due to narrowing of the cervical vertebral canal, and will lead to obtaining a CT Scan or Magnetic Resonance Image (MRI) of the cervical spine. When other areas of question appear they may be targeted for a MRI or a CT scan. With all the current discussion surrounding concussions and head trauma in current players, like Dan Morgan, and former NFL players, like Ted Johnson, this is an aspect of the medical examination that has been pushed to the forefront.
The cardiac exam has also gained increasing importance in recent years, following the untimely deaths of several athletes. Besides the history and physical, often an EKG (electorcardiogram) and an ECHO (Ultrasound of the heart) are performed. This helps in discovering congenital heart defects, cardiac enlargement as well as IHSS.
In the end the NFL and more specifically its teams make a huge investment in these players. This allows them to pool their resources in order to maximize potential and limit potential hazards and sources of liability. The failure rate for these million-dollar babies is high enough without any medical red flags. Teams simply must be satisfied that the high-priced meat they’re buying comes with no defects. As we all know, even the finest meat and other ingredients can go awry if you have the wrong cooks — see Carl Peterson, Herm Edwards and Gunther Cunningham — in the kitchen. Clearing players medically gives the coaching staff and front office a higher chance at successfully drafting and developing these prospects.
Fire away questions regarding this process. All questions will be answered in my next column.