NFL Draft 2014: Breaking Down the Medical Risk for Top Injured Players

Dave Siebert, M.D.@DaveMSiebertFeatured ColumnistMay 8, 2014

NFL Draft 2014: Breaking Down the Medical Risk for Top Injured Players

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    Starting Thursday night, more than 200 college football players will realize their dreams during the 2014 NFL draft.

    For some, their talent speaks for itself, and that dream is a given. For others—those with lingering question marks—the pressure continues to mount.

    Often, those question marks are medical in nature, and serious injuries or health conditions can derail NFL plans for even the top prospects.

    For example, last year, former University of South Carolina running back Marcus Lattimore suffered a dislocated knee and is still waiting to make an appearance in the NFL. Elsewhere, a surprise heart condition briefly cast doubts on the ability of Star Lotulelei to safely play football in the first place. Finally, cornerback D.J. Hayden nearly died after a tackle partially tore his inferior vena cava from his heart.

    Thankfully, one year later, Lattimore continues to recover. Additionally, Lotulelei's condition—a low left ventricular ejection fraction—proved temporary and reversible, and Hayden not only survived but performed quite well last year for the Oakland Raiders.

    This year, the field does not carry the same caliber of diagnoses. However, a number of knee, shoulder and foot injuries—to name a few—still cloud the draft profiles of several prospects.

    Starting with the least worrisome and moving toward the most concerning, let's take a look at the relative medical risk each injury poses to a particular athlete's career—and future NFL team.

    Author's note: The author does not have access to radiographic imaging or any other medical information on any of the following players. As such, the following analyses are based on incomplete information and thus are admittedly imperfect.

Risk Level Explanation

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    Without precise medical details, the exact prognosis for any given injury remains at least somewhat unclear—in fact, some degree of uncertainty usually exists even for those in the know.

    With that in mind, injury and medical risk for a particular player will fall into one of the following broad categories based on information that is currently available to the public:

    1. Green: While these players suffered ill-timed injuries, they should fully recover—and do so in time for the 2014 NFL season. Examples include a minor injury of relatively low significance or a moderate injury with a good to excellent prognosis.
    2. Yellow: These players suffered more serious or recent injuries that may not heal in time for full offseason workouts. Examples include an uncomplicated ACL tear sometime last year or an injury that may still require further intervention, but not those that seriously threaten a player's 2014 NFL season.
    3. Orange: Players who fall into the orange category suffered recent, serious injuries that either threaten or all but eliminate the chance to set foot on an NFL field for a good portion or all of 2014. Injuries with potential long-term complications also earn the "orange" tag. Examples include very recent ACL tears or possible degenerative joint issues.
    4. Red: A player rises to a "red" medical risk level when a devastating injury or medical condition calls into question a player's ability to play in the NFL at all. At one point in 2013, Star Lotulelei's transient heart condition had the potential to earn a red tag if tests revealed a serious underlying condition, as did D.J. Hayden's nearly fatal injury. Fortunately, from the far outside looking in, it is essentially impossible to confidently give any player a "red" flag in this year's class.

    Please note that players appear in approximate order of injury risk—even within the same risk tier. For example, lower-risk "green" players appear in this slideshow before higher-risk "green" players.

Eric Ebron, TE, University of North Carolina (Green)

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    Injury: Hamstring strain

    Risk level: Green

    Explanation: According to an interview with's Bryan Fischer, Eric Ebron suffered a hamstring strain during NFL Scouting Combine workouts. The injury proved minor—likely a low-grade strain. It likely healed in a few weeks without issue, and the former Tar Heel almost certainly feels no lingering effects. While one of the biggest risk factors for a future hamstring strain is a prior one, there is no reason to think he will suffer recurrent injuries—though the possibility exists.

    Matt Miller's overall ranking: First-ranked tight end, No. 13 overall

    Matt Miller's draft projection: First round, pick No. 12 to the New York Giants

James Hurst, OL, University of North Carolina (Green)

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    Injury: Non-displaced fibula fracture

    Risk level: Green

    Explanation: James Hurst broke his fibula late last season during the Belk Bowl. Fortunately, it maintained its alignment—or did not "displace." Non-displaced fibula fractures usually heal very well with simple rest followed by gradual return to sport with the help of physical therapy. Assuming no complications arose unbeknownst to the media, Hurst's stock should suffer minimally.

    Matt Miller's ranking: 17th-ranked offensive tackle, No. 203 overall

    Matt Miller's draft projection: Fifth round, pick No. 168 to the Carolina Panthers

Ryan Shazier, LB, Ohio State University (Green)

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    Injury: Hamstring strain(s)

    Risk level: Green

    Explanation: Ryan Shazier suffered two hamstring injuries over a relatively short timeframe earlier this year. The repeat injury places him at higher risk than Eric Ebron, as it might signify a higher risk of recurrent injuries in the future. For now, he remains "green" status—but slightly more tenuously.

    Matt Miller's ranking: Fourth-ranked outside linebacker, No. 37 overall

    Matt Miller's draft projection: First round, pick No. 31 to the Denver Broncos

Austin Seferian-Jenkins, TE, University of Washington (Green)

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    Injury: Fifth metatarsal stress fracture

    Risk level: Green

    Explanation: The medical exams at the NFL Scouting Combine served their purpose when it came to Austin Seferian-Jenkins. Doctors discovered a previously unknown stress fracture in his foot—presumably in his fifth metatarsal—allowing surgeons to intervene before it became a more significant problem. Following surgery to stabilize the bone, the former Husky may now sport some internal metal hardware—but an only slightly increased level of medical liability.

    Matt Miller's ranking: Third-ranked tight end, No. 50 overall

    Matt Miller's draft projection: Second round, pick No. 49 to the New York Jets

Stephon Tuitt, DL, University of Notre Dame (Green)

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    Injury: Jones fracture

    Risk level: Green

    Explanation: Similar to Seferian-Jenkins, doctors discovered a fifth metatarsal fracture in Stephon Tuitt's foot at the NFL Scouting Combine.'s Daniel Jeremiah reported the finding, calling the diagnosis a Jones fracture. Whether or not Tuitt suffered a true "Jones fracture" or actually a stress fracture in a slightly different location—see here for more details—is unclear. However, as with Seferian-Jenkins, surgical intervention will likely prevent him from falling too far down draft boards as a result.

    Matt Miller's ranking: Seventh-ranked defensive tackle, No. 87 overall

    Matt Miller's draft projection: Third round, pick No. 99 to the Baltimore Ravens

Vinnie Sunseri, S, University of Alabama (Yellow)

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    Injury: Torn ACL

    Risk level: Yellow

    Explanation: As's Andrew Gribble notes, Vinnie Sunseri declared for the draft relatively shortly after tearing his ACL. So far, it is working. Though an ACL tear is always a major injury, he proved his healing ability during Alabama's pro day in April. Now roughly seven months out from his tear, the proof of his recovery is nearly in the pudding.

    Matt Miller's ranking: Ninth-ranked strong safety, No. 270 overall

    Matt Miller's draft projection: Seventh round, pick No. 217 to the Washington Redskins

Aaron Murray, QB, University of Georgia (Yellow)

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    Injury: Torn ACL

    Risk level: Yellow

    Explanation: Similar to Sunseri, Aaron Murray suffered an ACL tear late in 2013. According to Seth Emerson of The Macon Telegraph, he did not injure any other ligaments, and the injury occurred on the run. Such an isolated, non-contact injury frequently carries an excellent prognosis after surgery. That said, rehab remains lengthy and complicated, buying the former Bulldog yellow status.

    Matt Miller's ranking: Sixth-ranked quarterback, No. 64 overall

    Matt Miller's draft projection: Third round, pick No. 91 to the New Orleans Saints

Jason Verrett, CB, Texas Christian University (Yellow)

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    Injury: Labrum tear

    Risk level: Yellow

    Explanation: Labral tears depend largely on the location and the extent of injury, as they come in many shapes and sizes. As the cornerback tweeted, Jason Verrett underwent surgery to repair his labrum in March. The type, location and amount of damage will determine his final recovery timeframe, but his prognosis as a non-throwing athlete is likely quite good. That said, labrums can sometimes prove stubborn to heal, and less than two months later, he may still be working on the middle stages of his rehab.

    Matt Miller's ranking: Third-ranked cornerback, No. 20 overall

    Matt Miller's draft projection: First round, pick No. 32 to the Seattle Seahawks

Tre Mason, RB, Auburn University (Yellow)

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    Injury: Scaphoid fracture (possible nonunion)

    Risk level: Yellow

    Explanation:'s Ian Rapoport reported Tre Mason needed surgery last month, later mentioning a poorly healing scaphoid. Mason later denied the report. Either way, scaphoid fractures may require surgical fixation when a break occurs in an area with a tenuous blood supply, and the possibility of surgery may still remain in some draft circles. Such a surgery does not necessarily bring about several-month rehabilitations, but it could cost Mason the beginning of his future squad's offseason activities.

    Matt Miller's ranking: Third-ranked running back, No. 53 overall

    Matt Miller's draft projection: Third round, pick No. 71 to the Cleveland Browns

Zach Mettenberger, QB, Louisiana State University (Yellow)

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    Injury: Torn ACL/MCL, spondylolysis

    Risk level: Yellow

    Explanation: As's Mike Triplett notes, Zach Mettenberger is recovering well from his ACL and MCL tears. That said, a contact, combination injury offers a more significant rehab challenge compared to a run-of-the-mill non-contact ACL tear. Additionally, this week, news of spondylolysis surfaced via's Ian Rapoport. Josh Katzowitz of notes Mettenberger's medical team identified the former Tiger's spondylolysis—the equivalent of a back stress fracture—early and successfully treated it without surgery. Nevertheless, the combination of a relatively recent severe knee injury and underlying prior back injuries puts LSU's former signal-caller in the higher end of the yellow range.

    Matt Miller's ranking: Fifth-ranked quarterback, No. 46 overall

    Matt Miller's draft projection: Second round, pick No. 33 to the Houston Texans

Dominique Easley, DL, University of Florida (Yellow)

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    Injury: ACL tear (x2), meniscus

    Risk Level: Yellow

    Explanation: Dominique Easley's college career included two ACL tears—one in each knee—with the most recent of which occurring in September 2013. According to Fox Sports' Ross Jones, the second also came with meniscal damage. While the former Gator is now more than six months out from surgery—and even if his recovery is proceeding without issue—the fact that he already carries such a large injury burden looms large among NFL draft circles. Furthermore, his next knee surgery—should he need one—will necessarily be a repeat operation on a previously injured knee, and future risk versus reward will always comes into play when it comes to long-term contracts.

    Matt Miller's ranking: Second-ranked defensive tackle, No. 19 overall

    Matt Miller's draft projection: First round, pick No. 29 to the New England Patriots

Jared Abbrederis, WR, University of Wisconsin (Yellow)

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    Injury: Concussions

    Risk level: Yellow

    Explanation: Bob McGinn of the Journal Sentinel noted Jared Abbrederis' concerning medical history earlier this year—one of multiple concussions. Though concussion theory continues to evolve, with each injury, an athlete may not only experience more severe or longer-lasting symptoms but also a lower contact threshold to suffer a subsequent concussion in the future. Given his position, Abbrederis' history will affect his draft position. It also merits him a reasonably high "yellow" tag.

    Matt Miller's ranking: 23rd-ranked wide receiver, No. 155 overall

    Matt Miller's draft projection: Fifth round, pick No. 156 to the Chicago Bears

Louis Nix III, DL, University of Notre Dame (Yellow)

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    Injury: Torn meniscus, tendinitis

    Risk level: Yellow

    Explanation: The highest yellow-level risk goes to Louis Nix III. According to Sports Illustrated's Zac Ellis, Nix went down with a torn meniscus late last year. He also battled tendinitis in his knee for much of last season. While there is no reason to expect any lingering issues from his recovery, early knee problems in a defensive lineman may not bode well. He will receive the best medical care out there—and he also has the talent to go very early in the draft—but a long NFL career will test his knee's limits.

    Matt Miller's ranking: Fifth-ranked defensive tackle, No. 47 overall

    Matt Miller's draft projection: Second round, pick No. 47 to the Dallas Cowboys

Aaron Colvin, CB, University of Oklahoma (Orange)

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    Injury: Torn ACL

    Risk level: Orange

    Explanation: In the end, the timing of Aaron Colvin's injury—January of this year—may matter most of all. After all, based on an interview with Packers blogger Vic Ketchman, it seems Colvin suffered an isolated non-contact ACL tear—similar to Aaron Murray. Barring complications, his prognosis is likely very good. However, he will likely miss most or all of the 2014 NFL season even under the best of circumstances, bumping his medical grade down quite a few notches—for the current season, at least. In fact, at one point, Matt Miller ranked Colvin as a first-round prospect.

    Matt Miller's ranking: 19th-ranked cornerback, No. 134 overall

    Matt Miller's draft projection: Fifth round, pick No. 160 to the Arizona Cardinals

Brandon Thomas, OL, Clemson University (Orange)

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    Injury: Torn ACL

    Risk level: Orange

    Explanation: No stock took a larger hit this year than Brandon Thomas' in April. According to ESPN's Adam Caplan, Thomas went down with a torn ACL. In the end, he may fully recover—and probably will—but the injury all but guarantees the former ACC standout will miss the entire 2014 season. ACL recoveries usually require upward of seven or eight months, which would put him ready for action—at best—for the last third of the season. Add in the fact that he will still need to learn his future team's playbook, and it seems he will make his NFL debut in 2015, not 2014.

    Matt Miller's ranking: Sixth-ranked offensive guard, No. 128 overall

    Matt Miller's draft projection: Fourth round, pick No. 125 to the San Diego Chargers

Cyrus Kouandjio, OT, University of Alabama (Yellow/Orange)

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    Injury: ACL/MCL surgery, question of arthritis

    Risk level: Yellow? Orange?

    Explanation: Cyrus Kouandjio's knee remains a bit of a mystery. According to Tommy Deas of, he underwent ACL/MCL repair surgery in 2011. This year,'s Ian Rapoport reported concern over an "arthritic knee" from a "failed surgery." Shortly thereafter, CBS Sports' Jason La Canfora said that Dr. James Andrews personally vouched for the relative health of Kouandjio's knee.

    On the one hand, the possibility of arthritis in a future NFL lineman raises serious concern. On the other hand, one of the best orthopedic surgeons in the country backed the former Crimson Tide star—that's about as ringing of an endorsement as one can get.

    In the end, each NFL medical staff will come to its own conclusion. Some may grade him down softly, while others may drop him completely. Only inner medical circles with access to his X-rays and medical history can come to a conclusion with any real confidence.

    Matt Miller's ranking: Fifth-ranked offensive tackle, No. 28 overall

    Matt Miller's draft projection: Second round, pick No. 37 to the Atlanta Falcons


    Dr. Dave Siebert is a resident physician at the University of Washington who plans to pursue fellowship training in Primary Care (non-operative) Sports Medicine.