Will Carroll is taking a look at the top draft picks in the 2013 NFL draft with any medical questions. Carroll takes a look at the full spectrum of info, including injury history and exclusive medical insight from Dr. Neal ElAttrache, a medical consultant to many pro teams and the current L.A. Dodgers team physician.
Star Lotulelei: 6'3" 311-pound, defensive lineman from Utah
Lotulelei has no significant injury history aside from a heart issue flagged at the NFL combine. Testing showed a reduced efficiency of his heart. The ejection fraction—a measurement of how well the heart is pumping—for Lotulelei was at 44 percent. A low-normal reading is about 60 percent. (I had a heart attack in early March and my percentage was never lower than 55 percent immediately following.)
Lotulelei was precluded from doing any of the physical activities at the combine, and worry that he had an enlarged heart or another serious heart condition had him dropping on mock drafts. Teams were a bit more sanguine while they awaited additional testing. Those tests, including extensive imaging including cardiac MRI and a 48-hour halter study, showed no problems. The most likely culprit for Lotulelei's initial abnormal result is a viral infection or rapid weight loss.
Lotulelei was issued a gold star by his cardiologist that includes no restrictions from activity. Lotulelei was not required to return for the medical re-check, a surprising move that speaks to the completeness of his medical file post-combine.
Lotulelei was precluded from participating in the performance portion of the combine after his abnormal tests. He did participate in Utah's Pro Day after being cleared. Lotulelei was slow, even for a player of his size, but many discounted the numbers due to an extended period off while his heart was being checked and re-checked. His power is unquestioned, putting up 38 reps in the bench. He also had several team visits, where there was further testing, medical and physical.
"They were right to be very careful with a heart condition. You have to be conservative. We'd bring in a cardiologist to check all the medical records, all the tests that were done. If there are any gaps in what the player agent did, we'd order those or have them done on a visit. It's not normal, but you have to check everything out with a player with this kind of possibility. If it checks out and was just one abnormal test with a good explanation, you go back to evaluating him normally." - Dr. Neal ElAttrache
Lotulelei's status has been all over the board, especially after his abnormal combine testing. Lotulelei has been seen as high as first overall pick, pre-combine, and as low as off the board when there were major concerns about a serious heart issue. With the medical clearance, Lotulelei has moved back up. He is rated the best 3-4 defensive end by Mike Mayock and is slotted as the seventh overall pick, to the Arizona Cardinals, in Matt Miller's latest mock.
There should be no concerns about Lotulelei's heart given the clearance, but there is little doubt that it will be in the minds of some GMs on draft day. Lotulelei will have to watch his weight to make sure he doesn't lose more speed and perhaps tax his heart. There has been some speculation that warm weather teams would avoid Lotulelei due to concerns with heat, but every team trains in heat, so this seems a bit specious.
These reports were compiled from various cited sources. All draft data courtesy NFL.com. Inside Look is exclusive to B/R from Dr. Neal ElAttrache of the Kerlan-Jobe Clinic and former team physician for the Los Angeles Rams. Dr. ElAttrache helps give insight into what the team doctors for NFL teams will be looking for in this type of player with injury concerns.
Will Carroll is the Lead Writer for Sports Medicine at Bleacher Report.