Influence of 49ers medical staff at the 2014 NFL Combine and Draft

Many know team doctors handle injuries and pain management during the season. We take a look at what the 49ers medical staff does during the Combine and in the days preceding the draft.

Preparing for the draft is a year long event. As soon as one draft ends, teams begin working on the next. By the time of the Combine, teams are already preparing their draft boards. In fact, Trent Baalke told 49ers.com the team's draft board is already 60-65% complete before the Combine even begins.

The Combine hosts the top prospects. Many NFL draft fans focus on Combine performance as some sort of difference maker come draft day. And, while a performance can alter where the draft prospect ultimately lands, many teams have top prospects in mind well before the time of the Combine. Since Baalke has taken the reigns as GM, the team does not send scouts to the Combine. The entire 49ers medical staff, however, is in full attendance.

Medical exams have been labeled by many general managers and coaches as the most important part of the Combine. And that is certainly true for the San Francisco 49ers. Last year, I wrote about how the 49ers have teamed up with Stanford University and have worked to create a medical-competitive edge. The team doctors [Tim McAdams (orthopaedic surgeon), Gary Fanton (orthopaedic surgeon), William Maloney (orthopaedic surgeon), Scott Hyver (eye doctor)], under the direction of Jeff Ferguson, are all Stanford physicians.

While there are some players who skip Combine workouts in favor of Pro Days, no player skips the medical portion of the event. Most players pass the medical exams; however, teams medical staffs are looking at what likely future problems the athlete may encounter.

By the time an athlete reaches the Combine, he has completed an extensive medical questionnaire listing any and all previous football and non-football injuries or conditions. On the first day of the Combine, diagnostic tests (MRI, x-rays, CT scans) are performed on any injured body parts. Blood work and urine testing is done, which includes screens for recreational and performance enhancing drugs.

The second day, with diagnostic results available, medical and orthopedic examinations occur. Every team will have at least one doctor in the room when doing the general medical exam. The players are examined by one or more doctors and medical findings are shared with the group. It is interesting that, because the medical portion of the Combine is so thorough, there always seems to be at least one medical surprise.

As an example, this year teams were eager to see Stephon Tuitt (defensive end, Notre Dame) workout. Unfortunately for Tuitt, his opportunity was curbed when a Jones fracture, a fracture in the fifth metatarsal on his left foot, was revealed in a scan done at the Combine. Tuitt probably did not even know about it, because the fracture is often misdiagnosed as a sprain.

The orthopedic exam is even more invasive. On days three through five, every athlete is examined (about 75-100 per day). Over half the athletes who attend the Combine have had some sort of orthopedic injury, so teams insist on having their own team doctors evaluate every player. If a player has had a knee surgery, he will have 32 doctors examine that knee.

There are even psychological tests. As you can see, one of the biggest pieces of information teams get from the Combine is the medical perspective of the prospect's durability and longevity.

Now that the Combine has concluded, the 49ers medical staff takes all the information obtained, i.e., x-rays, CTs, MRIs and goes through every medical study to give each prospect a grade. This grading process is strictly from a medical standpoint. The medical team's major objective is to arm the head coach and the GM with enough information, so they can make the right decision.

In 2013, the 49ers drafted two players with medical baggage, Tank Carradine in the second round (40 overall) and Marcus Lattimore in the fourth round (131 overall), and signed a third in Luke Marquardt as an undrafted free agent. There has been some discussion on this site stating the team has a philosophy of drafting injured players and the team should not take any players with injuries in 2014. Realistically, however, football is a violent sport and over half of the top 300 athletes have orthopedic injuries.

While the 49ers took a chance on Carradine, Lattimore and Marquardt, the remaining picks should not be labeled as a draft class comprised of medical misfits. And, even with Carradine and Lattimore, it is premature to say the picks have not worked out. The 49ers knew the risk going in. But, risk-versus-reward decisions are what sports medicine is about.

In the days preceding the 2014 draft, it will be interesting what conclusions the 49ers medical staff have made about each player's health report and prognosis. I am confident this team has one of the best, if not the best, medical programs in the NFL. There is a medical-competitive edge in San Francisco.

The 49ers medical staff does not make the final decisions, but they are among the best information gathers. If the 49ers decide to draft a player with a prior injury, I am confident the entire medical history has been considered and factored in the player's draft stock.

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