Why Tagovailoa won’t ‘fail’ physical
Let’s start here: NFL team doctors don’t “fail” players in a medical physical like coaches talk and reporters write. Not really. Not unless there’s some life-threatening issue, like a kidney or heart problem that needs medical treatment immediately.
In 17 years as the Miami Dolphins team doctor, George Caldwell helped spot such problems to save the life and temporarily stop the football career of the rare player during the NFL combine’s physicals of draft prospects. Such a player indeed got a “5” grade on the Dolphins’ scale. A fail.
And, yes, there is a scale based on a player’s physical condition rather than the thumbs up or thumbs down idea out in the greater public discussion. The scale ran from a five (fail) to a one (no medical issues). To be sure, prospects rarely got a perfect grade, too.
“Typically, it was probably a punter,’’ said Caldwell, who left the Dolphins in 2013 and practices in Broward County. “There’s a reason players are at the combine. They’re good. They’ve played a lot of football. And anyone who is good and played football in high school and college has had some injury.”
This is a column about how doctors examine players and how teams use that information around the NFL draft. This takes on increased importance this year between the injury history of Tua Tagovailoa, the standout Alabama quarterback, and team doctors not being able to examine players due to the coronavirus pandemic.
Don’t overdo that latter subject, Caldwell says. The heavy lifting for team doctors is at the combine on the scale of twos (low physical risk), threes and fours (high risk). Don’t make conclusions on what teams will do with the doctor’s awarded number, either.
Some Dolphins coaches during Caldwell’s time actually liked the lower physical grades on players. It meant they’d be available at lower picks in the draft. Of course, that came with a risk the coaches ignored. The Dolphins once picked four players who were graded with a “four” medical rating — high risk — in the same draft.
“At the end of training camp, all four were hurt,” Caldwell said.
When they entered the training room for treatment, one Dolphins official would say, like a maitre d’, “Table for four, please.” Yep, medical humor.
Here’s how it works: At the combine, players are met by groups of six teams’ medical staffs. The Dolphins group typically consisted of five doctors and trainers in Caldwell’s time. So one by one, the 300-plus players are all checked by six groups of roughly 30 team medical officials. It’s a grueling process.
“The typical routine is one person stands in the middle of the room and presents the player: ‘This is (name of the player). This is what I found on my examination. This is what the X-rays show,’” Caldwell said.
Questions are asked. MRI’s reviewed. Information isn’t just shared by the team medical staffs. It’s shared with the player, too. The doctors don’t hide any assessment. They want a young player with dreams to be educated on any physical issues.
Sure, there’s gamesmanship from certain players.
“Sometimes people are asking them to hide certain things — ‘don’t talk about your hamstring pull, don’t share what medicine you’re taking,’” Caldwell said. “We had one player (the Dolphins) actually drafted who had a wrist injury he hid. He took an MRI under an assumed name at the site of the (college) bowl game that year so no one would know. He was told to withhold information.”
Then again, this is an unusual setting for doctors.
“The combine is the only time you’re working for the club more than for the patient,’’ he said. “I don’t mean that in a bad way. Every time I dealt with a player, though, he was a patient. But you’re there to talk to the club about what you see.”
There’s even a re-check combine that Caldwell says is little known. Players who are recovering from injury at the main combine reconvene for a second combine to be reviewed by team doctors. Tagovailoa would have been a candidate for this — if, again, the coronavirus pandemic hadn’t changed things.
The medical report is really risk assessment answering three questions: How healthy is a player? Can he play to his potential? Can he play for the length of a contract (three or four years for a rookie)?
“The last thing they want is to sign a guy for a lot of money and he can’t get on the field,” Caldwell said. “We had a player, a wellknown one, whose joints were gone. He had arthritis in both knees like an 80 year old. He could play, but he got injections. He was giving it up for the college.
But could he last another three years? It was hard to imagine.”
Caldwell couldn’t address Tagovailoa’s surgically repaired hip specifically. He did frame the issue in the way teams will consider it. Even if the hip is cleared, teams will want to know the general health of the quarterback.
“If he’s a running quarterback and he lost 20 percent of his speed, would he still be effective?” he said. “When Dan Marino tore his Achilles, he wasn’t a scrambling quarterback. So you’d say it may affect his play some, but he could still play at a high level. Can (Tagovailoa’s) game accommodate some loss?”
The Drew Brees issue weighs on this franchise. Caldwell was on the team’s medical staff at the time. He won’t talk specifically about any player, but I reported what team owner H. Wayne Huizenga said at the time: The Dolphins sent Brees’ medical information to six top shoulder surgeons. They all came back with the same idea that Brees had a 20 percent chance of full recovery.
That’s not a medical “fail” of the physical. It’s a risk assessment. Coach Nick Saban, who talked with the outside doctors, played the odds and got played by them. It happens.
Caldwell never was in the Dolphins draft room on the big night. He wasn’t needed by that point.
“I’d wait to see who was drafted and see what the issues were,” he said. “Then I’d get to work.”