A Coach’s Dismay Keeps the Doctor Away

August 21, 2013 by Andrew Brandt

Having grown up a diehard Washington fan in DC, I am well aware of the galvanizing effect the team has always had. Washingtonians don’t agree on much, but they love their football team.

Now there is a player that singularly ratchets up that popularity and impact on the region. Robert Griffin III, known simply as RG3, has become the face of the franchise, with scintillating play on the field and a refreshing presence off it. All was bliss in the nation’s capitol during Griffin’s spectacular rookie season. Until, that is, a serious knee injury that could have been avoided knocked the region from cloud nine.

Griffin sprained his LCL ligament in a late-season game against the Ravens and sat out one game, returning to lead the team into the playoffs on a clearly weakened leg. In the playoff game, a wild-card round contest against the Seahawks on a perilous turf at FedEx Field, Griffin aggravated the previous knee injury, yet was allowed to continue to play in a compromised state. He didn’t come out, and he tore his ACL.

Griffin has now declared himself healthy enough to return by the opening game. But not just that, he wants to play in the preseason. Mike Shanahan wisely will not allow that, though he seems to acquiesce about Griffin playing opening night. But it might not be his call, anyway; owner Dan Snyder told ESPN that team doctor James Andrews would make that decision. If true, that’s huge progress for the team.

The issue of when Griffin returns shines the spotlight on, to me, the biggest question about the team after Griffin’s return: has the return-to-play protocol for Griffin been resolved to remove Griffin and Shanahan from decision-making, deferring to Dr. Andrews to make those calls?

“Scared the hell out of me”

Seven months after the ACL injury, the narrative about Griffin’s returning to play is still puzzling. Let’s look at the three parties involved.

Griffin wanted to keep playing, saying, “There was no way I was coming out of that game.” Of course Griffin wanted to play; that is what players do. He’s not thinking about long-term damage to his knee; he’s thinking about the next play, the next series.

Shanahan relied on Griffin’s assurances, saying, “That was enough for me.” He was a coach in the heat of a playoff game; like Griffin he was not thinking about the long-term.

Dr. Andrews, the person who should have made the decision, was removed from the equation. In a similar situation earlier against the Ravens, Andrews said “Coach Shanahan looks at me like, ‘Is he OK?’ and I give him the ‘Hi’ sign as in, ‘He’s running around, so I guess he’s OK.’ But I didn’t get to check him out until after the game. Scared the hell out of me.” Hmm.

As with the Ravens game, it appears that the immediate interests of the player and coach were prioritized over deferring to Andrews’ expertise.

Empowering the doctor

Robert Griffin III has been relegated to light work so far in training camp.
Robert Griffin III has been relegated to light work so far in training camp. (Steve Helber/AP)

In 25 years of being around professional athletes, I have learned that the biggest medical risks to players are players themselves. It is up to others, especially the team’s medical staff, to protect players from themselves. In order to do so, the doctor must be empowered—independent from the coach’s immediate needs and the player’s desires.

Andrews, a doctor with as flush a resume as any in sports medicine, was powerless on Griffin at the most crucial time. Were Andrews given final authority that day, Griffin likely would have not gone back in the game and suffered serious injury, as Andrews’ cryptic comments suggest.

Cutler crucified for right call

Jay Cutler, after suffering what turned out to be a Grade II MCL tear against the Packers in the NFC Championship Game in 2011, was removed from the game and shown on the sidelines with what appeared to be a benign injury. Cutler was torched on social media for not “toughing it out” in the NFC Championship.

Yet in Cutler’s case, the Bears simply had an empowered doctor. As Bears’ coach Lovie Smith described very simply in the post-game news conference: Cutler didn’t take himself out of the game, the doctor said he couldn’t go, so he was done. End of story.

Cutler was roasted for having a team doctor protect his long-term interests; Griffin was hailed for overruling the team doctor and putting himself at greater risk. The bottom line is this: the decision of whether Griffin or Cutler or any player should continue to play has to be taken out of the player’s hands. It was with Cutler, it wasn’t with Griffin.

Isn’t this where we have finally come to in the NFL regarding concussions? Why should it not be the same for orthopedic injuries? Sure, we all want to watch the star players play, but a team doctor has to make these decisions free from influence with a player’s long-term interest in mind. Otherwise, why is he even there?

In 2012 alone, Griffin returned a week after a concussion, two weeks after a significant knee injury, and a few plays after aggravating that same knee. He is now set to return eight months after a torn ACL, a decision that, as Snyder has suggested, is rightly being made by Dr. Andrews, not Griffin or Shanahan.

Beyond the decision for Griffin’s return, we hope all further return-to-play decisions—no matter the heat of the moment and the assurances of Griffin—are made by an empowered doctor, not an eager player or coach.

And now, your questions …

Dr. Andrews seems to be everywhere. What does Washington think of that?

Andrews has considerable influence. There are a few NFL team doctors who did their fellowships with him in Birmingham. He has performed surgeries on a who’s who of professional athletes, including Drew Brees, Adrian Peterson and now Griffin. He is the “go-to” doctor for second opinions and consultations, as top NFL agents want to bring their client to “the best” in the business.  And, as a final aside, Andrews is a medical consultant to both Auburn and Alabama.

Washington is obviously comfortable with his multiple duties and, like the agents, Snyder wanted the most well-known doctor in the business tending to his players.

How do teams feel about players getting second opinions?

It is the players’ collectively bargained right and most teams accept it as part of the business. The bigger issue, in my opinion, is a growing mistrust or distrust of team doctors by players, something I have noticed especially in recent years. I continue to hear of stories of players not trusting team doctors to look out for their best interests. This is something to watch.

With veteran kickers Rian Lindell and Dan Carpenter both released in the past week, are teams going with young kickers to save money?

Ask Away

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That is part of it. Teams are seeing equal or perhaps even better performance by the younger (and cheaper) player and thus moving on from the older, more established kicker. With the recent success of young kickers such as Justin Tucker in Baltimore, Greg Zuerlein in St. Louis and Alex Henery in Philadelphia, more teams are wading in with unproven kickers, and saving money in the process.

Why was Von Miller suspended six games and what will he lose?

The details of a potential suspension under the NFL Policy for Substance Abuse are kept highly confidential, and we may never know the full story of his transgression. His statement read in part: “Although my suspension doesn’t result from a positive test, there is no excuse for my violations of the rules.”

Without a positive test, I would sense—and I admit to speculating here—that there was a “diluted sample,” which would set off discussions of Miller trying to mask a positive reading of his sample, as well as testimony from the collector regarding irregularities in the collection process with Miller. Last season, D.J. Williams was suspended six games (per the Policy on Anabolics) for providing a nonhuman sample, but failed to persuade the NFL to reduce the penalty on appeal.

Miller will forfeit six games of his $2.28 million salary, or approximately $806,000. In addition, the Broncos are entitled to recover a prorated portion of 6/17th one of the four seasons of his $13.77 million signing bonus—for a forfeiture of $1.215 million—as per their right under the CBA. Thus, Miller’s transgression may cost him more than $2 million.

The Broncos are probably now wishing they had received that fax back in March confirming the renegotiated contract of Elvis Dumervil and didn’t have to release him.