Lions 2026 Draft Medical Analysis: Blake Miller & Day 2 Preview
Blake Miller analysis, plus prospects to target, and avoid, on Day 2 of the NFL Draft
Due to the health concerns and subsequent release of Taylor Decker, the Detroit Lions entered the 2026 NFL Draft in dire need of a long-term plan at offensive tackle. Mission accomplished with the addition of the medically low-risk Blake Miller.
Detroit Lions 1st Round - Blake Miller, OT (22yo)
The following is from my pre-draft medical report on Miller…
Projected round 1. #23 on Daniel Jeremiah board Jan 27.
Concern level 1/10
2025: 13/13 games
2024: 14/14 games. Wrist surgery in spring.
2023: 13/13 games
2022: 14/14 games
Miller has a history of a broken wrist during spring ball subsequent surgery. Any kind of fracture to the wrist joint could lead to arthritic issues down the road.
So far though, the wrist hasn’t affected him much, if at all. This ironman has a perfect track record of reliability in his 4-year career having played 54 games straight. He set the Clemson record for career snaps from scrimmage with 3,778. If the Lions want grit, Miller might be it.
Analysis of Lions 1st-round pick
Brad Holmes entered the offseason with the goal of getting younger and healthier. He’s off to a great start in the draft with Miller who is young with very low medical concern level and astounding reliability.
Was Monroe Freeling a consideration?
Many mocks had Freeling getting gobbled up by the Lions, as his availability at pick #17 was not even considered a possibility earlier in the draft season.
With the departing Lions OT, Taylor Decker, having had a career-altering shoulder issue (among other things), the Lions may have been dissuaded by Freeling’s history of shoulder surgery.
Freeling ended up going two picks later at #19 to the Panthers.
What other offensive tackles might have been in consideration at #17?
Max Iheanachor was drafted at #21 by the Steelers. Like Freeling, Iheanachor had shoulder surgery in his past as well as other issues leading to a 5/10 medical concern. There may have also been an age uncertainty there.
Caleb Lomu was my Low-risk Mock Draft projection due to being very young (21) and very clean (0/10 medical concern). The Lions must have liked Miller’s talent better. Lomu ended up going #28 to the Patriots.
What did Brad Holmes say about Miller?
After the 1st round, Holmes had these comments:
We definitely got younger. That’s going to be big going forward.
We’re excited about the youth injection.
Holmes continues to stress that age is important in the construction of the roster. He previously went deep into age concerns in his pre-draft press conference.
All the durability he’s displayed, he’s going to fit right in here.
With all the Lions injury woes the past two seasons, durability is clearly a major consideration for Holmes. Look for the Lions to continue to select young, reliable players in Rounds 2 and 3.
Update on Top Prospects with Medical Concerns
Francis Mauigoa, OT - #10 to NY Giants
The spinal concern was a big deal to me and possibly for the Lions considering all their back surgeries lately. Thus, having him go before the Lions pick was a good thing.
Caleb Downs, S - #11 to Cowboys
With the Cowboys penchant for drafting medical risks like Leighton Vander Esch, Jaylon Smith, and Shavon Revel, it’s hard to say if this early 1st-round selection dispels Downs’ knee concerns.
Caleb Banks, DT - #18 to Vikings
The multiple foot surgeries scared me, but did not scare off the Vikings at all. It will be interesting to watch Banks’ reliability over his career.
Akheem Mesidor, EDGE - #22 to Chargers
While many mocks had Mesidor going to the Lions, I never bought it due to the advanced age concern - not to mention a foot surgery in his past.
Jermod McCoy, CB - still available
The confirmation of significant articular cartilage damage in the knee could easily have him dropping past the 2nd round.
Lions 2nd & 3rd Round Wish List
If the Lions want to add low-risk players, these are good targets from my NFL Draft 2026 Medical Big Board. All the following players have 1/10 or less medical concern levels.
One position that is stocked with good options is CB, so it wouldn’t be a surprise for the Lions address their sneaky need at CB.
EDGE
Safety
Tight End
Cornerback
Offensive Guard
Defensive Tackle
Running Back
Linebacker
Lions 2nd & 3rd Round Avoid List
If the Lions want to stay medically clean, they should avoid drafting these players who are considered 2nd and 3rd round talents. All the following prospects have 6/10 or higher medical concern levels.
Jermod McCoy, CB (21): ACL January 2025. Bone plug to repair knee cartilage damage that may need additional surgery in future.
Gennings Dunker, OG (23): sesamoid surgery, ankle surgery, shoulder surgery, knee
Billy Schrauth, OG (23): recent MCL, bilateral ankle surgeries
Oscar Delp, TE (23): active hairline fracture in foot found at combine
Deion Burks, WR (23): neck?, multiple concussions, thigh
Jalen Hunt, DT (25?): knee, foot, possible neck, other unspecified injuries, age
Devin Moore, CB (22): groin surgery, shoulder surgery, severe shoulder injury, concussion, back
Genesis Smith, S (21): active foot fracture?
Josiah Trotter, LB (21): ACL, MCL, recent knee
For more prospects and their medical concern levels…