00:00:00
Speaker 1: We talk injuries and we got a lot to discuss multiple sports with one of the experts from Ortho since the orthopedics in sports medicine. What we love about Orthosincy is they have specialist locations and services all over the tri State including walk in orthopedic urgent care at five locations that includes extended evening and weekend hours in Edgewood and Anderson. Learn more at Orthosinc dot com. That's Ortho ci Ncy dot com. Doctor Jonathan's laughter is with us, we got good news, best case, Shamar Stewart. It's believed to be a hyper extended knee, so this is best case. Walk me through what the injury is.
00:00:35
Speaker 2: Yeah, So hyper extension injury is basically where your knee extends more than it's used to or more than it's capable or designed to, and that can put a lot of stress on the surrounding tissues, including the joint capsule, hamstrings, and a lot of times you can even see bone contusion where when you hyper extend, the bone of the femur can impact the bone of the tip, which then creates a bone bruise, swelling bleeding inside the bone without an actual fracture. We always fear, you know, tearing the ligaments like ACL, MCL, PCL with knee injuries which are more serious requires surgery, where hyper extension injury. If you don't tear any of the ligaments, don't tear the meniscus. Now you're just created. Now you've got basic, got strained soft tissues around it where you're going to work on getting the inflammation down, start stretching them out, get the motion going, get strength and get the balance back in the knee.
00:01:40
Speaker 1: Sir, are we talking about something where it's reasonable to expect that at least hope, maybe not expected he could play week one.
00:01:49
Speaker 2: I would be surprised if he didn't. If it's just a strain of the soft tissues around it and a bone bruise. And he continues to progress with the inflammation getting down, with getting his strength back, his balance and his proper reception where you basically body understands its position of where it's at.
00:02:08
Speaker 1: I want to ask you about another Bengal, Eric All and he looks awesome so far early in training camp, and we're all rooting for him for a bunch of different reasons, not the least of which is his injury history is really really significant. Had a season ending ACL tear in twenty twenty three when he was in college. He's had minimally invasive surgery for herniated disk when he was in college. He had another knee injury during his rookie season, right when he was starting to show a promise, and so he then had to have two more surgeries. And the way it's been framed is one surgery to fix the new injury and another surgery to fix the old injury that the previous surgery didn't necessarily fix. And I hope I'm not being too confusing based on what you know about this, Can you walk us through specifically, like for Eric indeed, how hard his return to the NFL field is and what he's trying to overcome.
00:03:07
Speaker 2: Yeah, now, a lot of it's gonna be overcovering scar tissue, some atrophy and the muscles from recovery process and just getting back into his elite form with that surgery, especially the ACL, when you tear it a second time, you first got to figure out why did it tear, Why did it fail? Was it something that was a little bit off in the first surgery, or in his case, more likely was it just another unfortunate positioning of his knee where the new reconstructed livement gave way.
00:03:43
Speaker 1: Let's talk about Spencer Steer. So it was odd watching the game on Sunday. He leaves the game during in that bat, he was not hit by a pitch. It looked like a normal swing, and they take him out of the game and he has been placed on the ten day injured list. They call it a right wrist. I've seen the term. It's sheath, which I've I've never heard about. I've that's a new one to me, the tendon sheath, which I guess keeps the right wrist tendon in place. And so he's not gonna have surgery, at least for now, but they're not discounting that as a possibility. Let's start with the term. I had never heard of a tendon sheath. What is it? How does it work?
00:04:21
Speaker 2: Yeah, So, a sheath is basically a covering tissue that covers the tendon, usually when it's going over a point of the bone, that often is a groove that it runs in, and that sheath helps keep that tendon in that groove so that it's not popping up over the edge of the bone of the groove, creating pain, a popping, catching inflammation.
00:04:47
Speaker 1: So it's a partial tear versus a full tear. Would a full tear have immediately required surgery for.
00:04:55
Speaker 2: Most likely I'm guessing this is the extensor carpiol and Maris tendon, which is a tendon on the small finger side. It attaches to the bone at the base of your small finger and extend your wrist. That is often seen in swinging sports, especially baseball. And if it is a full tear and that tendon is unstable where every time you're especially rotating the wrist, it's popping out of place. By far, majority of those are surgical. Sometimes you can get them. If you get them acutely right away, you can completely immobilize and splint the wrist and it can heal and scar back in place to avoid surgery as long as that tendon is then stable.
00:05:39
Speaker 1: How does something like this happen when he's just taking a normal swing.
00:05:43
Speaker 2: I wish I would have seen the swing because was it that exact swing or was there another one that he was fooled on? Because oftentimes these happen, especially with swinging like Mark TASHERA, Yeah, who's a batista? Anthony Radon all had this type of injury. It's often times you're starting your swing, you're starting your motion, you're expecting fastball or reading fastball, and all of a sudden realize it's an off speed pitch. You're now trying to slow down the explosion and speed of your swing to match the speed of the ball, and that tendon in the force can cause that sheath to rip. So a lot of times it's more often when you're fold on a pitch and trying to adjust and it is a normal swing.
00:06:28
Speaker 1: I think a lot of folks heard the original you know the plan for this, which right now doesn't involve surgery, and go look, just go ahead and have the surgery. It feels almost inevitable. What do you make of of the approach here? And is that maybe an unfair way of looking at things.
00:06:44
Speaker 2: It's a little bit unfair because you're talking when you start talking with sports, especially at the elite level, it's not just necessarily the injury, it's also the timing. Where is it in the season, where is it in the off season, Because if if you said, oh, well, this isn't going to heal when potentially could well, the rest of this season's out. Most likely he would be back at the start of next season. Where now you're like, well it's partially torn, it might not be fully subluxating or popping over the bone. If this can scar down, heel down, we can avoid surgery, play the rest of this season, rehab more in the off season, and then we don't miss much time. That's the art of being kind of a sports medicine doctor, where you're looking at where they are in the season, the timing, and if we did surgery, now, well he's out this season. Where if we try now and try to get him to come back, he doesn't come back. Okay, we're doing surgery. He misses the rest of the season, which he would have anyways, but he would still be back for next season. So it's more the art of sports medicine.
00:07:56
Speaker 1: One more to ask you about doctor Jonathan Slaughter from ORTHO, since is with us and this went down earlier today and we are not operating with a lot of information here, but I have to ask me being a huge juicy basketball fan, Tylan Riley, who is a senior, is going to be sidelined with a hand injury. Now that's you see specific verbiage. Nothing beyond that doesn't say the extent of the injury. And he's going to be reevaluated in four to six weeks. So I know I'm asking you to come and based on a very very tiny amount of information. But when you hear that, with your background hand injury reevaluation in four to six weeks, what possibilities come to mind?
00:08:36
Speaker 2: Yeah, like you said, it is hard not knowing the exact mechanism because that would open up a lot more diagnoses. But when I hear four to six recheck timeline, I start thinking more soft tissue like ligaments. He could have jammed his hand, He could have had a finger hyper extended or twisted in a certain way. Now where you're now concerned about one of the ligaments that leads to stability, where he might not be grossly unstable right now, but that ligament could potentially be torn, could be partially torn. And so let's get this to calm down, get it to start healing. Let's recheck, reassess, or if it's a bone, a fracture, you reassess X rays that might initially be negative, but you could have an occult fracture, which is a fracture. You can't see on initial X rays that then present later. So the things that you'd be looking at, well, is it a ligment, Let's reassess that is it bone? Let's re x ray, Let's see how he's progressing, how swelling going, how's his motion going. All those things kind of play in in the scenario.
00:09:35
Speaker 1: Tremendous insight, three different sports, four different athletes. Doctor Jonathan's laughter from Orthos, Since, thanks so.
00:09:41
Speaker 2: Much, Thank you, Moe.
00:09:43
Speaker 1: All right, there you have it. Doctor Jonathan's laughter from Orthos, Since I say it every week because it's true. The great thing about Orthos Sincy is they've got specialists and locations all over the Tri State. This includes walk in orthopedic urgent care weekdays nine a m. To nine pm and on Saturdays nine am to one pm at both Edgewood and Anderson. It's easy because you do not need an appointment, and it's definitely cheaper than going to an er. Whenever you have an urgent orthopedic injury, go to Orthosinc. Dot com. That's Orthos c I n c Y dot com. Tonypike next
Speaker 1: We talk injuries and we got a lot to discuss multiple sports with one of the experts from Ortho since the orthopedics in sports medicine. What we love about Orthosincy is they have specialist locations and services all over the tri State including walk in orthopedic urgent care at five locations that includes extended evening and weekend hours in Edgewood and Anderson. Learn more at Orthosinc dot com. That's Ortho ci Ncy dot com. Doctor Jonathan's laughter is with us, we got good news, best case, Shamar Stewart. It's believed to be a hyper extended knee, so this is best case. Walk me through what the injury is.
00:00:35
Speaker 2: Yeah, So hyper extension injury is basically where your knee extends more than it's used to or more than it's capable or designed to, and that can put a lot of stress on the surrounding tissues, including the joint capsule, hamstrings, and a lot of times you can even see bone contusion where when you hyper extend, the bone of the femur can impact the bone of the tip, which then creates a bone bruise, swelling bleeding inside the bone without an actual fracture. We always fear, you know, tearing the ligaments like ACL, MCL, PCL with knee injuries which are more serious requires surgery, where hyper extension injury. If you don't tear any of the ligaments, don't tear the meniscus. Now you're just created. Now you've got basic, got strained soft tissues around it where you're going to work on getting the inflammation down, start stretching them out, get the motion going, get strength and get the balance back in the knee.
00:01:40
Speaker 1: Sir, are we talking about something where it's reasonable to expect that at least hope, maybe not expected he could play week one.
00:01:49
Speaker 2: I would be surprised if he didn't. If it's just a strain of the soft tissues around it and a bone bruise. And he continues to progress with the inflammation getting down, with getting his strength back, his balance and his proper reception where you basically body understands its position of where it's at.
00:02:08
Speaker 1: I want to ask you about another Bengal, Eric All and he looks awesome so far early in training camp, and we're all rooting for him for a bunch of different reasons, not the least of which is his injury history is really really significant. Had a season ending ACL tear in twenty twenty three when he was in college. He's had minimally invasive surgery for herniated disk when he was in college. He had another knee injury during his rookie season, right when he was starting to show a promise, and so he then had to have two more surgeries. And the way it's been framed is one surgery to fix the new injury and another surgery to fix the old injury that the previous surgery didn't necessarily fix. And I hope I'm not being too confusing based on what you know about this, Can you walk us through specifically, like for Eric indeed, how hard his return to the NFL field is and what he's trying to overcome.
00:03:07
Speaker 2: Yeah, now, a lot of it's gonna be overcovering scar tissue, some atrophy and the muscles from recovery process and just getting back into his elite form with that surgery, especially the ACL, when you tear it a second time, you first got to figure out why did it tear, Why did it fail? Was it something that was a little bit off in the first surgery, or in his case, more likely was it just another unfortunate positioning of his knee where the new reconstructed livement gave way.
00:03:43
Speaker 1: Let's talk about Spencer Steer. So it was odd watching the game on Sunday. He leaves the game during in that bat, he was not hit by a pitch. It looked like a normal swing, and they take him out of the game and he has been placed on the ten day injured list. They call it a right wrist. I've seen the term. It's sheath, which I've I've never heard about. I've that's a new one to me, the tendon sheath, which I guess keeps the right wrist tendon in place. And so he's not gonna have surgery, at least for now, but they're not discounting that as a possibility. Let's start with the term. I had never heard of a tendon sheath. What is it? How does it work?
00:04:21
Speaker 2: Yeah, So, a sheath is basically a covering tissue that covers the tendon, usually when it's going over a point of the bone, that often is a groove that it runs in, and that sheath helps keep that tendon in that groove so that it's not popping up over the edge of the bone of the groove, creating pain, a popping, catching inflammation.
00:04:47
Speaker 1: So it's a partial tear versus a full tear. Would a full tear have immediately required surgery for.
00:04:55
Speaker 2: Most likely I'm guessing this is the extensor carpiol and Maris tendon, which is a tendon on the small finger side. It attaches to the bone at the base of your small finger and extend your wrist. That is often seen in swinging sports, especially baseball. And if it is a full tear and that tendon is unstable where every time you're especially rotating the wrist, it's popping out of place. By far, majority of those are surgical. Sometimes you can get them. If you get them acutely right away, you can completely immobilize and splint the wrist and it can heal and scar back in place to avoid surgery as long as that tendon is then stable.
00:05:39
Speaker 1: How does something like this happen when he's just taking a normal swing.
00:05:43
Speaker 2: I wish I would have seen the swing because was it that exact swing or was there another one that he was fooled on? Because oftentimes these happen, especially with swinging like Mark TASHERA, Yeah, who's a batista? Anthony Radon all had this type of injury. It's often times you're starting your swing, you're starting your motion, you're expecting fastball or reading fastball, and all of a sudden realize it's an off speed pitch. You're now trying to slow down the explosion and speed of your swing to match the speed of the ball, and that tendon in the force can cause that sheath to rip. So a lot of times it's more often when you're fold on a pitch and trying to adjust and it is a normal swing.
00:06:28
Speaker 1: I think a lot of folks heard the original you know the plan for this, which right now doesn't involve surgery, and go look, just go ahead and have the surgery. It feels almost inevitable. What do you make of of the approach here? And is that maybe an unfair way of looking at things.
00:06:44
Speaker 2: It's a little bit unfair because you're talking when you start talking with sports, especially at the elite level, it's not just necessarily the injury, it's also the timing. Where is it in the season, where is it in the off season, Because if if you said, oh, well, this isn't going to heal when potentially could well, the rest of this season's out. Most likely he would be back at the start of next season. Where now you're like, well it's partially torn, it might not be fully subluxating or popping over the bone. If this can scar down, heel down, we can avoid surgery, play the rest of this season, rehab more in the off season, and then we don't miss much time. That's the art of being kind of a sports medicine doctor, where you're looking at where they are in the season, the timing, and if we did surgery, now, well he's out this season. Where if we try now and try to get him to come back, he doesn't come back. Okay, we're doing surgery. He misses the rest of the season, which he would have anyways, but he would still be back for next season. So it's more the art of sports medicine.
00:07:56
Speaker 1: One more to ask you about doctor Jonathan Slaughter from ORTHO, since is with us and this went down earlier today and we are not operating with a lot of information here, but I have to ask me being a huge juicy basketball fan, Tylan Riley, who is a senior, is going to be sidelined with a hand injury. Now that's you see specific verbiage. Nothing beyond that doesn't say the extent of the injury. And he's going to be reevaluated in four to six weeks. So I know I'm asking you to come and based on a very very tiny amount of information. But when you hear that, with your background hand injury reevaluation in four to six weeks, what possibilities come to mind?
00:08:36
Speaker 2: Yeah, like you said, it is hard not knowing the exact mechanism because that would open up a lot more diagnoses. But when I hear four to six recheck timeline, I start thinking more soft tissue like ligaments. He could have jammed his hand, He could have had a finger hyper extended or twisted in a certain way. Now where you're now concerned about one of the ligaments that leads to stability, where he might not be grossly unstable right now, but that ligament could potentially be torn, could be partially torn. And so let's get this to calm down, get it to start healing. Let's recheck, reassess, or if it's a bone, a fracture, you reassess X rays that might initially be negative, but you could have an occult fracture, which is a fracture. You can't see on initial X rays that then present later. So the things that you'd be looking at, well, is it a ligment, Let's reassess that is it bone? Let's re x ray, Let's see how he's progressing, how swelling going, how's his motion going. All those things kind of play in in the scenario.
00:09:35
Speaker 1: Tremendous insight, three different sports, four different athletes. Doctor Jonathan's laughter from Orthos, Since, thanks so.
00:09:41
Speaker 2: Much, Thank you, Moe.
00:09:43
Speaker 1: All right, there you have it. Doctor Jonathan's laughter from Orthos, Since I say it every week because it's true. The great thing about Orthos Sincy is they've got specialists and locations all over the Tri State. This includes walk in orthopedic urgent care weekdays nine a m. To nine pm and on Saturdays nine am to one pm at both Edgewood and Anderson. It's easy because you do not need an appointment, and it's definitely cheaper than going to an er. Whenever you have an urgent orthopedic injury, go to Orthosinc. Dot com. That's Orthos c I n c Y dot com. Tonypike next
