Dane Dunning: No TJS just yet, rest and monitor

[caulfield12]

6 minutes ago, chitownsportsfan said:

Yea, rehab procedures change all the time.  My surgeon, who was world class, who did both my patella rupture repairs (I had a dual rupture 4 years ago that I have come back from incredibly well) advocated an out-dated rehab procedure that thank god I didn't follow.  I researched the cutting edge stuff online, from all sources, including youtube diaries, university level sports medicine journals, online forums etc.  I hardly pretend to know how to repair a ruptured patella but I do know that at 2 weeks followup visit I was doing things my surgeon was amazed at, like walking into his office without a walker, only using my braces.  I pushed it.  I was walking as much as possible even though I was tired all the time, 2-3 miles every day even tho most rehab from the 90s and early aughts advocated BED REST for a month.

I was running on the treadmill at 4 months and completed a 2000 ft hike (up and down, down is the hard part) less 6 months after surgery. 

Medicine procedures change all the time.  It's hardly an outlandish position to suggest that given the outcome here -- TJ surgery, perhaps in cases where imaging and diagnostics reveal small tears it's best to just completely replace the ligament even if there is a small, non zero chance of a catastrophic complication arising from the surgery.

Surgeons are smart people and they are well aware of "fat tail" outcomes from surgeries, unforeseen consequences and worst case scenarios.  They are trained to avoid these surgeries when possible.  Given the context of professional baseball and TJ, perhaps they should re-evaluate their procedures to fully inform their clients of the risks, but to also inform them of the possible upside as well, given how well the procedure is now done and how solid the expected outcomes are.

Christ some of you guys argue on here like it's an academic setting or some shit.  Good lord.

You're our Amir Khan arguing with his professor from Three Idiots.  Which is a compliment, by the way...

Edited February 27, 2019 by caulfield12

[TaylorStSox]

3 minutes ago, chitownsportsfan said:

Yea, rehab procedures change all the time.  My surgeon, who was world class, who did both my patella rupture repairs (I had a dual rupture 4 years ago that I have come back from incredibly well) advocated an out-dated rehab procedure that thank god I didn't follow.  I researched the cutting edge stuff online, from all sources, including youtube diaries, university level sports medicine journals, online forums etc.  I hardly pretend to know how to repair a ruptured patella but I do know that at 2 weeks followup visit I was doing things my surgeon was amazed at, like walking into his office without a walker, only using my braces.  I pushed it.  I was walking as much as possible even though I was tired all the time, 2-3 miles every day even tho most rehab from the 90s and early aughts advocated BED REST for a month.

I was running on the treadmill at 4 months and completed a 2000 ft hike (up and down, down is the hard part) less 6 months after surgery. 

Medicine procedures change all the time.  It's hardly an outlandish position to suggest that given the outcome here -- TJ surgery, perhaps in cases where imaging and diagnostics reveal small tears it's best to just completely replace the ligament even if there is a small, non zero chance of a catastrophic complication arising from the surgery.

Surgeons are smart people and they are well aware of "fat tail" outcomes from surgeries, unforeseen consequences and worst case scenarios.  They are trained to avoid these surgeries when possible.  Given the context of professional baseball and TJ, perhaps they should re-evaluate their procedures to fully inform their clients of the risks, but to also inform them of the possible upside as well, given how well the procedure is now done and how solid the expected outcomes are.

Christ some of you guys argue on here like it's an academic setting or some shit.  Good lord.

When you start a post implying you're qualified to argue with doctors, it's going to make the rest sound pretty outlandish. 

[ptatc]

10 minutes ago, caulfield12 said:

There was a theory there for a while it was the slider (Liriano)...too many two-seamers or sinkers/forkballs.

I'm sure 'til this day most youth baseball coaches will blame it on kids throwing curves and sliders when they're in 5th-9th grades.

It's the lower of the arm angle to get more movement on those pitches that does it, especially that young as the elbow epiphyseal plate hasn't closed.

[CaliSoxFanViaSWside]

2 hours ago, Whitesox27 said:

Fuck

 

Is being "elevated" some kind of new medical treatment ? Oh Maybe good OLD Bruce meant evaluated.

[ptatc]

9 minutes ago, Lillian said:

Maybe they will ultimately determine the optimum time to have the TJ, in a young pitcher's life and just make it routine. If they performed the procedure, before the injury occurred, would the results be the same, or even better?  I understand that such a practice would be very radical, but if it made the elbow stronger and dramatically reduced the incidences of UCL tears, maybe it would make sense. Is there a better way to perform the operation, if there is not already a tear? I'm thinking something like a "bionic arm". Would the procedure be any less risky, than when performed on a torn UCL?

While the success rate for this I jury is high, about 85-90% return to prior level of function,  no medical procedure is perfect.

Edited February 27, 2019 by ptatc

[Lillian]

1 minute ago, ptatc said:

It's the lower of the arm angle to get more movement on those pitches that does it, especially that young as the elbow epiphyseal plate hasn't closed.

At what age does the elbow epiphyseal plate close? (Whatever that is) LOL

[Lillian]

3 minutes ago, ptatc said:

While the success rate for this I jury is high, about 85-90% return to prior level of function,  no medical procedure is perfect.

Do you think that it would be feasible to modify the procedure, in a way that would be less risky and simply insert something to strengthen the UCL, so that it would reduce the risk of a future tear? Perhaps some synthetic, or biomechanical part could be devised. 

Edited February 27, 2019 by Lillian

[ptatc]

9 minutes ago, chitownsportsfan said:

Yea, rehab procedures change all the time.  My surgeon, who was world class, who did both my patella rupture repairs (I had a dual rupture 4 years ago that I have come back from incredibly well) advocated an out-dated rehab procedure that thank god I didn't follow.  I researched the cutting edge stuff online, from all sources, including youtube diaries, university level sports medicine journals, online forums etc.  I hardly pretend to know how to repair a ruptured patella but I do know that at 2 weeks followup visit I was doing things my surgeon was amazed at, like walking into his office without a walker, only using my braces.  I pushed it.  I was walking as much as possible even though I was tired all the time, 2-3 miles every day even tho most rehab from the 90s and early aughts advocated BED REST for a month.

I was running on the treadmill at 4 months and completed a 2000 ft hike (up and down, down is the hard part) less 6 months after surgery. 

Medicine procedures change all the time.  It's hardly an outlandish position to suggest that given the outcome here -- TJ surgery, perhaps in cases where imaging and diagnostics reveal small tears it's best to just completely replace the ligament even if there is a small, non zero chance of a catastrophic complication arising from the surgery.

Surgeons are smart people and they are well aware of "fat tail" outcomes from surgeries, unforeseen consequences and worst case scenarios.  They are trained to avoid these surgeries when possible.  Given the context of professional baseball and TJ, perhaps they should re-evaluate their procedures to fully inform their clients of the risks, but to also inform them of the possible upside as well, given how well the procedure is now done and how solid the expected outcomes are.

Christ some of you guys argue on here like it's an academic setting or some shit.  Good lord.

Wow were you lucky. Walking without supports 2 weeks after repairing both patella tendons was risky. The healing process is 6-8 weeks for the repair. Those could easily have ruptured again. How old were you?

Most surgeons are very eager to cut. That's all they know. Usually the rest of us need to work with them to not cut immediately. 

[ptatc]

9 minutes ago, caulfield12 said:

You're our Amir Khan arguing with his professor from Three Idiots.  Which is a compliment, by the way...

Never argue with your professor. ?

[ptatc]

7 minutes ago, CaliSoxFanViaSWside said:

Is being "elevated" some kind of new medical treatment ? Oh Maybe good OLD Bruce meant evaluated.

Well if there was a great deal of edema they would elevate it.?

[ptatc]

7 minutes ago, Lillian said:

At what age does the elbow epiphyseal plate close? (Whatever that is) LOL

In males usually 15-16. It's the growth plate in the medial elbow under the area where the UCL has its proximal attachment. 

[SoxAce]

It's almost getting comical at this point. 

[ptatc]

6 minutes ago, Lillian said:

Do you think that it would be feasible to modify the procedure, in a way that would be less risky and simply insert something to strengthen the UCL, so that it would reduce the risk of a future tear? Perhaps some synthetic, or biomechanical part could be devised. 

They've tried synthetic materials in the past usually gortex. However, there are 2 significant drawbacks. 1. They need to be too  ig to offer enough support and therefore limit  motion. 2. They only last about 10 years before they fray too much and cause other issues

[Lillian]

20 minutes ago, ptatc said:

They've tried synthetic materials in the past usually gortex. However, there are 2 significant drawbacks. 1. They need to be too  ig to offer enough support and therefore limit  motion. 2. They only last about 10 years before they fray too much and cause other issues

If they have already begun to explore the possibilities of using synthetic materials, one might imagine that they may ultimately discover a material that works even better than what they now use. Perhaps one day they will create a "super tendon". What do you think? Maybe that will happen and as a consequence, pitchers will put too much stress on their shoulders. "It's not nice to fool Mother Nature," as the old commercial said.

Edited February 27, 2019 by Lillian

[EloyJenkins]

Is anyone gonna wonder if Levine is escalating his source? Sometimes discomfort can just be soreness that needs a bit of time off.

 

But probably TJ.

[turnin' two]

37 minutes ago, CaliSoxFanViaSWside said:

Is being "elevated" some kind of new medical treatment ? Oh Maybe good OLD Bruce meant evaluated.

[whitesoxwinner]

45 minutes ago, ptatc said:

It's not really the increase in velocity as much as the throwing near max velocity for too many pitches. There is no "pacing."

Dont forget about mechanical issues as well. Look at the article I posted earlier this week.

What's the link?

Edit: Found it thanks

Edited February 27, 2019 by whitesoxwinner

[Balta1701]

11 minutes ago, EloyJenkins said:

Is anyone gonna wonder if Levine is escalating his source? Sometimes discomfort can just be soreness that needs a bit of time off.

 

But probably TJ.

if this was just the first time for him we'd still be going "oh no", hoping for the best but fearing the worst. @ptatchas often said that the trainers may be able to tell by feel whether something is torn even before the MRI, so the org probably has a good idea even before that.

Dunning's a special case in that we know he had a partial tear last summer that they rehabbed, so having this crop up within the first few days of pitching the next spring training - he's almost certainly headed for TJS as rehab last year clearly did not solve the issue. 

[ptatc]

28 minutes ago, Lillian said:

If they have already begun to explore the possibilities of using synthetic materials, one might imagine that they may ultimately discover a material that works even better than what they now use. Perhaps one day they will create a "super tendon". What do you think? Maybe that will happen and as a consequence, pitchers will put too much stress on their shoulders. "It's not nice to fool Mother Nature," as the old commercial said.

They've been working on synthetic materials for decades and can't find anything that can absorb the stress and maintain the flexibility of a tendon that becomes a ligament once the replace it. It may happen someday but not in the near future.

[ptatc]

24 minutes ago, EloyJenkins said:

Is anyone gonna wonder if Levine is escalating his source? Sometimes discomfort can just be soreness that needs a bit of time off.

 

But probably TJ.

It can be. However, with his history it doesn't look good. But it is possible that he is just sore because I'm sure he has continued with his rehab.

[shipps]

Since the pitching aspect of our rebuild has been taking a huge hit either via injury or lack of performance I am all for allocating our excess budget to pitching instead of FA position players at this point. F*** Harper, sign Keuchel or have a plan to trade or sign future TOR FA pitching. We have plenty of positional talent that we can roll the dice on to hopefully succeed. 

[ptatc]

1 hour ago, caulfield12 said:

It's the velocity.  With the Japanese pitchers, it's throwing 175-225 pitches in high school games...cumulative wear and tear, and manhood/macho idea that pitching until your arm/elbow/shoulder falls off, no matter how acute the pain, is like the modern-day version of being a warrior.

 

1 hour ago, caulfield12 said:

It's the velocity.  With the Japanese pitchers, it's throwing 175-225 pitches in high school games...cumulative wear and tear, and manhood/macho idea that pitching until your arm/elbow/shoulder falls off, no matter how acute the pain, is like the modern-day version of being a warrior.

Here is a good article on comparing Japanese and American pitchers. Japanese pitchers tend to have longer stride lengths and have a higher arm angle. When equalized for height and weight (American pitchers surprisingly are taller and heavier), Japanese pitchers put more torque on their shoulders.

2325967119825625.pdf

[caulfield12]

12 minutes ago, ptatc said:

 

Here is a good article on comparing Japanese and American pitchers. Japanese pitchers tend to have longer stride lengths and have a higher arm angle. When equalized for height and weight (American pitchers surprisingly are taller and heavier), Japanese pitchers put more torque on their shoulders.

2325967119825625.pdf

That makes sense...145-175 pound athletes are logically going to have a harder time putting the same amount of torque or pressure on their joints.

It's a different version of all the problems with his hips and knees and back that Tiger Woods has experienced the past decade...especially when you start swinging a club hundreds of times per day from the age of 2.

[ptatc]

24 minutes ago, caulfield12 said:

That makes sense...145-175 pound athletes are logically going to have a harder time putting the same amount of torque or pressure on their joints.

It's a different version of all the problems with his hips and knees and back that Tiger Woods has experienced the past decade...especially when you start swinging a club hundreds of times per day from the age of 2.

Tiger Woods had other chemically enhanced issues as well. 

[SonofaRoache]

1 hour ago, CaliSoxFanViaSWside said:

Is being "elevated" some kind of new medical treatment ? Oh Maybe good OLD Bruce meant evaluated.

Auto correct. 

And I gave up on Dane a long time ago. Anything positive from Dunning and Burgee will just be a pleasant surprise.