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Dane Dunning: No TJS just yet, rest and monitor


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2 minutes ago, ptatc said:

Yes. The surgeons thought that the tear was small enough that rehab would work. There were positive reports in the Fall but obviously it doesn't look like it worked. 

I'd argue those surgeons, as they are trained, were overly cautious.  In pro MLB and with pitcher elbows, aggressive surgical repair via TJ might be the best course of action even if it's not the conservative approach that most favor.

Anyways, just another brick in the wall.  This offseason sucks.  I guess we're in season now.  I need a shot of baseball life man.  I hope this team somehow wins 60 games before the ASB.  

 

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1 minute ago, chitownsportsfan said:

I'd argue those surgeons, as they are trained, were overly cautious.  In pro MLB and with pitcher elbows, aggressive surgical repair via TJ might be the best course of action even if it's not the conservative approach that most favor.

Anyways, just another brick in the wall.  This offseason sucks.  I guess we're in season now.  I need a shot of baseball life man.  I hope this team somehow wins 60 games before the ASB.  

 

You can argue that but I'll bet they seen a few hundred more professional pitcher elbow injuries than you have. Unfortunately either the rehab didn't work or the pitcher didn't make the changes he was supposed to.

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7 minutes ago, ptatc said:

You can argue that but I'll bet they seen a few hundred more professional pitcher elbow injuries than you have. Unfortunately either the rehab didn't work or the pitcher didn't make the changes he was supposed to.

Well that was one of my original speculations, that Dunning didn't follow the rehab and under-reported his symptoms.   And I'd argue that patient compliance and a realistic expectation of compliance for a young athlete might be a reason to get TJ rather than rely on compliance with a rehab and throwing program requiring mechanical adjustments.  

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So far, we've only lost Kopech, Burger, Dunning, Hansen (god knows whether it's physical or mental), Basabe...and Fulmer might as well be injured, for how he's looked more like the poor man's Addison Reed than his for his former teammate Walker Buehler.   Can add Adolfo's rehab, although he SHOULD be fine, arguably.

That would have been the Top 7 in a row of most White Sox Top 10 lists for the last decade on, before the Big 3 trades were executed.

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34 minutes ago, chitownsportsfan said:

I'd argue those surgeons, as they are trained, were overly cautious.  In pro MLB and with pitcher elbows, aggressive surgical repair via TJ might be the best course of action even if it's not the conservative approach that most favor.

Anyways, just another brick in the wall.  This offseason sucks.  I guess we're in season now.  I need a shot of baseball life man.  I hope this team somehow wins 60 games before the ASB.  

 

Did you stay at a Holiday Inn Express last night?

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Years ago, before Tommy John Surgery was available, I don't remember anywhere near the number of pitchers having this injury. It seems to have become the rule, rather than the exception. Very odd, especially since today's hurlers don't throw nearly as many pitches. This paradox has puzzled me, for a long time. Just strange.

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4 minutes ago, Lillian said:

Years ago, before Tommy John Surgery was available, I don't remember anywhere near the number of pitchers having this injury. It seems to have become the rule, rather than the exception. Very odd, especially since today's hurlers don't throw nearly as many pitches. This paradox has puzzled me, for a long time. Just strange.

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.

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4 minutes ago, Lillian said:

Years ago, before Tommy John Surgery was available, I don't remember anywhere near the number of pitchers having this injury. It seems to have become the rule, rather than the exception. Very odd, especially since today's hurlers don't throw nearly as many pitches. This paradox has puzzled me, for a long time. Just strange.

The type of pitches thrown combined with an increase in velocity are the culprits

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7 minutes ago, Lillian said:

Years ago, before Tommy John Surgery was available, I don't remember anywhere near the number of pitchers having this injury. It seems to have become the rule, rather than the exception. Very odd, especially since today's hurlers don't throw nearly as many pitches. This paradox has puzzled me, for a long time. Just strange.

Throwing too hard. Too much emphasis on k's. The game is cannibalizing itself to placate the stat guys. 

Edited by TaylorStSox
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5 minutes ago, whitesoxwinner said:

The type of pitches thrown combined with an increase in velocity are the culprits

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.

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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?

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33 minutes ago, chitownsportsfan said:

Well that was one of my original speculations, that Dunning didn't follow the rehab and under-reported his symptoms.   And I'd argue that patient compliance and a realistic expectation of compliance for a young athlete might be a reason to get TJ rather than rely on compliance with a rehab and throwing program requiring mechanical adjustments.  

It happens. You dont have to leave the me about patient compliance. However, your argument is flawed that compliance post surgery is probably more important than it would have been over the winter.

I was referring more to mechanical changes that they probably wanted to work on.

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1 hour ago, ptatc said:

I wouldnt totally disagree. The usual reason that a pitcher has a forearm strain is that there is something going on with the UCL. 

I would disagree that just because there is a forearm issue means they will eventually  have surgery.

Phew! Thought you were going to bring the hammer.

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14 minutes ago, TaylorStSox said:

? Hahaha. Is this serious? 

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.

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11 minutes ago, whitesoxwinner said:

The type of pitches thrown combined with an increase in velocity are the culprits

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.

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