Dr. TO 876

• Caitlin Clark calls out for wnba equal pay. 
• sports medicine 101 discussion 
• sports medicine in NBA

Episode Transcript

(00:00):
It's tip off time for Doctor t. O. Sorrel and Inside Sports Medicine
on ninety seven to one. TheFreak Doctor Sorriel, one of the nation's
leading orthopedic surgons and former head teamphysician for the Dallas Mavericks, bringing his
unique sports insights and stories from insidethe game. With special guests from the
world of professional, college and highschool sports and sports medicine, the Doctor

(00:20):
breaks it all down. Buckle upyour chin strap and tighten your laces for
the most informative ninety minutes in sportsmedicine. It's kickoff time for Inside Sports
Medicine with Doctor t O. Sorrialon ninety seven to one. A freak,
Oh the function, Oh good tobody most one, all this say,

(00:49):
I hope you okay? Your nousably good Saturday morning, in honor
of Taylor Swift. You're a SWIFTYEdoctor is going. I've never heard the

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song before in my life, butall the talk about the new album dropping
in the latest Rage worldwide, Ithought, eh, let's listen to that
this morning. And this is acollaboration with Post Malone, who's a das
guy. I think correct. Welcometo Inside Sports Medicine. Too. Sorry,
I'll here. I'm your host.Over the next ninety minutes, you're

(01:34):
going to be informed, entertained,and hopefully learn something new about sports medicine.
You'll have an opportunity to call inor text in any questions or comments.
We have a lot to get tolive in the studio today, doctor
Brad Bellard, Doctor Ryan Blaylock,and future doctor doctor Hunter spears. Though

(01:55):
you forgot my last name, Iwas, I was. I think he
realized he's a future doctor and thensaid doctor, I know. That's that's
what caught me. Yeah, wehave a lot to get to today on
this cold, rainy, thunderstorm Saturdaymorning in North Texas. Uh, kind
of a good day just to kindof to stick around the house and listen

(02:21):
to Inside Sports Medicine. So theNBA playoffs are in full swing, we
have sports medicine stuff to talk aboutsports medicine one oh one, Doctor Ballard's
gonna tell us a little bit aboutsoft tissue injuries and where we are still
in the dark ages. We're gonnaventure off into non sports medicine stuff,

(02:46):
talk about Caitlin Clark and this equalpaid debate. Yeah, you know what,
maybe we ought to start with that. Maybe we got to start with
that. Look, I think sheis a phenomenon for women's sports and just
sports in general. I heard avery interesting and slightly disturbing fact the other

(03:07):
day that the ladies' WNBA I'm sorry, the ladies NCAA Final four final game
drew more viewers than the men's no, first time in history. Yep,
eighteen million versus like sixteen million orsomething like. Really. Yeah, I

(03:30):
was blown away by that. Wow. But yes, I think that's the
Caitlin Clark effect. And look,I get the equal paything, but equal
pay in my mind, and bythe way, I have two daughters.
Okay, so two daughters. They'reprofessionals, not in sports. And yeah,

(03:55):
the equal pay thing, I getit, but that is assuming everything
else is equal. Yeah, thew n b A and the regular NBA
are not equal. They're not They'renot. So Hunter, you and I
have been talking about this just aboutevery day of the week. This week
seems like and I get it,you know, I mean, she is

(04:18):
a phenomenal talent, Caitlin Clark.I mean, all these women that we're
watching playing NCAA Final four WNBA,I mean they are extraordinarily talented. Take
nothing away from them without a doubt. However, it's it's the market that

(04:38):
calls for what is valuable enough towatch and put ads, because that's really
what it comes down to is viewership. You gotta have enough eyes watching for
you know, the the Coca Colasand the American airlines of the world to
put commercials on these, you know, on these games. And it's the

(05:00):
market that's establishing this. It's notanything other than that. Now, Doc,
you make a great point. Ifyour ship gets to consistently be where
rivals, not even rivals to men, but just you know, gets up
that level, I mean, thenthen yes, I mean, you're gonna
get contracts that are gonna be inthe millions. But you know, you
see Caitlin Clark's numbers for how muchshe's gonna get paid for the next what

(05:24):
four years, and it's like nomore than one hundred thousand dollars in any
one of the first four years inher class. Her starting salary is seventy
six thousand dollars. I mean,that's why a lot of these ladies go
over season play. I mean,it's how you know, Britney Grinder wound
up in Russia. When everything blewup, they go to supplement their salary.

(05:45):
Yeah, seventy six thousand dollars.And again, look that to me,
that's embarrassing. But I do wantto touch on something that you mentioned
just a second ago. If theladies NCAA final outdrew the men, then
there should be Now now we're talkingabout all things being equal. Now we're
talking about all things being equal.We're not talking about the NBA TV contract

(06:09):
versus the w NBA TV continent.Now we're talking about apples and apples.
Well, I think her NIL moneypretty much rifled any male athlete. Yeah,
for sure. In the men's final, she for sure made more than
seventy six thousand dollars in out withouta doubt. Well no, no,
no, So the talk was shewas making three four million dollars a year

(06:29):
in NIL money. I don't doubtit, Yeah, don't. I don't
doubt it at all. But Ithink that those numbers are probably higher than
any male collegiate basketball player. I'mtrying to think of who who's the number
one draft pick for the any NBAcollege. I believe he's an overseas guy
this year. Okay, consensus likenumber one college pick or high school pick.

(06:51):
Okay, that being the case,then I am pretty certain that she
made more money than any male collegebasketball player. Anybody hear what the ticket
price was for the NCAA female championshipversus male It was over well it was
I mean, that's the market doingwhat the market does, right. But
that But then you shift into ohmy gosh, this was our national news.

(07:14):
This was there was a national debateon should she be making what an
NBA rookie makes. No, No, it's it's it's it's like it's like
being a minor league baseball versus majorleague baseball. I think that's how you
look at the w n b A. And it's so again we hold on.

(07:40):
We talked about this this week.The the college the women's college final,
it's probably going to be it's probablygoing to draw more eyes than the
w n b A final game.Oh for sure. The w n B
A is just not getting people towatch it. That I mean, we
were watching YouTube videos of a kidgoing around outside of a stadium of a

(08:05):
w NBA game with one dollar inone hand, tickets in the other hand,
and asking people which do you want. People were taking the dollar.
Oh my goodness, do you understandwhat I'm telling you? Yeah, and
this is us. This is notus discrediting the w but that this is
what the market is saying. It'slike, I would rather take the dollar

(08:28):
than the tickets to you know,front court on w NBA. Well,
I don't know if it was frontcourt, but I mean, I do
think. I do think all thisis going to change now that she's in
the league. I do think thatthat the salaries are going to be elevated,
the viewership is going to be elevated. You know, the Dallas Wings
are selling out her opening Indiana Fevergame. Look, I think all this
is good. I think Caitlin Clarkis really good. But I think the

(08:52):
talk about equal pay, that is, assuming everything else is equal. The
NBA is a ten billion dollar ayear league. The WNBA is a two
hundred million dollar league. The seasonis shorter, the viewership is smaller.
When they when they do arenas,they only sell out the lower bowl they

(09:13):
don't sell out the upper bowls.It's just not apples with apples. So
when people talk about equal salaries,where do they want the money to come
from exactly? I mean, that'slike my question. I mean, the
best thing that could do is turnit on, right, I mean,
that's I mean, that's the bestthing to do is just turn it on
and start watching. If they don'tlike, you know, what's happening in
terms of the pay equality. Look, I thought, and I've watched a

(09:37):
few w NBA games, and Ialso watched the NCAA final, the women's
final. That was a great game. That was I was glued. That
was a great game. Well,and the storylines were great too. South
Carolina, South Carolina, all fivestarters are all stars. I mean,
it was really dogs. I don'tknow if I should say this, but

(09:58):
I think South Carolin that could probablybeat a lot of w NBA teams.
They can certainly compete with them.Well. And then the other interesting thing
is that you have people, whichI can kind of understand, WNBA players
hating on Caitlin Clark yeah, bigtime, Yeah, you know what I

(10:18):
mean, not fair flag on them. Well, and here's the interesting thing.
I saw a stat the other day. So she just signed a Nike
contract for a shoe. And there'sa two time WNBA MVP, two times
I think, two time champion,five time All Star. Who does not
have a Nike deal, which bringsup my point exactly. In the Nike

(10:41):
contract world, she should have equalpay. She should get whatever the number
one draft pick for out of collegeshould get. I mean, I would
argue you have to do a marketanalysis. You have to figure out,
like the amount of guys who wantto buy the Michael Jordan is much different
than the amount of people who probablywant to buy Kaitlin Clarks. You.

(11:03):
I think she will outsell and Ithink she's probably got guys who would rock
in the markets equal then just letthe market decide. Yeah, I think
in the Nike contract world, itwould be a travesty if she does not
get what the guys are getting.That would be a travesty because then you

(11:24):
are comparing apples with apples. She'sgot the following and the viewership. I
mean, she's got she's got itall in terms of you know, marketability.
Oh, she's a star. Yeah, she'll be a Tier one athlete
for them right away. Yeah.Yeah, she's just got a good on
court persona. She's she's extremely driven, she's she falls in that category we've
talked about on the show a milliontimes. Likable. She's likable, she's

(11:46):
changed, She's completely changed the game, the way the game is going to
be played. I mean, dude, they outdrew the man when when when?
I don't think that's ever been evenclose. So look, we're laboring
the point. I think we gotit across. But this does allow us
to move into the next phase.And this phase of the discussion does have

(12:09):
sports medicine angle. We're in theNBA playoffs. The risk reward equation changes
in the NBA playoffs. There aresome real key injuries that we're going to
bring up today. Butler with hisMCL. We're going to talk about what

(12:30):
the MCL means. But Miami killedhim last night even without Butler. You
know, we're talking about Giannis andhis calf strain, and now they're going
to be going against Indiana, who'sbeat him four out of five times this
year. Now they're going into itwithout Giannis and what is it yet you
can do for a calf strain tosee if we can get him back on

(12:54):
time. That's also going to bethe topic of the Sports Medicine one O
one section. And Kawhi Leonard goingup against the MAVs his knees a problem.
The sports medicine angle, and thisexplains why we're on episode eight and
seventy six after twenty three seasons onthe air. Sports medicine plays a huge

(13:18):
role in all of sports, butfor sure in the playoffs. For sure
in the playoffs. If so,I've just mentioned Butler, Giannis and Kawhi,
the three top players on their prospectiveteams, and they're going to be
out for game one of the playoffs. That changes everything, changes everything,

(13:39):
dude, That changes everything. AndI would say, and I got a
question for you when we really getinto it. But you know, a
soft tissue injury, meaning like ahamstring tear, partial tendon tear. I
mean going into the playoffs is tome one of the one of the worst

(14:03):
injuries that could happen. Oh yeah, because we don't have a quick fix
exactly. We do not have aquick fix. As far as medicine has
come, as far as sports medicinehave come has come. You know,
we've got arthroscopic surgery, We've gotimplantable devices that we can put in a
hand fracture so that they can beback really quickly. We've come a long

(14:26):
way. But if you pull ahammy, you're out. You're out to
do. That's just going to belike all right, this will definitely turn
the time. We can have youback in a week. Yeah. And
so Giannis apparently is a calf strain, which is sports medicine one oh one.
A strain versus a sprain. Asprain is an injury to a ligament,

(14:50):
like an ankle sprain or a kneesprain. A strain is an injury
to a muscle, such as ahamstring strain or a calf strain. So,
by definition, if you injure ahammy or calf, you tore some
fibers. And when you tear somemuscle fibers, you can't sew them up

(15:11):
because they don't hold a stitch.And even if you do sew them up,
that doesn't make it any faster.There's nothing that you can inject in
there to make it heal any faster. Bottom line is it's very time intensive
kind of injury that we don't havea fix for. I'm sure the caveman
pull a hammy, and we're probablytreating the caveman the same way. Now

(15:35):
that man was like you got ahammy, Like yeah, like that dinosaur
is going to catch you you're gonnabe the slowest one. I'm sorry,
man, But yeah, So whathappens in the risk reward equation for the
playoffs? This is this is avery interesting question. Obviously, the reward

(16:00):
becomes greater because now you're talking aboutadvancing in the playoffs and you know,
maybe winning a championship. But thereare some injuries that you don't really take
a big risk with. Hammy's oneof them because you don't want to come
back too early and tear it again. That's the problem. If it was
an ankle sprain, for example,and we lived through that with the MAVs

(16:22):
and Josh Howard back in two thousandand six. Yeah, you can tape
them up. Sometimes, you caninject them. Sometimes you can you know,
put them in a brace and geta Josh Howard back. But you
can't do that with a Hammy.I wouldn't even know if I don't think
there's a brace for it. Okay, so question real quick. If you

(16:45):
had to choose between, we'll comeback with the answer. But if you
have choose between. A moniscous tearjust before the playoffs, it's not an
unstable tear, but it's causing someswelling and some pain versus a grade to
hamstring. What's going to be easierto treat to get for the risk reward

(17:07):
and get them through the playoffs.I actually had went through that. So
when we come back from this quickbreak, we'll talk about it. This
is Inside Sports Medicine. Two onefour seven eight seven nineteen seventy one is
the phone number for comments, textsor well the text machine's not even working.
Can we see text? Oh wecan't see text two one four seven

(17:30):
eight seven nineteen seventy one. Phonecalls or text? This is Inside Sports
Medicine too. Sorry, all inagain, coming right back. Wow,
the sickest army coach just up inthe wall. Busy. Let's just send
my plastic smile. But you shouldhave seen it. My first god,

(17:52):
men, do they still have recordstore? How do I get this record
album? It'll drop on vitel prettysoon. You'll drop on vitel pretty soon,
drop on vinyl. So I guessit just drops like what on exactly?
My question? First? So apparentlyat two am she dropped her new

(18:15):
album. This is Taylor Swift.And if you guys listening don't know,
I'm a big Taylor Swift fan.But I only know three songs. So
she called out Kim k big time. Kim Kardashian really big time. She
straight out of her like even it'slike an I'm embarrassed song title. I'm
embarrassed that you know that. I'mabsolutely embarrassed that you know that I'm a

(18:36):
Swift knows that you I mean,like every song is a Swifty song this
morning. Well, I'm embarrassed forme for doing that. But so I
again, I do want to answerthe t's that you left us with,
because we are talking about NBA playoffsand the decision making in the sports medicine
angle of it. But back tomy original Taylor Swift question. When when

(19:02):
quote unquote you drop an album,how do you pick it up? I
mean, where do we buy it? Is? It? Is it Apple
Music? Like that's if you're aniPhone. I mean it's just so it's
not like a cassette. It's alldigital. That's what when I say it'll
drop on vinyl like she'll it'll likeyou'll be able to buy a target in
like a couple of weeks or amonth or something. The actual album,

(19:23):
the actual album album on a recordplay correct? Yeah, I actually I
still have vinyl. I have alot of vinyl. I have like five
hundred albums. And what I learned. We're off on a tangent today,
aren't we. Sorry. What Ilearned is that sometimes the album covers are
more valuable than the vinyl that's init. Really Yeah, that's interesting.

(19:47):
Yeah. So, so I askedyou before we went on break leading up
to the playoffs, what's what wouldyou, I guess, prefer to treat.
Do you think is going to beeasier to treat a meniscus tear that's
not causing a knee to like buckleor lock versus a grade two hamstring tear.

(20:11):
So this brings up, this bringsup all kinds of sports medicine discussion
points. So anatomically, the meniscus, and we have two of them.
You have one on the big toeside called the medial meniscus, one on
the little toe side, lateral meniscus. They're cushions. They're basically cushions in
the knee, and it's not sounusual for meniscus to tear. They rip

(20:33):
like a piece of paper. Ifthe symptoms are minimal, then you play
through it. Oh yeah, ithurts from time to time, or it
swells from time to time. Ifthe symptoms are major, which means that
it's actually a big tear and yourknee catches or locks, and usually those
have a lot more swelling and alot more pain, then it's arthroscopic.

(20:56):
You go in there with arthro's scopicsurgery, trim out the torn piece.
Uh and within two three weeks atleast for a professional athletes, within two
or three weeks, they should beable to come back and practice. So
that we actually, you know,a torn meniscus, which is really common.

(21:17):
It's not just in the pro world. It is moms and dads,
it is high school kids, itis torn meniscus is extraordinarily common. Sidebar.
If I operated in every torn meniscusthat came in the door, I
would be in all that time.Yea. So the real judgment is to

(21:37):
determine when, when, and howto treat what we're looking at, and
it all depends on the kind ofsymptoms. So NBA playoffs torn meniscus if
it's not very symptomatic, that's mychoice. Yeah, because we have things
that we can handle. We cando a cortisone shot, we can There
are lots of ways to manage thisso that the athlete can showcase their talents

(22:03):
and we'll deal with it after theseason's over. This happens in the NFL
all the time. Most linemen havetorn meniscus. Hunter has a torn meniscus.
So if you can manage, andyou can treat, and you can
allow them to showcase themselves on thehamstring injury, And you said something interesting
that probably the listeners don't understand.There's grade one, grade two, and

(22:26):
grade three as simple as mild,moderate, severe. A mild hamstring injury
or calf injury or groin injury orany muscle injury is a stretch where most
of the fibers are in tech.That's a seven to ten day deal.
We can handle that. A seconddegree means that some of the fibers are
torn, so it's a partial tear. That's a bit more of a challenge.

(22:49):
And I suspect I got a calllast week, and I'm not going
to go into too many details.I got a call last week about my
thoughts on Giannis because he had asecond degree calf injury. That usually means
fibers are torn. That usually meansthere's bleeding. That usually means that there

(23:14):
is limping and discomfort. And therisk here is that if you come back
too early, then you take asecond degree and make it a third degree.
So when you have a two centimetersworth of muscle damage and they come
back too early, then you gotfour centimeters of muscle damage and he's done

(23:36):
for the entire playoffs. The judgmentcall is is there anything we can do
to speed that up? And youknow, we throw them in the hyperbaric
chamber. There's some guys that doPRP playletat rich plasma. Bottom line is,
there's really nothing proven that's going tomake that go any faster. And
at the end of the day,it all depends on how many fibers are

(23:57):
involved and what kind of risk youwant to take about making it worse.
Yeah. So would I rather havea tournamentiscus or a torn muscle? Oh,
tournamentiscus in a minute. Yeah,So in the short term, I
would rather to treat a meniscus,But long term, the hamstring is not

(24:17):
going to give them much of aproblem. Yeah, Because so once the
hamstring heals, yeah, then they'regood. I think you're good to go.
Yeah. Now, depending on thedegree of the meniscus, tier if
they have, if you have togo in and clean it upright, they
may be at risk of some arthritisin the future. But yeah, I
mean long term, I would preferhamstring, but short term I would prefer

(24:44):
treating the meniscus. And these discussions, These discussions take place with medical staffs
in NBA, NFL, Major League, at every high school sports. These
the discussion you just heard now onInside Sports Medicine takes place at every level
because these injuries happen at every level. Now, the reason we talk about

(25:07):
him on radio is because there's somuch riding on this in the NBA playoffs.
I mean not only the money,but I mean there's a lot riding
on a torn meniscus. I wasthe Jimmy Butler MCL, which is there's
a difference between media collateral ligament anda torn meniscus, although anatomically they're literally

(25:27):
a centimeter apart, but ligament injuryversus a Carlidge injury. He played on
it. So he's got an mCL. He's got an m CL,
and they said he's out for afew weeks. You know, I think
I can probably brace him up andget him back faster. I'm really surprised

(25:48):
why they In fact, what Ihate this when they when teams do this,
he won't be evaluated again for twoweeks. Are you kidding me?
He's going to be evaluated every hour. Yeah, every hour. His trainer
is going to be looking at him. Yeah. But you know this that
if the player is like I don'tthink I can go, it doesn't matter

(26:14):
how injured they are, and that'sthe final authority. And that's it.
That is the final authority. Ifthe player and I've had this, I've
had this at the pro level,I don't think I can go absolutely.
I mean, you can't convince someotherwise even if you can't win that battle,
you don't want to win and Idon't want to have the back.
I mean, if you feel likeyou can't go, I mean, okay,
And then that goes into a wholeseparate discussion of like they're a specialists

(26:37):
in sports psychology, who these guys, you know, they've had a big
injury and they just can't wrap theirhead around like getting back out there.
And that's a whole separate part ofthe treatment. I mean, you're treating
the patient, not just the meniscus. It's funny you should say that because
all of us at any level,when you're a physician, especially in sports,
you have to be part psychologist.Oh and I was telling my patients

(26:59):
when to come back from an ACL, the toughest thing for you is going
to be the mental when you're backon the field and you're expected to do
the same exact maneuver that tour itin the first place. Yeah, for
sure, that is scary. Yeahyeah, but this whole if the player
doesn't think they can go, that'sit. That's the final call, which

(27:22):
brings up I'm sorry, who you'regonna talk about. Well, I don't
know the guy's name, but he'sa he's a prominent player I think for
Indiana, and Indiana is having areally good season and he's out with a
shoulder labral tear, out for theseason. And I was kind of scratching

(27:44):
my head, Wait, what whatpossibly might you have that will keep you
out for the season. And myguess is exactly what you said, is
that the player said I can't go. Yeah, I can't. I won't
go. There you go because inthe and I'm gonna get doctor Blaylock involved
here in a second, what Idon't I can't think of a shoulder problem

(28:12):
that will keep you out for theseason, right for the playoffs, for
the playoffs, you know, becauseand I think the details were he had
a subluxation episode where the shoulder kindof slipped in and out, and he's
got a laboral tear. That's whatI think. That's what came out publicly.
And then Okay, a labral tear. Uh, suck it up and
play and we'll deal with that afterthe season's over. I was kind of

(28:33):
surprised by that. So in thewrist, there's also a cartilage very similar
to the meniscus and the knee calledthe triangular fibrocartilage. Is if someone tears
that, can they still play Itreally depends on kind of the flavor of
the tear and the symptoms they're having. Is it dangerous? I mean,
is it dangerous if you play throughit, if you can tolerate the pain,

(28:57):
and the joint that it martially stabilizes, which is one of the joints
just above the risk called the distalradial owner joint, is stable. Yeah,
I think it's probably reasonable to playit. You know, now,
if you start, if you havelike a really bad tear from you know,
whatever injury and it results in someligament or some joint instability at the

(29:18):
distal radial owner joint, then youstart running into problems of like, okay,
if we keep pushing this, willthis get arthritick? Things like that,
But just a you know, peripheralor central TFCC tear and the risk
that is minimally symptomatic with certain motions. No, I think you could probably
play through. And it's and it'splayoffs, and it's playoffs, and you
got one of your main guys andhe has that you said, he actually

(29:41):
said something interesting that that I wantedto shed some light on. Guys,
aren't scared of future arthritis? Notat all? We are. We are.
That's so good. Yeah, we'reway more concerned about the future arthritis
than than than they ever will be, you know, because because when you're
talking about future arthritis, you're talkingabout a decade or two away from now.

(30:04):
And these twenty year olds, twentyfive year olds that are making millions
of dollars. It doesn't in theNFL, I'm going to tell you that.
I'm gonna tell you that eighty percentof the roster has ar it,
not not only has arthritis, butwill have will have arthritis, and they're

(30:25):
not the least bit worried about it. They may not be at least bit
worried about it, but you dohave to counsel them unshared and document and
to say like, you know,hey, look you can go with this
if you can tolerate it, butit's going to come at a cost,
and you're going to pay the piperat some point. Yeah, but they
can't appreciate the level of paying discomfort, you know, affecting quality of life

(30:52):
later when you tell I'm sorry Ididn't finish. Finish. So I've got
a college kid who wants to playin the lead. He's got some grade
four cartilage where already Yes, thatmeans bad. That means bad. And
he's like, do you know he'shaving a little bit of swelling in his
knee and it's not too bad.But I was like, listen, dude,

(31:14):
like this is all about preservation atthis point. You don't need a
surgery. You're starting to get someearlier arthritis. You're twenty two. Yeah,
I'm like, he's like, Doc, do I have to stop playing?
I'm like no, but we reallygot to do everything we can to
try to preserve your knee at thispay o the kitchen sink at it,
and that's what we talked about.We actually he's like, oh okay,

(31:37):
He's like, I thought I neededsurgery. Oh I'm like, I understand
you saying like I didn't need surgery. But I'm sitting here thinking, you
you got to you gotta road aheadof you man to try to really preserve
your knee and not make sure thatyou don't need a knee replacement at the
age of forty. I think alsothis probably necessitates at some point here a
discussion of what is arthrit is,because, like we use, we throw

(32:02):
this word around and a large numberof people don't really understand what actually is
arthritis and frequently think, oh,they're just gonna they're gonna clean out my
arthritis, and I'm good to goclean up. And we all know when
you hear clean out our thriatus,you're like, that's bad. You know,
you know you're in for a longvisit. You just tell your your

(32:22):
medical assistant like, hey, I'mgoing to need a second here, because
you're you're starting a whole separate discussion. So ourritus is when a joint wears
out and we're we're out living ourjoints. Now. So when you're seventy
or eighty years old, especially ifyou've been athletic, especially if you've got
a family history of wear and tear, we're all gonna have our thriatis because

(32:46):
the joint's worn out. Yeah.Well, and even even that explanation sometimes
gets blank stares for me. Sowhat does that mean? I like to
put it this way, I'm like, Okay, some people come from the
factory with fifty thousand mile tires.Some people come from the factory with one
hundred thousand mile tires. Now,if you're the type of person who drives
ten miles an hour to Highland ParkVillage to go have a cocktail every day

(33:08):
in the winter, your fifty thousandmiles tires are probably gonna last your whole
life. That's good. Now,if you're on seventy five going one hundred
driving like who's the guy who's gotthat wreck? You know, driving like
him? Your one hundred thousand miletires probably aren't gonna last your whole life.
And so that is my discussion ofIt's part genetics, what kind of
tires you came from the factory withand then part activity. That's how you

(33:30):
use it some and I'm gonna throwanother part bad luck, Yeah, because
it does play into it. Allright, we got to take a quick
break. The text is going Crazytwo one, four seven, eight seven,
nineteen seventy one. Also phone callsif you've got any questions or comments.
Inside Sports Medicine too. Story onthe game coming back. Yes,
it must be true. And myfriends all smell like weed a little babies.

(33:57):
They don't play in the city,driving myself crazy, little did you
know your homes really only a town? You're just a guesting so you work
your life? Oh wait, justto pay for a time to Welcome back
to Inside Sports Medicine. I don'tknow why I picked this. We're doing

(34:22):
Taylor Swift again anyway. Welcome backto Inside Sports Medicine too. Sorry,
I'll here live in the studio,Doctor Ballard, Doctor Blaylock in future,
Doctor Spears. You know, HunterSpears. You said you were on the
all name team from college. Gotcool name, very cool, Hunter Spears.

(34:45):
But I was going to ask youthis, did your parents purposefully do
that or was it an accident?I don't think it was purpose Oh,
I don't think Hunters that. Ithink Hunter and Spears is really cool.
I think that's a cool juxtaposition.But I didn't know if it was on
purpose or not for a defensive playeron a football team. Right, Yeah,
you can't get any better than that, like Hunter Spears. Oh,
who is that? My grandfather reallywanted to name my brother Fisher. No,

(35:07):
no, I have I have patientswho to the two boys are Hunter
and Fisher? I have absolutely Andthis was like twenty years ago. Who
was the quarterback for Notre Dame Gunnersomething? I thought that was a really

(35:28):
cool name, Gunner something? Uhtransferred after one year. Anyway, all
right, we we digressed. Welcomeback to Inside sports Medicine. We have
a lot to get to. We'llget to some phone calls here very or
text questions quickly. I wanted tofinish up our discussion on the sports medicine
impact for the NBA playoffs this particularyear. So Zion is out with they

(35:52):
said a hamstring injury, although itkind of I didn't look that bad.
Kawhi Leonard against the MAVs is questionablewith a swollen knee. Butler Miami's number
one guy's out, Giannis Milwaukee's numberone guy is questionable. There are a
lots of Zion already. I didsay Zion got it, So let's talk

(36:15):
about the Zion real quick. Iwas actually watching that game because I was
in New Orleans, and it didn'tlook like anything bad happened. I mean,
he was driving the lane, hewas in the near the end of
the game. It was like threeminutes ago. He was he had forty
point game going, lots of hewas. He was a monster that game,

(36:36):
and apparently something happened to him andhe got upset and he waved his
hand like I need to come off, and he walked off without a limp.
As soon as he landed exactly helooked he he he kind of turned
to the sideline and he pointed tothe sideline like I need somebody to get
me right. But he walked off. No severe. Something must have been

(37:01):
going on, though, because it'slike he's like it happened something. So
that's the other thing, is right, It is like with something already going
on, something brewing, right,And then that was the final kind of
straw, and he's and he actedmad. Yah, he was very upset.
As he was walking off, hethrew a towel and so he acted

(37:21):
mad. He sports medicine secret.We had this episode many many meeting years
ago. When when the press releasecomes out that he has a hamstring injury
and he will be re evaluated againin two weeks. I was kind of

(37:42):
scratched my head because that makes nosense. He's going to be reevaluated every
single day. I'm thinking they're throwingus off somehow with his knee history with
his knee. Yes, I thinkhe landed awkwardly. Something popped and that's
what he felt and that's why hewas able to walk off without a hitch,
and perhaps I think they may bethrowing us off. Dude, Listen,

(38:06):
when I pulled my hamstring, myit's almost like my hand like a
magnet grabbed the back of my appAbsolutely. You see these track guys run
and they pull a hammy, they'repulling up and like yo, you know
what I mean, like and they'regrabbed. He just he landed and it
was like, Yep, something happenedexactly like yo, I need somebody.
And we talked about this years agowhen he first got Yep, his first

(38:30):
year in the league. Zion isbuilt like a defensive tackle. He's a
big boy now he is. He'salways been big, but now you know,
even put on a couple of puton a couple of pounds with all
these injuries and stuff like that.And you know, you got all the
memes with him looking all big andall that stuff, and that's fine,
but he is a big dude,and those knees receive a lot of impact

(38:54):
with the way he plays physics.And we said this years ago, I
just don't if I was a bettingguy. Yeah, John Order right,
that's a whole nother conversation which wewere having at the break, But I
would bet that his his career isnot going to be long, just simply

(39:16):
based on the wear and tear becauseof how big he is, how he
plays, and he has to playlike that because that's his game. You
can't carry He's jumping up and down. He's a pain player. His play,
his style of play does not reallytranslate for a long career. No,
yeah not. And most jumpers don'tdo you see at the at the
end of the career, like Drekgrows their career from what you used to

(39:37):
be explosive is now short of pickingpop drive, pull up. It's not
dunkin on guys. And this yearhe played I think they said sixty maybe
seventy games in most games he playedall year. I mean, they would
really make in his career and hiscareer. So this this one is fishy.
It is. It is fish It'sjust the way it looked and and

(40:00):
yeah, the way look so.But again, the reason we're talking about
all this stuff is because we arenow in the NBA playoff season, which
is a whole different game. Theyplay it differently, and you've got teams
that are in the playoffs without theirleaders, without their top scorers. This
is where medical staffs earn their keep. Oh man, it's not in preseason.

(40:27):
It is in the playoffs. Andagain we peel the curtain back every
week on this show. There aredecisions that obviously everyone has to be on
board. The player has to beon board, the players agent has to
be on board, player's mother hasto be on board. Everybody has to
be on board when you make thesedecisions. We had a player a few

(40:49):
years ago going into the playoffs,and I think I told the story before
he got traded to US mid season, and our first round opponent was the
team that he got traded front andhe had a cartilage injury playing and he's
exactly he said, I'm playing.Well. The question was the question that
he posed to me before, iswhat would happen to my knee if I

(41:14):
play? And I said it couldget worse. And to follow up on
what doctor Blaylock was talking about,oh, I documented that. I documented
that everywhere we had a discussion,his knee could get worse, the cartilage
damage may get worse, blah blahhAnd I there was a page of disclaimers
in his chart, and he said, I'm playing because I want to show

(41:38):
them what they lost when they tradedme. So everybody has to be on
board, and everybody has to beaware of all the circumstances, and then
you make a decision together in theplayoffs. This is how it goes.
Again, there are the Qui Leonardthing with his knee swollen and all that.

(42:00):
You know, sometimes you can drainit and inject it and you know,
get a few games out of it. Yeah, I don't know what's
going to happen with him. SoI definitely don't think Zion's playing these these
first couple of games in the series. But do you think any shot that
he plays later in the series.Absolutely, Look, I don't know what
he's got. Hamstring if they can, you know, make it, you

(42:22):
know, several games in and youknow, if it's purely hamstring and he's
open to getting back, I thinkyes. But if if it's knee,
you know, I mean, Idon't, I don't know. Like Dox
said, I don't, I don'tknow if it's purely hamstring, because it
just didn't it didn't look like itthat when I saw the injury, I
wouldn't thinking hamstring. The first thingI thought was did he come down?

(42:43):
I mean something his knee? Youknow, should we talk Should we talk
about like a strain of a hamstring, like a muscle tear of a hamstring
versus a evulsion of a hamstring?Yeah, because those are those are two
truly different injuries. And you know, our listeners are probably like, oh,
it's a hamstring. And as witheverything, unfortunately in medicine, there's
all kinds of flavors, and ahamstring of vulsion is very different than just

(43:07):
like a hand dring strain, eventhough I think we all think that may
not be actually what he has.Yeah, look, don't I don't know,
But all I can tell you nowis that sometimes the story is change
to protect the innocence. See allright, So moving forward, I can't

(43:27):
read that. I can't read thatquestion. If you want me to,
well, hey, Garrett, canyou raise it up a little bit so
I can read the question? Ohyeah, yeah, yeah, I can
see it. Fifty one. Yeah, you want to do that on air?
You want to take a break?No, So it says I'm a
fifty one year old male, Ihave a torn ACL and meniscus in both

(43:49):
knees. Join the club, theBilateral Club, and consultation with a surgeon,
and he said it was too oldto fix it and too young for
a knee replacement, and just wantsto get shots. What else can I
do? That's a great question.That is a great question. That is
a great Let me do the science, yeah, and then you do the

(44:10):
treatment options for sure. Okay,So a torn ACL extremely common injury.
It has to do with stability,torn meniscus. We talked about the cartilage.
Often seventy percent of the time youtear the ACL and meniscus at the
same time. That's typical, andneither one of them heals. In neither

(44:35):
one of these conditions heal. Ifthey're not addressed early on, they can
lead to premature wear and tear anarthritis of that knee. And when I
say premature, as early as fiveyears and most typically ten to fifteen years.
So my guess here is you're fiftyone, you tore your ACL,

(44:57):
you tore your meniscus, and youtalk to somebody and they want to do
injections. So we're probably into thearthritis treatment category rather than the ACL treatment
category. Now, yeah, sono, that's good because those are two
completely different things, completely different options. So, yes, your ACL may
have been torn, it may haveeven gotten repaired, and even on this

(45:22):
newer MRI, if that's what youhad in terms of imaging, may show
that the ACL doesn't necessarily look healthy. But that's not your issue anymore.
It's more like doctor Blaylock was saying, which I use a very similar analogy,
the tread on your tires are startingto wear. Oh I like that.
The tread on your tires are startingto wear. And so now the

(45:43):
conversation is what can we do topreserve the tread on your tire as much
as we can so we can extendthe life of them. Particularly if he
said you were too young for aknee replacement. Now I would Actually I'm
not a joint when I say jointsurgeon. So orthopedic surgeons typically sub specialize.

(46:05):
Not everyone does, but that's prettytypical in this day and age.
A joint surgeon is somebody who specializesin joint replacement, most typically hip and
knee replacement. I think many jointsurgeons would probably take issues saying fifty one
is too young for a total kneebut that is probably a segment unto itself
for that discussion. You know,with new technology, new plastics, there's

(46:28):
a possibility and you know we canget a friend on who's a joint surgeon
to talk about it. But yeah, and I think there's an argument that
you could potentially get away with oneand done for the rest of your life,
depending on your activity level with ajoint replace, right, And that's
I was gonna say. And that'swhen you start really getting in the schools
of thought whether fifty one is tooyoung, well about and we don't know
how active this person is either.Because a lot of this and this is

(46:51):
the discussion I have with a lotof the patients who are quote unquote a
little too young for knee replacement?Is what are your goals? What is
your active trying to be like?Because if they're like, look, I
still like to do these things andI'm still functional enough, but it comes
with a little bit of pain.Well that's really what it's all about.
How functional are you looking to bewith as little pain as possible? And

(47:13):
maybe you can kick the can downthe road a while so that you can
extend the life of the knee andI get the knee replacement yet, So
what thirty five thirty four, that'sthe text number. What thirty five thirty
four wants to know is other thaninjections, what are the options? And
when we come back from this break, we'll have a discussion about it.
Yeah, for sure. This isinside sports medicine too. Sorry, I'll
coming right back. Two one,four, seven, eight seven, nineteen

(47:34):
seventy one and on the throttle thoughtI caught lightning in a bottle boom that
it's gone again, and it waswritten I got cursed like you've got bitten.
Yeah, okay, so what wasit? Punishment? Next week we're

(47:59):
going to go back to a CDC. In fact, do you have an
ac DC right now. See ifyou pull one up. I don't know
I like it. I haven't.I haven't listened to this new album.
I gotta I need to go ona long bike ride and like crank through
this new one. Well, it'snot appropriate for Saturday morning. I thought
it would be. With all thisrain and dreary. These ballads call up

(48:19):
at ac DC and then we'll comparethink about life. Oh yeah, bad
decisions. There we go, there, there you go, we go.
Remind me not to ever play TaylorTrift again. Like a wake you up
versus a lulla bar it is.It's a wake you up. Yeah,
but the weather's a metaphor for hermusic. It is. It definitely matches

(48:39):
the what it looks like outside.Welcome back to Inside Sports Medicine Final segment
two one four seven, eight seven, nineteen seventy one. Doctor Ballard,
Doctor Blaylock. Doctor spears kind ofand sorry, uh really really good question
on the text machine ACL and meniscusdamage. Sounds like he also has arthritis

(49:07):
and to the question, was thedoctor he saw said that you're too old
for an ACL reconstruction, too youngfor knee replacement, and he offered options
so we could actually do an entireshow on that one question, entire show.
I mean there's whole books written onthere. There are books written on
it. So the ACL condition antia cruciate ligament condition is a stability problem.

(49:36):
When a patient comes to me andsays, hey, I had this
injury and ever since then, myknee's been unstable, we go down the
left pathway to treat. Yeah,we need to restore your stability. If
a patient is ACL deficient and it'sbeen that way for a long time and
he comes back, comes to meand says, my knee hurts, that's
an arthritis condition, we go downthe right way. Those are two different

(50:01):
treatment options. So when I hearthat his doc said you're too old to
fix your ACL, he's barking upthe wrong tree. If the patient came
to me and with the knees unstable, on giving out all, I don't
care. If you're seventy five,I will. I'll stabilize your knee if
that's your primary problem. And I'vedone that. Yeah, yeah, you

(50:22):
know, if you're seventy five andyou got your ACL defiicsion and your knees
unstable, yeah, we need tofix it. So you don't fall down,
break a hip, and then we'regot all kinds of trouble. I
think another thing is saying that weall know, but like you know,
that's why we're here is to educate. I you don't like the ACL comes
out when you do a total kneereplacement, Yeah, exactly, it's it's

(50:43):
coming out. The ACL goes inthe bucket, right like there are knee
replacements where you need its brother,the PCL, But there are also ney
replacements where both the ACL and thePCL go in the bucket. So you
don't need to think, oh,I need my ACL fix so that my
total knee is better later. Thatdoesn't matter. That's coming out when you're
getting a total knee. So forthirty five thirty four, your treatment options

(51:06):
depend on what the symptoms are.And if your symptoms are instability, then
we go this way. If thesymptoms are pain and arthritis, then we
go that way. Injections are justas start. Yes, And when we
talk about injections, sometimes we talkabout cortisone shot, which is an anti
inflammatory. Sometimes we talk about gel, which we used to get from rooster

(51:28):
comb cartilage. But then there's regenerativeinjections. Yes, but there are also
simpler things in that too, likemodify your activities, lose some weight.
Both of those will make it yourwinn you feel better. Yeah, yeah,
so yes, I agree with you, because the other question is like
what activities are you trying to do? What's your lifestyle? I really try

(51:52):
to explain to my patients, particularlypeople who fall in this category of two
young for knee replacement but still havearthritis. These people are trying to be
active. Whatever their goals are,I'm trying they become my goals, and
I'm trying to help them reach theirgoals in terms of like, let's let's

(52:13):
have you be as functional as possiblewith as little pain as possible. And
yes, that's a conversation around whatare the activities that you're doing that are
putting your knee at risk, thatare putting your tread on your tire from
wearing more. So let's modify that. Let's try to get all the muscles
and stuff stronger around it. SoI usually tell them miss, look,

(52:37):
if we can do a combination ofregenerative medicine and rehab, you may have
a good recovery. So go Ilike that. That's kind of the formula
that we use, and I say, listen, So I'm going to work
on the inside of your knee.We're gonna do some platelet rich plasma,
which there's a paper that shows thatit outperforms the gel and the quarters own

(53:00):
long term wise, I like itbecause I mean it's it's it's your own
blood. It's yeah, I likeit. And so and then we can
add some bone marrow asp it concentrated, and then this kind of gets into
it gets a little yeah, butdo we use fat or do we use
bone marrow in terms of being ableto get young seals in the knee working

(53:22):
for you again, and it's allabout, hey, let's preserve the life
of your knee. One of thethings that you mentioned that I think it's
worth, uh emphasizing what are youexpecting as a patient out of this yes,
out of this knee. I'm gonnatell you a story about bo Jackson.
You guys remember Bo Jackson usual sportfreakish athlete. Was he not?

(53:46):
Maybe I'm confusing, wasn't he not? Was he not an All Star in
baseball and an All Pro and football? Yeah? Hell yeah? Okay,
So he had a football injury whenhe played for the Raiders. It was
on Monday that football I remember seeingit. It had to do with the
femeral neck of his hip and eventuallywent on to get a condition called a

(54:08):
vascular necrosis and ended up having ahip replacement and he could not play football
anymore, but he wanted to playbaseball. Well, he played baseball after
he had a hip replacement, whichwas done by doctor Andrews, Jimmy Andrews,
and he wore it out in twoyears. You know, you can't
run the bases, you can't playoutfield, you can't do it with a

(54:29):
hip replacement, and expected to last. But when was that though, eighties?
So I don't know that it's changedthe heck of a lot. The
plastic has changed a lot. Yeah, so his failure was at the bone
junction. But anyway, but that'sthe point. The bottom line is if
you're expecting to have a new replacementso that you can go back and run

(54:51):
marathons, yes, that is incorrect, Good job, doc, Yeah incorrect.
Yeah. Absolutely. So that's theother thing, because sometimes what people
may not understand is like, Okay, well let me just get let me
just get my knee replaced. Butif you're trying to do that. To
go back to, like you said, running marathon, running marathons, I
don't think that's gonna So there's gonnabe a sacrifice of your function now,

(55:12):
depending on what you're trying to do. But if quality of life is horrible
and you've tried everything, and yourarthritis is stage four in stage and it
is a quality of life paint issue, like I can't get around day to
day, and you're waving the whiteflag. I tell patients, you're gonna
let me know when it's time becauseyou come in and say, Doc,
I can't take it no more.And by the way, shout out to
my man a ray, because Iknow a ray is listening. Oh yeah,

(55:32):
listen a ray. My guy.Look, he's in the hospital recovery.
He understands, you know when whenwe talk about waving the white flag.
Right. So, but but ifyou're like, listen, I'm having
some pain, like but I stillwant to be functional, let's talk about
that, and we can preserve yourknee long enough to either not get a
replacement or get a replacement one timelater in life, which goes back to

(55:55):
what Ryan was saying. Doctor Blaylockwas saying about fifty one may not be
too young to have a hip replacementor a knee replacement if everything else has
been attempted and exhausted and you've hadand you continue to have, you know,
daily in discomfort. So you know, I want our listeners to understand

(56:15):
that, like, a hip replacementis very different than knee replacement. Yes
it is, and both are reallygood surgeries when done well by a competent
surgeon in the right patient who hastheir appropriate goals under it for the right
reason. Yeah, exactly. Now, hip replacement is, by some metrics,
the most successful surgery ever invented,like not just an orthopedics, but

(56:39):
literally ever invented. If you lookat them out of quality adjusted life years,
which is a metric of assessing howmuch as surgery does for somebody,
hip replacement is right up there.Like we are in a time when you
can put a hip replacement in athirty year old and that might last the
rest of their life. They aredone well. They are extremely good and

(57:02):
extremely effective. Now, why wouldyou put a hip replacement in a thirty
year old? There's a lot ofreasons. Most of them have to most
of them have to do with youwere born with something up with your hip
or you got a bad infection toyour hip as a kid. It's not
a standard practice, but hip replacementsare very good. Now you replacements are
solid, but not quite as goodoverall, different as a as a knee

(57:24):
as a hip replacement, but youknow, when done well, a total
knee is a good surgery. Yeah, yeah, Well I think we pretty
much answered that question, right,Yeah. And the other thing last thing
I will say is you have toyou have to. These are not like
scopes like you're walking in all letme just get my nee replaced and I'm

(57:44):
just going home. No, no, no, no, this These are
major surgeries. So you also haveto am I willing to incur risk?
So you got to look at allthat and then make a decision. If
you get an infection after a totalknee or a total hip, life it's
a life altering problem. Absolutely.I mean that's you know again, we
could have a whole week, ofa whole month of shows on your joint

(58:05):
replacement. So shifting gears, shiftinggears. We talked about this earlier in
the show today about what does arthritisreally mean? And you talked about the
what were you born with? Interms of treadlife on your car, and

(58:27):
Ballard was talking about using the samekind of tire analogy with the tread is
wearing off, et cetera, etcetera. What happens from a visible option.
The joints are covered with a layerof cartlage. It's a thin white
layer of cartlage. You've seen itif you've eaten a drumstick or a chicken

(58:47):
leg. That's it's that white capon the end of the bone. Arthritis
is the process where that cartilage wearsout and starts a flake off and the
bone is exposed. It doesn't typicallyhappen overnight. It happens over years.
There are people who are born witha genetic predisposition to have arthritis, so

(59:13):
no matter what they do, they'regoing to have arthritis when they're fifty.
We've all seen patients like that.And there are people that have arthritis from
a wear and tear called osteoarthritis becausethey played sports, because they ran marathons,
but whatever, whatever, And weall see the unfortunate subset that has
both you have a genetic predisposition,but you played in the NFL and you

(59:36):
have arthritis when you're thirty there isa very small subset that I really kind
of wanted to talk about briefly,briefly just to let all of you guys
know it exists. Earlier in theshow, we were talking about the sports
medicine decision making process when you're dealingwith a Kawhi Leonard who's probably has arthritis

(01:00:01):
in his knee, and that sortof thing where we throw the kitchen sink
at him, and we talk abouthow long of a window does a Kawhi
Leonard have in the NBA. Butthis subset that I'm talking about Hunter and
I saw a patient last week whowas sixteen, and he had what I

(01:00:30):
have have to believe is a geneticcongenital problem where the cartilage on the end
of his knee was literally just fallenoff. So he had a scope and
both he's had both scoped because thecartilage was literally just flaking off. And

(01:00:50):
they came to see me as asecond opinion, and I told him and
his mom and that, look,your window is short, Your window of
showcasing yourself is short. So eventhough you're in high school now, I
think we can probably throw the kitchensink at you and get you through college
and maybe maybe if your the talentis that good, then you might be

(01:01:13):
able to get into the pros.But your your window of opportunity is short.
Now. He got a little tearyeyed, and I apologized, but
I thought I was very diplomatic.He set up because I've heard it so
many times. That's why he gotteary eyed. I've heard this so many
times. Look, there are someguys who have made it to the NBA

(01:01:35):
that had this condition and they werelasted a year. Who was all right?
He played for a high state bigguy. He was the center,
Greg Odin. Greg Godin had thatcondition in that the cartilage on the end
of the bone was literally flicking off. Geez, there's not a fix for

(01:01:57):
that. I think Brandon Roy forPortland's I saw him as a patient.
Yeah, this is I don't knowhow to fix that. That's bad luck.
It's and the thing is And sowe had I had a really long
discussion with with with his mom.She she was on top of all of
this. Uh, if you're talented, and this young man is very talented,

(01:02:23):
some school is going to give youa full ride. You're going to
get a full ride. And andknowing that your window is short. I
told his mom, I said,the best thing I did for you today
is is tell you that you gota good four or five years. And
we're going to throw the kitchen sinkat him. Let's if he can get

(01:02:45):
it a scholarship, a full ride, maybe get a year in the NBA
or two. That's a huge homerun victory. There's another part to the
whole kitchen sink is like when Ihave these patients who have early arthritis,
you know, you're just you're grabbingat straws to try to figure out,

(01:03:07):
like how you're gonna get them through. I send a lot of those patients
to see a rheumatologist. Oh yeah, all the other Yeah. So rheumatologists,
if you don't know, are aredoctors who specialize in inflammatory conditions.
One we've all heard of is rheumatoidarthritis. Now there's a ton of other
ones that kind of fall into asimilar bucket. But having a good rheumatologist

(01:03:27):
who can look at you, doa bunch of lab tests and just kind
of see if they can find anythingelse that may be an underlying issue that
could be managed or corrected. Alot of times they come up with nothing
and I frequently tell the patients,you may go through all this and they
don't find anything, but on theoff chance they do find something that is
modifiable, then that's part of this, that's part of this kitchen. Certainly.

(01:03:49):
Certainly, Yeah, I've got I'vegot a patient right now, sorriatic
art Well has a history of psoriasisand is now starting to get both the
swollen and sore. I'm like,no, you got to go back,
go back to you rhematonie just I'mgonna do my part on my end,
but if we both work together,we may be able to get you,
you know, your recreational tennis gamewhere it was. Whoever can find a

(01:04:11):
solution for our thriatus other than areplacement, we'll win the Nobel Price and
be a trillionaire, like saying they'llbe able to buy a country. It
is a it is a condition thatwas a condition that is not reversible.
So by the time you see me, whatever our THREATI is, you got
ain't gonna get better. Our goalis to keep it from getting worse.

(01:04:32):
So it's it's not reversible, it'sit's manageable. And I think that's what
rheumatologists do. It's manageable, andwhen we throw the kitchen sink at you,
we're trying to manage it so thatyou can showcase your life. But
but we don't have a fix intwenty twenty four. We do not know
how to regrow joint cartilage. Likenow you can regrow Yeah, we can

(01:04:56):
do it. We can regrow thecells. But you know, that's what
that's like a true artist cartilage inthe in the way it's designed, in
the architecture of it. We cannotdo that. And we don't have twenty
four. And if anybody, oh, gosh, that time already. So
if if anybody in the regenerative world, there are clinics all over the place

(01:05:17):
that will tell you that you're goingto get stem cells so that you can
regrow cartilage, they're lying to runcannot happen for it is wet there.
We do regenerative treatments in our practice, but we do regenerative treatments without telling
people we're going to grow new cartlage. No, no, we can buy

(01:05:38):
you new cottage. That's not thedeal. We can buy you time.
Wow, that was good. Thatwas good. Okay, So is this
show over already? Yeah, that'sthat's what that music means. Yeah,
the pregnant woman. We also needsome classic tailors for a comparison. Can

(01:06:00):
we gotta shake it off to finishit out? Yeah, no, we
don't have time. So Episode seventysix is over. You can listen to
it on iHeartRadio app down the road. It's under the podcast by the way,
the iHeartRadio app. If you're outof town, you can listen to
it, and we have people thatare listening to it out of town right

(01:06:21):
now. You can also come seeus at Texas Sports Medicine. We are
always delighted to meet our listeners.Until next time on behalf of all of
us here on Inside Sports Medicine andninety seven won the Freak. Tell your friends