Dr.TO 867

Dr.TO is back and ready to talk Medicine. We start off with Dr.TO talking about his late fathers passing and his story of his father and him. Taylor Swift brings the NFL more viewerships than we think. Decision making on playing during the big game if your hurt or not. Dr.TO talks or tells listeners about the issue it comes when a doctor tells a player they ccan play for safety and then parents come after the doctor and coach. Dr.TO ended his show talking about not confusing strengthening with stretching.

Episode Transcript

(00:00):
It's tip off time for Doctor tO. Sorreel and Inside Sports Medicine on
ninety seven to one. The FreakDoctor Siel, one of the nation's leading
orthopedic surgeons and former head team physicianfor the Dallas Mavericks, bringing his unique
sports insights and stories from inside thegame. With special guests from the world
of professional, college and high schoolsports and sports medicine. The Doctor breaks

(00:20):
it all down. Buckle up yourchin strap and taking your laces for the
most informative ninety minutes in sports medicine. It's kickoff time for Inside Sports Medicine
with Doctor t O. Sorrel onninety seven to one. The Freak Cool

(00:46):
Drink going down real nast sly alone, cheer and sun sink and got a
good little puss, I'm working atall. Good Saturday morning, everyone,
and welcome to Inside Sports Medicine.Yatspe, sorry I'll hear live in the
studio, Episode eight hundred and sixtyseven. Is that right? Must be
right? So a slight deviation fromour normal opening and bear with me here

(01:19):
as we talk a little bit thesenext few minutes. This is the twenty
third year for Inside Sports Medicine.Our twenty third season, nineteen years at
ESPN, two years at the Ticketand a couple of months here on The

(01:45):
Freak ninety seven to one, andsomething happened that has never happened before in
the previous eight hundred and sixty sixepisodes. We were not on last week.
We were not on last week becauseof a certain event that kept me

(02:05):
from being on the air, andwe didn't have enough time to pull together
a best of episode. So myfather passed away last Friday night, and
he was ninety three. He wasin a nursing home, but nonetheless it
was a bit unexpected, and asa result, that's been probably one of

(02:35):
the longest weeks of my life,just trying to get things together. My
sister and I were the only two, and she flew in to help with
the arrangements. But one of thefirst things I thought about was the how
are we going to do the radionext morning. I was certainly not in

(02:57):
any shape to do it, sowe decided just to run national And what
ensued, I felt was very rewardinga little bit in that a lot of
you who are diehard listeners reached outwhat happened, what happened, Why weren't

(03:17):
you on the air? Everything okay, and I'm grateful. I'm very grateful.
You know, after twenty three yearson the air, you do have
somewhat of a loyal audience and theyfeel like they get to know you.
I love being on ninety seven toone in the Freak because their tagline is

(03:40):
where we say what we want.Not that ESPN didn't let me say what
I want, not that the ticketrestricted what we talked about. But sometimes
you go off script, and today'sone of those days where, at least
for the first few minutes I'm goingto go off script a little bit.

(04:00):
I wouldn't be where I am ifit wasn't for my parents, but my
dad especially, he's way more famousthan I was. I am. Those
of you who know me, youknow that I'm Egyptian too, stands for

(04:21):
Taric Omar, and when we immigratedto this country back in the mid sixties,
the other grade school kids didn't knowthe Taric and didn't know the Omar,
and they started calling me too.So I've been too since fifth grade
and it kind of stuck. NowEgyptian interesting, we are Coptic Orthodox Egyptians,

(04:53):
and I guess that very few ofyou have any idea what that means.
But not to get over religious here, and I'm not a theologian,
but the history was that it's oneof the first religions Christian religions. Ever
then there was the Greek Orthodox Churchin the Roman Catholic Church. And we

(05:16):
kind of trace our roots back,our family roots darned near two thousand years.
My grandparents are from a small villagethat was a Christian village and Upper
Egypt. The reason that's relevant isbecause my father really excelled in his career,

(05:38):
his early career as a police officer, despite the fact that he was
so back in the old country.They have a system of policing very similar
to English and other Europeans. Ayou go to the police academy, just
like you go to the Naval Academy, just like you go to the Coastcard

(06:01):
Academy. And they only took onehundred candidates every year, and only two
of those candidates are allowed to beChristian. You know, Egypt is a
Muslim country and so anyway, sohe was one of two chosen, and
he graduated top of his class,and he became a war hero, and

(06:27):
he was taken prisoner of war andhe escaped. And I'm not going to
bore you with that, but hefascinating, fascinating and in his career.
They actually made a movie about mydad there it's fascinating. And back in

(06:49):
the sixties, about the time thatwe immigrated legally to this country, he
wanted to come to the United Statesto further his education, so applied for
a visa for the United States.He brought my mom and my sister and

(07:10):
I and we came to Aubany,New York to get a postgraduate degree,
and then moved to Salt Lake City, Utah, where he got a PhD
degree. And about that time,back in the old country, things were
getting a bit difficult because the Moslimfundamentalist movement was kind of taken hold,

(07:34):
and they're still right now to thisday. There was a lot of biased
against Christian people and for my fatherto be in such a high ranking position,
I went to grade school in apolice car, and I always thought
that was because my dad was chiefof police, but no, it was
because there were kidnapping threats. Andso when all of this happened and he

(08:01):
was getting his degree at the Universityof Utah, he decided to stay in
this country and he became a collegeprofessor, and they somebody figured out that
his degree in political science was notwhere he was really beneficial. His police
background was where he was very helpful. And we were recruited. He was

(08:26):
we. There was no WI.It was my dad. He was recruited
to sam Houston State University in Huntsville, Texas. Why because they have one
of the top criminal justice programs inthe country. It was one of three
schools that offered a PhD in criminology, and so he was recruited to be
a professor there. He taught pHlevel courses for forty years. There are

(08:52):
three Distinguished Teaching Awards at sam HoustonState University. He won all three of
them. He's written six textbooks selectedby the United Nations to go to various
countries around the world and oversee theirhuman rights movements. Yeah, he is
a lot more famous than I willever be. And it was sad.

(09:18):
It's still sad. It still hasn'tsunk in yet. Obviously, if any
of you listening have gone through somethinglike this, the logistics overwhelm and it
takes a while for the grief tosit in a little bit. But anyway,
that's why we weren't on air lastweek. We weren't on the air
last week because something happened that Iwasn't expecting and I didn't know what to

(09:41):
do about it. So that said, let's talk about sports medicine. This
is your sports Medicine current events show, where the topics are ripped right off
of the sports desk over the nexttwo hours. Nope, not two hours,
ninety minutes. See that was athrowback to our days on the Ticket
and ESPN. Over the next ninetyminutes, you're going to be informed,

(10:01):
entertained, and hopefully learned something new. Joining me this morning, Brad Ballard,
Kyle Garrett, rainy, cold Saturday. You know what, We're going
to take an early break, andwhen we come back, we'll talk sports
medicine. It is Super Bowl weekend. I'm a swiftye Yeah, I'm a

(10:30):
swifty I admit it. We'll talkabout that. Coming right back is easy
things. Welcome back, Welcome backto Inside Sports Medicines. Has anyone ever

(10:54):
played Taylor Swift on the station?I have a couple of time for the
speakeasy when I fill in, Okay, I'll throw it in Taylor Swift every
once in a while for them fortheir intro music. I'm glad you did
I'm glad you did so. Iplayed one yesterday for them on their remote
and I played some Usher because Usheris the halftime show. If anybody's wondering,

(11:18):
like why we're playing Taylor's, Imean, you know, obviously Taylor
Swift is one of the bigger headlineswhen it comes to this sole super Bowl
deal. But on our way inwe were talking about, you know,
Taylor Swift. I said, doctor, you are swifty now, right,
which is like the little group,the groupie group. I'm not a teenage

(11:39):
girl, You're not a Yeah,you're not like a teeny bopper. I
don't even know if they use thatword anymore. But but when you really
peel back the curtain, because Iknow somebody might be like, why we're
listening to Taylor Swift this morning?Right? Usually it's a C D C.
It is rocking out right, butcheck this out. She is a
monster when it comes to everything thatshe does. She writes, she performed

(12:05):
tons of music, performance, ridiculouswork, ethic is off the charts.
She is an absolute beast and Ihave full full respect for same, absolutely
same. So I have always hadtremendous respect for people who are good at

(12:26):
their trade. If you're whether you'rea good mechanic or a good painter or
a good doctor, or any anybodywho is excels at their trade, I
respect that. I respect it.You can't help but respect the global phenomenon

(12:46):
that this woman is that you justcan't help but respect it. So I
agree with Charles Barkley. I hada chance to meet Charles a couple of
times, actually worked on him severaltimes, and he said, if you've
got a problem with Taylor Swift beingon TV for twenty five seconds during an

(13:11):
NFL game, then you're a loser. You're you're the problem. The fact
the fact that that she is affiliatingherself with the NFL through Kelsey, it's
good for the NFL. Well,yeah, it's good for the NFL.
So my assistant and I were talkingbecause she's a I think she's a swifty.

(13:33):
I think Grace is a swifty AndI was like, do you think
that this is going to be themost watched NFL, you know, super
Bowl football game? And if so, do you think it's going to be
because of her influence, and shewas like, maybe, what do you
think. I do think so,but it would be it'd be difficult to

(13:56):
measure it because you have to lookat from one year to the next what
the jump was if it was,you know, I think so if it
wasn't as predictable as you would thinkin terms of more more people. I
imagine every year it probably increases theamount of people who watch the Super Bowl.
I'm only assuming, but I'm like, what the jump would be in
terms of the percentage of more peoplethat watch. I think it would be

(14:18):
the Swift effect one hundred percent.Agree. I think there are more teenage
girls going to be watching it thanever before, just simply because they want
to see a glimpse of Taylor Swift. Right. And it's interesting because it's
so Usher is performing at halftime,right, yep. But but of the
two music stars, people are goingto be more focused on Swift, even

(14:41):
though Usher's doing a halftime shit.And you also have to think Pus Malone's
going to be there singing with ReevaMcIntyre nantas a lot of big name celebrities
are going to be there. Look, this is this is good for the
NFL. But now let's talk sportsmedicine. If you've been listening since episode
one twenty three years ago, thenyou've heard us talk about the risk reward

(15:05):
equation. The risk reward equation issomething that I was taught essentially the first
week in medical school. What isthe risk of taking an aspirin for your
headache versus the reward of getting ridof your headache? Yes, Aspirin's got
a lot of side effects. Itmakes you bleed, it can hurt your

(15:26):
stomach, et cetera, et cetera. But if you've got a really bad
headache, man, I'll do itin a heartbeat. Risk reward equation is
something we carry in our back pocketwith every decision we make. I do
it, Brad does it? Kyle, I'm sure does it. And actually,

(15:48):
in real life you may not callit risk reward, but every decision
you make, you're weighing your options. It's calculated, yes, risk reward.
The same exact ankle sprain is treateddifferently in preseason YEP than it is
tonight because the Super Bowl is tomorrow, That's right, So the same injury

(16:18):
shifts because of this risk reward equation. And perhaps other than the Olympics I'm
going to say that the Super Bowlis probably the biggest reward for a football
player for sure. Oh yeah.And the reason I said the Olympics is
because you know, Docummanding takes careof a lot of Olympians, and their
risk reward is the Olympics are onlyonce every four years. If I don't

(16:41):
do it now, I don't havea chance, So that risk reward equation
is equally weighty Olympics super Bowl.I always have this discussion with my patients
who are players, even if it'snot Super Bowl, we can because I
always want to know, do youthink you can be effective if you had

(17:03):
to play tomorrow? So I'll say, if tomorrow's a super Bowl, can
you suit it up? And they'llbe honest they say, yeah, I
play, that's right, that's right. You ask him that question in preseason?
Nah, you know, I thinkI think I can't cut right and
right? Yeah, So I hada I had a pro guy. We've

(17:26):
got the what's the league? Isthat the USFL is still called the USFL.
They just united right with the UFL, Right, but it's still the
USFL. Is that right together?Yeah? Okay? So their season is
starting in a couple of weeks andone of their athletes I was seeing and

(17:47):
my question, one of my firstquestions was when does the season start?
He said, Oh, I gota couple of weeks. I said,
okay, well, considering that thisis how we're going to manage what you
have, yep. But postseason youneed to come back because we got some
extra things that we need to do, because if we do those things right
now, you're not going to beable to start one hundred percent of season.

(18:10):
So part of what we're saying isthat depending on the timing of the
season or the impact of the upcominggame, will determine what the actual treatment
would be, and it could betwo completely different treatment options exactly. So
during during my NBA affiliation with theMavericks, it spanned twenty seven years,

(18:41):
but there was a five year gapfrom ninety two to I'm sorry, from
ninety six to two thousand and onewhere I stepped away from being the team
doctor and a lot of my friends, a lot of my friends in the
league, do you miss it?And I was, I was honest,

(19:02):
and that I said, the partthat I missed the most was the decision
making judgment. You know, itwasn't the going to games and you know,
let's tape this up and likes Isit. The easiest decision to make
in sports medicine is no, youbetter not play. The easiest decision decision

(19:22):
and intern no offense to interns.But a first year of sports medicine doc,
easiest decision is you better sit outbecause it's safe. Right. Where
you really earn your stripes as asports medicine doc is knowing when to say
yes. And that's judgment. Duringmy five year absence, that's what I

(19:48):
missed, and and I really feltthat I was good at that. I
was good at that judgment call whereyou know it, you're kind of sticking
your neck out there. Yeah.Yeah. But at the end of the
day, that's what Mark Cuban paidme for. That's how you earn your
money. That's how you get yourmoney. Is really decision making. And

(20:11):
as you said, we're safety officers, chief safety officer, safety officers.
But so in the conversation with theathletes that we take care of, oftentimes
what I'll say is, listen,my goal is your goal, yep.
However, in trying to help youachieve your goal in your sport, my

(20:33):
goal is to help you do itas safe and as fast as possible.
Both both those are sometimes those arethey work against one another. But I'm
like, that is the goal.My goal is your goals. But it's
it's to have it be done assafe and as quickly as possible. And

(20:53):
by the way, we're going todo that together. You and I are
going to do that together. Ithas to be that you have to be
on the same page. Uh.The player has to want to play.
The player has to want to play. Don't assume that that is just Oh,
I've been burned. I know that'swhat I'm saying. I've been burned.
Don't just assume that, because there'llbe multiple factors. If you talked

(21:15):
about before this contract, there's oh, there's people in your ear that are
we don't know about the but butthe player has to want to play.
I made this example many many yearsago. Blake Griffin. Remember Blake Griffin.
Yeah, okay, huge star,played center. I think he was

(21:37):
with the Clippers at the time.Oh yeah, freakish athlete. Yeah,
unbelievable. I think he's still inthe league, is he not? Garrett
sticking as he is not playing anymore. Garret would know Garrett and oh you
get yeah, he is not playinganymore. That must have been relatively recent,
like this year. Not because Ithought he was in the past four
years. He's retired. Give meone second look look it up. So

(22:02):
the Clippers were struggling. The Clipperswere struggling. We talked about this on
the show. Maybe I don't know, a decade ago. Clippers were struggling.
They make it into the playoffs.He sprains his big toe. He
had a I guess the equivalent ofa turf toe landed on somebody's foot,
his toe hyper extended, whatever,whatever. They go to the playoffs and

(22:27):
the medical staff decided to sit himout. I remember this. Yep,
he sat out before because of abig toe sprain. Then look, none
of us were there. But I'venever been impressed with the Clippers' medical staff
anyway. But we say what wewant, We say what we want.
Freak, they're not here. Theycan't hear this anyway. They end up

(22:52):
losing in the first round and theteam basically breaks everybody up. Yeah,
because I think Chris Paul was onthat team. We're gonna we're gonna rebuild.
Yeah, I remember that. Allof this was because of a poor
medical decision. That's how I lookat it. You know what, if
he played and you won that firstround, they wouldn't have broken up the
team. Well, it was alot of pressure that you remember, because

(23:15):
they had they had a solid squad. The expectation was that they were at
the very least go deep into theplayoffs. And within the absence of Blake
Griffin, you're not the same team. You're not the same team. You
can't you can't set your big starbecause of his big toe exactly. But

(23:36):
but so the decision making process andthe reason why we're talking about this today
is because it changes on the eveof the Super Bowl. If you're able
bodied, dude, you're playing.Look, so we've talked about this before,
you know, being being from fromHouston, and I've got you know,

(24:02):
some of my loyalty is to Houston. I have nothing against Dallas,
but some of my loyalties to Houston. So I can remember, speaking of
Chris Paul, there was a yearwhere I think it was Western Conference finals.
We were trying to make it intothe finals, or maybe it was
semi finals, I can't remember.It was Western Conference finals. Whenever he
did not play hammy. He hada hammy, yeah, And I remember

(24:30):
thinking, like, dude, justyour presence out there as a floor general.
I mean Chris paul Is, Imean he's he's a zen at playing
point guard. He knows the gamein and out. I was like,
just being out there at sixty percent. It's spot up shooting ability, yeah,
I mean, dude, just hisability to see the floor and draw
defense, like you said, openjump shot, be able to find somebody

(24:52):
he would contribute. And and I'mwatching him not I'm like, dude,
I'm curious, what what's the conversationLike, I'm trying to figure it.
I'm trying to figure it out.Willis Reid he was a hammy too,
Yes, and yet he limped onthe court and lifted his team. Look,
we don't have we don't have asolution in the sports medicine world for

(25:18):
a muscle injury. We don't.You can pull a hammy, you can
pull a groin. Of the oneof the k C stars is sitting out
because of a groin injury. AndI can't remember I saw the ticker going
by. I think he's alignment orsomething. We don't have a solution for
that, you know, it's notlike you can inject it. In fact,
you can inject it or make itworse. Oh his story, story,

(25:41):
story story, real quick. AboutBlake Griffin. He is currently a
free agent. He was with theBoston Celtics this past year season. Yeah,
but as of right now, he'sa free agent and he's not on
the roster. He is not playinganywhere right now. Okay. This was
also a few years ago. Oneof the Pittsburgh Steeler running backs had a

(26:07):
groin injury and in the locker room, somebody decided they were going to inject
it so he can play, andthey got the femoral nerve and he couldn't
walk and he had to sit out. Yeah, we got I'm sorry I
laugh, but you guys have noidea what I'm laughing about, because that's
one of those things that can happento any of us. But when you

(26:30):
put numbing medicine in a muscle,trying to numb it up so the guy
can play, if that stuff extravagatesand gets to the nerve and you've got
a wobbly leg, you're out.You're out. Yeah. Anyway, so
I forgot where I was going withit. Well, the reward for the
Super Bowl. Yes, it's it'sthe It's the holy Grail for football risk.

(26:56):
My level of toler for what I'mgoing to allow to be on that
field is going to be you know, I mean, like the athlete,
depending on what the injury is,is really gonna have to tell me like
I just can't go. Doc.We have to talk about two things that
you mentioned earlier. Number One,it has to be safe, correct.
Number one, We absolutely have tobe safe. Number Two, the player

(27:18):
has to be in on it.Yeah, yeah, okay. The player
has to be in on the decisionmaking. The player, his mom,
his uncle, his agent, everyonehas to be in on it. Then
we talk about the risk. Weabsolutely I had the the privilege of taking
care of a young man who playedfor the Mavericks a year after he was

(27:41):
traded from Houston. He had aknee problem and we were our first opponent
in the playoffs was Houston the Rockets, And he said, I'm playing because
I want to show them that theymade a mistake by letting me go.
I said there's a risk, andI said, he said, what is
it? I said, your injurycan get worse, So I'm taking that

(28:03):
risk. Okay, but that isthe decision making process, and there's some
guys who are girls who don't wantto take the risk. I get it,
and that's hard. Absolutely fine,I'll take the hit for that,
I'll say. And look, maybethat was a situation with Blake Griffin.
I don't know the man personally.Maybe he said I don't want to play

(28:23):
with a sore toe, and thatwas that was my assumption when it came
to Chris Paul and again, asAres, here's the deal. As a
fan and a sports medicine doc,I'm watching this saying, man like,
why is he not out there?You know so? But I don't know
what the back conversation was. Whoknows, none of It's just like,
listen, I'm not going to putthe rest of my career at risk or

(28:44):
whatever the case may be. Hislevel of tolerance is probably much lower than
maybe mine would have been as aphysician. But these are the things that
we have to consider whenever we're makinga decision. Somebody's gonna play, it's
got to be safe. I mean, if there is Look if it's a
sprained ankle, and we can tapeit up and sometimes we inject it and
protect you. I feel very comfortablesomeone playing on a springed ankle as long

(29:06):
as they're effective, you know.But that becomes a basketball decision or a
football decision. It's not a doctordecision. But I'm very comfortable with that
treatment option. But it's not justme. The player has to be comfortable
with it, his mom and dad, his agent, whatever, everybody's got
to be comfortable and on the samepage. It cannot be a unilateral decision.
I wrote a chapter. I wrotea chapter in a book about the

(29:33):
medical legal aspects of sports medicine andbeing a team doc. I spent the
summer at the SMU law Library lookingup case law of you know what doctors
have been sued and over what andwhatever. You get in trouble as a
medical staff when you keep something awayfrom the player or his people. So

(29:59):
there the one case. It wasa baseball case, and it was a
World Series and some baseball player wasrounding second towards a cl and the doctor
chose not to disclose that. Iknow, it was a long time ago,
it was in the sixties, andhe he didn't disclose it to the
player, and on the field thatday, just on exam, he said

(30:22):
he had an acl or. Itwas like weeks after there was during the
series. It was during the series, so I don't remember the specifics.
It might have happened game one,but he let him play Game three and
he look, maybe he didn't know. I don't know. But you get
in trouble as a sports medicine docif you don't disclose everything. If you're

(30:44):
giving someone a pill, if you'regiving someone an inject, you got to
tell them. You got to gettheir consent. You got to say this
is why you're getting this. Thisare the risks that or or and they
have to be in on it,right, all right, quick little break.
Lots more. We gotta give outthe number. I don't know if
we give it we have not twoone four seven eight seven nineteen seventy one.

(31:07):
Two one four seven eight seven nineteenseventy one. That number works for
text as well as phone calls.When we come back. Lots more inside
sports medicine, TiO. Sorry,I'll here Zion like the colors of Zora.

(31:44):
Welcome back, Garrett sitting on theother side of the board. Dude,
you're gonna have tell me the namesof these songs. That sounds good,
I know it's Taylor Swift, butthis one is called Red by Taylor
Swift, Red color Red. Ohis this the that got the Taylor's version?
Oh, this is Taylor's version ofwhat you mean? It's a remake.

(32:06):
So her whole music thing a coupleof years ago, she basically got
Spotify did selling to her music andcount and her agent and stuff to where
she basically re recorded all of hermusic and turned it into her own version.
Yeah, so they somehow owned acertain level of the rights of her

(32:29):
music, right it was somebody soldsomething contracts robber. So so she went
back into the studio recorded all ofhers with almost kind of like her you
know, with her style. Imean not that the other music ever saw,
but but but something that made thesong similar enough to the old song,
but was her renax and now itwas all her. So she went

(32:52):
back and told all of her Swiftiesgo listen to this music now, and
you know, things got redownloaded.It was kind of like, hey,
good for you. You know,she owned the movie. So my sister's
in the movie business and she wastelling me the story. So she pitched
her concert movie to I don't knowsomebody MGM whatever, whatever, and they

(33:14):
wanted a big chunk of the proceeds, and she said, you know what,
I can do this myself. MYeah. So she is the producer
of her own concert movie, Who's, which has made hundreds of millions.
Yeah, I have tremendous respect.Now, we started the show talking about
tremendous respect and for people who aregood at their craft. Yeah, she's
good at her Yeah. Yeah,I don't know. I think I maybe

(33:36):
know two songs, maybe I knowthree, you know three. I know
you know one more than I do. But I gotta respect the game.
I did. I did two.So during the break sometimes during the break
we have our best discussions, absolutebest discussions. And you know, when
we spent start spending more time developingour podcast. I think the podcast may

(34:00):
include the breaks. I think weshould do that. Anyway. During the
break, Kyle, who was visitingus from Birmingham, was saying that you
can't downplay the fact that you're thechief Medical Safety officer, and that is
true. So when we were talkingabout the risk reward equation changes for the

(34:23):
Super Bowl, there are certain limits. If you've got a head injury,
you ain't playing. There's some hardnos' there's some hard nos. You know,
if you have a cardiac arrhythmia,you ain't playing. There are some
hard nos. And I shared astory where and this was actually high school.

(34:44):
This was high school. So ayoung man played linebacker, took a
blow to the head in the firstquarter, first half of the game.
I called mom and dad at halftimeand saying, hey, listen, little
Johnny's got a CONCUSSI and I'm notgonna let him play the second half.
They pitched a fit, Oh heis playing, blah blah blah, And

(35:08):
they went to the coach and thankgoodness. You know, if you're going
to be an effective team, Doc, you have to you have to have
management support. So the coach said, if Doc says he's not playing,
he ain't playing right. Right.So, but that was high school.
Due there are some hard nos,dude. Everybody here can appreciate this at

(35:29):
this table, including you, Kyle. Sometimes the particularly in the high school
level, it's mom and dad.It's tough for dealing with the parents than
it is the player. Players likeokay, cool, like I'm good sitting
out to parents are like what AndI'm like, come on, man,
I told you, like like I'mI'm considering the safety of your child here,

(35:49):
you know, and the parents aregoing berserk. I think I told
you the story before. A youngman who was a tennis player, and
I think he was twelve, thirteensomething like that, and he was playing
three four hours of tennis. Hewas pulled out of school. He was
at a tennis academy, and hecame to see me with his mom for
I might have been a second,third, or fourth opinion. I don't

(36:10):
remember which. By the way,is a red flag A red flag when
you're on the third or fourth opinionsomebody coming in, I'm like, you're
looking for something. So he hada stress fracture of his foot and he
was limping around and all that stuffand what And I told mom, I
said, listen, I agree withthe other three doctors. I agree with

(36:30):
the other three doctors. I thinklittle Johnny needs to sit out till this
thing heals. He's only twelve.Yeah, she started crying, but he's
worked so hard. It was hershe was a problem. Yes, Little
Johnny was absolutely fine. Johnny waslike, I'm good. Yeah. So
the point you raise calls is veryvalid. You've got to be a chief

(36:51):
chief safety officer. I mean thatis, there are some hard nos.
This is a random thought, randomthought, but I thought I would.
It was on my notes to bringup today because we were Oh, we're
talking about the team docs and theirroles for the Super Bowl and their risk
reward equation. Manchester United soccer teamused to be most valuable franchise of all

(37:15):
of sports. Now they're second tothe Dallas Cowboys. Revamped their entire medical
staff, fired everybody, brought ina consultant and is revamping their entire medical
staff because they were not happy withthe way that their injuries were being treated.
The highest level of sports, themedical staff makes a huge difference,

(37:39):
even the lowest level of sports.You gotta have good medical advice. Weeah,
they're revamping. They basically fired everybody, the physio, the trainers,
whatever, and they're starting over.Well, I'd be curious to know what
happened first, right, Like,I really would be curious to know what
happened and see if it was youknow what, what if there was a

(38:00):
justifiable reason for for that, Butif, if, if people could understand
the level of value that you youknow, a good solid, well trained
team. Dot adds to an organization. You said this before because you've been
there, and I think it's fascinating. You said, a a quality medical

(38:23):
team is the difference of ten wincolumn win column. Yep, right,
A good medical staff, You're good. Yeah, a great medical staff will
win you a couple extra games,just purely on medical decision making. And
this goes from top down. Theorganization has to understand, Okay, if

(38:44):
we're gonna be top in class withhow we select our athletes, it's a
cultural thing, like they have tosay, Okay, well, if we're
gonna be top in class, we'renot gonna skim on medical you know,
because look if your shop if you'retrying to shop around for the best kind
of you know, I don't know, deal for your dog. And that's

(39:05):
how you're approaching it as a team. You got a problem. Yeah,
it's gonna be it's gonna be achallenge. I mentioned that can be difficult
to assess as well as it isvery an organization. Who you especialty is
not medicine difficult to recognize. It'svery difficult to recognize. Yes, but
but and I'm not sure what happenedwith man you I don't know, but
I think that there were a lotof players that were out and when they
were out, they were out forlonger than normal. And I think that

(39:29):
was the situation. I don't know. And and by the way, when
I say medical staff, that's notjust doctor, that's the athletic trainer,
the assistant athletic trainer, of thephysio, the massage therapist. I mean
there is an entire team, yes, that is devoted to the care the
nutritionists. So they basically revamped theirentire team. So and and and that

(39:52):
team has to work like an orchestra. Oh, that team, the medical
team, yes, has absolutely hasgot to work like an orchestra. If
on the sports medicine, the sportsscience part, and I've often said the
sports science is way ahead of sportsmedicine. So I can I can get

(40:13):
you trained and make sure you eatwell and get you bulked up. And
we've got some really new technologies andthis amino acid and that, But when
somebody pulls a hammy, I'm stillkind of back in the dark ages in
terms of nothing I can do aboutit. So sports science is way ahead.

(40:34):
And if you're if you're if you'repushing hard on the sports science strength
training side, of things. You'regonna have some injuries just because of that.
Well, that makes sense. I'msure I conveyed that. Yeah,
But here's the deal, and we'vetalked about this before. If a medical
if a IF an organization is lookingat your medical staff, similar to the

(40:58):
way insurance company, not a commandexactly. If you looking at it like,
hey, we just need a teamdoc. We just need to check
the box off and put a teamdoc here. You know, it's the
decision making ability of the physician that'sgonna that's going to make all the difference
in the world. Again, andthat's going to be different from doc to

(41:21):
doc, from from a level ofexperience. And by the way, the
because you said this, it's awell orchestrated team. The medical team has
to be on the same page.If me and my athletic trainer ain't getting
along and it ain't working and they'retrying to do their own thing when I'm
trying to say we need to gothis way, they want to go another

(41:43):
way, it's not it's not gonnawork. So you know, again,
I don't know the full story ofwhat happened with Man you no, no,
but again, but they certainly seemto be saying, hey, listen,
we we we want a pre wewant premium, we want to revamp.
So I was on them. Sowhen I was with the Maverick and
I was the president of the PhysiciansAssociation, and we had numerous conversations with

(42:10):
NBA brass at the very highest levelsabout what the qualifications are to be a
team doc in the NBA, andthey have the same thing in the NFL
and Major League Baseball, et cetera, et cetera, And all this came
around, and I'm not sure thatthis particular event is what set it off,

(42:30):
But when the Orlando Magic were formingwhenever, whatever year that was,
they put out kind of an RFPrequest for proposal from various medical people around

(42:50):
Orlando to be their docs, andit basically was going to go to the
highest bidder. And what the leaguewas concerned about was that the highest bidder
may not necessarily be the most qualified. And the reason that's problematic in the

(43:14):
NBA, not so much in theNFL, although it's problematic everywhere. You
can't you can't just put your yourteam, your assets in the hands of
the highest bidder. But anyway,in the NBA, the home team physician
is responsible for both teams. Soif Kobe Bryant was playing a game in

(43:37):
Orlando and he got hurt, theLakers were concerned about who's going to take
care of him. Well, sothey formed a committee. I was on
the committee of well, so whatare the minimum qualifications? It can't just
be the highest bidder, and thereare you know, the NFL has very

(43:58):
strict rules about who can be anNFL doc and what kind of experience and
fellowship trained, et cetera, etcetera. But the point is we're not
a commodity. There are there arecertain training prerequisites that have certain boxes have
to be clicked. An issue kindof took place with the Lakers, speaking

(44:23):
of Kobe maybe a few years ago, where the boxes were clicked. However,
the medical sponsor was UCLA Healthcare andthe Department of Orthopedics kind of got
the nod and they've never taken careof a pro team ever ever, so
there were some hiccups in the firstfew years with that particular relationship. Anyway,

(44:50):
this is kind of the appeeling thecurtain back. We have a question,
Hey, I have a eight fourseven zero is the number? I
have a sixteen year old son who'ssix foot two and eighty pounds, plays
o line as his back is alwayshurting, would a chiropractic visit be helpful?
The short answer is probably need adiagnosis first. Yes, so in

(45:15):
my opinion, sixteen years old,six foot two eighty that's a big boy.
That's a big boy, said oldline. I say, yeah,
he does. Yeah. And soif there are if there is some back
pain involved that's not normal, thatprobably should be evaluated first. Probably sports

(45:35):
medicine, docta and orthopedics, spinedoctor X ray MRI, get a diagnosis,
and then perhaps chiropractic treatment, butit probably wouldn't be my first I
agree, yep, I agree.We're taking a it's time for a break.
We're now back on schedule. Itis eight twenty eight. We are

(45:59):
now back on scared schedule two one, four, seven, eight seven,
nineteen seventy one. Phone calls,texts hoping you're having a good Saturday morning
in this cold rain. Will beright back. I can see it now

(46:20):
the first time. Daughter, welcomeback to Inside Sports Medicine too. Sorry,
I'll hear Brad Ballard there on theworld together, Taylor Swift there and

(46:40):
this one is called mine. Ilike that last one read. I've never
heard it before, but it's agood one her. It's one of her
like top five songs that she's evermade. So apparently she's she's gonna be
she's like in concert tonight, rightSo like right now, she's she's tour.
She's been there since performing since Thursdayor Wednesday, but she's had like

(47:05):
a four to three day type ofthing, and she's they're sixteen hours ahead
over there in Japan. So whenshe gets done, technically she'll be flying
out of Japan time a Sunday morning, which is still Saturday for us,
and by the time she gets intoVegas, it will be Sunday evening,

(47:27):
like Sunday late night. So itworks out perfectly for her to be to
miss the game. No, I'msaying, she'll be riving like pretty much
right there. She's either going tobe there Saturday night Vegas time or early
early morning Sunday, Vegas time,So she's gonna be there regardless. Do
you think she got upgraded, Well, she did. She did claim her

(47:47):
spot at the airport for her privatejet. You do have to do that
nowadays, where you have to claimyour spots. Oh, dude, jets,
She's got one. She's got oneof those private jets that has an
apartment in it, which she justsold. She sold one of her jets
because there's this climate activist who hasbeen coming out after like all these artists
and stuff about like you're spending you'reusing too much like carbon cognition print.

(48:15):
Yeah, and so she's like,Okay, I'll sell one of my jets,
but I'm keeping my main one.So I was I can't really believe
that we're spending so much time talkingabout this, but anyway, I'm going
to bring it up anyway. Somebodyasked yesterday, I think it was on
NBC, is Taylor Swift bigger thanthe NFL? And I'm going to say,

(48:37):
yes, she's global. Global.The amount of money she has actually
brought to the NFL this year hasprobably been the most the NFL has ever
received from anything, with Kansas CityChief Jerseys going up the publicity, the
Travis Kelcey stories all that she's she'sbringing in the NFL millions of dollars each

(49:01):
week just for her being at thegames and being on TV. All right,
So back to sports Medicine by theway the collar with the achilles.
Yes, morning pain stuff is aboard all that is problematic to me.

(49:22):
Uh, this sounds more like atendonosis issue, which is a is a
degenerative condition. It definitely ought tobe looked at. Uh, there are
things that can be done. Butif you've got morning pain, if you've
got pain sitting in the car,et cetera, et cetera, it's it's
probably more than just tendonitis. It'smost likely tendonosis. So uh, yeah,

(49:46):
that that that ought to get lookedat. Speaking of you know,
so to give people some context,I've torn both achilles yep. So I'm
not just a physician. I'm alsoa patient. I'm your you are Let's
just make this a clinic visit.Dot. Yeah, but you got a
problem. No, no, no, no, no, no, no,
this is good. This is goodinformation. So my right achilles I

(50:08):
tore, uh ten years ago,a little more than ten years ago.
My left one I tore a yearago. Last Monday. Oh my gosh,
it's now here and uh I'm shooting. I'm shooting again in the backyard.
The jumper is still wet, andI feel good. What has I've

(50:32):
been What does that mean jumpers stillwet. Splash it's a good thing,
like you know, that's a littlehip hop thing. No, it's what
the jumper it's raining, Garrett.Have you heard this? Have you heard
this phrase before? Yes, Kyle, to give you, to give you
perspective, we have sometimes we havehip hop word of the day, and
you know we the jumper still wet. The jumper is still wet. It's

(50:55):
basically saying the player's hot or hisshots are on fire. Might jump.
Yes, my jump shot is stillAnd how long has that been in use?
Do you mean the word? Yes, it's it's lingo. It's lingo.
It's look when you when you shoot, and it's Swiss. It's splashed.
I've heard the splash brothers of course. Yeah. But the jumper is

(51:19):
still wet. I've never heard ofWell that we learned it. We're gonna
have to implement that. Implement itword So you would say word word okay,
So Kobe taught me that that wasthat was a fact confirmatory word word
anyway. So are you going tobe playing soon? I think so.
I think I'm gonna start doing somehalf court three on three all right,

(51:40):
But I've been jogging I'm sub tenminute mile again now, so I'm feeling
good. So I appreciate you,thank you, congratulation. This is a
clearance, This is a clearance clinicvisit. So it goes back to I'm
glad you brought that up. Itgoes back to achilles ruptures, teller tendon
ruptures, rotator cuff ruptures. Healthytendons don't usually snap, so there almost

(52:08):
always has to be some kind ofa degenerative process going on. And you
had you had that and both achilles, you know, wear and tear of
playing football, basketball, being athleticyour whole life. It's it's mileage.
It's mileage. So when this caller, I keep saying, Coller, this
texture was telling me that his achillesis, you know, sore in the

(52:31):
mornings, stiff, it's been ayear. What that's the mileage I'm talking
about. And the reason it needsto be looked at is because you don't
want to rupture it one day andthen become a brad ballard. But I've
made a good recovery thanks to doyou know, putting me back together.

(52:52):
And one of the things that Iwanted to mention to folks, don't confuse
stretching with strengthening and stretching is it'sliterally just that. And if it's painful.
If you're stretching and you're painful,then that's a problem. A stretch

(53:12):
out, I feel like a stretchit should not hurt. If it hurts,
you're doing damage. So you're doingit wrong. Something is not right,
and I don't really You have tobe careful who stretches you. You
know, there are these stretching shopsaround town. There are specialists who helped

(53:36):
stretch. We have Kathleen at thePerformance Center. She's fantastic. She came
to us from who are the AztecsSan Diego State or oh yeah, yeah,
Sandie Right, she came to usfrom there, and the Mavericks had
a stretching person, but they doit properly. If done improperly, sometimes

(53:57):
you can do muscle damage. Youcan do tendon damage, you can do
nerve damage. You know, Isaw one of the most biggest names in
the league right now for that exactinjury. Yes, I remember where someone
stretched and he had a nerve injuryand it took us a while to get
over that. Yeah, so youhave to be really careful who stretches you
and if it hurts, it's probablyincorrect. Yeah. The other thing I

(54:23):
tell patients is there's a difference betweenstretching and warm up. Oh yeah,
yeah, yeah, yeah, yeah, go elaborate and yeah yeah, because
a lot of people are thinking like, okay, yeah, doc, Like
I like I stretched before the game, But my question did you warm up?
Because even you know, for me, the warm up is just as
important, if not more important,than the stretch. Because we were talking

(54:45):
about this risks to stretching, right, So Kyle was mentioning how what we
call a static stretch, which isbasically you just kind of standing in one
position and and and and and holdinga holding a stretch, you know,
may have some detrimental effects in termsof your performance. But if all you
do is stretch but you don't warmup jumping jacks, you might Yeah,

(55:07):
y'all, get the blood flowing,remember jumping jacks. You just mentioned it.
Yeah, yeah, that was awarm up. It's right, it's
warm That was a warm It's justbasically to get the blood flowing, flowing,
get the joints moving. I tellpeople, get on a stationary back
for five ten minutes. Just justget the heart rate up. Get just
break a little bit of a sweat. That's right. Then stop, then

(55:28):
stretch, yeah, exactly, Thendo your whatever athletic performance you want to
do. But that warm up isvital. Well going out there cold.
Look, stretching doesn't warm anything up, No, but particularly at my age.
I mean I have to warm thejoints up before I can go out

(55:49):
there in any way, shape orform and perform and at least have a
have a good time or else I'mjust gonna be in pain. The first
fifteen toy, somebody's making fun ofyou because of the sub ten minute mile.
He said, my wife can dothat. Listen. No, no,
no, that's I just leave it, leave it. No, no,

(56:09):
no, listen, that's good forme. Yeah, you know what
I'm saying, it's relatively speaking.I'm not I never broke any records,
but I mean we're still in thecomeback trail. We're on the comeback trip.
The Yeah, this is all relative, man, you know what I'm
saying. I'm sorry, I wasjust laughing not to mention that doc.
You know me, I'm not arunner. I don't have a runner's body,
but none of us I'm not aYeah, it's a runner, he's

(56:30):
a track star. What is thatfor that? I don't know. It's
some video from back in the day. He's a runner, she's a track
star. It's supposed to be afunny meme. Taylor Swift nop Okay,
I don't think she runs either,So where where did we go? Off
track? Hard? This stretching shouldnot be painful. Yeah, warming up

(56:52):
is vital strengthening. You're actually tryingto get the muscle too hypertrophy. And
so people say, well, Ido I do leg extensions to stretch.
No, you don't do leg extensionsto stretch. You do leg extensions just
strengthen. Those are two different animals, two different exercises, so don't confuse

(57:16):
those two. I forgot where Iwas going with us. I mean,
thank god, we only have fifteenmore minutes. I completely forgot where I
was going with us. All right, it'll come back to me. This
is another one of those story outstories that I kind of put on the

(57:39):
on my notes to talk about,and I'm not sure exactly how to bring
it up. Remember the NFL playeryou saw and you did a PRP and
you use the ultrasound guidance and MRIand all that stuff, and he suggested

(58:01):
that it might be cheaper to getit somewhere else. Oh yeah, yeah,
yeah, yeah, yeah yeah.Okay, all right, So this
was a note in that for thevast majority of us, of people who
are not medical, you kind ofdon't know the difference. This goes back
to, you know, medicine isnot a commodity. You know, the

(58:22):
team doctor is not a commodit.So we we have been on the forefront
of regeneritive medicine now for probably thelast fifteen twenty years. You know.
We we do some stem cell work, we do PRP playlet rich plasma,
but but it all has to bedirected with MRI with ultrasound. You have

(58:50):
to know where you're putting this veryexpensive treatment. So if you if you
do a seven thousand dollars stem celltreatment, but you put it in the
wrong spot, you just wasted thousanddollars. So you know, a few

(59:12):
years ago you used the example ofsomeone who is doing a hip injection without
any guidance whatsoever, and it wasvery expensive and it didn't work, and
the patient came to you for asecond opinions, And why don't you tell
the story, because this is itmakes all the difference in the world.
Well, we've got we've got greatrelationships with some you know, physical therapists,

(59:37):
you know, athletic trainers. Imean, we've got good relationships with
people who who know professional athletes whoare looking for second opinions or trying to
be seen. And one of thoseperformance centers that we have a relationship with
said, hey, listen, we'vegot an athlete who's looking for a non

(59:58):
surgical approach to an injury they have. And we know what you do,
doctor Ballard. We know this iskind of your wheelhouse. You do ultrasound
guidance, you're you're you know,well versed in p RP and bone marrow
aspect concentrated. We want to sendhim to you. And so I said,
listen, I'm happy to see him. And they were saying, well,

(01:00:19):
he's kind of wondering what's the price, And I'm like, well,
he probably needs to come see mefirst, right, so that he can
understand the value and and understand thatwhat's involved. I was like, because
if he's if he's shopping for thebest price, I'm probably not his guy.

(01:00:43):
True, And because this is whatI do every day, This is
what I've studied for a long periodof time, and so you know,
the conversation came into well, he'snot sure if he's gonna come and say
and I said, okay. Butone of the things that we talked about
in clinic is that, you know, and I learned this a while ago,

(01:01:04):
it's that in the absence of value, people worry about price, right
in the absolute value. So Isaid, listen, have him come in
and let's talk this thing out.He can see what's going on now.
After he came in, I showedhim his MRI. We talked about the
different options. We talked about riskversus benefit and reward. It's like then

(01:01:25):
he understood, right. But youknow, and that's part of our job
is to make sure that we explainto the patients what the value is that
we're that we're giving. But thisis this is one of those things where
every every dock is not the same, every PRP is not the same,

(01:01:47):
every injection is not the same.And so if you want high quality medicine
and be taken care of at ahigh level, yeah, you know,
look, I don't think lawyers shouldbe interchangeable. You know that there are

(01:02:09):
certain lawyers who charge a certain amountof money per hour, and they're worth
their value. I think the samething with what we do. Certainly.
You know, we talked in thepast about in fact, this was your
story, Brad, not mine,because it happened to you. A lady
with a hip problem and she hadan injection somewhere else and didn't work for

(01:02:32):
her, and then you saw herand you said, you know, we
might want to try this again.Yeah. Yeah, because the first doc
didn't get an m R, didn'tuse an ultrasound. You know, the
hip joint is one of those jointsthat is so deep, listen. I
mean, so she came in.She was extremely frustrated. She came in,

(01:02:53):
you know, and her frustration extendedlike just toward the medical community.
She's like, I don't know whatyou're gonna do for me. But here's
what happened at the last At thelast visit, I told him I had
hip pain. He told me Ihad arthritis. Three minutes later, he
came in with an injection wipe myhip off and just stuck it in my
leg. And I'm still hurting.And so I'm like, listen, I'll

(01:03:15):
be honest with you. You know, you need an injection. That's not
how we were doing it right,right, right, you need an injection.
I was like, but trust meon this, you need this like
guided, try to do what hedid was shooting in the dark. Right.
Sometimes when patient stories are so farfrom what you would do, or
so far from what you'd expect someoneto do, you hope that they're misinformed

(01:03:37):
her, they're confused about what actuallyhappens. But I give it. I
always give them the benefit of they'reprobably right. Yeah, oh they were
right. So she was so farfrom the standard right, so much so
that we did the injection and bythe way, that takes more resources on
ari end absolutely to do. Takethe time, schedule it, ultrasound guided
where the floor or whatever the casemay be. And minutes after the injection,

(01:03:59):
she's like, I haven't walked thisgood and I can't even remember.
And you know why, because youput it in the right place. You
know, it's it's if the decisionmaking is correct, if the p RP
is correct. But if I missedthe spot, it ain't gonna work.
It doesn't matter, it just ain'tgonna work. And then let me make

(01:04:23):
sure that you guys understand we don'talways hit the spot, but I think
our track record is probably better thanput it this way. That's the exception,
not the rule. And for thehit. For intra articular injections,
you would you need guidance. Gotsomeone out there is getting tropant bursta injections,

(01:04:44):
probably still better image guided. Butit's not crazy if someone out there
is just sticking a needle in theside of your hip exactly. But this
was the person told us she hadarthritis and didn't didn't go inside the joints.
So great after you did it.But but here's the here's the here's
the kicker is that, you know, from an insurance perspective, and Doc,

(01:05:04):
I know, you get nervous andyou kind of get, you know,
feeling some kind of way when westart talking about the business of medicine.
Yeah, but here's the reality.Is that the guy who you know,
the physician who did the first ingestiongot reimbursed the same as what I
did. Yeah, for that.And that's that's not equivalent value. No,

(01:05:28):
that's that's provided anyway. All Right, we got to wrap it up.
We got to wrap it up.Episode eight sixty seven, Uh is
complete. I want to thank youguys for listening. I I'm always grateful.
I'm always grateful when you spend someof your time with us on a

(01:05:48):
Saturday morning, especially a cold,rainy Saturday morning. We love taking your
questions. We love the phone callsand emails as well. If you want
to see us, just go toex to Sports Medicine, just google it.
Our web our new website. Ournew website is going to be live
beginning of the week, and ifyou miss any part of the show or

(01:06:12):
you want to hear it again onyour own time, the podcast will be
up when I should have it uplater today. If not today's tomorrow perfect,
And we are we're working on onexpanding our podcast, so perhaps we
might even have video. And wewill definitely include the discussions between segments because

(01:06:39):
those end up being quite lively.I hope you guys enjoy your Super Bowl
weekend. I feel bad that it'sgoing to be rainy. Hear that it's
going to be rainy the whole weekend, but try to enjoy it anyway.
On behalf of all of us here, on behalf of Doctor Ballard, Kyle
Garrett, myself and all of thosehere on ninety seven to one, the
freak until next week. Tell yourfriends,