WVU Community Health Forum Injury Reports

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Episode Transcript

(00:00):
Good morning, good evening, goodafternoon. We are back again today with
another episode of the WVU Community HealthForum presented by WVU Medicine camnan Clark Medical
Center. Today I have James Dearianwith me. He's an athletic trainer over
at WVU Medicine and he's an athletictrainer at the Williamstown Yellowjackets High School.

(00:20):
So it is great to have youin here today. James, how are
you doing today? I'm doing verywell. Thank you for having me.
It's an honor, yep. Absolutely. So what is on the docket for
today that you would like to discussbecause I'm looking at the kind of the
rough draft of what you guys havegoing on, and it looks like we're
talking about some injury stuff, possiblyjust common injuries with high school athletes and

(00:41):
probably middle school athletes also just commoninjuries. Right, so right off into
the right off in the gates here, what is the most common injury that
you've dealt with with high school studentsmiddle school students and the treatment that you've
had to use on those students withthose particular injuries. So the most common
is mostly sprains and streams like theankle so predominantly there's three grades of ankle

(01:03):
sprains, first degree, second degree, in third degree most common. I
see first degree, sometimes second,and hopefully I never see a third degree.
So a third degree is surgery rightoff the bat, we're just trying
to put that together. Second degreeice stem rehab treatment. We're gonna put
you in a boot, get youcomfortable, and walk it off. First
degree, excuse me, is icestem. Let's walk it off, Let's

(01:26):
do some rehab and get you backout there. That's the most common that
I see as a first degree anklesprain. And how do you determine whether
it's a first, second, orthird? Like, what's I mean?
Kind of meat? Being a littlenot so knowledgeable in that particular department,
but what would classify it as likea first degree, second degree, third
degree type? That? Sure?First degree is moderate swelling, there's no

(01:47):
tears whatsoever. You can just seesome bruising. It's sort of walk on.
A second degree is there is somefibers that are torn in the ligments
and tendons. You can walk onit, but it's very painful. And
third degree is a total rupture andyou're gonna have to have surgery. Okay,
And I don't know if you mentionedthis or not, but did you
say this was the most common thatyou see in adolescents. It's one of
the most common. Yeah. Youalso have knee injuries, knee sprains,

(02:08):
anything that's a sprain or strain,you see a common of it. But
ankle injuries because it happens in soccer, basketball, football, I mean even
in swimming, because they hit it, hit it against the wall. It's
probably one of the most common.Gotcha. Now, I know a lot
of you see it in the NFL, and you see a lot in college
as well, but a lot ofACL tears, MCL tears, meniscus tears.

(02:29):
How common is that on the Iwould say the high school adolescent scale,
it's it's still fairly common. Aclsare usually everybody thinks contact injury.
Well, actually it's a non contactinjury. They're usually cutting or breaking into
there and they come down awkwardly onit and they tear it. Acls are
very common still. Meniscus injuries arecommon. That's the cushion in between your

(02:50):
knees. They kind of like ashredding mechanism, so it tears a lot
easier. It happens a lot.In females, acls are more common than
male It's just because of their Q, which is their their hips are wider,
so that makes that angle different inthe knee. I did not know
that that is. That's that's interesting. That's good to know. Now today's
not wasted because I now I knowsomething that I didn't know earlier. Now

(03:14):
you're saying it with contact injury,and I mean, what is the most
like actually so so football basketball.I mean you see sprays. What's the
second most common contact injury or likea like the biggest contact injury other than
sprains that you see probably a breakbreak? Yeah, uh, you know
you can have a dislocations also,but you know, an arm breake,

(03:37):
finger brake, toes and stuff like. You just see those all the time
all the time. Then I can'tI just watching breaks and seeing breaks.
This grosses me out, almost tothe point of passing out. It's just
now I can't do this. Butwhat is the what is the recovery time
for like saying a CLMCL meniscus becauseI know my kind of going into my
background, Dad had a meniscus tearwhenever I was like fifteen, And I

(04:00):
mean it was a pretty extensive periodof time. What kind of goes into
the rehab and the treatment and everythingwith say a meniscus, an a CL
or an MCL, so an ACL, you know, it determines what the
doctor says. Usually it's a sixmonth to twelve month injury if it's just
an ACL isolated. If you havean ACL and a meniscus, you can
either repair the meniscus or you cantake out the meniscus. Younger athletes,

(04:23):
younger people, they want to keepthe meniscus intact because that's your cushioning,
so all the weight bearings going onyour knees, so you don't want arthritis
or anything like that, so they'lltry to keep that intact. So that's
a non weight bearing injury. Sothey peach you, keep you off off
on crutches, and then it's aboutsix months before you can actually do anything
with that, and a lot ofrehab, a lot of treatment of the

(04:43):
quadriceps and hamstrings. It just itjust sounds painful, very painful you said
taking out the meniscus or anything,and you mean by like like if you're
an adult, completely taking the meniscusout right. Yeah, they'll cut the
portion of the meniscus that's injured out. Ooh ooh, and that does that
does that's like make the treatment longerif they do it that way. Actually,

(05:05):
it it's probably a little bit shorterbecause they take that injury out and
they don't have to sew it backon. But yet, Arthur as all
right, this comes in arthritis,a lot of pain and stuff like that
when you get older. Ok,that's you know, in the NFL and
college they usually take that out sothey're in the next week. But high
school, we want to preserve thatbecause these kids got a lot to live

(05:25):
for a long life, oh exactly. And then if they plan ongoing,
say to college and playing and Imean aspirations are playing in the NFL,
like most kids do at this pointin their life. I mean, you
want to keep your body in theright shape and keep it, keep it
in the same healthy state that youwant it to be, and so you
can go to that distance. Absolutely, a lot of kids, you know,

(05:46):
college and stuff like that, theywant to get in their prime health
and that's probably we want to keepthat, you know, everything intact.
Right now, they're shoulder injuries howcommon or shoulder injuries because I've seen they
been on the rise here lately.I mean they know a lot of like
baseball players get shoulder injuries, Basketballplayers get shoulder injuries. I mean I've
seen a few football players get someshoulder injuries. Maybe like collar bone and

(06:10):
stuff are close to it. Whatattributes to that injury or that type of
injury, Uh, most likely withlike with baseball, it's the overuse.
These kids are just playing all thetime and finally they just get fatigued a
lot of you know, with football, it's a lot of contact. Yeah,
you get you know, you getyour shoulder sprains, you get your

(06:32):
ac separations, you get your clavicaldislocations and stuff like that and fractures.
But mostly, like with baseball,it's just the overuse. They're always just
throwing and throwing and throwing. Wethat's why now they've mandated that. You
know, there's a pitch camp,and you see in the Little League World
Series if they only they're only allowedthroats seventy five pitches. You know,
they say if they throw that manypitches, they're off for three days.

(06:54):
They're really trying to limit that area. What other kind of things are they
trying to do to help it's like, I mean, like you said,
how baseball and they're limiting the pitchcounts and everything, But is there a
like is there like basketball, footballor anything like that that they're trying to
do to limit injuries? Like,is there anything in place at the moment?
Not really, I mean more padding. They have a lot of padding.

(07:15):
Uh. You know when I playedbasketball, we didn't have all these
new pads that you know, thearm sleeves and the Now they're bringing those
in stuff like that. There thetechnology is finally catching up to where we
are right and it's and it's crazyto see how the technology has gone from
say, whenever I was in peeweefootball and versus now where these kids are

(07:35):
getting all these different pads, likethey're I mean in a sense they're kind
of like in a protective bubble almost, which I mean for the right reason,
I mean, granted, But atthe same time, it's just like
it's change and evolve so much andjust even the last twenty years, let
alone last ten, and it's it'swild to see and colleges are using those

(07:57):
what is it the censor helmets?Yeah, the censor How what what do
those actually do? I'm curious.So the censor helmets are there for like
concussions and oh, concussions, anduh, they're the force that's on the
hits and that that really you know, that data goes to all those people

(08:20):
that are higher up than the athletictrainers and doctors, so that really helps
them, you know, focus onwhere to put the pads and stuff like
that. Gotcha, Okay, Soit's basically data collection to help better the
technology later down the reds awesome.And then I know that the technology has
kind of grown to where football playersnow with the NFL being as popular as

(08:43):
it's ever been, they've changed thehelmet that they've used. I can't remember
who or what it used to be, but I know there's two different quarterbacks
in the NFL that are now usingit. I think it's to like limit
the concussions or limit I can't remembremember what the helmet was called or what
the model was, but I readsomewhere that it mentioned that it limits the

(09:07):
movement of the head in the helmet. And I mean, granted, whenever
I was in school, your headwas bobbling around there like it was like
a nut and a bowl. Itwas going rattling around, but they have
come up with this helmet that keepsit more cushioned and more protected. I
guess the helmets more strectually into yourhead, so they put a lot of

(09:31):
air into it and they put youknow, the cushions where you're going to
get hit. You can't really preventa concussion as much as you know,
try to, you know, subduethem as much as they can, because
we still don't know much how andyou know, it's a violent, violent
sport like football is. Right now. Another question that kind of just popped

(09:52):
into my head just a second agowith concussions. On the topic of concussions,
is say that two people have neverhad a concussion in their life.
Is it based is one person moreprone to getting a concussion than another person?
Is it based off the person oris it the based off of the
severity of the hit on that particularperson. It just curious. Well,

(10:15):
it's it's we do it by symptoms. You know, if you have a
symptom, you're sitting out. Sowe have a mandated that you have to
go through a percussion protocol to goback onto the field. You know,
it could be a minimum of tendays. It could be a maximum,
you know, two hundred and sixtyfive days. It just depends on how
they feel and how they are reallystrict on that because of all the you

(10:39):
know, the CTEs and you knowand stuff like that. Right, and
with with how Williams Sound has beenplaying the last the last two weeks,
putting up big numbers from what I'veseen, you need to make sure every
single one of those guys are healthyand on track to continue that alast of
the year and to defend the title. Amen, you got it. You
got to defend the title, soyou got to keep them healthy. Kind

(11:01):
of one last question before we getinto more open discussion. Ligaments in pro
sports or in the news. Whatis that? The owner collateral ligaments UCL
that's in the elbow so Tommy Johnsurgery. So you know it's popular because
now there's like little kids that aregetting it twelve years old, thirteen years
old because they think, well,if I get it now, then I

(11:24):
don't have to get it on lateron. Well, that's not how it
works. You know. There's alot of documentation that's you know, little
kids are getting it just to getit. That's not getting what. Yeah,
So so let me let me letme backtrack here, So kids as
young as twelve or are they intentionallytrying to get it so they don't have
to or is it? Is itjust like they're just getting it because they

(11:45):
they're overworked or they're overworked. Wow, Yeah, that's that's wild. I
mean, the only the only elbowinjury that I mean, I wouldn't even
see it considered an injury. ButI mean, I had really bad tennis
elbow the last week and I'm tellingyou what that hurt so bad? Yeah,
and I mean ice heat, nothingit did. It didn't go away,

(12:07):
and I just had to sit thereand wait it out. And I
cannot, I cannot imagine what TommyJohn surgery would be like, because I
mean, you see a lot ofprofessional baseball players get it. What exactly
would do they have to do whenyou get Tommy John surgery? Exactly?
So they go in and they replacethe ligament they own a collateral ligament,
and you know, and strengthen itand tighten it so it doesn't rupture again.

(12:30):
Gotcha? And do you see that? I mean, well, how
we said we like younger kids,is twelve seeing it? Do you see
that? A lot like in thehigh school level still or kind of not
so much, not so much collegein college in high school is not as
much. But just pros just becausetheir strength and the velocity and their arm
rotations stuff like that. It's justis phenomenal, and it's just your body

(12:50):
can only take so much, right, And then with the little leagues and
the pros and everything, the ifI if my memory and my knowledge serves
correct, the pitching mound in littleleagues is a lot closer correct because obviously
they don't have the arm strength toget there. But then in the pros
it goes back to I think it'swhat sixty feet or somewhere. I think
something like that. I heard arumor that they're going to push it even

(13:11):
farther back because of the ball velocitythat I do not now. It's it
was something that I read, andI mean, I always bring it up
with anybody that's like sports incline justbecause it's something that is changing. And
they changed that rule back in likethe early days of baseball, it was
like fifty five feet and then itwas fifty feet and then it got pushed.

(13:31):
It's changed so much and sports havechanged so many times. But kind
of Staying on the topic of theinjuries and everything, where do you see
sports medicine and like athletic training andstuff like that going on in the future,
Like what is this future looking likefor that exactly technologically wise and just
treatment wise, well, treatment wise. I think every high school needs an

(13:54):
athletic trainer. I think every collegeneeds three or four athletic trainers just because
of the knowledge that we have withsports injuries and how we can translate that
into for the doctors. You know, an athletic trainer. It's just a
necessity, especially for small high schoolsand you know, people that don't don't

(14:16):
know where, Hey, where shouldI go? Well, let's let's get
you into the doctor, Let's getyou into a chiropractor, Let's get you
into somebody. And that's you know, we've saved so many lives through you
know, an a d CPR andstuff like that. Is it. We're
pretty much essential in high schools,absolutely, and one hundred percent agree with

(14:37):
that, even even more so now, especially after like some of the things
that happened and like the pros andeverything with what happened back at the end
of last season with tomorrow. Yes, I just didn't I didn't want to
go too deep into that one,but you saw how that happened, and
you saw how that played out thefact that the coaches and the training staff
and everybody were out there, theyhad an ad machine and they had the

(14:58):
trade and they had the expertise tobe able to save save him on the
field, and with everybody knowing howthat happened. I mean, he was
down for a long time, yea. And if that doesn't tell you that
they need training staff, athletic trainers, some form of medical staff on the
sideline at all times, then Idon't know what does, right. I

(15:20):
mean, it actually at the guyat one point, it could be life
or death. If they get hita certain way, or they get hit
a certain in a certain spot,it could hurt them, right, And
that's when technology progresses. That's whensafety stuff progresses, and it just goes
from there. Is there anything elsethat you want to cover, James,

(15:41):
while we're while we're still here?Actually no, I think we're good right
now. All right, Well,I appreciate you coming out, I appreciate
you being here. I hope Iwill probably see you at some Williamstown games
pretty pretty soon. I'm usually withthe younger crowd, so probably not so
much, but I'll hear you.I'll probably stop at one of the high
school games. I have been overthere. I haven't been to a high
school game in a long time.So well, we just had our first

(16:03):
home game and over just over lessthan two years because of the construction and
stuff like that. So yeah,we had a pretty great crab. Yeah,
I heard it was I heard itwas a barn burner. You guys
were you guys were torturing them.Yeah, So I'm congradulation on the win
this past week. I give youthat, and hopefully it continues for the
rest of the season. Defend this, defend that title. You need to

(16:23):
injury free, injury free exactly,injury free. But if we've got nothing
else to cover, again, justwant to thank you again for being here.
And this was the WVU Community HealthForm presented by WVU Medicine Camden Clark
Medical Center. We'll see you guysin the next episode.