June 27, 2024 • 13 mins
Dr. Jonathan Slaughter from OrthoCincy joined us to help make sense of Christian Encarnacion-Strand's injury saga.
He also gave us some insight into the recent injury woes of TJ Friedl, Matt Miazga, and Nick Hagglund.
Learn more about OrthoCincy by going here.
Listen to the show live weekday afternoons 3:00 - 6:00 on ESPN1530.
Listen Live: ESPN1530.com/listen
Get more: https://linktr.ee/MoEgger
He also gave us some insight into the recent injury woes of TJ Friedl, Matt Miazga, and Nick Hagglund.
Learn more about OrthoCincy by going here.
Listen to the show live weekday afternoons 3:00 - 6:00 on ESPN1530.
Listen Live: ESPN1530.com/listen
Get more: https://linktr.ee/MoEgger
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Which leads us to something we doon a weekly basis. We're doing it
a day late this week because Iwasn't here yesterday. But we love having
with us the experts from Orthos sincethe Orthopedic Sports Medicine. These guys,
they have specialists and locations across theTri State. They offer walk in orthopedic
urgent care, which means you don'tneed an appointment weekdays nine am to nine
(00:23):
pm, Saturdays nine am to onepm. Learn more at orthosinc dot com.
That's orthos ci nzy dot com.Doctor Jonathan Slaughter is with us.
It would take me ten minutes towork through the entire last two months as
it relates to Christian and Karnasi onstrand, So I'm gonna save some time
(00:44):
by not doing that. But theoriginal injury this year at least came after
he was hit in a game thatwas played two months ago today, April
twenty seventh. He's gonna finally havesurgery on July the eleventh. Explain to
me how and why. So hisstory is interesting because it was initial hit
(01:07):
by pitch old or sub acute fracturescene. Then MRI started to come back
have more pain than all. Actuallyhe does have an Honor styloid fracture six
to eight weeks apparently cleared by redStaff, but I'm guessing that he was
still having some discomfort or pain,sought a second opinion. Now there's ligament
(01:32):
damage and now there's surgery. Soit's a complex story of like, well,
how did all this come about?What took so long? And it's
hard because without truly seeing MRI's imaging, examining him, knowing exactly what the
diagnosis is, it can be difficult. But my guess with him hearing ligament
(01:53):
damage, especially with a known lnorstyloid fracture. So again, on the
small fingerside of your wrist, it'sthat long bone that goes from the elbow
to the wrist, and you canfeel a little bump on that small finger
side right at your wrist. That'syour owner styloid. What attaches to that
Olner styloid is a disc of cartilagecalled your triangular fibro cartilage complex or the
(02:17):
TFCC. It almost acts like ameniscus of the wrist. My guess without
knowing the true diagnosis is that's probablythe ligament that is torn. The TFCC
that ligament can help provide stability betweenthe two long bones of your form,
the radius and the ulna. Andif he was still symptomatic having pain and
(02:39):
an MRI showed tearing of that discof cartilage, my guess is that's likely
what's going to be repaired, especiallyif he's having any subtle instability or some
increased movement between the two bones,the radius and the ulment the wrist.
So procedur will take place July theeleventh. What we have read, what
(03:04):
we've heard is three month recovery.That obviously pretty much kills the rest of
his season, which it stinks ona thousand different levels. So kind of
walk me through the timeline and willit end with him being able to go
for the beginning of spring training intwenty twenty five. Yeah, So if
it is that TFCC, that discof cartilage, and if it is repaarable,
(03:25):
because it's like in meniscus, notall moniscus tears in a knee are
repaarable. Sometimes you just have todebreed them. But if his tear is
more on the edge or the peripheryof that TFCC, it is repairable.
So then you go in, yourepair it, attach it back down to
the alna or where it's torn offof and then you immobilize the risk,
(03:46):
including trying to limit a rotation ofthe risk for the first six weeks to
get initial healing. Then at thesix week mark, I initiate range of
motion with therapy, just getting rededemotion back so that when you're getting to
the ten to twelve week or thethree month mark, now you're working on
the strengthening and starting to resume morenormal type activities with the wrist. And
(04:11):
again that's if the ligament that he'shaving repaired is that TFCC. I doubt
it's one of the bigger ligaments likea Joe Burrow with a scape of lunate
ligament or a Luno trecolicial ligament,which there's many other ligaments, but my
guests, especially with an ulner styloid, is that it's at TFCC. Let's
talk about TJ. Friedel, andunfortunately in my conversations with many of your
(04:34):
colleagues, he has been a frequenttopic and is back on the injury list
again with a hamstring strain. What'sinteresting is he originally suffered the injury in
the game against the Pirates last week, made a great catch, and then
he sits for a day, comesback and plays, and then they ultimately
determine let's go ahead and put himon the il. How much risk did
(04:55):
they run by having him play acouple of games while he was dealing with
this. It depends on on howbad his initial strain or tear of the
hamstring was. Most likely it wasa low grade just partial pole or very
minimal tearing of the hamstring. Andso anytime you have an injury to a
muscle, you're going to be anincreased risk of further injury if you play.
(05:16):
But you're talking about professional athletes thatare playing one hundred and sixty two
games in baseball by this time ofthe year, I'd say most athletes are
having some sort of aches and painsof going through through the rigors of the
season, and so putting him necessarilyat risk for further injury, I would
say, especially with how depleted theReds are right now, most doctors,
(05:42):
if it was a minor strain,would say, yeah, you could potentially
make this worse. But it wasactually hot out, which is actually can
be sometimes preventive of muscle poles.It's more the cold that we worry about
with muscle injuries. I think itwould probably be reasonable if it was a
very mild strain of a hamstring tolet him try. All right, So
(06:05):
you you kind of referenced something thatI was going to ask about next.
It's it hasn't just been hot.I mean, for a while it was,
it was it was unreal. Uh, But that's that's conducive to being
able to bounce back from something likethis. Because you hear all the time
about cramps in extreme heat, that'snot something you worry about with something like
(06:26):
this in the weather. So justa strain, No, the cramps you
worry about more due to dehydration,lack of fluid intake and electrolytes from how
much you're constantly sweating in heat.So in heat you worry more about heat
exhaustion, dehydration which can lead tocramps and muscle and you see especially in
(06:46):
like soccer players football players going downstretching out due to more fluid loss,
not a true muscle pull. Whenwhen you have tight or strain of a
muscle, he can actually be moreprotective because it's easier to stretch out and
keep the muscles loose, which canbe protective. Let's talking about a pair
(07:06):
of FC Cincinnati players, Matt Miasga. Those who follow that team know how
important he is to their fortunes.His season is over. He is undergone
surgery for a PCL and moniscus tear. The injury originally suffered a couple of
weeks ago and sort of felt likefrom the get go he was taken off
in a stretcher. This wasn't goingto be good. So walk me through
(07:30):
this injury. What's he dealing with? Yeah, so a PCL injury.
So the post heer care ligament isa ligament in the back of the knee
that helps protect against your shin translatingor moving backwards on your thigh bone or
your femur. Isolated PCL injuries arenot near as common as like an ACL,
(07:56):
which we hear about all the time, but usually it's a dashboard type
injury is what we call where theknee is flexed and it takes a direct
blow causing a shift of the shinbone on the femur or thigh bone.
And that's exactly what you saw whenhe did that side tackle trying to save
the cross or the goal, whichhe did his knee was flexed and his
(08:20):
shin went right into the goalpost,creating that dashboard type injury. He then
sought an opinion with medical treatment withdoctors in New York City and they proceeded
with a poster a cruciate ligament reconstructionof meniscus repair. So had the procedure.
(08:43):
Obviously he's not going to play thisseason. Are we talking about something
that could jeopardize the beginning of twentytwenty five? Yeah, And I even
talked with some of my sports docsthat you know, anytime you have an
injury like this that involves some ofthe major ligments of the knee, you
really are looking at potential nine monthsfor recovery. So it would put the
(09:05):
initial start of the season in jeopardy. But he is also high level athlete
working with some of the top specialist, top rehab, top trainers, so
he's going to get exceptional rehab thatwill make it possible to come back at
the beginning of the season. Onemore to talk about doctor Jonathan Slaughter from
(09:26):
Worthos since he is with US.Nick Haglan local kid, another kid on
that back line for FC Cincinnati,is dealing with a broken fibula he was
carried off the field on a stretcherand there lost in New England last week.
Let's start with that body part,the fibula. We hear about it.
I think sometimes we hear about thatparticular body part and we're not necessarily
(09:48):
certain what it is. What isa fibula. So the fibula, it's
one of your in your shin.You have two long bones in your shin.
You've got your big one, whichis your tibia, that's your main
weight bearing bone, and then youhave a smaller, skinnier bone on the
outside of your leg called the fibulagis from the knee down to the ankle
(10:09):
and helps make up part of yourankle joint. What's kind of interesting about
this? The first thing, thefirst thing that jumped to mind to me
was there are NFL players who haveplayed in football games through fibula fractures.
I think Alex Mack Cole Beasley,those two players come to mind, Mac
in the Super Bowl. How isthat possible? It all depends on where
(10:30):
the fracture is in the fibula.The most common fibula fractures that we see
as orthopedic surgeons are down at theankle. Usually some you roll your ankle
in you break the fibula down nearthe ankle, and depending on even there,
it could be just a small littletip of the very end of the
bone where the ligaments attached, pullsa fleck a bone off, which then
(10:52):
acts more like a really bad lowankle sprint you could play through. The
higher up you go in the anklemakes it less likely to be able to
play on it, the more likelyfor some instability of the ankle that would
require surgery. Or sometimes you caneven break it right from like a direct
blow in the midshaft, so rightin the middle of the leg, or
(11:15):
even up closer to the knee.Those typically, as long as it's not
a twisting injury that disrupts the ligamentthat connects the two main bones of the
leg, can be treated with partialweight bearing or even full protected weight bearing,
which could potentially allow you to playthrough. So what's the treatment here
and should we expect him to returnin time for the beginning of the next
(11:39):
season With a typical fhibilar fracture,I would have low or I would very
much expect him to be back nextyear, Not knowing exactly where he broke
it. But from everything and ftSinsin is very good about being tight lipped
at not shitting, letting things slipout, not knowing exactly where it is.
(12:03):
If it's just a if it's alow fibular fracture, let it heal,
protected weight bearing, I mean evenmaybe the into August, potentially returning
to play if it's higher up.I haven't heard anything that this is going
to require surgery, so I don'tthink it's an unstable ankle fracture. I
(12:24):
think it's a stable ankle fracture,going to be more lower down and likely
going to be treated either in acast or a boot, protected weight bearing,
get initial healing, start increasing weightbearing, start working with rehab therapy,
increasing strength. So from everything Isee, I would be surprised if
(12:45):
he's not back at the at thebeginning next year. A lot to discuss,
a lot to sift through, alot to pay attention to. You
always provide such great perspective. We'lldo it again, man, Thank you
so much. I appreciate it.Mother. Thank you. That's doctor Jonathan
Slaughter from Orthosinc dot com. Thegreat thing about Orthosinc. Is they have
specialists on locations, all over thetri State that includes walkin orthopedic urgent care
(13:11):
weekdays nine a m. To ninepm and on Saturdays nine am to one
pm at both Edgewood and Anderson.It's easier, and it goes without saying
it's cheaper than going to an er. Whenever you have an urgent orthopedic injury,
go to Orthosinc dot com. That'sOrtho c I n c Y dot com
Which leads us to something we doon a weekly basis. We're doing it
a day late this week because Iwasn't here yesterday. But we love having
with us the experts from Orthos sincethe Orthopedic Sports Medicine. These guys,
they have specialists and locations across theTri State. They offer walk in orthopedic
urgent care, which means you don'tneed an appointment weekdays nine am to nine
(00:23):
pm, Saturdays nine am to onepm. Learn more at orthosinc dot com.
That's orthos ci nzy dot com.Doctor Jonathan Slaughter is with us.
It would take me ten minutes towork through the entire last two months as
it relates to Christian and Karnasi onstrand, So I'm gonna save some time
(00:44):
by not doing that. But theoriginal injury this year at least came after
he was hit in a game thatwas played two months ago today, April
twenty seventh. He's gonna finally havesurgery on July the eleventh. Explain to
me how and why. So hisstory is interesting because it was initial hit
(01:07):
by pitch old or sub acute fracturescene. Then MRI started to come back
have more pain than all. Actuallyhe does have an Honor styloid fracture six
to eight weeks apparently cleared by redStaff, but I'm guessing that he was
still having some discomfort or pain,sought a second opinion. Now there's ligament
(01:32):
damage and now there's surgery. Soit's a complex story of like, well,
how did all this come about?What took so long? And it's
hard because without truly seeing MRI's imaging, examining him, knowing exactly what the
diagnosis is, it can be difficult. But my guess with him hearing ligament
(01:53):
damage, especially with a known lnorstyloid fracture. So again, on the
small fingerside of your wrist, it'sthat long bone that goes from the elbow
to the wrist, and you canfeel a little bump on that small finger
side right at your wrist. That'syour owner styloid. What attaches to that
Olner styloid is a disc of cartilagecalled your triangular fibro cartilage complex or the
(02:17):
TFCC. It almost acts like ameniscus of the wrist. My guess without
knowing the true diagnosis is that's probablythe ligament that is torn. The TFCC
that ligament can help provide stability betweenthe two long bones of your form,
the radius and the ulna. Andif he was still symptomatic having pain and
(02:39):
an MRI showed tearing of that discof cartilage, my guess is that's likely
what's going to be repaired, especiallyif he's having any subtle instability or some
increased movement between the two bones,the radius and the ulment the wrist.
So procedur will take place July theeleventh. What we have read, what
(03:04):
we've heard is three month recovery.That obviously pretty much kills the rest of
his season, which it stinks ona thousand different levels. So kind of
walk me through the timeline and willit end with him being able to go
for the beginning of spring training intwenty twenty five. Yeah, So if
it is that TFCC, that discof cartilage, and if it is repaarable,
(03:25):
because it's like in meniscus, notall moniscus tears in a knee are
repaarable. Sometimes you just have todebreed them. But if his tear is
more on the edge or the peripheryof that TFCC, it is repairable.
So then you go in, yourepair it, attach it back down to
the alna or where it's torn offof and then you immobilize the risk,
(03:46):
including trying to limit a rotation ofthe risk for the first six weeks to
get initial healing. Then at thesix week mark, I initiate range of
motion with therapy, just getting rededemotion back so that when you're getting to
the ten to twelve week or thethree month mark, now you're working on
the strengthening and starting to resume morenormal type activities with the wrist. And
(04:11):
again that's if the ligament that he'shaving repaired is that TFCC. I doubt
it's one of the bigger ligaments likea Joe Burrow with a scape of lunate
ligament or a Luno trecolicial ligament,which there's many other ligaments, but my
guests, especially with an ulner styloid, is that it's at TFCC. Let's
talk about TJ. Friedel, andunfortunately in my conversations with many of your
(04:34):
colleagues, he has been a frequenttopic and is back on the injury list
again with a hamstring strain. What'sinteresting is he originally suffered the injury in
the game against the Pirates last week, made a great catch, and then
he sits for a day, comesback and plays, and then they ultimately
determine let's go ahead and put himon the il. How much risk did
(04:55):
they run by having him play acouple of games while he was dealing with
this. It depends on on howbad his initial strain or tear of the
hamstring was. Most likely it wasa low grade just partial pole or very
minimal tearing of the hamstring. Andso anytime you have an injury to a
muscle, you're going to be anincreased risk of further injury if you play.
(05:16):
But you're talking about professional athletes thatare playing one hundred and sixty two
games in baseball by this time ofthe year, I'd say most athletes are
having some sort of aches and painsof going through through the rigors of the
season, and so putting him necessarilyat risk for further injury, I would
say, especially with how depleted theReds are right now, most doctors,
(05:42):
if it was a minor strain,would say, yeah, you could potentially
make this worse. But it wasactually hot out, which is actually can
be sometimes preventive of muscle poles.It's more the cold that we worry about
with muscle injuries. I think itwould probably be reasonable if it was a
very mild strain of a hamstring tolet him try. All right, So
(06:05):
you you kind of referenced something thatI was going to ask about next.
It's it hasn't just been hot.I mean, for a while it was,
it was it was unreal. Uh, But that's that's conducive to being
able to bounce back from something likethis. Because you hear all the time
about cramps in extreme heat, that'snot something you worry about with something like
(06:26):
this in the weather. So justa strain, No, the cramps you
worry about more due to dehydration,lack of fluid intake and electrolytes from how
much you're constantly sweating in heat.So in heat you worry more about heat
exhaustion, dehydration which can lead tocramps and muscle and you see especially in
(06:46):
like soccer players football players going downstretching out due to more fluid loss,
not a true muscle pull. Whenwhen you have tight or strain of a
muscle, he can actually be moreprotective because it's easier to stretch out and
keep the muscles loose, which canbe protective. Let's talking about a pair
(07:06):
of FC Cincinnati players, Matt Miasga. Those who follow that team know how
important he is to their fortunes.His season is over. He is undergone
surgery for a PCL and moniscus tear. The injury originally suffered a couple of
weeks ago and sort of felt likefrom the get go he was taken off
in a stretcher. This wasn't goingto be good. So walk me through
(07:30):
this injury. What's he dealing with? Yeah, so a PCL injury.
So the post heer care ligament isa ligament in the back of the knee
that helps protect against your shin translatingor moving backwards on your thigh bone or
your femur. Isolated PCL injuries arenot near as common as like an ACL,
(07:56):
which we hear about all the time, but usually it's a dashboard type
injury is what we call where theknee is flexed and it takes a direct
blow causing a shift of the shinbone on the femur or thigh bone.
And that's exactly what you saw whenhe did that side tackle trying to save
the cross or the goal, whichhe did his knee was flexed and his
(08:20):
shin went right into the goalpost,creating that dashboard type injury. He then
sought an opinion with medical treatment withdoctors in New York City and they proceeded
with a poster a cruciate ligament reconstructionof meniscus repair. So had the procedure.
(08:43):
Obviously he's not going to play thisseason. Are we talking about something
that could jeopardize the beginning of twentytwenty five? Yeah, And I even
talked with some of my sports docsthat you know, anytime you have an
injury like this that involves some ofthe major ligments of the knee, you
really are looking at potential nine monthsfor recovery. So it would put the
(09:05):
initial start of the season in jeopardy. But he is also high level athlete
working with some of the top specialist, top rehab, top trainers, so
he's going to get exceptional rehab thatwill make it possible to come back at
the beginning of the season. Onemore to talk about doctor Jonathan Slaughter from
(09:26):
Worthos since he is with US.Nick Haglan local kid, another kid on
that back line for FC Cincinnati,is dealing with a broken fibula he was
carried off the field on a stretcherand there lost in New England last week.
Let's start with that body part,the fibula. We hear about it.
I think sometimes we hear about thatparticular body part and we're not necessarily
(09:48):
certain what it is. What isa fibula. So the fibula, it's
one of your in your shin.You have two long bones in your shin.
You've got your big one, whichis your tibia, that's your main
weight bearing bone, and then youhave a smaller, skinnier bone on the
outside of your leg called the fibulagis from the knee down to the ankle
(10:09):
and helps make up part of yourankle joint. What's kind of interesting about
this? The first thing, thefirst thing that jumped to mind to me
was there are NFL players who haveplayed in football games through fibula fractures.
I think Alex Mack Cole Beasley,those two players come to mind, Mac
in the Super Bowl. How isthat possible? It all depends on where
(10:30):
the fracture is in the fibula.The most common fibula fractures that we see
as orthopedic surgeons are down at theankle. Usually some you roll your ankle
in you break the fibula down nearthe ankle, and depending on even there,
it could be just a small littletip of the very end of the
bone where the ligaments attached, pullsa fleck a bone off, which then
(10:52):
acts more like a really bad lowankle sprint you could play through. The
higher up you go in the anklemakes it less likely to be able to
play on it, the more likelyfor some instability of the ankle that would
require surgery. Or sometimes you caneven break it right from like a direct
blow in the midshaft, so rightin the middle of the leg, or
(11:15):
even up closer to the knee.Those typically, as long as it's not
a twisting injury that disrupts the ligamentthat connects the two main bones of the
leg, can be treated with partialweight bearing or even full protected weight bearing,
which could potentially allow you to playthrough. So what's the treatment here
and should we expect him to returnin time for the beginning of the next
(11:39):
season With a typical fhibilar fracture,I would have low or I would very
much expect him to be back nextyear, Not knowing exactly where he broke
it. But from everything and ftSinsin is very good about being tight lipped
at not shitting, letting things slipout, not knowing exactly where it is.
(12:03):
If it's just a if it's alow fibular fracture, let it heal,
protected weight bearing, I mean evenmaybe the into August, potentially returning
to play if it's higher up.I haven't heard anything that this is going
to require surgery, so I don'tthink it's an unstable ankle fracture. I
(12:24):
think it's a stable ankle fracture,going to be more lower down and likely
going to be treated either in acast or a boot, protected weight bearing,
get initial healing, start increasing weightbearing, start working with rehab therapy,
increasing strength. So from everything Isee, I would be surprised if
(12:45):
he's not back at the at thebeginning next year. A lot to discuss,
a lot to sift through, alot to pay attention to. You
always provide such great perspective. We'lldo it again, man, Thank you
so much. I appreciate it.Mother. Thank you. That's doctor Jonathan
Slaughter from Orthosinc dot com. Thegreat thing about Orthosinc. Is they have
specialists on locations, all over thetri State that includes walkin orthopedic urgent care
(13:11):
weekdays nine a m. To ninepm and on Saturdays nine am to one
pm at both Edgewood and Anderson.It's easier, and it goes without saying
it's cheaper than going to an er. Whenever you have an urgent orthopedic injury,
go to Orthosinc dot com. That'sOrtho c I n c Y dot com
Mo Egger News
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