August 22, 2024 • 7 mins
Dr. Adam Metzler from OrthoCincy joined us to talk about Hunter Greene's elbow soreness, the possibility that he may be dealing with something severe, and whether or not he should be shut down for the season.
We also discussed Jeimer Canderlio's busted toe, and two Bengals dealing with season-ending injuries.
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
Podcasts of The Mo Egger Radio Show are a service of Longnecks Sports Grill.
Listen to the show live weekday afternoons 3:00 - 6:00 on ESPN1530.
Listen Live: ESPN1530.com/listen
Get more: https://linktr.ee/MoEgger
Follow on X: @MoEgger
Instagram too: @MoEgger
We also discussed Jeimer Canderlio's busted toe, and two Bengals dealing with season-ending injuries.
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
Podcasts of The Mo Egger Radio Show are a service of Longnecks Sports Grill.
Listen to the show live weekday afternoons 3:00 - 6:00 on ESPN1530.
Listen Live: ESPN1530.com/listen
Get more: https://linktr.ee/MoEgger
Follow on X: @MoEgger
Instagram too: @MoEgger
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
We do this every Wednesday, we talk injuries with one
of the experts from Orthos sincey Orthos since he has
specialists and locations all over the Dry State, and they
also offer walk in orthopedic urgent care during the week
from nine a m. To nine pm and on Saturdays
nine am to one pm. You can learn more at
orthosinc dot com, Orthos c I NCY dot com. Doctor
(00:24):
Adam Metzler from Orthosincia is with us. We got some
sobering news over the weekend. Hunter Green goes on the
injured list. Now the Reds are insisting this is precautionary.
We don't think this is going to be anything that
we really have to fret that much about. But it's
the staff ace. It's a guy who's had Tommy John
surgery before. It's an elbow issue, and he is one
(00:46):
of the faces of this franchise. So let me start
with this. They've done an MRI, he's going to get
a second opinion. But when they review the MRI with
Hunter Green, what sort of stuff are they looking for?
Speaker 2 (00:59):
Yeah, I mean look at the elbow there. You're he's
had that previous injury and issue in surgery to that arm,
and so referencing that area, he'd be looking to make
sure the previous ligament that they used to reconstruct, the
Honor collateral ligament also known as the Tommy John ligament
and Layman's terms, really just looking to make sure that's intact.
(01:20):
And so there might sometimes be some inflammation, which is
seen on Murah as well. But the big key that
Murah is looking to make sure that the actual ligament
reconstruction that was performance time surgery is fully intact.
Speaker 1 (01:34):
So he's going to get a second opinion. Let me
ask you about that, is that is that commonplace when
we're talking about athletes with the profile of a guy
like Hunter Green.
Speaker 2 (01:43):
I think many professional athletes get multiple opinions anymore, is
very standard to get different opinions from different surgeons with
different experiences. So even at the college level, it's not
uncommed aymore, it was really much more common and the
professional circuit.
Speaker 1 (02:01):
So they've done the MRI, and then there are the
next steps. Should the next steps, out of maybe an
abundance of precaution, be to just shut them down for
the year, Well.
Speaker 2 (02:13):
It seems like with the current pathway that the team's on,
there wouldn't be a lot of reason to continue to
throw your stud pitcher until something worse happens. Pending that
MRI is relatively benign in nature, don't see a huge
reason to push your stud pitcher into a situation that
would put them into making their twenty twenty five campaign
more vulnerable. But that's my independent discretion or decision.
Speaker 1 (02:37):
Yeah, no, I think you and I are on the
same page. So if we're dealing with something here that's
maybe on the little bit more benign level but is
still significant, yet it's not going to get to the
level of Tommy John surgery, what sort of possibilities are
we dealing with?
Speaker 2 (02:53):
Well, if hopefully it's just inflame, and you know, maybe
take a work on some small mechanics a month, some
manti inflammatory medications and some rehabilitative protocols that get things
strengthen around the elbow and shoulder to reduce the mechanical
torque on that area. Hopefully the symptoms resolve, and sometimes
that can take weeks, sometimes it can take months, And
so that would be the best case scenario for his situation.
Speaker 1 (03:17):
He obviously has had Tommy John surgery before. Does having
that in his history make him more susceptible to elbow injuries.
Speaker 2 (03:25):
Absolutely. Anytime you've had any surgery to any joint, your
risk of injury or further injuries increased.
Speaker 1 (03:31):
Want to ask you about jam Or Candelario, who has
been placed on the injury list with a big toe fracture.
They've called it the great toe. I'll call it the
big toe for something like this. Is there is there
any treatment beyond rest.
Speaker 2 (03:45):
Well, yes there is, but most of the time it
is non surgical intervention. The big tow we caught the
great toe for whatever reason in the orthopedic glature. But
that toe, if it does go into the joint, and
so if it involves the cartilage or the joint, that
can be something that needs surgery because we don't want
that joint to kind of fall apart and separate and
that can cause early arthritis. That really be, you know,
(04:09):
one of the only major indications for surgical intervention, or
if it's significantly angled one way or the other or dislocated.
But many times these are indirect hit injuries and they'll
have a subtle kind of hairline fractures, if you will,
and they can heal on eventually in a boot and
protective weight bearing and protected from being hit and you
(04:29):
do a lot of running, it does slow that healing
process down, so they have to lower the impact type
of activities that they're doing until they start to seek
healing and on X ray as well as the athlete
feels more comfortable.
Speaker 1 (04:42):
We had last week. Doctor Adam Messler from Moortho Cincia
is with us. We had last week during the same
joint practice, two Bengals get carted off with patella tendon tears.
Both Deontay Smith and Chris Evans out for the season
with this injury. Can you start with the patella tendon
and tell me what it is and what it does.
Speaker 2 (05:02):
So it's it's a vital structure to our knee. It
connects the kneecap or patella down to the tibbya the
shinbone and allows you to straighten your legout. And so
it's vital for everything every athlete needs to do, which
is cut and pivot and do squats and push athletes away.
And whether you're a big guy in the trenches or
(05:22):
or a skilled player making cuts in the backfield, heats
your ptel a tenon and when it ruptures, you know
you need surgery, and it's a pretty long rehabit and
pretty significant recovery for these guys. But it's always a
surgical problem.
Speaker 1 (05:38):
So we've got a lineman and we've got a pretty
diminutive running back. Does the recovery and the rehab differ
based on, you know, one guy being much much bigger
and playing a different position than the other.
Speaker 2 (05:51):
Well, what I tell my patients is biology is biology.
I need to get attended and healed of a bone.
And whether you're a running back or an offensive lineman,
you need biology. You need it to heal. So our
job as a surgeon is to reattach your pateel attendon
back to its home location, typically the ptella. And then
your job is to follow the protocols. And these protocols,
as I say, are not at a Meser's protocols. These
(06:11):
are national protocols set in stone, and it's a tough,
slow rehab. They're locked in full extension for walking for
six weeks and they do start early rehab for swelling
control and very limited range of motion when seated, and
we typically advance that motion slowly to hopefully by three
months we have full motion. But you got to get
the tendon to heals the bone, you know, and bone
(06:32):
likes to heal. Bone heels pretty quick. Ten into bone
healing is much slower process, and so that's why these
rehab protocols are much slower than you know. If you
break your collar bone, we put a plate on it
and by three months usually back playing sport, maybe even earlier.
For the tendon like this, you're looking at nine to
twelve months for a high level skilled athlete to return
back to the field at their previous level of function,
pending everything goes well with rehab and recovery, whether that
(06:55):
surgery is done here in Cincinnati or in San Francisco,
those protocols are there, they're place, and that's the big rehap.
It takes a long time to get your muscles reactivated
around that joint as well.
Speaker 1 (07:05):
Yeah, really unfortunate that the two injuries occurring minutes within
each other. I appreciate the expertise and your time is
always doctor Metsler, Thanks so much, No, have a great day.
I'll try doctor Adam Metzler from Orthos since I say
it is every single week. The great thing about the
people at Ortho Sincy is they have specialists and locations
across the tri State. This includes walk in orthopedic urgent
(07:27):
care weekdays nine a m. To nine pm and on
Saturdays nine am to one pm at both Edgewood and Anderson.
It is easier and cheaper than going to an er.
When you have an urgent orthopedic injury, go to orthosinc
dot com. That's Ortho c I n c Y dot
com
We do this every Wednesday, we talk injuries with one
of the experts from Orthos sincey Orthos since he has
specialists and locations all over the Dry State, and they
also offer walk in orthopedic urgent care during the week
from nine a m. To nine pm and on Saturdays
nine am to one pm. You can learn more at
orthosinc dot com, Orthos c I NCY dot com. Doctor
(00:24):
Adam Metzler from Orthosincia is with us. We got some
sobering news over the weekend. Hunter Green goes on the
injured list. Now the Reds are insisting this is precautionary.
We don't think this is going to be anything that
we really have to fret that much about. But it's
the staff ace. It's a guy who's had Tommy John
surgery before. It's an elbow issue, and he is one
(00:46):
of the faces of this franchise. So let me start
with this. They've done an MRI, he's going to get
a second opinion. But when they review the MRI with
Hunter Green, what sort of stuff are they looking for?
Speaker 2 (00:59):
Yeah, I mean look at the elbow there. You're he's
had that previous injury and issue in surgery to that arm,
and so referencing that area, he'd be looking to make
sure the previous ligament that they used to reconstruct, the
Honor collateral ligament also known as the Tommy John ligament
and Layman's terms, really just looking to make sure that's intact.
(01:20):
And so there might sometimes be some inflammation, which is
seen on Murah as well. But the big key that
Murah is looking to make sure that the actual ligament
reconstruction that was performance time surgery is fully intact.
Speaker 1 (01:34):
So he's going to get a second opinion. Let me
ask you about that, is that is that commonplace when
we're talking about athletes with the profile of a guy
like Hunter Green.
Speaker 2 (01:43):
I think many professional athletes get multiple opinions anymore, is
very standard to get different opinions from different surgeons with
different experiences. So even at the college level, it's not
uncommed aymore, it was really much more common and the
professional circuit.
Speaker 1 (02:01):
So they've done the MRI, and then there are the
next steps. Should the next steps, out of maybe an
abundance of precaution, be to just shut them down for
the year, Well.
Speaker 2 (02:13):
It seems like with the current pathway that the team's on,
there wouldn't be a lot of reason to continue to
throw your stud pitcher until something worse happens. Pending that
MRI is relatively benign in nature, don't see a huge
reason to push your stud pitcher into a situation that
would put them into making their twenty twenty five campaign
more vulnerable. But that's my independent discretion or decision.
Speaker 1 (02:37):
Yeah, no, I think you and I are on the
same page. So if we're dealing with something here that's
maybe on the little bit more benign level but is
still significant, yet it's not going to get to the
level of Tommy John surgery, what sort of possibilities are
we dealing with?
Speaker 2 (02:53):
Well, if hopefully it's just inflame, and you know, maybe
take a work on some small mechanics a month, some
manti inflammatory medications and some rehabilitative protocols that get things
strengthen around the elbow and shoulder to reduce the mechanical
torque on that area. Hopefully the symptoms resolve, and sometimes
that can take weeks, sometimes it can take months, And
so that would be the best case scenario for his situation.
Speaker 1 (03:17):
He obviously has had Tommy John surgery before. Does having
that in his history make him more susceptible to elbow injuries.
Speaker 2 (03:25):
Absolutely. Anytime you've had any surgery to any joint, your
risk of injury or further injuries increased.
Speaker 1 (03:31):
Want to ask you about jam Or Candelario, who has
been placed on the injury list with a big toe fracture.
They've called it the great toe. I'll call it the
big toe for something like this. Is there is there
any treatment beyond rest.
Speaker 2 (03:45):
Well, yes there is, but most of the time it
is non surgical intervention. The big tow we caught the
great toe for whatever reason in the orthopedic glature. But
that toe, if it does go into the joint, and
so if it involves the cartilage or the joint, that
can be something that needs surgery because we don't want
that joint to kind of fall apart and separate and
that can cause early arthritis. That really be, you know,
(04:09):
one of the only major indications for surgical intervention, or
if it's significantly angled one way or the other or dislocated.
But many times these are indirect hit injuries and they'll
have a subtle kind of hairline fractures, if you will,
and they can heal on eventually in a boot and
protective weight bearing and protected from being hit and you
(04:29):
do a lot of running, it does slow that healing
process down, so they have to lower the impact type
of activities that they're doing until they start to seek
healing and on X ray as well as the athlete
feels more comfortable.
Speaker 1 (04:42):
We had last week. Doctor Adam Messler from Moortho Cincia
is with us. We had last week during the same
joint practice, two Bengals get carted off with patella tendon tears.
Both Deontay Smith and Chris Evans out for the season
with this injury. Can you start with the patella tendon
and tell me what it is and what it does.
Speaker 2 (05:02):
So it's it's a vital structure to our knee. It
connects the kneecap or patella down to the tibbya the
shinbone and allows you to straighten your legout. And so
it's vital for everything every athlete needs to do, which
is cut and pivot and do squats and push athletes away.
And whether you're a big guy in the trenches or
(05:22):
or a skilled player making cuts in the backfield, heats
your ptel a tenon and when it ruptures, you know
you need surgery, and it's a pretty long rehabit and
pretty significant recovery for these guys. But it's always a
surgical problem.
Speaker 1 (05:38):
So we've got a lineman and we've got a pretty
diminutive running back. Does the recovery and the rehab differ
based on, you know, one guy being much much bigger
and playing a different position than the other.
Speaker 2 (05:51):
Well, what I tell my patients is biology is biology.
I need to get attended and healed of a bone.
And whether you're a running back or an offensive lineman,
you need biology. You need it to heal. So our
job as a surgeon is to reattach your pateel attendon
back to its home location, typically the ptella. And then
your job is to follow the protocols. And these protocols,
as I say, are not at a Meser's protocols. These
(06:11):
are national protocols set in stone, and it's a tough,
slow rehab. They're locked in full extension for walking for
six weeks and they do start early rehab for swelling
control and very limited range of motion when seated, and
we typically advance that motion slowly to hopefully by three
months we have full motion. But you got to get
the tendon to heals the bone, you know, and bone
(06:32):
likes to heal. Bone heels pretty quick. Ten into bone
healing is much slower process, and so that's why these
rehab protocols are much slower than you know. If you
break your collar bone, we put a plate on it
and by three months usually back playing sport, maybe even earlier.
For the tendon like this, you're looking at nine to
twelve months for a high level skilled athlete to return
back to the field at their previous level of function,
pending everything goes well with rehab and recovery, whether that
(06:55):
surgery is done here in Cincinnati or in San Francisco,
those protocols are there, they're place, and that's the big rehap.
It takes a long time to get your muscles reactivated
around that joint as well.
Speaker 1 (07:05):
Yeah, really unfortunate that the two injuries occurring minutes within
each other. I appreciate the expertise and your time is
always doctor Metsler, Thanks so much, No, have a great day.
I'll try doctor Adam Metzler from Orthos since I say
it is every single week. The great thing about the
people at Ortho Sincy is they have specialists and locations
across the tri State. This includes walk in orthopedic urgent
(07:27):
care weekdays nine a m. To nine pm and on
Saturdays nine am to one pm at both Edgewood and Anderson.
It is easier and cheaper than going to an er.
When you have an urgent orthopedic injury, go to orthosinc
dot com. That's Ortho c I n c Y dot
com
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