Episode Transcript
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Speaker 1 (00:06):
Back on The Rob Double Show with Ben Darnell in
your Afternoon Tribe. We are joined now by orthopedic surgeon
doctor Patrick Garvin. Played some D one and D two
baseball in his career before he went back to med school, and.
Speaker 2 (00:19):
So that's awesome.
Speaker 1 (00:21):
We were just talking about this and you know, elbows
and kind of the Tommy John surgery and kind of
the evolution of it. And even in two thousand and
nine you didn't have your elbow worked on. Now it's
almost a routine thing. I mean, do you do you
explore every possibility still to not whether it's a knee,
whether it's an elbow, to go in and do surgery
(00:44):
on somebody.
Speaker 3 (00:44):
Yeah, I think it really depends on the injury. I
think for the elbow and pitchers specifically, it depends. Now
we have so much data that looks at the tear patterns,
and so there's a lot of data that's come out
looking at whether or not it's a partial tear a
full tear. If it's something that has been torn for
a long period of time, it looks chronic that will
kind of push this one way or the other. Typically
it's something that tears over time and then you kind
(01:05):
of have. It's like a rubber band. It's been stretched
to you know, one hundred times, and on that one
hundred and first time it goes. So the MRIs are
super useful to making that decision. We always try nonoperative
treatment and a lot of it depends on, you know,
the time of the season. The rehab for a for
a reconstruction is like a year now, so that will
kind of dictate, Okay, are we going to do this now?
Speaker 2 (01:24):
Are we going to wait till the end of the year.
Speaker 3 (01:26):
But I think it's definitely become more prominent and people
are quicker to recommend it. I know when I had
a couple opinions when I hurt mine, and one of
them was, you know, try PRP, so playlet rich plasma
injection where we kind of isolate growth factors from your
blood and then inject them into the ligament to try
to stimulate some healing.
Speaker 2 (01:41):
So I actually had that REVTMRI.
Speaker 3 (01:43):
My ligament healed, but I had like a stress fracture
in my elbow and my velocity went down. So that's
what kind of ended my throwing career, pitching career. But
the PRP, like that's what Otani had first, and then
I think he got his ultimately got his reconstructed. So
it's something that a lot of the pro guys will
have access to that stuff because they don't have there's
no financial burden for them, right, they can throw thousands
(02:03):
of dollars for this fancy biologic treatment, whereas normal people
usually you try some therapy, but the end of the
day for that for throwers.
Speaker 2 (02:10):
Is typically an operative thing.
Speaker 3 (02:12):
But there's a little consideration of like where the tear
is and the MRI is helpful in that regard.
Speaker 4 (02:16):
There's somewhat of a unicorn, sir. I mean, we don't
have that many orthopedic surgeons that played the game, especially
at the level that you played. I mean, you're a
small percentage of people that make it out of high
school as a baseball player and then make it to
a Division one university. By the way, we're asking, we
saw your perfect game chart seventeen years and nine months
for the two thousand and nine draft.
Speaker 2 (02:35):
Was your age?
Speaker 4 (02:35):
That's the only stat I got a lot of NRS
for this perfect game?
Speaker 2 (02:40):
Is that not real? Yeah? I wasn't.
Speaker 3 (02:41):
I was not a prolific I wasn't a high top
ratted recruit.
Speaker 2 (02:45):
Out of high school by any means, But.
Speaker 4 (02:46):
You went through all the struggles of being a baseball
player and trying to make it, and as a picture man, like,
there's so much that you, so many balls, so many
throws that you have made from the age of seven
to where you were at in two thousand.
Speaker 2 (02:57):
And nine as a surgeon.
Speaker 4 (02:59):
Now, if you could have talked to your twelve year
old self, was there something maybe you would have done
different at a younger age, whether it's strength conditioning and
building up a specific muscle, or not throwing a curve
or a slider at a certain age.
Speaker 2 (03:12):
That's a good question.
Speaker 3 (03:14):
And I think that's where most of the new literature
and the new evidence that we have says that what
leads to at least elbow and throwing injuries and pitchers
is so too many innings year round baseball, and the
harder you throw, the more likely are to have an
elbow injury. So like, those are the three things like
that I focused on right when I was in high
school trying to get recruited was play year round, get
(03:36):
looked at by scouts and college coaches. Throw as hard
as you can, because if the radar gun doesn't say
ninety you maybe aren't going to get a scholarship. And
so I think that encompassed a lot of the injuries.
So what we've noticed now is multiple actually playing multiple
different sports. So kids that play multiple different sports actually
have lower injury risk than just specializing in one sport.
And I think a lot of that has to do
(03:56):
with the conditioning is different.
Speaker 2 (03:58):
Right.
Speaker 3 (03:58):
So I think if I had one thing to say
to my younger self would probably have been, maybe try
to focus on something different from a like I played
a little bit of high school foball played freshman football.
I was like a backup quarterback and played you know,
a little defensive line. I probably would have been in
better shape if I continue to play football. And the
thing about pitching, too is everything starts with the core, right,
It all starts with your hips. It starts with your
core muscles. The stronger those are, the better shape those are,
(04:21):
in the less likelihood you're gonna have an elbow or
throwing injury or shoulder injury. So I think that now,
in hindsight, right when I was in high school, I
wanted to just play baseball. It was better at baseball
than I was at football, and I was you know,
I was a backup quarterback. I wasn't fast enough to
play you know, high level quarterback and throw.
Speaker 2 (04:36):
That was about it. So that's that's what I would
tell myself.
Speaker 3 (04:39):
But I think I think the multiple sport component nowadays
is really important. So when kids play, you know, soccer
and basketball and growing up, I said, don't pick one early,
because people ask me all the time, like, should we
just focus on the more important one, right of the
one they most have a higher likelihood of going getting
a scholarship on. I said, you know, play multiple sports
and let they Ultimately you'll kind of you'll have to
choose at some point, But don't do that.
Speaker 1 (05:01):
When you're, know fourteen, Do you do that when you're seventeen?
Talking to doctor Patrick Garvin at the Bone Joint Institute
here Earth Peak Surgeon and obviously you're doing arms and
legs and stuff like that.
Speaker 2 (05:12):
Let's talk World Series.
Speaker 1 (05:13):
Boba Schett, shortstop for the Toronto and Blue Jays, missed
all the postseasons so far because he's got a PCL strain.
Talk about straining a ligament versus tearing a ligament that
needs to be repaired, and obviously they can't just like
snap back like a rubber band, and if you tear
portion of it, it's going to be remain torn.
Speaker 2 (05:34):
Correct Am I correct about that?
Speaker 3 (05:36):
Yeah, there are certain ligaments that have a better propensity
to heal just because they have better blood supply. So
like the classic when we talk about in the knee,
like the MCL on the inside of the knee that
has extremely good blood supply.
Speaker 2 (05:46):
So if you strained the.
Speaker 3 (05:47):
Most, that's what happens is the most it could come back.
Offensive linemen get rolled up on. That's the ligament that
gets injured that very commonly can heal without surgery because it.
Speaker 2 (05:55):
Has better blood supply. It's outside of the joint.
Speaker 3 (05:57):
The ACL and the PCL of less blood supply inside
the joint, so they have a harder time healing. The
thing about the PCL that's interesting is your PCL the
function For a lot of athletes it and if you're
running in straight lines, it's not as important for like
cutting and pivoting as the ACL is. So there's actually
a lot of PCL injuries that get managed not operatively too,
So I think that's the main difference. The ACL controls
(06:19):
your tibia and its ability to shift and rotate and
so when it's torn, you have a really difficult time
pivoting and cutting. The PCL is a little less important
for that, and so I think that's why we treat
a lot of those nonoperatively. In somebody like Christian McCaffrey
got treated nonoperatively. He's a running back right now. That
was last year and me he had to do a
lot of rehab and some other you know, treatments and
(06:40):
things like that, but I think you know, ultimately he
avoided an operation for that.
Speaker 4 (06:44):
So have you seen upticks or even down ticks in
football injuries? You brought up offensive lineman. There's not many
Division one offensive linemen that I don't see with two
knee braces, And I think getting rolled up on is
such a normal terminology now. Twenty years ago that was
like an anomaly kind of conversation, But now offensive linemen
are cognizant of that. Have you seen an uptick or
(07:06):
a downtick anywhere in the game of football, high school,
college or pro?
Speaker 3 (07:09):
Yeah, I mean there's they actually they made they published
a study. I think it came out a couple of
years ago. They looked at the transition from twenty twenty
pre COVID, and there were more preseason games and more
training camps. And then they looked at the injury uptick
in the years with COVID where they had less preseason games,
and they actually found a significant increase in all injuries,
(07:30):
whether it was knee, hamstring, soft tissue injuries, and they
think that it's probably I kind of agree, it's probably
related to the conditioning that you got for those preseason
reps like that, those full speed reps that are really
hard to replicate, and then they now, all of a sudden,
you jump into a full speed game. So there was
a statistically a significant increase in soft tissue injuries after COVID,
(07:53):
you know, in terms of like whether or not this year,
because this year seems like there's a lot of injuries recently,
and there's bad injuries. There's these big kind of multi
ligament the injuries that we've seen with like guys like
Tyreek Hill, and so I think I don't know necessarily
if there's a much more percent injuries this year than
compared to others. I think we definitely are picking up
on more of them. I think the media and the
kind of awareness of it now is so heightened. But
(08:16):
you know, I think, like I said, there has been
some data to suggest that with a decrease in like
contact training, camp, and preseason games, that there is a
slightly higher.
Speaker 2 (08:24):
Increase in soft tissue injuries.
Speaker 1 (08:26):
So I was telling you that I still coach sixteen
and seventeen in you baseball, and two of my thirteen
pitchers had to get Tommy John this season, both of
them from lifting weights and doing cross training during baseball season.
I also told my other eleven pitchers to take the
fall off. Some listen, Some didn't still want to play
a year round, which I'm not for. I didn't do it.
(08:48):
I didn't do it as a major league I don't
believe in it. But your thoughts on you know, the
younger injuries, the younger Tommy John surgeries, These kids that
are now specializing in just one sport, and it's not
just baseball.
Speaker 2 (09:01):
They're doing in football. Kids are quitting earlier.
Speaker 1 (09:04):
I've already had kids quit my baseball program and say
all right, I'm just gonna focus on football, or I'm
gonna focus on hockey or whatnot. Your your thoughts on this,
because you're the expert. Are we wearing these kids out
by letting them play one sport year round.
Speaker 3 (09:17):
Yeah, I think I think that's what the that's what
the evidence suggests. I think it's hard, right, and every
kid's different. And I think ultimately, if the kid is
high level and is getting recruited and is going to
try to play Division one, I think it's it's a
year round activity. I don't think necessarily playing competitively year around.
I think playing on like multiple teams, that's where I
think the big issue is because you have guys, especially
(09:39):
in pitchers, you have guys that are on let's say
you're on a travel ball team for the fall, and
then you go into your high school season a pitcher,
like once you're in the game, like you're one hundred percent,
Like you're throwing one hundred percent.
Speaker 2 (09:49):
There's no way to like limit that.
Speaker 3 (09:50):
Even your pitch counts, it's still that those are still
game reps on that elbow or that shoulder. So I
think it's a lot harder to control. I think the
a year round one sport for football just is just
increasing the chance of injury. And so I do think
it contributes a lot to throwing injuries in particular. And
like I said earlier, like I think I think multi
(10:12):
sport participating in these different things. I think ultimately you
have to make a choice, probably like junior senior year
of high school, to really say, look like, you know,
if I'm playing basketball for fun, but I have a
chance to play Division one college, whether it's football or
baseball or something. Ultimately you have to commit to one
just just to you know, go get a college scholarship
or go get education.
Speaker 2 (10:31):
But I think doing that later is probably best.
Speaker 4 (10:33):
Talking to doctor Garvin Bona joint inst to Hartford Healthcare,
dumb question of the day. Why are hamstrings it's like
so hard to heal, Like I'm still getting over one
from eight years ago. Lamar is going to be out
for another couple of weeks. Who knows when he's coming back.
My man Daniel Jones had a tweak.
Speaker 2 (10:49):
Hopefully that's good.
Speaker 4 (10:51):
Why Why is hamstrings like such the lingering one that
is the hardest to heal?
Speaker 3 (10:56):
I think so, I think it goes back to to
what I said earlier about like the training camp, the physical,
like the contact that those practices that have down in
volume have gone down, and then like a lack of
preseason game. So I think you guys that are going
in full speed game reps and then you tweak something,
and so like the hamstrings have been I think we're
noticing more, we're classifying them better because of how much
(11:17):
advanced imaging now we have on all of the data
that these guys have, And so guys that probably would
be playing through these injuries twenty years ago, now they've
got an MRI the next day, they've got a classification
scheme that says, Okay, we have this pattern on the
MRI that says we're gonna miss this amount of time.
So instead of maybe letting them play through it, we're like, okay,
(11:37):
we're gonna shut you down. So I think I think
we're the teams are a little more and the teams
have to do this because they're these contracts are so enormous.
Now they're not going to let somebody play through a
hamstring strain with the with the risk of it getting
worse and missing like the whole season. So they're way
quicker to just shut people down. I think that's probably it.
I don't necessarily know if the hamstring rates themselves have changed.
(11:57):
I think probably it's something like because back in the
day years ago, I'm sure guys were like, oh, yeah, whatever,
I strained my.
Speaker 2 (12:02):
Answering, I'm still gonna play.
Speaker 3 (12:03):
Whereas now it's like if you're a skill player and
you have an amsering injury, they're shutting you down. They're
making that it's got to be perfect before you go
back in the game because they don't want.
Speaker 1 (12:09):
It to get worse. All right, World Series starts Friday.
Who do you like Dodgers or the Blue Jays or
do you have another That's funny.
Speaker 2 (12:17):
I grew up.
Speaker 3 (12:18):
I grew up an Oakland A's fan, real, yes, really, Yeah,
so I grew up in California, So.
Speaker 4 (12:23):
All these Hartford Whaler fans around. Yeah, now the Connecticut
we're all brothers.
Speaker 2 (12:29):
Yeah, so it.
Speaker 3 (12:29):
Sucks because, yeah, they my team was when they're in Oakland.
So now they've left. So I'm kind of I kind
of hate I hate the Yankees and Red Sox because
I just grew up watching the Yankees and Red Sox
beat the A's like my entire childhood. It was one
year it wasn't the Yankees, the next year it was.
Speaker 1 (12:43):
You still remember Jeter's little play, now his favorite.
Speaker 3 (12:48):
Play, he's doing a commercial on it because it's like
they they talk about Jeter's play right, and they always
talk about that all.
Speaker 2 (12:55):
That's why you have to back up the throw if
you're in.
Speaker 3 (12:57):
I'm like, no, Jeremy Imbrie slid right, there wouldn't be
an issue at all. It would have been safe. But
I grew up watching that replay over and over again.
If it wasn't that, it was the Red Sox beating us. So,
you know, I think Otani is like prolific, So it's
hard for me to think that anybody but the Dodgers
are going to win. But I kind of like the
(13:18):
Blue Jays. I like George Springer. I mean, he was
on the ace for a little bit. He's a local
Connecticut guy, so yeah, what's the Yukon? Yeah, great kid
from Yeah, So I like Springer. So I've always liked
the Blue Jays. So we'll see.
Speaker 2 (13:30):
And I like rooting for the underdog a little bit.
Speaker 4 (13:32):
So Springer's age like something we should be talking about him.
He's thirty five, he's leading off, he's playing center field.
Speaker 2 (13:38):
Ye crazy that he's thirty five.
Speaker 3 (13:40):
Yeah, No, I you know, I think I think he
you know, he's there's baseball players they can play a
little longer than that. But yeah, he's he's doing a
high level now. I'm glad he's back. Kind of you know,
he had he was kind of a streaky guy, right.
He has years where he'd go off and then years
where he'd have down years. So he's super talented obviously,
So I'm happy, I mean happy for I was excited
to see him hit that home run.
Speaker 4 (13:58):
So what was it like when you told your mom
I'm giving up baseball and I'm a bit doctor.
Speaker 3 (14:03):
Yeah, I think my parents were. My parents were happy,
so yeah, no, it was it was easy. And I
mean family in medicine. Like my grandpa was a cardiologist,
so I grew up with medicine. My dad actually worked
in the medical device industry. My mom worked in the
medical device industry, so like I was always replaced in
the parts that or just sports men. Like my dad
was a sales rep in med device so he got
(14:24):
me into it, like he actually he worked for the
team surgery for the Reds for a while, so got.
Speaker 2 (14:29):
The crime check. Yeah, I just saw three weeks ago.
My dad, Oh my god, my Drad had a really
good relationship with him.
Speaker 3 (14:38):
So actually, like when I was younger, we got to
go to uh Sarasota for like spring training.
Speaker 2 (14:43):
I was like a ball boy. I got to meet
kingkri Vy Junior, all this.
Speaker 3 (14:45):
Stuff, my dad and my dad's relationships with the medical
staff for the Reds. So yeah, so it's a small world,
but I kind of that's how I that was really
introduced to it when I was super young.
Speaker 2 (14:54):
Who is your who's your favorite Oaklana?
Speaker 3 (14:56):
That's a good question, you know. I always liked Tim Hudson.
I like Tim Hudson.
Speaker 2 (15:05):
I liked there's so many good ones.
Speaker 3 (15:09):
I liked Johnnie when he was with the A's, but
they just like they were just a farm team for
the Yankees, right, And so I like I like Josh
Donaldson a lot. That was my kind of the later
era of A's guys. He was one of my favorite players.
Speaker 2 (15:22):
So but yeah, A's have had a lot of good
a lot of good. Uh good, guys.
Speaker 1 (15:27):
I'm gonna go back to your job because I saw
one of my players. They took the ligament out of
his right wrist and put it in his right elbow.
I mean, I heard hamstring, I heard opposite arm. When
did they start doing that same arm? And that's pretty common.
Speaker 2 (15:43):
You guys are ridiculous.
Speaker 3 (15:45):
Yeah, So like a lot of times you can take
it from the same arm. You can also take it
from the control out of arms. So like if you
do that, So you called your Paul Mayers tendon. Not
everybody has it, so you got to make sure if
somebody that has it, but you're Paul Mayra's tendon, it's uh,
it's it's a little forum flexer. But if you take it,
it doesn't affect the forum strength or motion or anything,
(16:05):
but it works. Is a really nice graft for a
older cloud or reconstruction. So yeah, it's not crazy to
do that. But yeah, you take it yourself or does
another doctor take it if it tends. I think a
lot of times you take it yourself to do it.
Some some guys will have someone else harvest it, but typically.
Speaker 1 (16:21):
Not usually take it yourself. That's fantastic, dude, then real,
Thank God for you and what you think. I'm happy
you picked the medicine. Yeah, well, well I'm sure we'll
catch up again. Doctor Patrick Garvin over here at the
Bone Joint Institute at Hartford Hospital, thank you so much
for coming out.
Speaker 2 (16:38):
Yeah, great, great to be here. Appreciate you
Back on The Rob Double Show with Ben Darnell in
your Afternoon Tribe. We are joined now by orthopedic surgeon
doctor Patrick Garvin. Played some D one and D two
baseball in his career before he went back to med school, and.
Speaker 2 (00:19):
So that's awesome.
Speaker 1 (00:21):
We were just talking about this and you know, elbows
and kind of the Tommy John surgery and kind of
the evolution of it. And even in two thousand and
nine you didn't have your elbow worked on. Now it's
almost a routine thing. I mean, do you do you
explore every possibility still to not whether it's a knee,
whether it's an elbow, to go in and do surgery
(00:44):
on somebody.
Speaker 3 (00:44):
Yeah, I think it really depends on the injury. I
think for the elbow and pitchers specifically, it depends. Now
we have so much data that looks at the tear patterns,
and so there's a lot of data that's come out
looking at whether or not it's a partial tear a
full tear. If it's something that has been torn for
a long period of time, it looks chronic that will
kind of push this one way or the other. Typically
it's something that tears over time and then you kind
(01:05):
of have. It's like a rubber band. It's been stretched
to you know, one hundred times, and on that one
hundred and first time it goes. So the MRIs are
super useful to making that decision. We always try nonoperative
treatment and a lot of it depends on, you know,
the time of the season. The rehab for a for
a reconstruction is like a year now, so that will
kind of dictate, Okay, are we going to do this now?
Speaker 2 (01:24):
Are we going to wait till the end of the year.
Speaker 3 (01:26):
But I think it's definitely become more prominent and people
are quicker to recommend it. I know when I had
a couple opinions when I hurt mine, and one of
them was, you know, try PRP, so playlet rich plasma
injection where we kind of isolate growth factors from your
blood and then inject them into the ligament to try
to stimulate some healing.
Speaker 2 (01:41):
So I actually had that REVTMRI.
Speaker 3 (01:43):
My ligament healed, but I had like a stress fracture
in my elbow and my velocity went down. So that's
what kind of ended my throwing career, pitching career. But
the PRP, like that's what Otani had first, and then
I think he got his ultimately got his reconstructed. So
it's something that a lot of the pro guys will
have access to that stuff because they don't have there's
no financial burden for them, right, they can throw thousands
(02:03):
of dollars for this fancy biologic treatment, whereas normal people
usually you try some therapy, but the end of the
day for that for throwers.
Speaker 2 (02:10):
Is typically an operative thing.
Speaker 3 (02:12):
But there's a little consideration of like where the tear
is and the MRI is helpful in that regard.
Speaker 4 (02:16):
There's somewhat of a unicorn, sir. I mean, we don't
have that many orthopedic surgeons that played the game, especially
at the level that you played. I mean, you're a
small percentage of people that make it out of high
school as a baseball player and then make it to
a Division one university. By the way, we're asking, we
saw your perfect game chart seventeen years and nine months
for the two thousand and nine draft.
Speaker 2 (02:35):
Was your age?
Speaker 4 (02:35):
That's the only stat I got a lot of NRS
for this perfect game?
Speaker 2 (02:40):
Is that not real? Yeah? I wasn't.
Speaker 3 (02:41):
I was not a prolific I wasn't a high top
ratted recruit.
Speaker 2 (02:45):
Out of high school by any means, But.
Speaker 4 (02:46):
You went through all the struggles of being a baseball
player and trying to make it, and as a picture man, like,
there's so much that you, so many balls, so many
throws that you have made from the age of seven
to where you were at in two thousand.
Speaker 2 (02:57):
And nine as a surgeon.
Speaker 4 (02:59):
Now, if you could have talked to your twelve year
old self, was there something maybe you would have done
different at a younger age, whether it's strength conditioning and
building up a specific muscle, or not throwing a curve
or a slider at a certain age.
Speaker 2 (03:12):
That's a good question.
Speaker 3 (03:14):
And I think that's where most of the new literature
and the new evidence that we have says that what
leads to at least elbow and throwing injuries and pitchers
is so too many innings year round baseball, and the
harder you throw, the more likely are to have an
elbow injury. So like, those are the three things like
that I focused on right when I was in high
school trying to get recruited was play year round, get
(03:36):
looked at by scouts and college coaches. Throw as hard
as you can, because if the radar gun doesn't say
ninety you maybe aren't going to get a scholarship. And
so I think that encompassed a lot of the injuries.
So what we've noticed now is multiple actually playing multiple
different sports. So kids that play multiple different sports actually
have lower injury risk than just specializing in one sport.
And I think a lot of that has to do
(03:56):
with the conditioning is different.
Speaker 2 (03:58):
Right.
Speaker 3 (03:58):
So I think if I had one thing to say
to my younger self would probably have been, maybe try
to focus on something different from a like I played
a little bit of high school foball played freshman football.
I was like a backup quarterback and played you know,
a little defensive line. I probably would have been in
better shape if I continue to play football. And the
thing about pitching, too is everything starts with the core, right,
It all starts with your hips. It starts with your
core muscles. The stronger those are, the better shape those are,
(04:21):
in the less likelihood you're gonna have an elbow or
throwing injury or shoulder injury. So I think that now,
in hindsight, right when I was in high school, I
wanted to just play baseball. It was better at baseball
than I was at football, and I was you know,
I was a backup quarterback. I wasn't fast enough to
play you know, high level quarterback and throw.
Speaker 2 (04:36):
That was about it. So that's that's what I would
tell myself.
Speaker 3 (04:39):
But I think I think the multiple sport component nowadays
is really important. So when kids play, you know, soccer
and basketball and growing up, I said, don't pick one early,
because people ask me all the time, like, should we
just focus on the more important one, right of the
one they most have a higher likelihood of going getting
a scholarship on. I said, you know, play multiple sports
and let they Ultimately you'll kind of you'll have to
choose at some point, But don't do that.
Speaker 1 (05:01):
When you're, know fourteen, Do you do that when you're seventeen?
Talking to doctor Patrick Garvin at the Bone Joint Institute
here Earth Peak Surgeon and obviously you're doing arms and
legs and stuff like that.
Speaker 2 (05:12):
Let's talk World Series.
Speaker 1 (05:13):
Boba Schett, shortstop for the Toronto and Blue Jays, missed
all the postseasons so far because he's got a PCL strain.
Talk about straining a ligament versus tearing a ligament that
needs to be repaired, and obviously they can't just like
snap back like a rubber band, and if you tear
portion of it, it's going to be remain torn.
Speaker 2 (05:34):
Correct Am I correct about that?
Speaker 3 (05:36):
Yeah, there are certain ligaments that have a better propensity
to heal just because they have better blood supply. So
like the classic when we talk about in the knee,
like the MCL on the inside of the knee that
has extremely good blood supply.
Speaker 2 (05:46):
So if you strained the.
Speaker 3 (05:47):
Most, that's what happens is the most it could come back.
Offensive linemen get rolled up on. That's the ligament that
gets injured that very commonly can heal without surgery because it.
Speaker 2 (05:55):
Has better blood supply. It's outside of the joint.
Speaker 3 (05:57):
The ACL and the PCL of less blood supply inside
the joint, so they have a harder time healing. The
thing about the PCL that's interesting is your PCL the
function For a lot of athletes it and if you're
running in straight lines, it's not as important for like
cutting and pivoting as the ACL is. So there's actually
a lot of PCL injuries that get managed not operatively too,
So I think that's the main difference. The ACL controls
(06:19):
your tibia and its ability to shift and rotate and
so when it's torn, you have a really difficult time
pivoting and cutting. The PCL is a little less important
for that, and so I think that's why we treat
a lot of those nonoperatively. In somebody like Christian McCaffrey
got treated nonoperatively. He's a running back right now. That
was last year and me he had to do a
lot of rehab and some other you know, treatments and
(06:40):
things like that, but I think you know, ultimately he
avoided an operation for that.
Speaker 4 (06:44):
So have you seen upticks or even down ticks in
football injuries? You brought up offensive lineman. There's not many
Division one offensive linemen that I don't see with two
knee braces, And I think getting rolled up on is
such a normal terminology now. Twenty years ago that was
like an anomaly kind of conversation, But now offensive linemen
are cognizant of that. Have you seen an uptick or
(07:06):
a downtick anywhere in the game of football, high school,
college or pro?
Speaker 3 (07:09):
Yeah, I mean there's they actually they made they published
a study. I think it came out a couple of
years ago. They looked at the transition from twenty twenty
pre COVID, and there were more preseason games and more
training camps. And then they looked at the injury uptick
in the years with COVID where they had less preseason games,
and they actually found a significant increase in all injuries,
(07:30):
whether it was knee, hamstring, soft tissue injuries, and they
think that it's probably I kind of agree, it's probably
related to the conditioning that you got for those preseason
reps like that, those full speed reps that are really
hard to replicate, and then they now, all of a sudden,
you jump into a full speed game. So there was
a statistically a significant increase in soft tissue injuries after COVID,
(07:53):
you know, in terms of like whether or not this year,
because this year seems like there's a lot of injuries recently,
and there's bad injuries. There's these big kind of multi
ligament the injuries that we've seen with like guys like
Tyreek Hill, and so I think I don't know necessarily
if there's a much more percent injuries this year than
compared to others. I think we definitely are picking up
on more of them. I think the media and the
kind of awareness of it now is so heightened. But
(08:16):
you know, I think, like I said, there has been
some data to suggest that with a decrease in like
contact training, camp, and preseason games, that there is a
slightly higher.
Speaker 2 (08:24):
Increase in soft tissue injuries.
Speaker 1 (08:26):
So I was telling you that I still coach sixteen
and seventeen in you baseball, and two of my thirteen
pitchers had to get Tommy John this season, both of
them from lifting weights and doing cross training during baseball season.
I also told my other eleven pitchers to take the
fall off. Some listen, Some didn't still want to play
a year round, which I'm not for. I didn't do it.
(08:48):
I didn't do it as a major league I don't
believe in it. But your thoughts on you know, the
younger injuries, the younger Tommy John surgeries, These kids that
are now specializing in just one sport, and it's not
just baseball.
Speaker 2 (09:01):
They're doing in football. Kids are quitting earlier.
Speaker 1 (09:04):
I've already had kids quit my baseball program and say
all right, I'm just gonna focus on football, or I'm
gonna focus on hockey or whatnot. Your your thoughts on this,
because you're the expert. Are we wearing these kids out
by letting them play one sport year round.
Speaker 3 (09:17):
Yeah, I think I think that's what the that's what
the evidence suggests. I think it's hard, right, and every
kid's different. And I think ultimately, if the kid is
high level and is getting recruited and is going to
try to play Division one, I think it's it's a
year round activity. I don't think necessarily playing competitively year around.
I think playing on like multiple teams, that's where I
think the big issue is because you have guys, especially
(09:39):
in pitchers, you have guys that are on let's say
you're on a travel ball team for the fall, and
then you go into your high school season a pitcher,
like once you're in the game, like you're one hundred percent,
Like you're throwing one hundred percent.
Speaker 2 (09:49):
There's no way to like limit that.
Speaker 3 (09:50):
Even your pitch counts, it's still that those are still
game reps on that elbow or that shoulder. So I
think it's a lot harder to control. I think the
a year round one sport for football just is just
increasing the chance of injury. And so I do think
it contributes a lot to throwing injuries in particular. And
like I said earlier, like I think I think multi
(10:12):
sport participating in these different things. I think ultimately you
have to make a choice, probably like junior senior year
of high school, to really say, look like, you know,
if I'm playing basketball for fun, but I have a
chance to play Division one college, whether it's football or
baseball or something. Ultimately you have to commit to one
just just to you know, go get a college scholarship
or go get education.
Speaker 2 (10:31):
But I think doing that later is probably best.
Speaker 4 (10:33):
Talking to doctor Garvin Bona joint inst to Hartford Healthcare,
dumb question of the day. Why are hamstrings it's like
so hard to heal, Like I'm still getting over one
from eight years ago. Lamar is going to be out
for another couple of weeks. Who knows when he's coming back.
My man Daniel Jones had a tweak.
Speaker 2 (10:49):
Hopefully that's good.
Speaker 4 (10:51):
Why Why is hamstrings like such the lingering one that
is the hardest to heal?
Speaker 3 (10:56):
I think so, I think it goes back to to
what I said earlier about like the training camp, the physical,
like the contact that those practices that have down in
volume have gone down, and then like a lack of
preseason game. So I think you guys that are going
in full speed game reps and then you tweak something,
and so like the hamstrings have been I think we're
noticing more, we're classifying them better because of how much
(11:17):
advanced imaging now we have on all of the data
that these guys have, And so guys that probably would
be playing through these injuries twenty years ago, now they've
got an MRI the next day, they've got a classification
scheme that says, Okay, we have this pattern on the
MRI that says we're gonna miss this amount of time.
So instead of maybe letting them play through it, we're like, okay,
(11:37):
we're gonna shut you down. So I think I think
we're the teams are a little more and the teams
have to do this because they're these contracts are so enormous.
Now they're not going to let somebody play through a
hamstring strain with the with the risk of it getting
worse and missing like the whole season. So they're way
quicker to just shut people down. I think that's probably it.
I don't necessarily know if the hamstring rates themselves have changed.
(11:57):
I think probably it's something like because back in the
day years ago, I'm sure guys were like, oh, yeah, whatever,
I strained my.
Speaker 2 (12:02):
Answering, I'm still gonna play.
Speaker 3 (12:03):
Whereas now it's like if you're a skill player and
you have an amsering injury, they're shutting you down. They're
making that it's got to be perfect before you go
back in the game because they don't want.
Speaker 1 (12:09):
It to get worse. All right, World Series starts Friday.
Who do you like Dodgers or the Blue Jays or
do you have another That's funny.
Speaker 2 (12:17):
I grew up.
Speaker 3 (12:18):
I grew up an Oakland A's fan, real, yes, really, Yeah,
so I grew up in California, So.
Speaker 4 (12:23):
All these Hartford Whaler fans around. Yeah, now the Connecticut
we're all brothers.
Speaker 2 (12:29):
Yeah, so it.
Speaker 3 (12:29):
Sucks because, yeah, they my team was when they're in Oakland.
So now they've left. So I'm kind of I kind
of hate I hate the Yankees and Red Sox because
I just grew up watching the Yankees and Red Sox
beat the A's like my entire childhood. It was one
year it wasn't the Yankees, the next year it was.
Speaker 1 (12:43):
You still remember Jeter's little play, now his favorite.
Speaker 3 (12:48):
Play, he's doing a commercial on it because it's like
they they talk about Jeter's play right, and they always
talk about that all.
Speaker 2 (12:55):
That's why you have to back up the throw if
you're in.
Speaker 3 (12:57):
I'm like, no, Jeremy Imbrie slid right, there wouldn't be
an issue at all. It would have been safe. But
I grew up watching that replay over and over again.
If it wasn't that, it was the Red Sox beating us. So,
you know, I think Otani is like prolific, So it's
hard for me to think that anybody but the Dodgers
are going to win. But I kind of like the
(13:18):
Blue Jays. I like George Springer. I mean, he was
on the ace for a little bit. He's a local
Connecticut guy, so yeah, what's the Yukon? Yeah, great kid
from Yeah, So I like Springer. So I've always liked
the Blue Jays. So we'll see.
Speaker 2 (13:30):
And I like rooting for the underdog a little bit.
Speaker 4 (13:32):
So Springer's age like something we should be talking about him.
He's thirty five, he's leading off, he's playing center field.
Speaker 2 (13:38):
Ye crazy that he's thirty five.
Speaker 3 (13:40):
Yeah, No, I you know, I think I think he
you know, he's there's baseball players they can play a
little longer than that. But yeah, he's he's doing a
high level now. I'm glad he's back. Kind of you know,
he had he was kind of a streaky guy, right.
He has years where he'd go off and then years
where he'd have down years. So he's super talented obviously,
So I'm happy, I mean happy for I was excited
to see him hit that home run.
Speaker 4 (13:58):
So what was it like when you told your mom
I'm giving up baseball and I'm a bit doctor.
Speaker 3 (14:03):
Yeah, I think my parents were. My parents were happy,
so yeah, no, it was it was easy. And I
mean family in medicine. Like my grandpa was a cardiologist,
so I grew up with medicine. My dad actually worked
in the medical device industry. My mom worked in the
medical device industry, so like I was always replaced in
the parts that or just sports men. Like my dad
was a sales rep in med device so he got
(14:24):
me into it, like he actually he worked for the
team surgery for the Reds for a while, so got.
Speaker 2 (14:29):
The crime check. Yeah, I just saw three weeks ago.
My dad, Oh my god, my Drad had a really
good relationship with him.
Speaker 3 (14:38):
So actually, like when I was younger, we got to
go to uh Sarasota for like spring training.
Speaker 2 (14:43):
I was like a ball boy. I got to meet
kingkri Vy Junior, all this.
Speaker 3 (14:45):
Stuff, my dad and my dad's relationships with the medical
staff for the Reds. So yeah, so it's a small world,
but I kind of that's how I that was really
introduced to it when I was super young.
Speaker 2 (14:54):
Who is your who's your favorite Oaklana?
Speaker 3 (14:56):
That's a good question, you know. I always liked Tim Hudson.
I like Tim Hudson.
Speaker 2 (15:05):
I liked there's so many good ones.
Speaker 3 (15:09):
I liked Johnnie when he was with the A's, but
they just like they were just a farm team for
the Yankees, right, And so I like I like Josh
Donaldson a lot. That was my kind of the later
era of A's guys. He was one of my favorite players.
Speaker 2 (15:22):
So but yeah, A's have had a lot of good
a lot of good. Uh good, guys.
Speaker 1 (15:27):
I'm gonna go back to your job because I saw
one of my players. They took the ligament out of
his right wrist and put it in his right elbow.
I mean, I heard hamstring, I heard opposite arm. When
did they start doing that same arm? And that's pretty common.
Speaker 2 (15:43):
You guys are ridiculous.
Speaker 3 (15:45):
Yeah, So like a lot of times you can take
it from the same arm. You can also take it
from the control out of arms. So like if you
do that, So you called your Paul Mayers tendon. Not
everybody has it, so you got to make sure if
somebody that has it, but you're Paul Mayra's tendon, it's uh,
it's it's a little forum flexer. But if you take it,
it doesn't affect the forum strength or motion or anything,
(16:05):
but it works. Is a really nice graft for a
older cloud or reconstruction. So yeah, it's not crazy to
do that. But yeah, you take it yourself or does
another doctor take it if it tends. I think a
lot of times you take it yourself to do it.
Some some guys will have someone else harvest it, but typically.
Speaker 1 (16:21):
Not usually take it yourself. That's fantastic, dude, then real,
Thank God for you and what you think. I'm happy
you picked the medicine. Yeah, well, well I'm sure we'll
catch up again. Doctor Patrick Garvin over here at the
Bone Joint Institute at Hartford Hospital, thank you so much
for coming out.
Speaker 2 (16:38):
Yeah, great, great to be here. Appreciate you
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