Episode Transcript
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Speaker 1 (00:00):
We do this every week we talk injuries with one
of the experts from Orthos. Since Orthos since he has
specialists of locations across the tri State and they offer
walk in orthopedic urgent care during the week from nine
am to nine pm and on Saturday nine am to
one pm. Learn more at orthosinc dot com. That's Orthos
(00:20):
ci NCY dot com doctor Trevor.
Speaker 2 (00:23):
Wilkes from Orthos since he is with us.
Speaker 1 (00:25):
Unfortunately, we have three Red starting pitchers to talk about.
It feels like there's a lot of encouraging news related
to Hunter Green. He's had three MRIs, he's had inflammation.
Nobody is talking surgery. In fact, the Reds are at
least allowing for the possibility that he may still pitch
in twenty twenty four. Start with the three MRIs. When
(00:45):
they do those procedures, what are they looking for?
Speaker 2 (00:49):
Yeah, good questions.
Speaker 3 (00:51):
So, I mean, obviously Reds fans are sort of on
pins and needles about Hunter Green's elbow. His history of
the Tommy John surgery is obviously what makes everybody nervous.
With the MRI, they are looking at the structural integrity
of his elbow, so they're, you know, looking at his
his ligament repair. They're trying to make sure he's not
(01:14):
picked up cartilage damage over the years, and they can
see some you know, extra things like inflammation and other
things while they're there. The multiple MRIs probably indicate that
that the first MRI had some questions to it, and
then they might have done a second one with with
what's called contrast or a die, which can just make
(01:35):
it a little bit easier to see stuff.
Speaker 2 (01:37):
But but that that's kind of the background on the MRIs.
Speaker 1 (01:39):
So you mentioned the word inflammation, Ken, and this this
is admittedly kind of a dumb question.
Speaker 2 (01:44):
Ken.
Speaker 1 (01:45):
Can you tell me what inflammation is and what bruising
is as it relates to something like this.
Speaker 3 (01:52):
Yeah, yeah, so common terms and they I think your
point your question is not it's a good question because
they get thrown around a lot. Now. Bruising specifically obviously
is referring to blood, right, so any kind of injury,
ruptured blood vessels, localized bleeding. Inflammation being a different term
for the process of think of like little chemical messages
(02:16):
in your body everybody. Inflammation at its core can have
good components to it. It's a part of how we heal,
but Oftentimes inflammation goes overboard, there's too much of it,
and it holds up our healing. So when people see
like swelling, anytime that you've got anything that seems like swollen, irritable,
(02:38):
these are just signs of inflammation and you can see
it on MRIs as increased water or edema in the
in the tissues.
Speaker 1 (02:49):
So obviously there's a few weeks left in the season.
From a baseball perspective, the Reds have faded from contention
understanding what we know about all that, but also under
standing what we know about Hunter's injury history, which has
grown to be pretty extensive, and his overall importance to
the team. Does it make sense to even try to
(03:10):
put him back out there at some point in twenty
twenty four.
Speaker 2 (03:13):
Yeah, that's a great question.
Speaker 3 (03:15):
I think the Reds have done a really good job
of trying to handle him carefully. All baseball fans you
know that guys who've had Tommy John surgery, they're really
careful about their pitch counts and they watch them closely.
Speaker 2 (03:28):
But it's a good question, you know.
Speaker 3 (03:31):
I would just say they should proceed very carefully. The
risk reward ratio may really tilt in favor of resting
him and rehabbing him and just letting him get into
the offseason. But if he comes back, I think you'll
see him be really cautious with him.
Speaker 2 (03:47):
That's one picture. Another is Andrew Abbott.
Speaker 1 (03:50):
He has been placed on the injured list with a
left shoulder strain. Kind of guide me through the possibilities here.
Speaker 3 (03:57):
Yeah, so again, hoping the best for Andrew, but your
shoulder strain. In sports medicine, we use these, you know,
general vague terms that kind of cover a lot of
different things. I mean, they could cover the spectrum modem
from from fatigue and a kind of a tired dead
arm all the way to a structural problem, you know,
(04:19):
like a like a labral tear or rotator cuff irritation.
You know, in in Andrew's specific situation, I did notice,
you know, he has already thrown one hundred and thirty
eight innings this season, which is over forty innings more
than he's thrown before in his career. So there really
could be a component of fatigue and tiredness going into this.
Speaker 1 (04:39):
All right, So tired arm doesn't sound like the most
clinical term, but it is.
Speaker 2 (04:44):
What's tired arm? Yeah?
Speaker 3 (04:46):
Good? Good quest. I mean, you know when you are
when you're pitching. Obviously it's a complicated motion. It involves
your whole body. So a tired arm can even reflect
tiredness in your legs, your core, your shoulder blade. Even
tiny differences in your ball release points can make huge
differences in your velocity and accuracy. They're correlated to pain
(05:11):
in your shoulder and elbow, so a tired arm can
just be that whole spectrum. Another thing that doesn't get
talked a lot that is kind of interesting to baseball
fans mo is the is the concept that with starting
pictures of their rest and recovery, and over the process
of a season, sometimes it gets harder and harder to
be fully rested and recovered for your next outing. A
(05:32):
lot of really interesting new research is looking at measurements
of inflammation and muscle strength to try to objectively assess
whether a picture is going to be ready for their
next outing or they need another couple of days. But
but yeah, tired arms a real thing, then.
Speaker 1 (05:48):
Doctor Trevor wilkeson worthos since the one more picture to
talk about Nico Lodolo. When he's been on the mound,
he's often been quite good. He just hasn't been on
the mound nearly enough. He's back on the injured us
now with a strained finger. Maybe another dumb question, How
does one strain a finger?
Speaker 3 (06:09):
Yeah, so, I mean with pictures a lot of times, mo,
it's the tip of their finger. So the last little
joint at the end of your finger, because it's so
involved in spin right, curveballs and other things like that,
sometimes you can irritate or inflame the joint it self.
(06:31):
You can actually strain the little collateral ligaments that stabilize
the end of your finger. You know, if you throw
a lot of curveballs that the end of your middle
finger can get pretty inflamed. So I'm thinking it may
be something along those lines.
Speaker 2 (06:47):
Is this the sort of thing that we have to
worry about long term?
Speaker 3 (06:51):
No, I think we can put this one in a
hopefully my optimism. I know he's been in and out
all season long, but of the other injuries, this seems
like it's probably in the less serious, more optimistically handled
kind of situation.
Speaker 1 (07:06):
All Right, we have one Bengal to talk about, and
I feel like, relative to what our fears were when
he first went down with an injury, that the news
has been good. Best case for Miles Murphy, he's got
a sprained MCL. He is going to miss time placed
on injured reserve, so he'll miss at least the first
four games. But there does seem to be a lot
of optimism about his chances of playing for the Bengals
(07:27):
in twenty twenty four, which is great. Let's start with them.
We hear MCL, we hear ACL, we hear PCL. Specifically,
the MCL, what does it do and when there are sprains,
what do the various grades mean?
Speaker 3 (07:39):
Yeah, good, good question, thanks mos So. The MCL, the
letters stand for medial collateral ligament, So it's a really
big strong ligament on the inside of your knee, stabilizes
your knee against forces that kind of bring your foot outward.
It's one of the four main ligaments that the difference
between the MCL and say, for example, the ACL and
(08:01):
PCL is your MCL has a rich blood supply and
actually heals very well on its own. So we grade
the injuries typically a one, two three scales used ones
and twos have a great track record of healing well
without surgery, and the four to six week timeframe four
Miles would be in line with that. We'll usually brace it,
(08:23):
allow it to start to heal, modify the athletes's activities,
and then rehab them. But you know, the good news
for Bengals fans is the prognosis for return is usually
very good. I wouldn't be surprised to see embrace him
for the first few games when he returns. But good
outlook for us.
Speaker 1 (08:42):
Yeah, no, it definitely feels that way. The insight is
always awesome. Great to have you. We'll do it again soon,
Doctor Trevor Wilkes, Orthos Cincy. I do appreciate it, man,
Thanks so much, thanks for having me. Much appreciated, Doctor Trevor. Well,
Doc doctor Trevor Wilkes from Orthos Cincy.
Speaker 2 (08:56):
Every week. I say this.
Speaker 1 (08:57):
The great thing about the people at Orthos Sincy is
they've got specialists, including our friend doctor Trevor Wilkes, and
locations across the tri State. This includes walk into orthopedic
urgent care weekdays nine to nine Saturdays nine am to
one pm at both Edgewood and Anderson, easier and cheaper
than going to an er. Whenever you have an urgent
orthopedic injury, go to where I took my daughter when
(09:19):
she busted her foot about a year ago. Orthosincy. That's
Orthosinsey dot com, orthos ci Ncy dot com