The Pat and Aaron Show – Injury Report 9/5/2024 with Dr. Gasser

Aaron: The Pat and Aaron Show Injury Report presented by Florida Orthopedic Institute in partnership with Tampa General Hospital and joining us now on the hotline we love him, Dr. Seth Gasser. Dr Gasser, it’s been way too long. How you doing my friend?

Dr. Gasser: Doing great how you guys?

Aaron: Doing fantastic, doing better than some players heading into the NFL season, I’ll tell you that. Let’s start with this, as far as injuries are concerned. Christian McCaffrey. He’s returned to practice with the 49ers but he’s been dealing with that calf injury, really all throughout training camp all throughout preseason. When it comes to Christian McCaffrey and the calf, do you think that that is precautionary from what you’re seeing or is he dealing with something that could linger with the calf?

Dr. Gasser: Well, you know, it depends on the severity of his calf injury, so these are usually muscular injuries. A calf strain is a muscle injury to the back of your leg where your muscle attaches to the Achilles tendon. Thankfully it’s not his Achilles or he’d be out for the season. So, it just depends on the grade of the injury as to how much muscle damage he had. Typically, it takes about six weeks or so to recover from this for those guys and he’s about at that point so I don’t think they’d risk it if he wasn’t ready. So, I think he’s probably ready to go.

Pat: I once blew my calf out or something like that playing wallyball. Where I jumped for a ball and all of a sudden, I felt, like a pop. I couldn’t hear it, but I felt the pop in my calf and I couldn’t walk for, I felt like days, and I felt the pain. It just lingered for a long time. How common is that and how different is that for a world class athlete versus a 40-year-old fat guy?

Aaron: We’re 2 minutes into this Dr. Gasser, into this first one of the Season and he’s already brought up wallyball and his injury, he does it every year.

Dr. Gasser: There you go. Actually, that’s a really common history for people that have this injury. They’re either playing basketball or some explosive sport that you have to jump or requires change in direction, and they feel a pop in the back of their calf and then they have acute pain and swelling. It’s difficult to bear weight on it sometimes and it can be pretty painful. So typically, the treatment is we immobilize it for a short period of time, compression, ice, activity modification and then it’s a gradual sort of return to play protocol. Like most injuries, yeah, they can. They can be lingering especially if you go back too soon because there’s a chance that you could reinjure it.

Pat: Aaron you know Dr. Gasser and all of our doctors at Florida Orthopedic Institute have heard much more about your mallet finger than my calf.

Aaron: That’s true. That is fair. You brought up the Achilles earlier, do you think that and can you tell us with the injury to the calf, is there a chance or a better chance now if he doesn’t make sure he’s 100% that he and that Achilles could be, you know structurally damaged or on its way to being.

Pat: Speaking of Achilles, when you’ve got an Achilles injury, they’re pretty uncommon and we don’t know a ton about the recovery from them. When you’ve got, you know, we’ve got Kurt Cousins obviously and Aaron Rogers both coming off of that devastating injury, how much more difficult is it to: A, recover from an injury like that? but also B, not suffer a reinjury to an Achilles when you’re late in your 30s like those guys are.

Dr. Gasser: You know, it’s hard to get over but it’s not that common to reinjure it. It takes a long time to get over an Achilles tendon rupture, the vast majority of high-profile athletes are going to be treated surgically. It’s a long recovery which is why these guys have been out for a while but it’s not that common. You know, in my 30 years of practice, I’m not sure I’ve ever fixed one that I’ve seen re-tear.

Aaron: Interesting, very interesting news there. I want to get into Hollywood Brown who’s not going to be playing tonight against the Chiefs. He hurt his shoulder on August 10th and doesn’t expect, not expected or for the Chiefs I mean, and not expected to go tonight against the Ravens. What issues could you see coming from the shoulder especially with the receiver? You know, when we’re talking about receivers using their shoulders?

Dr. Gasser: Well, that’s a really interesting question because he had a very unusual injury to his, not really his shoulder, but part of the shoulder girdle. So, he had a sternal clavicular dislocation and that’s – you know your clavicle or your collar bone. Typically, the collarbone injuries in football players are out over their shoulder area where it attaches to your shoulder cap, that’s the AC joint and they get AC joint sprains from landing on their shoulder. He actually dislocated the opposite end of his clavicle, where it attaches to your breastbone or your sternum. So, same similar mechanism but much, much less common. And they can be pretty serious depending on the type of sternoclavicular dislocation that you have. Typically they’re not going to go back and play as quickly as an AC joint separation, which is at the other end of the clavicle.

Pat: I’m not sure if I I’ve ever heard of a shoulder girdle can you explain that to the rest of us layman schmucks?

Dr. Gasser: Well when we talk about the shoulder girdle we’re talking about the whole complex including, the humerus which is your arm bone, the shoulder cap which is part of the scapula or your wing bone in the back, and the clavicle. So those three bones sort of make up the whole complex of the shoulder girdle.

Aaron: The Bucs are getting back YaYa Diaby which is so important for this defense. He had the ankle injury early on in training camp. Let’s just go over different type of ankle injuries just to set this off because I know we’re going to have a ton of them throughout the season here.

Dr. Gasser: Yeah, we talk about this every year, ankle sprains and there’s really two types of ankle sprains. There’s low ankle sprains and high ankle sprains. The ankle is a is a joint that obviously your foot goes up and down through the ankle joint and there’s three bones that make up the joint. Those are the tibia and the fibula, which are the bones in your leg. And then the bone that sits between them is the talus, which is the ankle bone. So, the ligaments that connect the tibia and the fibula to the ankle bone below it are the ones commonly sprained. And then there’s these ligaments that hold those two leg bones together very tightly so they don’t splay apart and that’s a high ankle sprain. So, he actually had a high ankle sprain. The low ankle sprains tend to get better pretty quickly. A high ankle sprain will usually take twice as long to get better compared to a low ankle sprain and that’s what he had.

Pat: YaYa seems to have been walking normally for a while now. We saw him at training camp, you know, quite a while ago and he just seemed to be walking very comfortably. He’s a full participant in practice on the first injury report of the year yesterday. I imagine you would expect if he’s a full participant in practice he’s going to be listed as probably, he’s going to go – he’s probably 100% by now right?

Dr. Gasser: Yeah, I would think so as well. I agree with that.

Aaron: Let’s get into Ricky Pierce. Saw this just crazy story out of San Francisco. Placed on the reserve NFL, NFI list, NFL list meaning, he’s going to miss at least four games. The first four games of the regular season here as he recovers from that gunshot wound of the chest. Just a crazy story, let’s start with this, Dr. Gasser, how lucky is he just to be alive?

Dr. Gasser: Yeah right, we don’t talk much about many gunshot wounds on our injury report do we?

Pat: No first one,

Dr. Gasser: Well anybody gets shot in the chest and has a through and through injury with a gunshot wound to his chest has to be pretty lucky right? There are a lot of bad things in your chest that you can damage and a lot of them are fatal, so, the fact that he was released 24 hours after his injury means that he didn’t hit any vital structures. Which is lucky in itself and then it’s going to probably take him a while to recover depending on where the bullet entered and exited and what was damaged. Lucky for him nothing major and that could have been sort of the end of him forever. Obviously.

Pat: Yeah obviously, we don’t talk a lot about this on our injury reports because we’re fortunate enough that this does not happen to athletes a lot. But I imagine, that this is something that maybe you all see at Florida Orthopedic Institute from time to time. Is people who are recovering from these type of things that are pretty rare. What kind of muscular damage do you see with something like that? With a bullet going straight through a muscle, straight through the body. Right? It exited out his back. What kind of muscle damage do you see and what kind of recovery is there from that? How much does it differ maybe from person to person trying to get over something like a gunshot wound that most of us fortunately will never experience?

Dr. Gasser: I mean it really differs based on the damage and it’s typically the exit wound is always bigger than the entry wound. So, there’s more damage as the bullet is coming out and that ballistic effect happens as it goes through the tissue. So, you can get a tremendous amount of tissue damage from just the track of a bullet wound. And then hopefully if it hits bone, obvious it’s going to fracture your bone, and if it’s anything else it’s going to cause damage to it. It’s not only getting over the physical aspect of the injury but really a lot of it involves getting over the mental aspect of actually being shot.

Pat: No doubt.

Dr. Gasser: What all that entails, yeah. The PTSD from that.

Aaron: No doubt about it and you made me just think there because I didn’t realize that I just heard that from you. You know, the exit wound typically larger than the entry wound, would you, with that being said, do you think it’s easier if the exit wound is out the back or if it’s out the chest?

Dr. Gasser: Probably out the back, easier. As long as it doesn’t hit your scapula or your shoulder blade and fracture that. You know, there are a lot of things and not a lot of space for a bullet to get through your chest and not really hit anything significant so maybe he should buy a lottery ticket.

Aaron: Yea seriously, some people. We’re getting some great texts here Dr. Gasser. Somebody from the 813 here in Tampa. “Dr. Seth Gasser is the greatest. He fixed both my shoulder rotator cuffs.” So, you have a very happy patient there. And then somebody from the 703, have no idea where that is from, but he said, “Love this guy. Feel like I got smarter and realized how dumb I am at the same time.” So, that’s the effect you’re having on a lot of our listeners Dr. Gasser. We love that.

Dr. Gasser: Well, thank you, that’s my job.

Aaron: We thank you and we can’t wait to talk to you all and all the doctors at Florida Orthopedic Institute and Tampa General Hospital throughout the football season. Thanks so much Dr. Gasser. Talk to you later.

Dr. Gasser: Yeah, thank you guys, love your show.

Pat: Thanks Doc

Aaron: And the Pat and Aaron Show Injury Report was presented by Tampa General Hospital in partnership with Florida Orthopedic Institute. They provide you access to one of the top Orthopedic programs in the nation. Schedule an appointment today at Floridaortho.com