The Pat and Aaron Show Injury Report 9/19/2024 with Dr. Remaley

Aaron: Pat and Aaron Show, it is time now for The Injury Report presented by Florida Orthopedic Institute in partnership with Tampa General Hospital. We tell you about the great work they do over there and if you’re dealing with any injuries, you know who to see, Florida Orthopedic Institute and Tampa General Hospital. Joining us now on the hotline for the first time this season, we were looking forward to, we had him on couple times last year, and the last couple years. Dr. Trey Ramaley from the Florida Orthopedic Institute. Dr Ramaley, how you doing?

Dr. Remaley: Wonderful gentlemen, how are you guys doing?

Aaron: Doing great. It’s good to talk to you again and unfortunately the injuries have not stopped. It’s early in the season but every team has been bit by the bug and the Buccaneers are one of them. Let’s start with Vita Vea. That was the big story all week. He’s got the MCL sprain. We did get good news on it, that it’s day-to-day so, this is best case scenario. Of course, right doctor?

Dr. Remaley: Yeah, these injuries, especially the MCL can be a little bit of a problematic issue. You know, there’s a couple of athletes throughout the NFL that are dealing with these but day to-day is actually a good upgrade. Really, it gives him opportunity to probably get out and practice. The MCL, you know, can be an issue that can linger for a while. So it’s pretty important to be consistent with the rehab and treatment and stuff but he’s got some of the best in the league there.

Pat: Yeah, I’m very curious, you know, they said it was a grade two MCL strain and that’s the reason why he’s day-to-day. Originally, of course, when you see an injury like that your first fear is ACL and done for the season. Then we heard they think it’s a MCL so it’ll likely be only 2 to 4 weeks. Explain to us, if you don’t mind, the grades right? The different grades of a MCL strain and what do you see within the MCL? What do you see within the diagnostic that tells you okay, instead of it being 2 to 4 weeks it’s actually just day-to-day? What are the differences between those grades of strain?

Dr. Remaley: That’s a great question. So, these are graded pretty much Grade 0 to Grade 3 and the higher the number, the more severe the injury is. Typically, you know, Grade 1 can be pretty common. We on MRI, when you get that study, you just see a little bit of swelling around the ligament but it’s still intact. Grade 2 means there’s increased fluid and you can see some of the signal. What we see on MRI, we call it a signal. You know, where it either attaches above the knee or below the knee and just a higher grade of amount of fluid and things. Then Grade 3 means it’s actually torn and that’s kind of worst-case scenario. The Grade 2 generally, a lot of the treatment is really based on getting the inflammation down and working on range of motion because these can cause a lot of stiffness in the knee as well. Then, the other thing is really, the level of pain that the athlete can tolerate and what they’re doing. You know, different positions will put different stress on that and so you’re really working on that and putting them through a lot of tests to make sure that they can run or push off or move side to side and things like that.

Aaron: Viking Kings receiver Justin Jefferson, he’s got a quad injury, he had it last week against the 49ers. He said, thigh bruise, contusion, he said, whatever you want to call it. Is this something you should be concerned about? What is the thigh bruise?

Dr. Remaley: So, the muscle has a lot of blood flow to it and just like our skin when we get hit, that the muscles can bruise too. And that again, you’ll see on MRI, seeing a lot of fluid or blood product, kind of what it looks like on the MRI through the muscle and low grade. Again, you kind of grade these similar to what you do with ligament injuries. You know, and as long as it’s a low grade and the athlete can kind of tolerate some movement, usually the recovery is pretty quick. You can get ones that are pretty severe where that blood, the body, as it tries to heal, will actually maybe turn it into some like bone deposits. And those are the ones that get pretty significantly symptomatic and progressively painful and can be bothersome. So, I think his is a low grade as we were looking at it and you know, he should do pretty well overall.

Aaron: You said it’s a low grade. How much will that, I mean, it, obviously being able to play is one thing, but being a receiver and utilizing the speed that a guy like Justin Jefferson has for a team that’s been really good this year so far, with Sam Darnold, how much impact will that have on his speed Doctor?

Dr. Remaley: Yeah, it definitely can, especially in these early phases of recovery. Because you require, you know, and rely on your quad muscles to help you push off and accelerate. Then obviously jump for the balls to get over the corners and stuff like that so, it can affect that. The nice thing about these athletes at this high level and we’ve talked about this before, they’ve got such amazing treatment from their athletic trainers, which are very vital for their recovery. And they get a lot more access to different things that should help with that and help restore most of that function.

Pat: Is this something too where you don’t have to worry too much about reinjury?

Dr. Remaley: That’s a great question and yeah, you actually do. A lot of these, what we call, soft tissue injuries, the muscle belly injuries of the quads or the hamstrings, they’re ones that can, what I call, linger longer. And if you know, you don’t get your full treatment and you’re continuing to play causing little, tiny, injuries here and there, it can be something that’s symptomatic and bothersome throughout the entire season.

Aaron: Speaking of lingering, let’s go to Calijah Kancey of the Buccaneers. This calf strain is just lingering, what’s going on? Do you think with Calijah Kancey, with a calf strain like this and could it lead to something potentially more serious and maybe that’s why they’re holding them out?

Dr. Remaly: Yeah, this, the calf strain, what we deal with both in the muscle belly and even along into the Achilles tendon where you can get some tendonitis or inflammation of that tendon. These things can be very bothersome for a long time because it’s not only, you know, we’re looking at them as athletes running and jumping but even with just daily activity. You know, you really want to protect that and with non-football type activities as well, because it can still cause some injury there. These things just take a lot of, a lot of load throughout the day and that’s why they can linger that long, just because they are so symptomatic for so long.

Pat: When you look at that injury, you know, a lot of us immediately assumed and expected because Calijah Kancey had a calf thing last year, that it was the same calf. And then, it was reported later, it was actually the opposite calf than he had injured a season ago. When you see that, where somebody suffers the same injury on both legs or both arms, whatever it might be, is there something that, you know, then, or that it tells you, when somebody suffers the same kind of or very similar injury to the same muscle on both legs? Like, is there something there that maybe he should know, or that he can do, to avoid that? Or something that like, he’s lacking that that leads to the same injury on both legs or similar injuries on both legs?

Dr. Remlay: The best answer for that is sometimes. And the, and I know that you know may not fulfill everything, but a lot of the issues that can be is, you know, underlying biology or pathology, that the athlete may have. A lot of it is dealing with their mechanics and how they run, how they jump, the way that they plant their feet, in what direction they plant their feet, what surface they’re playing on, and then also repetitive overload. You know, what are they doing in practice and what are they doing on their own and their own personal workouts outside of practice? So, a lot of that stuff, you know, we take into consideration when we’re working with the athletes and working on treatment plans. It may be these recurrent type injuries.

Aaron: Dr. Remaly, I I thought this a little earlier and then it was noted on the text line. Pat has so far has received two-That’s a great question, and Aaron has received zero. Pat is up two-to-nothing. I felt it as well, that’s fine, I lost this round. Dr Remaley, I will be better next round. I will get a great question out of you.

Dr. Remaley: We will. We will get it for you, for sure.

Aaron: Dr Ramaley, great stuff as always. 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. You just heard it with Dr Remaley. Any doctor, any injury you’re dealing with, they have the best of the best. Schedule an appointment today at FloridaOrtho.com. Dr. Ramaley, we will talk to you soon and I will get a good question out of you.

Dr. Remaley: Appreciate you.

Pat: Thanks doc, see ya.

Aaron: You won two to nothing today bud, I felt it too. I’m glad somebody picked up on that. I did feel it.