The Pat and Aaron Injury Report 11/17/22 with Dr. Gasser

Aaron: Oye Como Va. Welcome to The Pat and Aaron Show 95.3 WDAE and AM 620.

Pat: What did you say?

Aaron: I saw Santana recently Earth, Wind & Fire and Santana. Oh, Santana still got it, man. Santana still got it.

Pat: I won’t tell you about when I saw Santana.

Aaron: I had the smile on your face as it all.

Pat: It didn’t last long.

Aaron: The Pat and Aaron Show Injury Report time now presented by Florida Orthopaedic Institute in partnership with Tampa General Hospital that Santana story from Pat for another day, because it’s now time to talk with our good buddy, Dr. Seth Gasser. Dr. Gasser, thanks for joining us again this morning.

Dr. Seth Gasser: Thanks, guys. It’s good to be back.

Aaron: Well, we’ve got a lot to get to here and I want to start with tight end Zach Ertz a big loss for the Cardinals. He’s going to be out the rest of the season after an MRI revealed some extensive damage to his knee. Sometimes, Doctor, we see when some of these leg injuries, especially the knee, we don’t get the initial diagnosis for a while after, and it really varies. How come we see a lot of the announcements for this varying in time?

Dr. Gasser: I think that first of all, teams are a little reluctant to release the data before confirmation. I’ll be honest with you, most of the time, that doctor who’s taking care of the player is fairly sure of the diagnosis just based on the ability to see the play and know the mechanism of injury and get to examine the patient shortly thereafter. The MRI typically just confirms what the doctor feels at that point. Without confirmation of an MRI, I think they’re a little reluctant to release information that may not be 100% accurate. In general, for most injuries, MRIs usually confirm what we suspect just based on a detailed history and physical examination.

Pat: We’ve talked of course the ACL is the one we talk about the most but we know that knee injuries on the treatment of knee injuries have come so far and the guys are able to come back quicker. That said, is the recovery any easier, or there’s still a lot of work to do to get to that point?

Dr. Gasser: I think with some of these major knee injuries or surgeries, only 50% of the game and really the recovery is equally important. It’s a long road back from some of these injuries and this is where the athletic training staff for some of these professional teams, does a great job and really rehabilitating the athletes so that it’s safe for them to come back in a relatively timely fashion.

Aaron: Dr. Gasser, we know what a weapon Cooper Kupp has been for the LA Rams, especially us here in Tampa Bay. After the injury last week, we’re waiting to see exactly what Cooper Kupp was dealing with, with that high ankle sprain, well high ankle injury. Well, he is headed to the IR and required surgery on that ankle. What’s the indicator for you that an injury like this is going to require surgery instead of just being able to heal on its own without that surgery?

Dr. Gasser: That’s a great question. high ankle sprains or sprains of the ligaments that really connect the two-bit bones of your leg, the tibia, and the fibula right above the ankle joint. They occur by a little different mechanism than your standard run-of-the-mill low ankle sprain. The reason for surgery in high ankle sprains is if there’s actually any instability between those two bones, then they need to be repaired. That involves an operation to reconnect those bones. Typically, it was done with screws and now, it’s done more with these special sutures and buttons that have a little bit of motion that’s allowed in that joint, and that’s become pretty popular and has had a lot of national media attention in that what they call that TightRope repair this syndesmosis.

Aaron: Doctor, last night I was on the softball field and I’ve got this thing right now, I guess I’m not too confident with myself and my ability to feel the ground ball. At second base, I’ve been getting to one knee to feel my ground balls. Now I used to do that sometimes when I was like 12, 13, and I never used to hurt my knee. Now, I’ve realized at my old age, it hurt my knee. What type of damage am I doing to–

[music]

Pat, you better not play that sad Titanic music. What type of damage am I doing to my knee? Why am I not able to sustain that type of knee to the ground like I was when I was 13?

Dr. Gasser: Well, I think you know as we get older, our joints sometimes can get stiffer and we can get a little bit of wear and tear in our knee. I think sometimes it’s just a lack of appropriate pre-game preparation as far as just specific warmup and conditioning drills that you can do to loosen up your joints. If you have any significant pain that leads to swelling, it’s probably at that point in time to see somebody and get some imaging study to make sure there’s not something else going on.

Aaron: Well, that’s when I comes to you, Dr. Gasser. Expect a call in a week if it doesn’t go away.

Pat: Just expect to call in a week is what I definitely would say.

Aaron: It’s probably a good plan.

Pat: You mentioned with Cooper Kupp and his surgery the fact that it used to be done that surgery with screws and now it’s the sutures that allow to have some flexibility there within the joint. How much does that help when it comes to recovery? How much does that help when it comes to just the surgery itself, not having to put a screw in there and having something like that, that is more flexible for the patient?

Dr. Gasser: It helps tremendously. First of all, the screws require much bigger holes to be drilled to the bones. Then typically the screws need to be taken out because they will eventually break because that joint does have micro motion. The sutures are put into very small drill holes. It’s much less invasive. There’s less tissue and bone damage and it certainly allows for a much quicker recovery. As we’ve seen in some of these high-profile players that have had that they’ve gotten back to play in probably a third of the time that the normal screw fixation would allow.

Aaron: Leonard Fournette got a little banged up in Munich, but he is expected to be back after the bye week when the Bucs take on Cleveland. They’re calling it a hip-pointer injury. Can you describe to us what that hip pointer injury looks like, Dr. Gasser?

Dr. Gasser: Yes, sure. A hip pointer is really a bruise or contusion of the bone of your pelvis which is that prominence that you feel on the side of your torso that sticks out that’s called the iliac wing. It’s usually from landing on that or taking a helmet to that area where you get a contusion that can involve the muscles that attach there including the underlying bone. It’s typically a pain-related issue. It can be very painful since some of your abdominal muscles and your leg muscles attached to that bony prominence, which makes it hard to rotate or pivot, especially for a running back.

It’s one of those things that usually resolves relatively quickly and with a bye week, I don’t see any reason he couldn’t be back and playing for the next Bucs team.

Pat: Assuming that there weren’t a bye week coming up, is it the type of thing where there is some risk of re-injury if you play through something like that, or is it just simply pain management? If you can go and you can get it out, you can go.

Dr. Gasser: I think it’s pain management and be able to do those things required of your position to do them effectively based on the level of pain you have. They can pad that area with some more padding that would help. If it’s really sore, your body just not going to let you do those aggressive movements needed to be effective and that will be what would shut you down. It’s more of a pain issue than risking some permanent damage by trying.

Aaron: Now listen, we love having the doctors on from the Florida Orthopaedic Institute in partnership with Tampa General Hospital to talk about some of the football players around the league and really in any professional sport dealing with an injury.

Pat: And Aaron’s softball injuries, of course.

Aaron: That’s right because listen, if we can relate to it and we have an injury, it’s exactly why we have our good friends and doctors on from the Florida Orthopaedic Institute and Tampa General Hospital like Dr. Gasser here, so if you are having an issue, make sure you book that appointment today. The Pat and Aaron Show Injury report presented by Tampa General Hospital in partnership with Florida Orthopaedic Institute, they provide you access to one of the top orthopedic programs in the nation. Make that appointment today, floridaortho.com. Dr. Gasser, appreciate you coming on today. Thanks so much.

Dr. Gasser: Thanks, guys. Love your morning show.

Pat: Thank you, Doc.

Aaron: Thank you, Dr. Gasser. We love having Dr. Gasser on. He was back with us back to the mid-days when we were on and we love having him on in the morning along with all the doctors there seriously. If you’re dealing with a nagging injury, do not do that any longer. You have the doctor right here in your backyard. Book that appointment today once again, floridaortho.com.