The Pat and Aaron Injury Report 12/8/22 with Dr. Echols

Pat: Our number three of the Pat Aaron Show. Thanks again to USF head coach Alex Golesh for joining us for an extra-long conversation. We stretched things out a little bit. Normally about 7:45 we have our injury report with our friends from Florida Orthopaedic Institute, but instead we had to move that into the 8:00 hour and move to right now. And of course, the Pat Aaron Show Injury Report is presented by Florida Orthopaedic Institute in partnership with Tampa General Hospital. And joining us right now for the first time, we’re always excited to get a new doctor on, Dr. Eddie Echols. Dr., good morning! Thanks for being with us.

Dr. Echols: Good morning!

Pat: So Lamar Jackson, of course, suffered a knee injury this week. He’s being considered week to week for the Baltimore Ravens. He exited, of course, in the second quarter with a potential PCL strain and/or bone bruise, which is confusing to me that a bruise and a ligament could be confused or, you know, it could potentially be one or the other. First of all, talk about what the PCL is because we don’t hear about that ligament as often as say the ACL. And how is it that you could confuse potentially a ligament injury with a bone injury? How is that something that’s not I guess a little easier to detect?

Dr. Echols: Okay, so, alright, so you’re right. We hear about the ACL more frequently than we do the PCL. And the PCL is actually a lot harder to deal with when it is injured. Now the way that you routinely injure your PCL is if you have an injury, a blow to the inter-aspect of your knee. So in that regard, you know, a bone bruise, it’s just like you get a contusion. Say if you hit your arm really hard and it gets sore, it’s a contusion. Well, a bone bruise is kind of the same thing. You basically see fluid within the bone on the MRI. So when we’re looking at MRI and we’re evaluating ligaments, then we’re looking for what we call “signal” within those ligaments. And so in that regard, you could actually have signal in the adjacent bone as well as that ligament. And just to kinda explain what the PCL is, you know, the ACL and the PCL are those ligaments in the knee that keep your shin bone from moving forward or backward in relation to your bone. And you know, there you have it. So yes, he sustained that injury, and you know, the good news is that it doesn’t appear to be a complete tear from what they’re saying. So, you know, that’s the positive aspect of it.

Aaron: Dr. Echols, one of the reasons we love you all so much, we love having the doctors on from the Florida Orthopaedic Institute and Tampa General Hospital is y’all have personalities and y’all have, you like sports as well. I’m seeing on the text line, somebody must know you, they’re toying with you. We got a text, “go Army, beat Navy.” Are you a Navy grad?

Dr. Echols: Yes, I am an Annapolis grad, but I’m sure Navy will prevail.

Aaron: Well, thank you for everything you’ve done and certainly going to Navy. Extremely impressive. We, Pat and I,this is the first year we’re not going to be in Philadelphia for the Army-Navy game. Our good friends Zack Blatner and Jay Recher, they’re there, but I’ll tell you it is so much fun every single year, Dr. Echols.

Dr. Echols: Yes. Yes. It’s

Aaron: All right. So I wanna get back into, uh, football here. Kenneth Walker, we all know he is having a really good year’s running back for the Seattle Seahawks. Saw he had an ankle strain and coach Pete Carroll had to come out and say the MRI revealed it was a strain and not a sprain. So what’s the difference between a strain and a sprain?

Dr. Echols: Okay, so in essence, they are along the same category. You know, it’s a difference in severity. So when we look at a sprain, once again, when we refer back to “signal” on the MRI, we’re basically looking at, you know, fluid within that ligament. Um, now when we talk about strains, we’re really kind of talking about partial tearing or stretching the ligament. Now here, you hear, mild, moderate, severe. So technically to be outta a sprain, then there’s the signal within that ligament without any stretching or caring of the structure.

Pat: Now, Jimmy Garoppolo, it sounds like he could be potentially okay for the playoffs. Of course, he went out this past week and they thought originally it could be a Lisfranc injury, but they’re, they’re saying he did not suffer Lisfranc injury to his broken foot and he’s not gonna need surgery if his rehabilitation goes. Well, they said he could be back in seven to eight weeks. What would have to happen for him to be ready to return for the playoffs in that seven to eight weeks or so?

Dr. Echols: Okay, so ultimately everything would have to heal and then he’d have to be pain-free. Yeah, that, that’s gonna be the key thing because you have to be able to try to get out there, react and protect yourself. So the Lisfranc injury is an injury to a specific joint in the foot, which is very difficult to heal and to run on. Luckily, he obviously did not injure that joint, but must have had fractures in the bone surrounding the joint, which once again, pretends more of a positive prognosis because once the bone heals, then the joint is stable. And to answer your question, once it heals and he’s pain-free, then he should be able to play. But that’s, that’s the tricky part you know, being pain-free and able to react.

Pat: And let me ask you about that. When you say being pain-free, right? Is that because if he’s not, you’re concerned about re-injury, or is that just because if he’s not, you don’t think he could really perform well enough?

Dr. Echols: Actually both. Okay. Um, so if he’s not, then he’s probably not gonna perform well. And on top of that, if in fact he’s not pain-free as he’s running and doing things, then you place strain on other structures that you don’t normally place that amount of strain on, which could lead to other injuries.

Aaron: Matthew Stafford dealing with a spinal cord contusion, he’ll be out the rest of the season. But I’m thinking this could end his career, right, doctor?

Dr. Echols: Not necessarily. No.

Aaron: Well, that’s why I’m not a doctor.

Dr. Echols: So the key thing there is the other structures around the spinal cord. So for instance, said he had broken vertebrae and he had say bone fragments affecting the spine or something like that. That’s a different story. Um, the contusion once again is, you know, he, he got hit, he fell and the cord got bruised per se, but if all the structures are still intact, then once again, it’s just a matter of the bruise resolving. And as long as he doesn’t have any neurologic impairment, which I don’t think he does, I think they would’ve indicated that if that were the case, then no, he can come back from that in appropriate time.

Aaron: Doctor, uh, my finger, I gotta bring this up. I had my finger tipped in softball the other day. It got hit by a softball and I knew something was wrong, and I went yesterday to urgent care. Turns out, I got an x-ray. It’s broken, it’s dislocated, apparently broken and fractured are the same thing. I’m actually going, I’ve got an appointment today with you all at Florida Orthopaedic Institute at about 10:45. But I, before I do that, should I just cut the tip off or like just go see you guys and, and get further evaluation because I’m ready to cut it off. It’s, it’s gnarly.

Dr. Echols: You know, the, the only person that I know that just had their finger cut off because of an injury was Ronnie Lock. Yep, that’s right. San Francisco 49ers. I don’t think it’s gonna be that important to just have the finger taken off. Alright..

Aaron: So don’t take it off.

Dr. Echols: No, don’t take it off. That should, that should heal. You know, obviously, we’ll evaluate you. We’ll determine whether or not there’s been any tendon injury as well. And as long as the tendons are intact, um, and it’s just kind of, you know, a fracture to the bone once again in time, that should heal in place and you should regain full function for golf.

Aaron: Six to eight weeks. Or will I be out on the course?

Pat: Never, never again.

Aaron: Don’t say that, Pat.

Dr. Echols: Well, I tell, you know what, how good is your golf game?

Aaron: I’m average.

Dr. Echols: Okay, well, alright man, well then we may get you back out there. Six, eight weeks, which, which finger is it?

Aaron: It’s my middle, my right hand, my dominant hand, middle finger. I’m flicking everyone off.

Dr. Echols: All right. And if, and it’s a tip that used to be okay, you should be okay. 

Aaron: I love you doc.

Dr. Echols: You’ll be able to grip the club okay in that regard. Now look, hey, but if you lose the strokes on your game, don’t blame me.

Aaron: Good deal.

Pat: Hey, hey Doc, really quickly before we let you go, uh, to be a hundred percent serious, we got a text here on the Bartow Ford D8 text line that says “I’m a 100% disabled veteran that is allowed to work. Without Florida Orthopedic Institute. I’d be hurting a lot.” Uh, I think that’s maybe something people don’t understand a lot, right? It’s not only, is this something where you may need the Florida Orthopaedic Institute and help for catastrophic immediate injury, but something that’s long-term pain management, you guys can really help in that area as well, right?

Dr. Echols: Definitely, definitely. Oftentimes, uh, individuals have problems dealing with their spine and things of that nature, and sometimes things can’t be corrected with surgery. But in those instances, then we can also help, you know, with daily management from a standpoint of pain and things of that nature so that we can once again keep you moving, keep you active, and get you back in the game.

Pat:  Hey doc, really quick again, before we let you go, has anybody ever told you, you sound a little bit like Dave Chappelle?

Dr. Echols: I gotta tell you, I haven’t gotten that one, but there’s a first time for everything!

Pat: Hey, the Pat Aaron Show injury report is 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. You can schedule an appointment today floridaortho.com. Again, Dr. Eddie Echols joining us for the first time. Doc, really appreciate your time today. Thanks for being with us.

Dr. Echols: Hey, thanks for having me.

Aaron: Hey, great stuff. And go Navy.

Dr. Echols: Beat Army. That’s right.

Aaron: Thank you Doc.