The Pat and Aaron Injury Report 11/10/22 with Dr. Remaley

Aaron: Pat And Aaron Show 95.3 WDAE and AM 6:20. Time now for the Pat & Aaron Show injury report presented by our good friends at the Florida Orthopaedic Institute in partnership with Tampa General Hotline. Let’s go now to the friendly care, DAE hotline, where Dr. Trey Remaley joins us once again. Dr. Remaley, thank you for coming on with us today.

Dr. Trey Remaley: Of course, gentlemen, it’s awesome being back on.

Aaron: I want to start with Josh Allen because we were talking about this a little bit earlier. He’s dealing with his UCL injury. First, let’s just talk about what the UCL injury is and how they vary.

Dr. Remaley: The UCL commonly here in baseball terms as the Tommy John ligament, it’s inside the elbow and it gives some good stability for throwers. It’s pretty important for quarterbacks in everything. It can run a gamut from an injury level of just a mild strain to a complete tear. In throwers, if you have a tear, then it’s a surgical situation and then you’re looking at about a year of rehab. I think the word came out that his was a strain and he’s probably still questionable in day-to-day at this point.

Most of that depends on what his exam is and truly what his function is, can he tolerate throwing and things like that? After the injury happened, he stayed in the game and didn’t miss any more snaps or anything, but it could keep him out of a few games depending on how severe it is through the week and things like that. It’s pretty significant ligament for elbow stability for throwers, so definitely keep an eye on that.

Pat: He dealt with a similar injury his rookie season. If you’re seeing a patient and they have something like this and it is something that has happened, even if it’s been a couple of years, something they’ve had before, are you any more cautious? Do you handle the injury any differently because it’s something that is a reoccurring thing for them?

Dr. Remaley: Well, you always keep it in mind and you look at, truly it comes down to what his exam is like and what his function is. You’ll use the imaging, MRI, to see exactly what the character of the ligament itself looks like. Most of his recovery in rehab, what he is getting from the athletic trainers and everything, we’ll watch his progress and as long as he can function and can deal with it, usually, it won’t be too much of an issue if you’re just dealing with a strain long-term.

Aaron: Ezekiel Elliot for the Cowboys, doctor, has been dealing with a knee injury for a while now. They do expect him to go this Sunday and give it a go against Green Bay. How do you determine the extent of knee injuries, especially with a running back who’s using his legs all the time?

Dr. Remaley: It’s a pretty important joint for running backs. A lot of it depends, again, you got to look at the joint, look at the function, what does your exam show, how stable does the knee feel. Then, really one thing that we’re finding out with a lot of knee injuries and recoveries and stuff is this thing called a knee confidence. How much is your mind telling you and how confident do you feel in the stability and the function of the knee?

You got to look at what they can do based on the injury and what are the things that they can’t do. Especially for a running back, it’s definitely about the sudden stops and starts and cutting. You’ll do some functional evaluations on them and look at what your exam is of the knee. Then, of course, using the imaging studies that people get X-rays and more importantly, the MRI. A lot of it comes down to what is his functionability? What can he do? And how confident does he feel in what he is able to do?

Pat: What about regular schmucks? Like say, I don’t know, me, and if I have a knee that it’s just been weird since I had it, I don’t even know exactly what the injury, honestly. As a young person, I got hit by a car and then also got tackled weird playing football with my brothers. From time to time, I’ll be walking and it’ll just give out. I could almost hit the deck if my other leg didn’t kick in and hold me up. Is there any way to know what that is or how worrisome that is, if I should see somebody about it? Because for the most part, I’m not in a lot of pain from day to day, although from time to time it gets a little cranky, but every now and then, like I said, I’ll be walking and it’ll just drop right out from under me.

Dr. Remaley: Those are the things that we get worried about a lot of times when patients just describe, “It kind of gives out.” It can be anything from maybe a small meniscus tear that can be symptomatic or a cartilage injury, and even some earlier arthritis. Dare say that you have arthritis because I doubt you’re that old, but —

Pat: Oh, I am.

Dr. Remaley: [chuckles] Again, it’ll come down to what does our exam show? What is the imaging look like, and those same questions that we would ask you. What are the things that you can do, and what are the things you can’t do? If it’s starting to give out on a more regular basis with just daily activities, it’ll probably be worthwhile looking into to make sure there’s not something structurally wrong that needed to be addressed to make sure you’re not falling down all the time.

Aaron: Dr. Remaley, I don’t know how– we usually send you guys a list of some of the NFL injuries and we go into that, but you all are so good at going off the cusp here. How familiar are you with what happened with Edmonton Oilers Forward, Evander Kane against the Lightning the other day?

Dr. Remaley: I haven’t looked into what his injury is.

Aaron: Well, I want to ask you because he got cut on his left wrist by a skate blade and it was really bad. You saw, and we heard about the amount of blood that was coming out. What shocked me is, once I found out he was okay, I felt, “Okay, they’ll stitch them up, they’ll get him back and he’ll be back on the ice.” We found out he’s going to be missing three to four months after that injury. What goes into that, and why is the recovery process so long for a cut?

Dr. Remaley: Well, the first thing you obviously got to get the blood stopped, and bleeding stopped, and get it controlled, and looked at. Across the wrist, depending on where the cut was, obviously, you’ve got the arteries and everything there but more importantly too are just as important are the ligaments and the tendons for your fingers. If those got cut in any way, those would have to be repaired, and then going through the rehab and making sure they heal up, can take a couple months for that.

It’s pretty important to, again, look at the functional evaluation, and what’s working and what isn’t, and even if you injure a nerve, because there’s several nerves across the wrist too, they give you function to your hand and so if any of those are injured, those become pretty significant concerns as well for recovery and what is the function going to be like down the road.

Aaron: It was really a scary injury, and glad to see he’s on the mend. It really was. The Pat and Aaron 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. Schedule that appointment today, floridaortho.com. Seriously, don’t deal with those nagging injuries anymore. These are the people you need to see Dr. Trey Remaley, thank you so much for joining us again.

Dr. Remaley: You bet guys. You got to take care and stay safe out there.

Aaron: You as well.

Pat: Thank you, Doc.