The Pat and Aaron Injury Report 2/3/23 with Dr. Nofsinger

Announcer: Now, back to the Pat & Aaron Show. Mornings on WDAE and streaming live on the free iHartRADIO app.

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Aaron: Pat & Aaron Show, 95.3 WDAE AM 620. It’s time now for the Pat & Aaron Show Injury Report presented by Florida Orthopaedic Institute in partnership with Tampa General Hospital. Let’s go to the hotline now where our good friend Dr. Charles Nofsinger joins us. Dr. Nofsinger, thanks for joining us again. How are you?

Dr. Nofsinger: Good. Good morning guys.

Aaron: Let’s get right into it here, because we’ve got a week and a half until the Super Bowl is in Arizona, and you got the Chiefs and the Eagles and Patrick Mahomes high ankle sprain going into that championship game. I’m sure they did a lot of work on it leading up to it to get them ready for that game. He made it through. It looked like it got a little worse and it was wearing on him as the game went on. How much will the two weeks of rest– Because we know it’s not completely healed, Doctor, especially with the high ankle sprains, we’ve spoken about this before. How will the two weeks help him in preparation to get as close to normal as possible?

Dr. Nofsinger: It’ll help a lot. He’s got a really good athletic trainer. At college and pro level we have athletic trainers that literally their whole focus is on returning the athletes to play. He’ll get a lot better. He won’t be normal. High ankle sprains actually take about four months to fully heal. Guys, I know, it’s not a fun injury. He’ll be, with the adrenaline and all the care and the taping, he’ll probably be 85%, but that’s probably– I’m hoping it’s enough. I’m a Chief’s fan myself.

Aaron: 85% of Patrick Mahomes is better than 95% of the rest of the league.

Dr. Nofsinger: He is good. The NFL is, though. You’re at the absolute top level, so it’s a weighty scenario.

Pat: No doubt about it. Aaron, I think you mentioned, as the game went on it seemed like the injury got worse. I think it was also as the game went on and as the drugs wore off.

Aaron: Yes, the drugs went bye-bye.

Dr. Nofsinger: Yes, no question.

Pat: When you talk about rehabing from an injury like this, first of all, what kind of things do you do, when it’s short of surgery, what kind of things do you do in that rehabilitation process? If you’re working with someone like Patrick where you know they’ve got to try to use that ankle, even if they shouldn’t, even if you’d rather they don’t, you know they have to try to use that ankle sooner than you would ask them to, or you would want them to. Is that process, is any of that rehabilitation different? Do you do any kind of different exercises because that guy’s being rushed back into action?

Dr. Nofsinger: Yes. There’s a cold compression system that applies continuous pressure from your toes up to your thigh and cold at the same time. That really helps eliminate a lot of the swelling, which can be the source of the pain in this injury. Then we also have pretty wild new things .There’s something called blood flow restriction where you basically have two computer-controlled tourniquets, and you fire the muscle under these computer-controlled tourniquets, and it helps return the muscles, for instance, in his calf, much faster than they would otherwise. Then there’s even other wild things, like there’s something called the AlterG. It’s a treadmill that basically suspends you over the treadmill so you put just enough weight to fire the muscles but not enough to cause damage. He’ll be doing all that kind of thing.

Aaron: I want to ask you about Travis Kelce, because it was very odd. He appeared before the championship game on the injury report with back spasms. He played, maybe affected by them, didn’t have as much production as we’ve seen from him in the recent past. My buddy over here, Pat, is dealing with back issues himself. When you hear spasms, what exactly is Travis Kelce probably dealing with here?

Dr. Nofsinger: With his position, where you’re using the muscles in your back to either take down or hold off the opposing player, you can tear those little muscles that run along your spine back there. It doesn’t even have to be a bad tear. Then the little sensory nerves and the nerves that control them get trapped in that little tissue, and it’s brutal. I’ve had it myself. It sounds like it’s something minor, but those back spasms can be a real challenge. In terms of treatment, it’s the same thing. You do massage, you do what’s called electrical stim on those things, and then there’s some medication. It can be a really challenging problem to get over, even though it seems like a minor issue. I thought his recovery sounded like it was good, was my impression.

Pat: I was very interested/confused/ surprised when I saw the report that Brock Purdy is going to miss six months, regardless of whether or not he has surgery on his torn UCL. How common is that? How many injuries are there where your recovery is going to be basically the same regardless of if you have surgery or not? Also, why is that, and why would you opt with surgery if you’re going to have the same recovery time either way?

Dr. Nofsinger: Yes, that’s a really interesting problem. That tear that he’s got is what baseball pitchers get. If you’ve heard of Tommy John Surgery, that’s what we’re talking about. There’s a newer version. If you tear your ulnar collateral, which, talk about bad luck, huh? Yes, if you tear your ulnar collateral these days in a non-pitcher, like a football player or a wrestler or something like that, you can do an ulnar collateral repair. That’s what they’re going to do. They’re going to repair that thing, and then they put in what’s called an internal brace. It’s a special little support device you can put in there that allows the ligament to heal.

He’ll actually be back playing in six months, whereas typically if it was a pitcher, they’re not going to be throwing full gas until a year. Now, as to being non-op, I don’t think anybody in their right mind these days would not op that injury, because what’s going to happen is as soon as he goes out and gets even a minor hit like he had before, he’s going to be out again. I don’t know why they said six months non-op. Let’s say he had a partial tear, you could inject this stuff called PRP in there, and then he could be back as fast as three months. I think that statement was more for than it was for the athlete, in my impression.

Aaron: The body is fascinating, Dr. Nofsinger, and I’m realizing it myself. I never broke– I’m such a wuss–

Pat: Here comes the finger again.

Aaron: Hold on, Pat. All right, just give me a second. I had never broken anything in my body and I broke my fingertip and I went over, Dr. Neidich took care of me, put me in a splint, and he was like, “Hey, six to eight weeks you’ll be good.” I’m like, “That doesn’t make sense. You’re splinting me up, you’re taking the splint off to go in the shower,” but when I got the X-rays after about seven weeks the finger was healed and I was like, “I’m going to go play some golf.” I went and played some golf and my finger did not hurt. You think, “Six weeks? Oh, that’s a long time.” It really is not for that bone to really heal, and that’s a minor injury. I don’t even have a question. I just want to tell you, the body’s fascinating. I’m learning it.

Dr. Nofsinger: No, I’m with you, man. I’m glad it worked out. Did you end up just playing without the buddy taping?

Aaron: I tried the taping and I couldn’t hit naturally with it, so I took it off just to feel it out. Did it get a little swollen after I iced it up? Yes, but the function was there. I shot at 86. What’s up?

Dr. Nofsinger: Nice.

Aaron: It was so bizarre to me after the feeling I had when I broke it and how much it hurt to me being able to play golf seven weeks later. The body is fascinating.

Dr. Nofsinger: Yes, it’s amazing.

Aaron: That’s how I’m going to end it. That’s all I got there. Oh, I was going to say for Landon– Let’s end it with this, Landon Dickerson dealing with a hyperextended elbow. He’s expected to play. We saw something similar with our Donovan Smith, here in Tampa Bay. What impact will that have on a guy like Landon Dickerson?

Dr. Nofsinger: Zero, once the adrenaline hits. When you hyperextend your elbow you stretch the ligaments out and the capsule in the front of your elbow. You have a balloon around every joint that keeps the fluid in and keeps it stable. With that injury, when the adrenaline hits, it’s going to have zero effect on him.

Aaron: All right. Listen, we will certainly keep our eyes on these injuries and catch up with the Florida Orthopeadic Institute in Tampa General Hospital next week. For now, Dr. Charles Nofsinger, always love having you on the show, thanks for joining us today.

Dr. Nofsinger: All right, I appreciate it, guys.

Pat: Thanks, Doc.

Aaron: Good luck to your Chiefs. I mean that.

Pat: Oh, I mean that, too. F the Eagles, dude. F the Eagles.

Aaron: I’m with it. On the text line, you guys stop being mean to me. All right, I know. You may not care about my dumb little finger. I was just trying to say how the body is fascinating.

Pat: Your dumb little finger.

Aaron: I know.

Pat: The vitriol.

Aaron: The things I have to deal with. It’s unbelievable. The Pat and Aaron Show Injury Report presented by Tampa General Hospital in partnership with Florida Orthopedic Institute, providing you access to one of the top orthopedic programs in the nation. Schedule an appointment today at floridaortho.com. May I add that-

Pat: You may.

Aaron: -that it is so easy when you go there. I love that. The convenience of it. I’m a guy who is very impatient, especially when I have things to do. It’s a well oiled machine, whether it’s the X-rays you have to get and then see the doctor after, they move you along.

Pat: Not like us.

Aaron: Yes. Seriously, we’re late. All right, but they move you along. Florida Orthopaedic Institute, book that appointment today at floridaortho.com