Tommy Tuberville expecting injured RB Eric Stephens to play this season
"The doctors' theory is patients should begin knee rehabilitation work before having surgery so the doctors can see what's going to heal naturally and where they need to step in and operate to promote healing."
4 months ago
jdhud
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The nuts and bolts of this, here is the study on it:
Here are the links from google:
http://well.blogs.nytimes.com/2010/08/04/phys-ed-how-much-does-knee-surgery-really-help/
http://www.nejm.org/doi/full/10.1056/NEJMoa0907797?siteid=nejm&keytype=ref&ijkey=G71WpXzKHwYf2&#t=articleTop
http://thechart.blogs.cnn.com/2010/07/22/torn-acl-may-not-always-mean-surgery/
This is one small, short term study in a junk-drawer/catchall journal, and not a specialized journal in the specific field. The authors fall all over themselves to make it clear that you can’t interpret anything from the study they just did because we aren’t really saying what we are trying to make it look like we are saying.
In fact the letters to the editor point out that with the people who ran the study responding in vigorous agreement!
Now, I am not a doctor, but anyone who has been to college can read and interpret a scientific journal when it is straightforward- and have been trained to do as much in their studies. I found often enough that such articles were carefully engineered to be completely deceptive to fool those who weren’t paying very close attention. So many of them were designed to make headlines and bring in money for the inevitable “further research is needed” part while being totally fast and loose with the science that got them to that point- but they were still published. This one here looks insignificant and incomplete, and the authors would probably agree with me.
So how do we get from here to Tubs and the team doctors making a big shift in treatment in the real world on a real player? That’s a pretty damn bold thing to do if you ask me. I would also like to point out that the study has nothing to do with what Tubs is describing, so he or the doctors has completely missed the point of the study.
Right here: “Tuberville said Tech’s team doctors have a new approach to knee injuries and implemented them on Stephens. The doctors’ theory is patients should begin knee rehabilitation work before having surgery so the doctors can see what’s going to heal naturally and where they need to step in and operate to promote healing.”
This wouldn’t be happening if Stephens didn’t want to play.
He wants to take the risk, so Tubs will let him, but really this new wave thinking and course reversal doesn’t amount to a hill of beans except something to point to if it goes badly.
It might make the perceived risks less, that’s about it.
No one can say for sure what will happen. Here’s to hoping it works out okay.
And the different groups are rated on selected sub scales of the KOOS before and after treatment.
That’s nice and dandy and all, but the KOOS is a far cry from NCAA division I football. As a physical therapist, I’m all about conservative treatment. And for many average young and middle-aged people who are not in competitive athletics, sure, it may be likely that they could achieve a similar quality of life without surgery. But I find it hard to believe that a non-operated knee is going to be as dynamically stable in a high-impact competitive setting such as football, especially for a back. The very article pointed out another study that looked at knees 10 years out from rehab, comparing operated and non-operated knees. Guess what: the non-operated knees were found to be less stable. Dynamic muscle control can do a lot for stability around a structurally compromised knee, but when your playing aggressively and taking big hits, you need every advantage you can get which includes inherent joint stability.
My guess is that they’re just letting rehab go for a while before doing the surgery, but they are still planning on doing a surgery. I don’t see any big draw-back from that other than the actual time it takes to recover post-op. As long as they don’t cut it too close to a new season, not doing a surgery right away won’t necessarily impact him negatively.
"They challenged us. They said, 'Here, try to run past us, try to run inside us.' And they were better at preventing that than we were throwing and catching it." --Mike Leach
So then
there is always a risk of more damage, since this is an athlete? This potential damage would progress through the knee’s other parts due to the instability?
I get that Tubs isn’t forcing injured players out on the field and it is a personal choice, but it looks to me like they might have some concerns because they have a study that- on the surface, backs up their call to let him out.
I mean I only see it happening this way if the forecast is not good for this season. If they need that to let the guy play then, hmm, ya know?
He just sounds so vulnerable.
Heck, even healthy knees are vulnerable in college football
So there is always a risk for re-injury. My understanding is that most re-injury in athletics occurs due to impact, and who’s to say that impact wouldn’t have damaged a healthy knee as well? Football is a high risk game when it comes to ACL’s.
In another fan shot, guys talk about the training regimen that Wes Welker has now after his knee surgery. Wes trains so hard to try and reduce the risk of re-injury. Studies I’ve seen show that just having a reconstruction can significantly decrease in re-injury rates. The risk can be reduced even further with good training to improve the dynamic stability around the knee (muscle control).
The problem with instability is that it reduces the ability to plant and cut or do sudden dynamic shifts which are necessary for most running backs. If there is instability and the joint gives, there tends to be a collapse. I’ve worked with patients with enough instability that their knee would buckle just walking through a room. With training and strengthening, they can generally learn to prevent that. However, you can see the benefit of not having to worry about the instability causing collapse in the first place.
ACL repair generally takes away much of the instability and weakness within the joint itself. And then the athlete trains hard to increase the muscular stability around the knee to further protect it.
"They challenged us. They said, 'Here, try to run past us, try to run inside us.' And they were better at preventing that than we were throwing and catching it." --Mike Leach
Two words
Wes Welker.
If you want to follow what he did to have a successful comeback, then I would say do that. Something new, as mentioned above, may work, but we know what Wes did really worked. And to be fair, Welker probably worked out sooner than the docs expected and he was so determined to make a comeback that he never considered failing. Doggedness. Perserverance. Strong will. Focus. It all comes into play, besides the actual operation. Also, Wes did not start rehab unil after the surgery was performed. If Stephens would discuss this with anyone, it should be Wes Welker. I think Stephens can do this. But, if the new theory is applied, I sure hope it can and will have the same effect as what Wes went through. Hopefully as quickly and as good.
TTpilk
"Never, never, never give up." Winston Churchill
Didn't he
just dislocate his knee? I haven’t heard this ACL/MCL stuff ’till now.
Shawn Johnson... she's a nice lady
Well, seeing as how the ACL/PCL and collateral ligaments are purposed to prevent the knee from dislocating....
it’s not surprising that they suffered damage.
"They challenged us. They said, 'Here, try to run past us, try to run inside us.' And they were better at preventing that than we were throwing and catching it." --Mike Leach
This is scarey to me.
Eric’s medical team is using this study to inform his treatment? The comments from the last link and the third and last link in the top three are not positive to me. I really hope the best for him, but this would not be my advice.
It's cloudy
but doctors generally don’t just start doing new things without some information behind it. (This is the division between medicine and witchcraft.) So I went and looked for a magic new ACL study and this was the top of the charts. Makes enough sense to me.
The picture I am starting to see is that is is probably not bad UNLESS something else happens Could be riskier, Could be fine.
Not a doctor, and that study is pretty much all I know about knees. Seems that the TTU model is a mix of this study and tradition.
More of a gamble than knowing for sure perhaps, but if he wants to play then, well, there is something out there that quasi covers TTU’s butts on it.
Anything else you will have to ask Silver_ because he appears to have a handle on this stuff.
Haha...I don't know that I have a handle so much.
I’ve worked with a bunch of ACL repairs in my career, but my specialization is neuro. And the same as you, I am not a surgeon. Most cutters know what they’re doing and like to stay on top of the game. It’s a competitive field, and they’re kind of like the fighter pilots of medicine. The team doctors have the health and wellness of the athletes in mind in addition to the success of the program. So, I trust that they’re not doing anything without reason.
I still think he’ll have the surgery. Most patients have PT to some degree on another prior to surgery. It sounds like they’re just letting him work a bit harder prior to surgery. It makes me wonder if he has just a partial tear or something vs. a full thickness tear. Don’t know. We’re just on the outside looking in with this one.
"They challenged us. They said, 'Here, try to run past us, try to run inside us.' And they were better at preventing that than we were throwing and catching it." --Mike Leach
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