2011 Spring Training General Discussion

[Ramp]

I think AJ Burnett is going to have a nice bounce back season

He's looked great in ST thus far.... I know I should know better, but yea

[THE_REAL_MIBS]

Ken_Rosenthal: Greinke suffering from some type of ribcage injury. #Brewers about to inform the media. Will miss first 3 starts of season. #MLB

/Twitter

Heard he got hurt playing basketball.

[Ramp]

Says he could start if this was the playoffs

[jOOj]

I think AJ Burnett is going to have a nice bounce back season

He's looked great in ST thus far.... I know I should know better, but yea

MLBnet had a segment showing how he's cleaned up his delivery. It actually seems like it worked, got rid of the Kev Brown turn.

[Miamarlin21]

/Twitter

Heard he got hurt playing basketball.

He was playing against Aaron Boone.

[MiamiHomer]

Is this talk true that the Phillies fear that Utley's knee issues might keep him out for the season?

[DColts]

Diagnosing Utley’s Injury
March 9th, 2011, Author: David Hale, Categories: Uncategorized

An MRI on Monday revealed that Chase Utley not only was dealing with patellar tendonitis, but also a condition called chondromalacia, otherwise known as runner’s knee.

Of course, most of us don’t know much about it, and the Phillies offered a pretty vague diagnosis.

I figured we should get some background from someone with a little more knowledge of the injury and how it is typically handled.

I spoke with Dr. David Rubenstein, who is head of sports medicine at Lankenau Hospital and the team orthopedic surgeon for both the 76ers and the Philadelphia Soul. While Rubenstein is not directly familiar with Utley’s case, here’s what he had to say about the typical process for an athlete dealing with chondromalacia.

DH: First off, what exactly is chondromalacia?


DR: Chondromalacia, otherwise known as patellar pain, is a very common diagnosis, anywhere from kids all the way up. When kids have it, it’s typically not associated with arthritis, but when adults have it, it can be. When they first said the diagnosis as patellar tendonitis, it’s probably because they had a typical chondromalacia picture, but the expectation was he would get better, so why not give a diagnosis with a short-term improvement. Now that he’s not improving as quickly, that diagnosis would change to one that is probably the more specific diagnosis, and that explains why he might not be getting better.

DH: So what would be the typical course of action you would take for a patient dealing with these problems?


DR: Chondromalacia is basically wear under the knee cap. In a patient with chondromalacia, it’s not unusual to perform injections. There’s two types, steroid injections or artificial lubricants. When they inject him, it’s typically one of those. It’s rare to inject patellar tendonitis, which makes me believe the diagnosis all along was the (chondromalacia) problem. That really does make sense. I do the same thing.
DH: You mention the word ‘chronic.’ That’s probably a little scary to Phillies fans. Is this something that could be a recurring issue for Utley in the future?


DR: It’s a chronic condition. It tends to recur. You can have it, you’re great, come back, five months later you can develop it again because the same activities that caused it the first time are typically the same activities he’s doing on a repetitive basis. So the things you would do is to try to get him better and try to prevent a return. Typically the way you do that is flexibility exercises, a good strengthening program and an appropriate practice schedule.

In his case, it’s interesting because here’s a guy who has a condition that seems so benign in patellar chondromalacia, no big deal. Yet, this is the same guy that had hip problems, thumb surgery, and has bounced back. So it just makes you start to wonder if it’s a little bit more of a serious patellar chondromalacia than you see in the average individual, just based upon his history. It’s a common problem, but it’s clearly more severe with him.

DH: Brandon Inge, a player for the Tigers, reported similar problems and said that, after surgery, it took him a year to get back to being completely healthy. Is this typical? What does the surgery entail?


DR: First of all, surgery is rarely, rarely, rarely appropriate for this condition. You rarely do it. If you look back at the typical sports medicine doctor’s practice, and you look at the number of times he operates on cartilage tears or ligament tears vs. the number of times he operates just on a kneecap problem like this, it’s really rare. The plain and simple reason is most people do get better. If you are forced to operate, there’s two reasons: First, it portends that this is a worse condition. The second thing is the surgery is incredibly simple – it’s called a patellar chondroplasty, you simply smooth out the cartilage. You make the rough ends smoother. The procedure itself is like a 15-minute operation. So when you talk about a professional athlete who says, ‘Boy, it’s taking me a year to get back,’ you start to wonder if it’s the actual procedure or more likely it’s the underlying condition that’s still bugging him.

DH: You mentioned one other word that I think will worry some people, and that’s ‘arthritis.’ Is this injury typical of something more degenerative?


DR: Baseball players don’t like to use the term arthritis, but it’s clearly arthritis. That’s pretty much what they have. Even though he’s 32 years old, given the type of activities he’s done and the intensity he’s played with, it could easily cause arthritis. A lot of times, the teams, the doctors, the players don’t like to use the word. It’s a negative word, and that’s understandable. It’s just an arthritic condition. Basically any wear under the kneecap, by definition, it’s an arthritic condition.

DH: OK, so let’s assume you have a patient who has experienced symptoms similar to what Utley has reported, had the cortisone injection, rested for several weeks, and still it’s not better. What then?


DR: Surgery is not something you push for unless it’s literally getting to the point where nothing else is working. Most people if they’re getting to this point, whether they’re pro athletes or just regular average joes, do get better without surgery. So that’s always in your favor. The big negative here is that he’s on a timeline, and that timeline is probably the only thing that would push you to consider surgery for this condition.

DH: So given Utley’s timeline, at what point would you expect the surgical option to enter the picture?


DR: Since we know now, it’s not just patellar tendonitis, I’d say if this guy is not better by the beginning of the season, he’s going to get scoped. That’s my opinion. He’s had a long enough timeline for conservative care, he is in great shape, most likely he kept himself in good shape in the offseason. … Beyond that injection, certainly they could try another one, but if he’s not playing at the beginning of the season, you’ve got to do something.

DH: And if he does have surgery, what’s a typical recovery time?


DR: The typical recovery time is, just in general, very quick procedure, on crutches for just a couple days, taking it easy the first week, beginning exercise at one week, and then it’s what we call ‘as tolerated.’ That means if a guy within four weeks after that, from the time he begins his exercises, can run, can cut, can do everything with minimal swelling, good range of motion, a little pain, he could play. So we don’t limit people after this type of surgery as opposed to an ACL or rotator cuff where we say six months or however many months. It really depends on how the patient does, and some people are quicker than others.

***

So the bottom line here is this is not a catastrophe. It’s more serious than fans probably hoped, but this isn’t something that should keep Utley out for the season.

What struck me is how similar what Dr. Rubenstein said mirrored what Scott Sheridan and Ruben Amaro said. It’s a situation that can resolve itself with time, if the team and the player are willing to give it that time. It’s not a season-ending problem. It’s something that will simply require some patience and, if all else fails, surgery.

So, hopefully this eases some fears. Continue on with your day now.

http://blogs.delawareonline.com/phil...utleys-injury/

[emkayseven]

[MiamiHomer]

I prefer to watch it.

[ame]http://www.youtube.com/watch?v=djQZhUc-0U0[/ame]

[Miamarlin21]

Now on MLB Network, Jorge Cantu and his nasty porn stache.

[Miamarlin21]

Luis Salazar had his left eye removed.

[Ramp]

http://bcove.me/3runeegg

Mariners always have the best commercials

[Todd]

Luis Salazar had his left eye removed.

Sorry to hear that.

[Ramp]

CBS is better than this... right? (look at name of column, with story)

[emkayseven]

I guess I'm missing something
--------------------
oh it's called eye on baseball

well that's just unfortunate