Mar 6, 2017|
Rob Bradford is joined by Dr. Nick Leong of Newton-Wellesley Orthopedic Associates to discuss all the ins and outs of David Price's injured elbow. Dr. Leung explains why the Red Sox and Price might have taken the course of action they did, what the prognosis could mean and where the pitcher goes from here.
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Add road show. That might open definitely probably would have brought that I don't. Wearing where you don't know what you're stupid Brad broad show. That's delicious. I don't know if you heard this of David Price of the elbow issue. So that big of MRI went through the best start in the world is now everything seems to be five or roll. Like I didn't. We felt facilities. But what does this actually mean for prices elbow going Ford and what exactly happened. I don't feel like I'm equipped to tell you. If he's gonna be okay or if it's at the right route. Or or really how all this came about. But I do know a man who can help put a lot of these questions. That's why you should pay attention this. Joining us from Newton Wellesley. Orthopedic associated this doctor nick Leon. Once again on the Brad vote showed darken the young's thanks so much for joining us because there is no better time it's always good to have you on the there's no better time than right now because. The talk of baseball. Has to do with something that you actually are. Have a lot of the milk here parity with which is the human elbow and in this case David price's humor ago. I. So let's get right to it. David Price has a lot of people known had an elbow injury he went through a simulated games which means he threw two innings worth of pitches. He came out of that and he had some discomfort in the elbow forearm area. And then it was enough discomfort in the forearm and noble in areas to. Actually get an MRI and then after that MRI he had a second opinion this flown up the Indianapolis. To visit way of two guys who are perceived as the best around other than yourself. But I got a doctor James injures and doctor Neil Allen tribes are you familiar with those guys by the way. Oh yeah no question about it go to Europe some of the most prominent and or medicine. It. To hear from two groups of guys out there it's it's. Finally. So so if your if your gonna fly to Indianapolis Hewitt Hewitt and confirm. Those are two guys who you were one fly Indianapolis for. Oh absolutely go there that went through name bigger most. Are it's a work of the first questions I have for you is before we get into the meat and potatoes of the elbow. Is that I. When we heard of this week we heard second opinion darker handers specifically. It's our ball and I know there's been cases where he's he's actually steered people in the opposite direction of the first opinion. Ball why do you get the second opinion is it normally when you do that is it normally because there is some thing there. That is very very concerning or would you think that almost is a thirty million dollar a year guy so you're just covering your bases. What being largely probably more the second for. A player they're part regarded certainly water sure absolutely sure and double and triple check make sure of it on the right thing. And I think possibly another. Mark mark. Thought I'm outrage. Media or elbow Buren in your opinion on in apartment elbow and a throwing arm. A pitcher. And so many times I mean what. What are people think of course which. The public don't interest and down. Earlier this but I hear that it's not and that that we did note surgery and we're just going to. I rescue in rehab year that may possibly it might cost per capita well I certainly don't fault anybody predict a second opinion about it. None I don't either and as it turns out like is the darker and uses steered guys one way or the other which might have been opposite of what how they were gone so. It is good for the patient good for the team. Now when we talk about the the the mild strain of a flex their muscle and bone Spurs is what report Lee white David Price test. When we hear strain there was an executive that told me one point in baseball they said when they say strain that means there. Is it would that be accurate for the most part. Yeah well there's a lot of political weight you can word I'm injury a strain that basically an injury to a muscle some. Strange indeed I'm not I'm out. On the weekend and plan on pick up baseball and you're reputed and it could mean pumping all the Richard. To and you're saying. A era muscles efforts. And then the computer and grit and how much of that market there and was a long look at varying degrees how long it take wonder recovered a thorn claim form so. Be. So you are right in. You know what aspect of strainer there's such a wide variety of Spain and I've been for that reason there's such a wide credit treatment and not always a single and a. Right focus because what people are going to be ours through darker when people here strain. They feel like all in the Olympic basketball I strain my something rather. But when they hear hair it's it's a little bit more freak out situation so I guess him. Yeah and an MRI it's hard to tell the difference between the puke all go out there are a lot of times are. True mottled here. I can look a lot of strange question it at a restaurant and the quickness that because there's so much looted and how much swelling in the area of a strain quote unquote. That it Campbell to read don't and your code and extent our collectors. Muscle and they're not connected to other. It's so sold this go back to calm the actual news of David Price. And and when you sort of start looking at this researching and saw the the timeline we talked a little bit of time on earlier. What was your first reaction one of the first before you answer one of the first things that we have to preface. Two things number one and we understand you are familiar with the condition but not familiar with a patient right item I'm covering your bases right. A if you don't have a lot yes. In you know the other thing is is that it is just. You have you have a situation here where. We don't we don't know exactly what happened we don't know exactly. Come. The how he hit fell in the past but we do know what he said what he's been on record saying. And that a lot of pitchers. And this is probably the case of David Price have something in their arm because pitching is an unnatural motion and when you have a guy who has thrown more pitches than anybody in baseball over the last three years. Then he is probably gonna have some thing in there so. Would those two aside when you heard what happened or of the sort of timeline of things what was your initial reaction. Why initially excellent reporting the bone Spurs. Not surprised. Car repair torn apart they're part. And not having a ball more and more I would cry. A treat a lot of you can child upbeat and teenager have beat them. You get your mind you he's our kids who have been playing baseball were. You know just young up even get into any Little League or under and it and it may even have bone Spurs so deep bone Spurs quote unquote then yeah we're not surprised. The strain indeed format the more acute injury that's more have been issued got out on court. And at that. Certainly the hardest one to call like it or thought Kurt strain it. And or and have their ability in Guatemala orders and I don't envy any direct a and if the doctors are there. Sanders are out front after the in this situation I look at it and say well we have to look a bit angry look at you'd. Look at what the calendar hedonism and you'll make prediction. It's hard. It there are considering it would hypocrite well. What is what is the reality when you have something on this of this knocked getting worse because this is sort of the merit of that we've been talking about the last couple days since the diagnosis. It was great it was great it was the best diagnosis that you could ever have. But still there's something there there's something that made this happen there's something we gave the discomfort before. And probably down the line there's going to be something because once again it is an unnatural act to throw a baseball would that be fair to say. Yeah that would be a deterrent. I think good news part of it is that it is what an apartment. I think you're good looking at this situation I would have been great news of the it is an oracle. The at that level that. Got Professional League. Players are growing. It's a bit of a strain or multiple entries can be a significant performance affect actor. So it's really America's grip to take the credit we currently are we you know at least from being under or. I don't trust a standard that. It does not appeared in jeopardy that would be one thing to be the dagger and see him out. Per year apartment more. Yeah and and that's the thing that everyone is awaiting the first thing after the the diagnosis came out the first thing everyone want to note surgery or no surgery now the next thing on the list. Was PRP injections platelet rich plasma injections which seems to be a big thing now Tom and and that did correct me if I'm wrong that's sort of if you Arkin Tommy John this is the other course of action you can take is not gonna put you wealth or year first look you explain what exactly that is. You have pure peace and for a platelet rich plasma injections and that their procedure where your blood drawn like a lot of what you. Would get from a normal lab tests under annual but. But you lose a large about what it. America like the Mets could do a little center. Which is literally just been good at a certain speed and a certain time so that bit the concentration. Growth factor completely at the bottom of the U and then it that's not the draw and then injected. You know they're a traitor or into an art and and Mets series what that does it produces rapid healing up injured part. So so it's great for. If period great for a soft drink attendant that. So why what why wouldn't they do this in this case. Well it keeps you out it keeps you out a month or it is the third clarify this isn't something that'd. You just do a new year back within a week this'll keep yell for a month or two right. Right right at Eldred benign as it just an injection but at this site that reject it does get pretty or and it Kurt Owens or awhile. And but other bat they're not really any physical down. Therapy cortisone injections get a bit of bad rap too many current and next week and structured and beaten a rupture of Anders structure for that Keppinger to them being here as far as the lead dog and has published. Information epidemic into ever that's I've. The is so when you when you in this case and once again we clarify we don't know the patient we note no we haven't seen the MRIs and and you know exactly what is going on but. The doubt when when they come out and say there's no surgery and then they say no he RPI think that's when people got really excited because like all my goodness this really must be nothing. In and RB is that sort of how were you not nothing but is that how sour Javier took it well if they are doing the PRP then they really must be optimistic about this. I believe so I think what I would take. It's you when you make it. Summer here as waited pluck occurred in the car and go to bed happy in the situation it's a really bad off but probably not been able way to crack the ball and I think you do not going to. If you. At what it felt like as you are good enough to get back your opponent and then. Turkey who would actually. Sent him back temporarily to be out for their. Over the wall in group arm out and become rejection so he may be immutable that this group of the pro and con that you know what the problem we prepared. And have a projection right now and it wouldn't really help you all a couple of and make you better than you already are. It has it been in this sort of this I'm glad you said that I've very informative because that's sort of the road that I thought. There are going down and along those lines in and just a DV a little bit from price drew pom rants is the guy in the Red Sox pitching staff this this offseason. Chose not to have the PRP and actually had stem cell injections. Do you know anything about this or what the differences and I'm not saying this is what price should have done. But it seems talkative Palmer and the body said this is sort of the next wave. Of approached their a lot of these guys Giambi taking. You know we'll both Europeans stamp on there still and I'm very experimental. All that and there. Certainly in different technologies have been shown not have an armed. They don't really go to the same kind of regular athlete is a lot of drug and medical device. They're basically your own you know. Your own stuff in this potentially. That's pretty incredible what went blood doping but. It to put in reverse order experiment or not a lot of it collect. To show that they really do a whole lot better a lot of not theory. Regret it is true that they do have been committed to undergo a lot of cricket animal experiments that shows that at a molecular all of these things really arguing. So. I think when you're at a level of and happy what collective pride. You will do these things because there's a possible upside and almost no downside and do a lot of expense because these are cobra insurance to comment on. We are happy with the current twelve to exempt you know and our contract. Cost of things it's a drop in the. Well all why would why would armor and Stew and he's he's explained to me about him in the ultimate layman's terms. But why would you say I'm doing stem cells at a few RP. That. There I'm sure they're probably the cricket and Jim. Injection probably has their own rationale reunion where. There is under a lot of which is at the moment when things. You know and meaningless well I give it to you know need to be to well. There's also a lot of sort of rationalizing and belief in that. Besides that it will work even though I haven't yet been born out in large scale. They're recruit we don't study it though a lot of those probably answered it and it you know here you are spent spelled that problem with it or Palmer one way or another. It's not great at bat and bad of a bad reason. Since this is one of the benefits of covering baseline as seemed very intelligent throwing around these terms and ends it's only because. It is thrown at me every single day and I'm I'm really not intelligent at all. Tom and that's why I'm having yard because you are intelligent and know about this start to Nick Young new all orthopedic associates. It's so okay so the dopey RP dose stem cell injections. What they've landed that is is seven to ten days of of now I'm holding a Michael fingers rest. And medication. Once again we don't know exactly situation but what is your guess in terms of what type of medication this is where you would say. Take this medication for seven to ten days and then we'll regroup and reevaluate. Well in most cases or just something as simple answer over the other Alomar Carl and Obi. These things are exotic or sexy sounding but had about what we do and it almost it would be you can bet initial period of rest. And bad trying to get the pain and inflammation down. We all are and it's been. I am glad you said that because I was I was bracing myself for some sort of medicine that I could not spell in a million different in million years. The by the way you said that those great expensive that's the honest number one even if it was great expense of the players it's not a problem. And number two there's no way the team's not paying for that care if it's certain not. This is this this is basically like the acquittal of those guys giving fine for wearing them on cleats the team's always gonna step up. But so. All right so let's say yes truth several attendees. Now he's not going to be the the doctor Andrews doctor Allen tried again after the 710 days. And then. And then you go you take the medicine take the time and all you take the the children's Tylenol whatever it is a I hear it you take the five hour energy whatever could get you through today. And and so you get to the end there at that time span so now what do you do you view do you think that is another MRI involved. Do you think that and says hey you know this see how it feels when you throw baseball. You do strength tests and what do you do. That makes you feel like he can actually not a silly get on a mound again but just row start throwing. Yet not yet but it really where you know the art of medicine trumpet not there's a lot of I'd met them but it. Were there are a lot of our. And every occasion and and it really. True react in what turns a bit by bit so hey Evan agent question creation and go to some emotion. And essentially. It'd just how it is and they got a lot a lot of that and experience into the net how. But from what computers in perspective how do you think that we going to do and whether they're ready on. And Eric yet that level. In our keeping a cap number happen. And I had this 13 of the green going to the net there and and their leaders. That question being out what you're independent and they are they are the dirt and start. Not for. Some more rigorous strengthening our combined with some are growing. And and at a bit of suburbia or an interval throwing program order starting with. Like half speed pitchers sure that it shorter shorter it will be week by week working according to a written program that could you. At a longer to an event higher velocity. The Almonte couldn't go out there and throw a baseball and all know what I'm backing down. What everybody who loves who she won't lose my body lets itself an awful awful lot of it. Pretty good job it's. It by the a's if there's any it from your experience if Theres. Say that there's there's any discomfort law's not the discovery he said he's had discovered before and it wasn't a big deal. But now you've gone through this process and year in your going in you're going in you have a little discovered right you still throw. We went at what point do you actually go back in the AMR I Booth. And I know it's like all the time ride Booth by the MRI machine and there aren't the MIA tech going to the magnate. And angle at what point do you do you do that or do you just toll drubbing it is this. Because it must be a very very fine line for these pitchers because once again there's always something wrong with them is there's a lot of times is this how much can you tolerate. Yeah. Look to answer questions to a few we're bigoted or MRI probably year. Thinking that may prefer MRI missed something or that something has dramatically changed the works and you may be revisiting their option to. And certainly if you're gonna erupt for certain market and more of these instance. A I personally it'd be unlikely that you can go back during an MRI and probably worked his era outlook. Is special putt we progress on some kind of a throwing program. And ask you'll either do great or you will article along. Little slower and talk about it and I highly doubt it would be goes back on this program and just to Matt would only get worse. What all what makes it also difficult doctors that you're dealing with a magical elbow. So every this is that the core the quote was as David Price tonight the doctors and these two renowned doctors said that he is a very unique elbow. Very unique field. I don't know who. I've heard that before is good enough from you guys do. Will be on the serve the ballroom in the truth as many doubles and we'll be looked at. I'll save for a third time this yes you do not have the MRIs you do not know David Price is elbow. But please tell me because I think that of all the things that people listen to this park has won and now. They wanna know how old do you have a unique elbow because I have always liked all the elbows and I've looked at looked exactly the same. Yeah I would there Torre lot harder and they are are about to. Most of our. You're able to get as. Fired it bit or replace the word you're lucky. So I didn't care or comment earlier you don't. Ohman the other two are gone down. Our didn't. And have a chance that he can repeat. Well okay so there's so how how is that the case how. How is it your best guests that guy is able to avoid that is it because you have a more developed. A muscle in your elbow is it just because of I don't know it is is there a reason why. A guy you might be less affected by that many pitches and be able to what he does have some soreness there be able void the the TV. Word. Have idea. It is possible that he's prepared for. They're a part of very well put up good crumpled on form good technique. Well well swept recorded multiple. And that it had been able to come out there hurting them treatment upon their their. Whereas the words of like worth a flex or protein in muscle. We just smoke. Earl either of you speak a big group of muscle becomes the inner elbow and it comparable to or are on that side the side that you know Republican chuck it walk and and muscle control a whole bunch of sponsors including. Rotation of form. Question of risk and at grip and these are all very important early. And it looked pretty good on monopoly in Mecca beat form multiple. But it's most probably weren't prominent when you're in a couple of are different not one muscle. To us that's Russell now everywhere are gonna be focused on a looking at his. His forearm saying what I meant that the heat who wanted the best flex a priority to muscle in the entire American League right there. Exactly the demo listen whatever it takes. The last question is it obvious from your perspective. Are masking all these questions and and you're giving off some answers and you have a perspective like. I couldn't in that nobody have doctors certainly since this happened has had. From your perspective though when you were in you're talking about the stuff and when you hear about. David Price in a hotel suite where these two orthopedic. Is it is sort of is a fascinating to you what there might be doing there how they're testing is in the league does something like this. You wish you were in the hotel room watching what they were or who is going on. Ya wouldn't wanna be one actually make him feel great that it's a darker there would look good or how about all. There are a couple of beauties of what it is one of these. Factored Richard so much practice on it would have meant and it's an area and then some to be your cup up MRI here as well. Was sort of a basket mean this is no MRI machine in the hotel room that they have the MRI which their their basing minute they're using the to have the second opinion. So they have the MRI. They've evaluate the MRI and when they get to the room there. And they have them right there what they Dillon that is manipulating his arm and appealing his elbow what are they doing. Oh yeah physical ability level can be quickly performed in order to be performed on on the guilt in the clinic in the training room in October. And if you have an MRI there and Eritrea. And now he's at Berkeley. You acceptable as we could enact nationalist he'd he'd. From where I got to realize and you've got all the information at your fingertips. But watching these guys do is it to the level where they care and they can manipulate the elbow manipulate the armed in certain degrees in certain ways. That is gonna tell you almost as much as the MRI can tell you in other words they in this is that like all my arm like Rodney Dangerfield and in casual my arm. But it's it but can they actually they are there their expertise is the level where they can. Poke and prod in bad and and say you have this. Yeah absolutely I have no doubt that we are you. Good point question and record exam of the double murder or ten minutes or so you can get a pretty good idea what is going yeah tomorrow I really looked. Clint in the is and it really eager to answer one question is adamant ordered. Bark. So. So it in Medicaid to. You can sort of make at diagnosis. A bit of experience what it or urgent and make that diagnosis without looking at ams are. I'm again it's when you start to make a really good division but are we gonna do certain on the argument wanna get Panama. And that's what you do the Arctic player patiently. Yeah well I've this is why we're talking about it because who's the highest of the high stakes in. And and went and we when we have a question about thirty million dollar a year players we call you doctor nick Leon knew no clear orthopedic asserted. Thanks so much you've been you've been. Ten times more for a little informative of any yes I've had on this podcasts or last year particularly Doss and an Arroyo just yelled at me. So so I really appreciated doctor in and I look for a talk greed on the road. Are at my pleasure thank you bird and Brad Evans.