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.
Transcript - Not for consumer use. Robot overlords only. Will not be accurate.
Add road show. That might open definitely probably would have brought that I don't. Query where you don't know what you're stupid Brad broad show. That's delicious. I don't know if you heard this David Price of elbow issue. So they figured MRI went through the best start in the world is now everything seems to be five or role. Like I didn't. Over the open relative. 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 of 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 associates 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 prices humor ago. It. So let's get right to it. David Price has a lot of people known had an elbow injury he went through a simulated game 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 yet a second opinion this flown up to Indianapolis. The visit wave two guys who are perceived as the best around other than yourself. But doctor 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. The finally. So so if your if your gonna fly to Indianapolis you would you would and confirm. Those are two guys who you were one apply Indianapolis for. Oh absolutely go directly through named Kirk most. I did so well the first questions I have for you is before we get into the meat and potatoes of the elbow. Is I. When we heard of this week we heard second opinion darker handers specifically. As a follow 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 just covering your bases. What being largely probably more the second they're. A player they're part regarded certainly wanna ensure an 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 outraged. Media or public view and in the opinion on in apartment elbow and a throwing arm. Picture. And so many times I mean what. What people think Taurus which. Apartment door entered and down. Earlier this but I hear that not and that the traditional surgery and we're just going to. Our rescue that we have here that may possibly it might cost per capita well I certainly don't fault anybody for an epic opinion about it. None I don't either and as it turns out lawyers the darker and uses steered guys one way or the other which might have been opposite of 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 although flex her 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 without be accurate for the most part. Yeah well there's a lot of political weight you can word on injuries or strain has basically an injury to muscle some. The strange indeed I'm not I'm out. On the weekend and the plan and pick up baseball and you're reputed and it could mean pumping all the Richard. Two and you're saying. A terror muscles experts. And then the computer and great how much of that mountain there and we all look at varying degrees how long it takes one to recover a door and claim form so. Be. Are you are right in. You know what aspect of strainer there's such a wide projects and and have been for that reason there's such a wide credit treatment and not always a single ant. Roku. Because what people are going to be ours through darker when people hear strain. They feel like all in the Olympic basketball I strain my something or other. But when they hear hair it's it's a little bit more freak out situation so I asked him. Yeah and an MRI it's hard to tell the difference between dispute all there are a lot of times are. True multiple air. Chemical Ali a strange question it at a restaurant in the quickness but because there's so much Lou had and how much swelling in the area of terrain quote unquote. That it Campbell to riddled and your code and expand 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 over 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 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. Room that is how he just 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 is David Price have something in their arm because pitching is an unnatural motion and when you have a guy who is throw more pitches than anybody in baseball over the last three years. Then he's 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 report bone spurs. Not surprised. Record there part market part. And not having an animal market and our I would cry. A treat a lot of you can child that beat and teenage beat them. You you don't mind you he's our kids who have been playing baseball were. You know just young up even get into any Little League and under and it and it may even have bone spurs couldn't bone spurs quote unquote yeah we're not surprised. The strain indeed orbit the more acute injury but more big issue. Out on court. And at that. So really the hardest one to call like that supports our current strain. And or and have their ability in Guatemala pointers and I don't envy any direct. And it doctors like there. Andrew don't trust epidemic 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 deal will make prediction. It's hard. It there are considering it would hypocrite well. What is the what is the reality when you have something on this of this not 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. Yes 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 inspect. The building great news of the it is an oracle. The at that level that. Got professionally. Clear to our growing. It's a bit of strain or multiple entry can be a significant performance of certain actor. So this is written a terrific integrity and we currently are we do know at least from this of that port. Trust and that is that. It does not appeared in jeopardy that would be one thing they'll be the dagger and you can beat out. Per year apartment more. The 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 are 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 this knock on the put you wealth or year first look you explain what exactly that is. You have pure peace intra platelet rich plasma injections and that good 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 lark about what it. America let the Mets could do a little center. Which literally ended at a certain speed and a certain time of that bit the concentration. Growth factor completely at the bottom of the view that it that's the draw and then re injected. You know there are a traitor or entity in. And met Siri what that does is it produces rapid healing of the injured part. So so great for. It's hearing a great uptrend attendant that out. So why would why would they do this in this case. Well it keeps you out it keeps you out a month or this suit to clarify this isn't something that'd. You just do in the year back within a week this'll keep you all for a month or two right. Right right at foundered denied that it just an injection but at this site that reject it does get released the war and paper or or oil. And but other and that they're not really any physical count that. They're being a cortisone injections get a bit of a bad rap and Dominica and extra week in structure and and beaten rupture. Anders structure for a peer into accident scene here as our dog and has published. Information epidemic in ever that's I've. The is so when you when you in this case and once again we clarify that we don't know the patient we note no we haven't seen the MRIs and and you know exactly what is going on by it. 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're when you're mid. Summer of pure as waited plot code in the car and go to bed happy in the situation it's a really bad off as probably not been able way to crack alt and I think you do not going to. It keys. At what it felt like there's you and could not get back at our own again and Turkey who would actually. Send them back temporarily be out for their. The flaw in group arm after Japan rejection so he may be inevitable that this with the appropriate content 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 group armory it's of 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 must say this is what price should have done. But it seems talking to pomerantz about he said this is sort of the next wave. Of approached their a lot of these guys MB taking. Yellow book European stamp on there still another very experimental. That and there. Certainly in different technologies that have been shown not have an armed. They don't really go to the same kind of regular app which is a lot of drug and medical device. It 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 and collect it. 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 record 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 price. You will do these things because there's a possible upside and almost no down side and a lot of expense because these are corporate insurance to apple ought. We are happy with the current twelve contempt you know and our contract. Cost of things it's a drop in the. Well all why would why would armor and stoop 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 PR pre. 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 anecdotal met in acting. You know and to me like well I give it to you know beat and beat well. There's also a lot of sort of rationalizing and a belief in that. Science and it will work even though yet been born out in large scale. Very rigorously inspected. Though a lot of those public interest in that you know here you are spam go and how we put upon or one lawyer and other. It's not regret that as 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 stark and young knew all orthopedic associates. It's so okay so the dopey RP dose stem cell injections. What they've landed that is there is some attendees of of now I'm holding a Michael finger at rest. And medication. Once again we don't know the 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 outlawed croak and Obi. These things are exotic or sexy sounding but had about what we do and at almost it would be you can bet initial period of rest. And bad trying to get the pain and inflammation down. Bill I mean that's the 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 expense of this be 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 a key markets in certain. This is this this is basically like the acquittal of those guys giving fine for wearing Enron cleats that he'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 test 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 met him but it. And you were a lot of our. And every patient friend and it really. True react in what terms a bit by bit so he examined the patient question patient and cook resemble most and and essentially. Get accused of power here than they got a lot a lot of credit and experience and to book yet how. The prominent 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 own app on their app. There's one girdle to McCree looked gaunt the next and and their leaders. That's been questioning how would you direct interest that attended or they are and dirt and start. Not from. Some more rigorous strengthening our combined with some are growing. And at a bit of suburbia or an interval throwing program later starting with. Like half speed it is sure shorter shorter it oh we week I'd we working according to a written program that could you. At a laundered it and prevent higher velocity. The homeowner who couldn't drive through flu baseball and all knowing on the back. What everybody who's watching Q you'll lose my body lets itself an awful awful lot of it. Pretty good job it's. It by there is if there's any it from your experience if Theres. Say that there's there's any discomfort laws not the discovery he said he's had discovered before and it wasn't a big deal. But now he's gone through this process and you're in your going in you're going in you have a little discovered right you still throw. They went at what point do you actually go back in the Amara a Booth. And I know it's like all the in my Booth by the MRI machine in camera the MI shekel one of the magnate. And and at what point do you do you do that or do you just toll drive that it is this. Because it must be a very very fine line for these pictures because once again there's always something wrong with a because there's a lot of times is this how much can you tolerate. Yeah. Look to answer questions to a few were evicted or MRI was probably the thinking that may prefer MR I missed something or that something has dramatically changed the works and you may be revisiting their option to. And certainly if you're gonna wrap certain market and more of these instance. A I personally it'd be unlikely that you can go back during an MRI and public works is our outlook. Is that it probably 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 quote 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 booted me enough room to. Will be on the serve the ballroom and 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 MRI as 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 album because I have always liked all the elbows and I've looked at looking exactly the same. Yeah I would there story a lot of ordered the current. There are about to. Most of our. You're able to apparent. Fired it bit or replace the word you're lucky. Some Interior Department or your. Don't. Omen the other two are gone down there are. And had a chance that he can repeat. Well OK 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 near elbow is it just because 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. But a part of very well developed good report on form protect me well well what supported muffled. And that it had been able to I'm out there hurting them treatment but the extent the. Whereas the words of flex worth of flex or protein in muscle. We just smoke. Earl either BP or the big group of muscle becomes the inner elbow and it comparable to the war on that side the side that you know Republican chair and walk and and the local control hold on to function in particular form. Question of risk and at grip and older report early. And it looked pretty good on monopoly in Mecca beat form multiple. There's the most problem when it's prominent on air in the crippled are different not one must. Let's that's Russell now everyone's going to be focused on looking at his. His forearm saying one man that that he who wanted the best reflects a priority to muscle in the entire American League right there. Exactly the well 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 ever prospective like. I couldn't in that nobody have doctors certainly since this happened has had. From your perspective though we knew where you're talking about the stuff in 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 this hotel room watching what they were or who is going on. Ya wouldn't wanna be one actually make an edict. That they are they're there would look well at all. It's the portable beauty of what it is one of these. Thanks Richard Burt so much practice on it would have meant and it's hit the area and then some to be your cup up MRI here as well. Was sort of gonna ask you 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 do and other dissed manipulating his arm and appealing his elbow what are they doing. Yep physical inevitable can be quickly performed in order to be performed on on the guilt in the clinic in the training room in a hotel room. And if you have an MRI there and Eritrea. And now he's at Berkeley. You acceptable as we could enact Nationalists beauty. From where conduct allies and you've got out of commission to fingertips. But what can these guys do is it to the level where they care and they can manipulate the album manipulate the arm in certain degrees in certain ways. That is gonna tell you almost as much as the MRI can tell you in other words like this is that like all my arm like Rodney Dangerfield and in casual my arm. But it's it but can they actually there are there their expertise is the level where they can. Poke and prod in band and say you have this. Yeah absolutely I've 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 critical you know what is going yeah MRI is really looked. Clint in the it is and it really eager to answer one question is adamant ordered. Bark. So. So in many cases. You can so make at diagnosis. A bit of that unit quote spirited and make that diagnosis without looking at our. Again it's when you start to make a really good decision by we can do certain on the argument wanna get them Mara and especially when you do the Arctic where a patient like that. 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 in we when we have a question about thirty million dollar year players recall you doctor nick Leon knew all clear can be considered idiots. Thanks so much you've been you've been. Ten times more for a vote informative of any yes I've had on this podcasts are last year particularly Doss and android and just yelled at me. So so I really appreciated doctor in and I look for a talk greed on the road. Are it's my pleasure thank you for Democrats haven't.