1
Wish I could, but ortho/sports medicine is a totally different track out of med school with basically no overlap with real (heh) surgery. Sure sounds bad though. G probably can do a lot better.
Tarvaris Jackson's Torn Pec
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=== Calling Dr. Grumpy ===
... or G-Moneyball, or whoever can answer...
This interesting Field Gulls comments thread shows a general sentiment that Jackson is probably out weeks-to-months.
From my heartless standpoint, this would suddenly create the possibility of a dynamic Seahawks season. Throwing the ball 15+ yards downfield has been an important part of the NFL game, since approximately Norm van Brocklin or so. The player, not the coach.
I haven't seen the study on Hardball Times, but the tendency to throw forward passes appears to have increased with the introduction of Johnny Unitas, then Terry Bradshaw, and then Tom Brady into the league.
I personally would prefer that the Seahawks win games with 80-yard drives that last 6 plays, rather than 16. Running sixteen plays would appear to give you 16 or so chances to throw intercepts on 5-yard out patterns.
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Be that as it may, I don't have the first clue how Pete Carroll can announce a "Grade 3 Pectoral Strain" or "High Grade Pectoral Strain" and then follow up with "Well, Tarvaris won't practice in full pads today, but we'll see about tomorrow."
At Field Gulls, Bonecruncher offers that
- Grade 1 = 25% or less fiber tear and 1-6 weeks rehab
- Grade 2 = 25-50% fiber tear and 1-6 month rehab
- Grade 3 = 50% or more with up to 2 years rehab
IanW refers to this legit medical link, which defines "high grade" as 70% or more of the fibers torn. Some other commenter opined that at 50% or more, you'd be talking about surgery.
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The basic Field Gulls' reconcilation is that Pete Carroll is famous for saying "we expect him to be ready tomorrow" every day right up until the player is placed on the injured reserve for the year ... Walter Jones went through a dog-and-pony show his last year.
Even allowing for the NFL player's ability to play through injury -- Sidney Rice reportedly has a torn labrum -- and even allowing for the fact that "Grade 3 Strain" may be a sloppy way to characterize the diagnosis -- it's hard for me to see how Jackson is a possible starter for 10 days from now.
Then again, if the Seahawks are going to try to play without the possibility of a 15-yard pass, maybe going to a Full House backfield with two tight ends, I guess they could ...
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Granted you don't have the pictures of the injury Dr. G (or G-Money, whoever) can you give us a feel for this basic situation? You're talking about Jackson being out for months, and the Seahawks being idjits about the P.R., or not?
We did notice that after Carroll got the medical reports back, he began praising Charlie Whitehurst this week. You know, "It's nice to have two quarterbacks you can win with" type stuff.
Comments
2
We could talk about this, but there really isn't much to discuss. A Grade 3 "strain" of the pec is gonna be surgery, rehab, and done for the season. Elvis Dumervil had one last year, and if you looked at how much of the season he played in...yeah...
Grade 2 would make him take a month off, at least, so if they made an incorrect diagnosis, there's a chance for the 2nd half of the season, I guess, but not for the next game.
But it's not the sort of diagnosis that you tend to screw up. When you rip a muscle off a bone, it sort of makes itself obvious. They don't call it a rupture for nothing, and QBs don't tend to attempt many forward passes with ruptured chest muscles.
Time for plan B.
~G
3
I figured the M.D. alone would put you ahead of us net rats... woulda assumed that any surgeon would have a nodding familiarity with trauma to muscle tissue ... but then again you probably also have a nodding familiarity with not trying to make a diagnosis that isn't warranted ... :- )
Of course, I'm not conversant with the difference between OBGYN and OBP, so hopefully you can pardon the dumb question ....
Bail us out Gordon? Is TJack looking at throwing the deep ball in 10 days if he has a "high grade" or "Grade 3" pectoral "strain"?
4
... at FG they brought up Mario somebody who recently "strained" a pec and missed the season, too...
And can you give us a sense for whether --- > it might actually have been a Grade 2, but they mischaracterized it? Doesn't seem like Carroll would have *over*stated the problem.
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Nice to have our own SSI cyber-med staff on retainer, ain't it? :- )
5
You might misdiagnose a strain as grade 1 when it's actually grade 2, or grade 2 when it's actually grade three, but it's not as common to call something a grade 3 and then step it back to grade 2.
It happens. You see those sorts of things in baseball where one doc recommends surgery and another rest and rehab. That's a borderline call when one doctor believes it to be just that side of a grade 3 (aka, requiring surgery) and the other think it's barely on this side of a grade 2, where the body might knit itself back together faster than the surgery recovery time.
But calling something a definite grade 3 means they decided muscle fibers were either severed from each other across too large an area for natural healing, or he tore the muscle right off the bone, so they're not going to knit back together any more than a snipped rubber band will magically heal itself to allow you to shoot it at your little sister.
When you say Grade 3 strain, you mean surgery. When you say pec surgery to knit one the largest and strongest chest muscles back together (and by this I mean reattach a tendon to its bone anchor, in most cases), you mean that dude is done for the year.
If he HAS a Grade 3 strain, he's done. Unless you hear him shopping for a second opinion, put a cork in his season.
~G
6
Just had some recent personal experience with this.
Back in March I tore my calf. It made an audible pop and dropped me to my knee. It scared me. I grabbed my Achilles to make sure it was still there. Absolutely couldn't walk. Ortho sent me for an MRI. When I returned with the image the Dr. looked at it and chuckled. He said he had never seen a tear like mine. An entire segment tore away. What was odd is it tore away from the muscle group and not on the tendon end.
He advised that it's extremely difficult to successfully reattach muscle to muscle without it simply tearing again. He told me that the rest of the calf muscle would build up and compensate but it would be a bit misshapen so my career as an underwear model was over. :-(
I spent a month in a boot and another two weeks wincing whenever I looked at stairs or even an incline. It was somewhere past eight weeks before I took a VERY short jog.
I'm very well aware that there is a world of difference between a calf and pec but I'd be amazed if his season wasn't over.
7
The well trained technician is loathe to stake his reputation on an opinion outside his area of expertise. You couldn't pay me to give you opinions on drug discovery or string theory :)
8
... what is Carroll doing saying stuff like, "Well, he won't practice *today*." LOL.
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Another question, while you're on a roll ... what is the best-case scenario from Jackson's point of view, given the public quotes? That he's got a 30-50% tear and that, with a bodyful of unethical painkillers and anti-inflammatories, that he starts trying to play through the pain in a couple of weeks?
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Grokking a lot here G. Nice to have a feel for the actual situation, as opposed to the spin for public situation.
9
Heh!
No, you're right of course ... that's where I had it pictured amigo. The smarter somebody is, the slower he is to give you a firm opinion on anything. Which is why people flock to SSI, so they can feel smart compared to the chimps typing out the posts.
If Dr. D were even half-serious about baseball, SSI would sound like you and Dr. G usually do... You can't give James to give you an unequivocal assessment of any current ballplayer any more...
I notice you didn't take an office-pool number on Jackson's date of return......
10
Have done the calf a few times, the hammy once, and the groin twice, not *quite* as bad as you describe.
Even the kind of tear where you can't walk for three days... it's so susceptible to tearing again that you're out a long time...
Anecdotal again, but it all points to that amazement I had when Carroll combined the two ideas of "Grade 3" and "Hopefully he can play against the Browns." :- )
Thanks for the $0.03 Auto5.
11
I wouldn't give pseudo informed opinions on areas where I am not a leading expert. Doesn't do anyone any good.
However, one thing did occur to me this morning... There are actually two pec muscles... The pec major and the pec minor. If the injury is to the minor, it may not be much of an issue. Didn't Elway or someone play with a complete rupture of one of his biceps heads?
12
Pec minor is what rotates your shoulder blades "up and over" so that you can hunch over a keyboard all day. It attaches directly to the ribs and not the humerus in any way. You'd basically have to rip the shoulder blade off the body to cause a complete rupture of pec minor in most cases, and if that happened you'd have other more pressing issues. ;)
And Doc, my guess is Carroll is getting a 2nd opinion before he puts him on IR for the season. I don't think it'll help, but there's always the chance.
When your pec major is flapping in the wind, though, just wishing for it to reattach itself is probably a poor plan. I'm not a big surgery guy - I think people, even athletes, get cut on too early in the process. When I hear about pitchers having sections of their ribs cut out and major blood vessels re-routed because of Thoracic Outlet Syndrome I want to beat someone, because that is usually fixable with therapy, as it's simply bad postural mechanics compressing the chest in a way that impedes blood flow (and sometimes nerve function).
But when surgery IS required, I tend to bow out gracefully, and there's nothing I can do for reattaching a severed muscle. My work starts after it's reattached.
~G
13
As a surgeon, think surgery is great! Lol. Still the best way to take care of GI cancers. We do most of our stuff laparoscopically, so rehab is usually unnecessary.
14
Surgeons wanna cut, therapists wanna rehab, Naturopaths wanna work the diet, Acupuncturists have a needle fetish. *grins*
I don't necessarily blame surgeons for telling clients they can fix their ills with a knife, I just would prefer that they tried less drastic measures first occasionally (though with things like GI cancers it's not usually a good idea to wait and try other approaches first...).
And get your diagnosis right, por favor - I've worked on too many people who got cut in the wrong place because a doctor didn't care enough to find out which fingers were going numb (and therefore misdiagnosed the problem).
Professionalism and care for the clients at all times please. :)
~G
15
This seems like a common injury in the NFL, yet I almost never hear about this occurring in college. Why is that? What is the normal cause for football players? I can't think of play where a guy got hurt and it ended up being his pectoral muscle so I can't visualize how it occurs.
16
I didn't see anything whatsoever that happened to him, other than maybe a tackler pushing Jackson's head forward during the action.