All posts by David Ring

All Blogs, Baseball, Elbow, Pitcher's Elbow

José De León’s Medial Collateral Ligament

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José De León, 25 years old, was diagnosed with a torn medial collateral ligament (MCL) in his right elbow this spring. Throwing athletes (baseball pitchers and javelin throwers) can develop a looseness in the MCL after years of repeatedly throwing as hard as possible. In baseball, a single fastball creates enough force to completely tear the MCL, but the stabilizing force of the muscles prevents this. The theory is that repeated small sprains (ligament tears) outpace the body’s healing capacity leading to thinning of the MCL. A thin MCL leads to joint looseness and a specific pattern of elbow arthritis, called valgus extension overload.

All successful throwing athletes have changes in their elbow over the years. They all develop some thinning of the MCL and some level of arthritis. So “injury” is not the correct term. On occasion, the thinned ligament has an acute complete tear, but more typically it is a gradual thinning and arthritis in the elbow make a pitcher less effective.

Strengthening of the forearm muscles that stabilize the elbow can help manage symptoms and help throwers be effective again. If there is substantial laxity, the MCL can be reconstructed by taking a tendon from another part of the body and creating a new ligament. But this means a year off from throwing and does not always get throwers back to the same performance level.

http://sites.utexas.edu/sports-blog/pitchers-elbow/ ‎

This article was made by Hebah Mughal and David Ring

All Blogs, Basketball, Knee

Kyrie Irving’s Knee Fracture

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Celtics all-star point guard Kyrie Irving is out of the NBA playoffs due to a complication knee from prior knee surgery.

Irving fractured his patella (kneecap) in an injury during the NBA Finals on June 4, 2015. The fracture required surgery to hold the fracture together with two pieces of wire threaded through two screws while the bone healed. After the bone heals, patients can keep the wires and screws in place; however, the kneecap is a prominent area and the metal may become bothersome.

On March 24, they removed the wire only. The knot used to tighten the wire is often the most irritating part.

On April 7, they decided to remove the screws as well. When they removed the screws they encountered a low-grade infection. Bacteria can hide from the immune system alongside metal or other foreign material. Once the metal is removed, the infection should resolve.

With the metal out of place the holes in the bone make it a little weaker and at risk for re-fracture with jumping, falling or contact with another player. When the decision was made to remove the screws, it also became necessary to stay out of full-contact basketball for four to six months while the bone strengthens after removing the screws.

This article was made by Paul Bonilla and David Ring

All Blogs, Knee

Filipe Luis’ Left Fibula Fracture

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Star defender Filipe Luis, who plays for Atletico Madrid in the Europa League, fractured his left fibula after he was caught in a striker’s follow through in a game against Lokomotiv Moscow on March 16th, 2018. Luis was escorted off the field in a stretcher and promptly taken to the hospital to for x-rays. The Brazilian native may miss the upcoming World Cup.

The lower leg is made up of a series of bones that includes the tibia, fibula, and tarsals. The tibia, commonly referred to as the shinbone, is the large bone that connects the knee and the ankle. The fibula is the thin, lateral bone that is parallel to the tibia and plays a role in support for the tibia and is a crucial site for the attachment of ligaments at the knee and ankle.

A fibula fracture that is part of a twisting ankle injury is often repaired with a plate and screws in order to line up and stabilize the ankle while it heals. Fracture of the fibula from direct contact will heal on its own and is not usually considered for surgery. Bone healing gets to about 80% strength over 3 to 4 months and up to 100% strength in a year. Athletes are usually given the option to pay after 3 to 4 months of healing, when they are comfortable and mobile enough to be effective. For many sports, it takes 6 to 12 months to return to top level play after a leg fracture. If this is a direct fibula fracture, it may be relatively quick to return to high level of play.

Athletes are usually eager to return to play and may be willing to take some risks to do so. It’s possible–with some risk–that Filipe could play in the World Cup this summer.

This article was made by Paul Bonilla and David Ring