The Pat and Aaron Injury Report 2/9/23 with Dr. Gasser

Aaron: Pat & Aaron Show 953 WDAE AM 620. Let’s go right to the hotline now because we got a lot to get to with the big game coming up this weekend. It’s time for The Pat & Aaron Show Injury Report presented by Florida Orthopaedic Institute in partnership with Tampa General Hospital. Joining us once again, Dr. Seth Gasser. Dr. Gasser, good morning. Thanks for joining us today.

Dr. Gasser: Good morning guys. Great to be back.

Aaron: Great to have you back. Unfortunately, it’s the last time we will have our injury report today, but it’s been such a great year covering all the NFL news with everyone over there. All the great doctors at the Florida Orthopaedic Institute in Tampa General Hospital all season long. The big question Dr. Gasser for Sunday is, how’s Patrick Mahomes going to look? Of course, the high ankle sprain that he injured in the divisional round against the Jags. He’s been fighting through it and he gave a positive update, Dr. Gasser. He said he’s feeling good and definitely better than he did going into the championship game. Should he be close to 100% by game time?

Dr. Gasser: Yes, we’ve talked about these high ankle sprains several times in the past. They do in general, tend to take about twice as long as your run-of-the-mill sprains to heal. I think it’s probably been now three weeks or so for him. He’s definitely going to be better than last game. I don’t think he’s going to be quite 100%, but he’ll be probably 90 or so percent on the way to healing. I think it’s just as long as he doesn’t re-injure it, he’ll probably be pretty effective and much more mobile than he is been in the previous games.

Pat: It’s a little confusing, surprising. It obviously is helpful for him that he’s still a young player. We’ve talked about these injuries with you guys over the years and typically as you just referenced, we’re talking about at least a month with a high ankle sprain. How impressive is it that he was able to get back for that AFC championship game? We did see after taking a couple of hits that he did start to limp it seemed like maybe. I’m sure he was on some pain medication that maybe was wearing off during the game.

Do you think we’ll see that again on Sunday where he’s there, he is playing, but he’s still not himself and he’s doing some limping around or do you think that it might be not noticeable at all come Sunday?

Dr. Gasser: I think that you’ll probably notice it. His mobility will be a little bit limited. His ability to push off and throw is probably going to be better in the pocket, but I think he’s going to be a little cautious about taking hits and trying to limit some of the more running-type things that he normally is quite efficient at.

Aaron: Kadarius Toney, Chiefs’ wide receiver, since he’s been traded to this team, he’s been really effective for them, but he hurt himself. He hurt his ankle in the championship game in the AFC championship game. How being a receiver is preparing his ankle for this game different than that of his quarterback Patrick Mahomes?

Dr. Gasser: I think his ankle sprain is more the run-a-mil inversion rolling your ankle, low ankle sprain, not a high ankle sprain. The recovery from those is pretty quick actually, depending on the severity of that sprain. Obviously, those aggressive change of direction and cutting and pivoting might still bother him, but I’m sure he is been working with the training staff on a daily basis. I expect him to be pretty effective and able to play almost at a normal level for him.

Pat: We saw that Myles Garrett dislocated his toe during the Pro Bowl games in Vegas. The Browns confirmed that with X-rays and that the X-rays came back negative, I should say, but he’s going to need a few weeks, I’m sure for some rehab. How many different toe injuries are there? We don’t hear a lot about them. We hear about turf toe a lot, which of course I feel like is probably the worst of them if I’m correct. Let me know if I’m wrong, but how many different toe injuries are there? Because you don’t hear about a lot of them.

Dr. Gasser: There are lots of toe injuries that players get and you’re absolutely correct. Turf toe is the worst. Turf toe involves your big toe and it’s a hyperextension injury of your big toe. If you have a severe turf toe injury, you actually tear some of the stabilizing structures, particularly on the bottom of your foot.

Pat: Dr. Gasser, you can’t get turf toe with any of your other toes, it’s only the big toe? I did not know that.

Dr. Gasser: Turf toe in general references the great toe or the hallux. You can get dislocations and fractures and other things in the lesser toes or the smaller toes, but in general, when you’re talking about turf toe, it’s in reference to the big toe. For a football player, turf toe can be a really significant injury, pretty serious. It’s hard to function because all that strength of pushing off, most of that comes through your big toe. If it’s one of the other toes and he had a dislocation with normal X-rays that should be no problem getting over. Sometimes turf toes can linger and if you get a bad turf toe during the season, it can be really hard. You’re not going to be 100% with a bad turf toe injury for sometimes like a high ankle spraining.

Pat: Dr. Gasser, I noticed you call it the great toe and then you refer to the other toes as lesser toes. What’s up with that man?

Dr. Gasser: That’s just the medical verbiage. [chuckles]

Pat: Oh, okay. I was just seeing if it– because they are. It makes sense, actually. It is the greater toe and the rest are the lesser of the toes. I want to ask you, Dr. Gasser, specifically when it comes to recovering from any injuries, what do you find the most challenging part of recovering for a lot of people and not just athletes, anyone who’s dealing with an injury?

Dr. Gasser: There’s really two parts to recovering from an injury. One is the physical part and that involves allowing the injury to heal and going through appropriate rehabilitation so that you’re ready to go. Then the other is the psychological part of recovering from an injury, and that’s the one that doesn’t get as much publicity or press. That’s probably the most significant factor for lots of injuries that delays return to play. If you look at common injury like ACL reconstruction and tears with athletes, the reason most of them don’t get back as soon as you might think is because of the fear of re-injury and the psychological part of getting over that.

That’s really where sports psychologists and some other things can be quite helpful. It’s something that’s often overlooked in the recovery from an injury.

Pat: Have you heard of anyone, Dr. Gasser, who has had mallet finger and after 10 weeks played softball? Have you ever heard of a heroic act like that?

Dr. Gasser: Just some very gifted and special athletes would be able to do that.

Pat: That’s what I’ve heard. That’s right. I was thrown the bass. I felt good. It was amazing to me. The body’s incredible. I say this all the time, that my finger was dangling, the tip of my finger. I was ready to cut it off, Dr. Gasser. I was ready to chop it right off and then you guys fixed it and we’ve splinted it up and now, and last night I was very worried to play. Didn’t even feel it at all. Didn’t feel any pain.

Dr. Gasser: Typically once you get over a mallet finger, sometimes you have still a little drop at the tip of your finger but it-

Pat: I Do– [crosstalk]

Dr. Gasser: -function’s just fine.

Pat: I got to bend in it.

Dr. Gasser: That’s difficult even with surgery. You can get those same finger injuries with toes, so you can get a mallet toe and you ask about toe injuries. All those things that can happen to a finger can happen to your toe.

Pat: I don’t even care what it looks like, as long as I can function with it, I don’t care if it’s bent.

Dr. Gasser: A little bit of bend is normal after even having surgery for a mallet finger.

Aaron: Doctor, we’re up against it. We only have about a minute left, but I am curious when you’re talking about the psychological part of injury and then the physical part, how often do you see where that psychological part impacts the physical part? Were people are shying away from using something that’s been injured and then that leads to further injury or another injury.

Dr. Gasser: Typically what I see is that psychological part leads to delayed rehab because they’re afraid to stress the body part as we would like them to in the recovery phase. It just prolongs their recovery significantly. That’s really where the surgeon can intervene and explain it and really take some time with the patient to give them confidence that they’re not causing further injury. That actually sometimes not doing some of that rehab is causing the damage and the delayed recovery more so than doing it.

That’s a conversation that you really have to have and you have to be cognizant and try to recognize that in your patients when they’re not progressing as you would like. That’s often then most commonly the reason is because of fear of injuring their part that has previously been injured.

Aaron: Dr. Gasser, we always hate when football season comes to an end because we’re losing football, but we also hate that we’re not going to be able to speak with you all until the next football season. Something else to look forward to aside from football is to get you all back on the air with us. We really appreciate all the work you’ve done with us this year and in the previous years. The listeners love it. They get a lot from it and we do as well, so thank you.

Dr. Gasser: You’re welcome. By the way, love your show as well. It’s awesome.

Pat: Thanks doc.

Aaron: Thank you, Dr. Gasser. There you go. There you have it. The great Dr. Seth Gasser, The Pat & Aaron Show Injury Report presented by Tampa General Hospital in partnership with Florida Orthopaedic Institute. They provide you access to one of the top orthopedic programs in the nation. Go ahead, schedule that appointment today at floridaortho.com.