Originally posted by Hawaii49er:
Originally posted by ronniefreakinlott42:
Originally posted by pasodoc9er:
Just spent a week at UCLA with my wife with the ENT oncology head guy, no more than early 40s, but altho in private practice, remains as Assistant Professor at UCLA Med School, and has 4 yrs of med school, a yr of internship, 5 yrs of residency in ENT, then 4 yrs fellowship in ENT, followed by another three yrs of fellowship in an associated field, and probably only 40. He has students, interns, residents, fellows, all following him around, learning from the master. Including med school i think he has 17 yrs more training. Yeah, think on that a moment. On top of that, the guy is just an outstanding person.
Point is, altho i have 2 specialties and 6 yrs of training post medical school, there are those guys out there, superhuman, super trained docs, that literally know everything. (Not I). I would be very surprised if we did not have some orthopedists on the team who are also still involved in academia, ie, taking on residents and fellows, that also have a private practice but stay right at the top of their field with current literature, so they know every new bit of orthopedic new info that comes out. But for what ever reason that has not been enough.
Pretty obvious that hiring guys with pre-existing injury (for less $$) has been a disaster for us (moneyball), and that alone will help put a dent in the injury business. But maybe we need to reshuffle our team docs/ S&C guys and instead go with guys who are still in academia but have a private practice, including 49ers. I don't know for sure, but would not be surprised if we had one orthopod for ankles (incl high ankles), another for knees, another for hamstrings, another specializing in groin pulls, and others specializing in upper extremity injury.. Still it might be worth while to see if there are others out there , still Assistant professors at Stanford (or UCSF, UCLA) who also have a private practice. For example, What we would be looking for is someone who has written definitive scientific publications on "HIGH ANKLES" ,or "Hamstring injuries", or Knee (ligaments and cartilage ACL, PCL, MCL, LCL, medial and lateral meniscus), or GROIN PULLs, so THEY are the ones with the most recent papers (and knowledge) on the below the waist injuries, and are still publishing new ways of prevention, treatment , and so on, in each specific category. For our players, a general orthopedist is fine, but a younger guy with 10-14 yrs of post doc residency and fellowship would be a whole lot better, especially if he remained on as an assistant clinical professor at one of the aforementioned universities.
It has been so long that i had forgotten just how good the BEST can be. Last week at UCLA reminded me of that. I strongly believe we should be looking for those kinds of docs on our staff who know the moment some new gee-gaw is out that will revolutionize treatment or prevention of ankles, hammies, knees, or groins. Maybe the wizened older guys isn't where we should be looking. Surely wouldn't hurt to have one or more of them too, but i am talking about the younger incredibly multi-yr trained specialist in each of the anatomical areas we are getting killed in.
In S& C, IDK. I have taken the position that football S&C would seem to be better than those specializing in hockey for reasons noted before. In hockey you got skates…and NOT CLEATS. Makes a helluva difference in the injuries seen between the two sports. I applaud JL and KS for thinking out of the box, but just feel we are better going with S&C guys with football specialty, and who remain on teaching staffs at major universities. Also , look for S&C guys, like docs, who are writing definitive papers on S &C, and by still being in Academia, are up on every new thing that comes down the pike.
Were i in charge of troubleshooting our injury issues, this is where i would start…after first making the first move of schid canning moneyball…which kS/JL already did.. No more injury players, regardless of how good they used to be. Julio was a great case in point. (Missed 7 games last yr with nagging injuries…sound familiar?")
Note, i am not an expert in team injuries, but if asked, these are the kinds of guys i would be constantly seeking. Just exactly like KS/JL do for players.
Very insightful. Thanks, Doc!
Thanks for that! Pasodoc, do you think theres anything to do with injuries pertaining to the size of today's athletes as well as the sport specific training these kids go through at such an early age? Speaking generally.
We've been up there with league injuries the past few seasons and the trend continues and you've brought up excellent points 🤬🤬🤬
Hawaii, i have a long record of too much beef on too little joints. It has been around a long , long time and i post on it maybe once a yr or two. I actually posted an article where scientists (docs in academia) stressed cartilage to different # of foot pounds of pressure, until they figured out at what force or pressure cartilage would break…or crack. Problem is you can't do that in humans, because, too much force, or weight, does have a tipping point beyond which cartilage cannot sustain the weight. Someone asked me if we could use that technique to calculate the maximum weight a set of meniscus could tolerate and same for ligament rupture. (Keep in mind in addition to just weight there are sheer stresses from abrupt stoping and changing 90 degree direction.). Anyway, you can't experiment on humans , at least in the Western Hemisphere, to test something like what is the weight beyond which an in individual's cartilage tears…or ligaments blow up.
My opinion from long ago is that too much weight on knees, ankles, was grossly responsible for so much tearing of ligaments or cartilage. So yes, i agree with you whole heartedly,, but we just can't get that kind of data…at least right now until some geek wizard comes up with a way to do so that is safe for players to undergo, without subjecting them to actual rupture.
[ Edited by pasodoc9er on Jun 9, 2021 at 4:58 PM ]
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What the hell were we doing between 2012 and 2013? And what the difference between 2008 - 2012 and 2008 to now? I have to believe that there's something different the organization was doing pre 2013 than what the organization has been doing since 2013. The reason I'm saying "the organization" because this injury issue is transcending coaching staffs, so perhaps this could have something to do with our strength and conditioning protocols. For example, could our ramp up/ramp down conditioning be mal-thought or mal-configured? 