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About slubcr

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  1. slubcr

    Tricky ACL dilema for Dr. Mark

    I hear you about not letting personal experiences affect what we do and lead us away from evidence based medicine, however, after experiencing the severe side of the anterior knee pain and sequelae you can't blame me for being shy. What's your thoughts on the hamstring graft? All the research shows similar end results, similar laxity scores, similar tensile strengths, and a trade of for hamsting weakness and recovery vs the anterior knee problems. The biggest differences I see is the longer healing time related to tendon to bone healing time, fixation issues, and tunnel widening (whether that matters or not). Are these enough to concrete the decision? If I understand you right, I guess they are. Thanks.
  2. I am a 35 year old family physician and just tore my right ACL (along with 2 meniscus tears and a tibial plateau crush injury that is mild). I would love to have a contralateral patellar graft done, however when I was 20 I dislocated my left knee and ended up with a unhappy triad. I had the ACL reparied with a same side patella graft which left me with severe anterior knee compartment pain and arthritis ever since. I am not sure now what way to go. I am not going to have a same side patella graft again, but not sure if it would be worth looking into the contralateral side or proceeding with a hamstring graft, keeping in mind its limitations. I have researched your site and have ruled out the allograft. Any advise would be great, and thanks for all you have done for our sport and medicine. Dr. Justin Buls
  3. Without examining CR's shoulder it's imposible to comment on the extent of the injury. IF it was a 1st degree separation, or a partial separation of the AC (acromioclavicular) joint, they are quite easily managed. I have injected many for local athletes and with special taping for support of the clavicle one can function fairly well and with little pain. In the long run these are nagging injuries that heal very slowly and have multiple relapses. Although complete healing is the most likely. 2nd degree separation is a complete tear of the AC joint is often more painful initially, but usually has less pain later. We had a hockey player that had a 2nd degree separation and played every weekend with just taping alone. Its common for a 2nd degree separation to just form a loose fibrous joint that often causes no pain at all, although many develope severe AC arthritis. Both 1st and 2nd degree separations can be fixed if causing severe pain or resulting arthritis, by cutting off the end of the clavicle and forming the fibrous joint. Fusion for these is rarely done now. A 3rd degree separation is the most severe, painful, and hardest to fix. This is a complete separation of the AC joint and the coracoclavicular ligaments. Surgery is often offered and still involves cutting off the distal clavicle. see this site for info and pics http://www.steadman-hawkins.com/shoulder_acSeperation/overview.asp Anyway, Chad's injury although painful and nagging, was still overplayed by the media. The shot involves local anesthetic, like Marcaine which is longer acting than lidocaine and can last ~4-6 hours. It also has a steroid medicine like Kenalog or cortisone, for decreasing inflammation and pain 2-3 days later lasting months if lucky. With the shot and taping in a well trained athlete, they usually function quite normally. I do give him kudos for thanking the astrix team. I'm sure it hurt like heck, but this is nothing new in the world of sports and nowhere as threatening as the media played it. I doubt it was Chad's idea. Sorry this post is long and full of crap most of you will care less about.
  4. The guy just plain hauls @$$. He's incredible. I think he hates losing...
  5. slubcr

    Fonseca down?

    I'm a doctor as well and would put money that Dr. Davbarcus quoted that from his mind (NO COPYRIGHT NEEDED FOR THAT). I thought at first his post was a rebutle to my layman's version I posted earlier. I've chatted with him a few times since and know he has a special interest in the neurologic system. We deal with things so frequently, and with an interest in something, it makes this kind of text-book like info roll off the tongue. I was joking with him that most the time I am spending my time talking at others' level that I find myself forgetting the medical jargon. Give him a break (I did), he was just trying to help. We all mean well and wish Ernie the best.
  6. He came damn close to finishing Erzberg. But bike broke down. Plus he was running pretty good too. Led most of it. Simply put Travis is amazing, he can do whatever he sets his mind to. The kid has more natural talent than anyone. Seems he's the next Ron Lichien, but I think even more talented. FOCUS is right. If he shows up to Daytona in shape and focused, who knows. Thats why we love him, keeps us watching.
  7. slubcr

    Fonseca down?

    My bad hadn't read your PM yet. Thanks for the reply and appoligies this way as well.
  8. slubcr

    Fonseca down?

    Don't give yourself a false sense of security. I had my chest-protector, with the complete back, on when I broke my back (complete blow-out fracture of T6 and compression fracture of T5). I wear all the protective gear including a neck roll, but they are only good for so much. By the way, many ACL tears in the knee happen in people wearing knee braces. Even the sports medicine research on athletes wearing knee braces in multiple sports (not including motocross) quote a minimal benefit if any. Now imagine that with the extreme forces our sport places on us when we crash. The gear may help some, but chances are hitting the ground as hard as we do may over come the potential benefit. Again know your abilities, be careful, and have fun.
  9. slubcr

    Fonseca down?

    I'm glad to see the report that his cord wasn't severed. I promise not to read medical text books to you like Davbrucas did in his attack. C7 is a cervical vertebrae at the base of the neck, not at the mid chest and gives nerve supply to the arms hince the reason Ernie was having partial arm symptoms as well. Anyway, doesn't matter really, stills sucks and I feel terrible. Hopefully with time and decreased swelling he will gain stuff back. Time will tell. Good luck Ernie. I have to say that racing is dangerous. I have definitely dialed things down. I have learned my limits over the years with multiple injuries. My advise to all is to learn your limits and abilities, as with everything you do, and stay as safe as possible doing what you love to do.
  10. slubcr

    Fonseca down?

    This scares me. I feel terrible for Ernie. I hope things are OK. The foot test they are talking about, could actually be a very bad sign depending on the exact response. When you scratch the bottom of a foot the normal response is for the toes to deviate down. If there is a break in the spinal cord or damage to the brain (ie a stroke) when you scratch the foot the toes will fan upward. You still have reflexes if you have a spinal cord injury, its just that they lack the higher function from the brain to coordinate them appropriately. Also the reflexes at the knee become spastic as well as the tone of the muscles increases. Immediately after an injury there is a varied response due to many reasons but mainly swelling, so the response is not completely reliable although can be helpful. Dirt Rider should not be claiming this is a good sign without knowing what the test really means. It is always possible to lose function and feeling with just swelling and not damage to the spinal cord fibers, and with resolution of the swelling things may come back. I just hope things turn out the best for Ernie. I hate it when these things happen. I broke my back in 1996 and had some mild numbness in my feet, but after surgery all was fine and I've been racing ever since. I am now a doctor, and thought I'd give out some info. Ernie you have my best wishes.
  11. Yeah really. You could see the rear of the bike was sagging when he pulled off. The fender was only about 4-6" from the rear tire. I have it recorded and watched it again after he said it. RC hasn't made an excuse in his life unlike most of the others out there, esp. JS.
  12. god I love that video. Makes me laugh every time. lol
  13. slubcr

    450 Shootout Results

    nice math and good post. I guess it's clear the CRF owns another year. I can say that because I have one. lol. They are all great bikes. These bikes are amazing and so easy to ride. I mean could you imagine riding a 2-smoke anymore... ouch, I just hurt my brain.
  14. slubcr

    So is Mcgrath a dirty rider?

    Good job MC. Man he gets drilled by JS and says nothing, not a peep. Then this week gives JS a little bumped on the start, and JS is whining as always. "I don't know why he'd do something like that?" How about because you deserved it punk. This was exactly what I had in mind when I started the post last week. I could just see JS whining about something he does to others all the time. lol. Just strengthens my point that he needs to grow up. He'll end up with 19 guys gunning for him if he's not careful. Just ask Alessi, who's all of a sudden a saint out there this year, and at least showed that he has a few cells up in the cranium working. Oh yeah and don't tell me JS landing in the middle of RC's back at Unadilla was clean. Give me a break, this kid is out of control, and very lucky RC isn't into paybacks, because he owes him a half a dozen from last year.