0:00

And now, and now

0:02

back to Hale Varsity Radio. Time

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for a jock-dock Wednesday, Nebraska Orthopedic

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Center. Dr. Brandon Seifert

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with us, and Dr. Brandon, let's talk

0:12

a little baseball. How are we doing?

0:15

Hey, I'm doing great fellas. Absolutely, let's

0:17

talk some baseball. I can't believe it's

0:20

upon us already. It is. And how

0:23

many baseball fractured rib

0:26

injuries have you heard or seen in

0:28

your time? You

0:30

know, fortunately pretty rare having the fractures, but

0:32

obviously you think about all the stuff they

0:34

do. It's pretty easy to have collisions on

0:36

the field and you run it into another

0:38

player. Pretty easy to have a

0:40

collision with the catcher. Obviously

0:42

the big thing you think about, you know, taking a baseball

0:45

shot to the ribs, whether you're a hitter or out in

0:47

the field. So, you know, it's

0:49

surprising it doesn't happen more often than it

0:51

does. I was going to say the same

0:53

thing, Dr. Brandon, because I know pitchers will

0:55

say they don't target hitters, but whenever they

0:57

do, where they typically aim, right between

0:59

the numbers where you turn the back and get them in the ribs,

1:01

you would think it'd be an injury you see more in baseball. But

1:05

we got Cody Bellinger on the injured

1:07

list with fractured ribs, and it wasn't from that at all.

1:09

It was from crashing into a wall. Yeah,

1:12

absolutely. And, you know, again, kind of that

1:14

concept there is, you know, either A, that

1:18

direct impact into something, you know, a sister object to

1:20

a wall, another player is part of it. The other

1:22

thing, too, is you think about just kind of

1:24

in general the ribs and kind of the shape and

1:27

the anatomy of those, it's kind of like an accordion.

1:30

So, of course, your ribs, your chest walls are to

1:32

protect your internal organs, but that

1:34

also does kind of function in the way kind

1:36

of like an accordion, kind of allow you to

1:38

kind of flex one way or the other with

1:40

the rotation piece, the flexion bending piece. And

1:42

as you do that, you know, there's this kind

1:44

of soft structure that's in between those ribs, you

1:47

know, called cartilage. And so pretty easy as

1:49

you kind of flex one way to stretch it on one

1:51

side. If you kind of rotate vigorously,

1:53

obviously you can stretch it in that direction

1:55

or ultimately get to that kind of next

1:57

level where you get such a high impact.

2:00

that you have a fracture of the ribs. We

2:03

have a fracture we're talking about with

2:05

Bellinger. And tell

2:07

me about the healing process with it, how

2:10

you get healed. I know rest and don't

2:12

touch. I get all that. As

2:15

we talk a little bit here, timeline

2:18

on return to play and then just

2:21

can you tweak this thing as well? I mean,

2:23

I just think Bellinger was on an eight game

2:25

hitting streak, had five home runs this

2:27

time of year. And I

2:30

know how good he is with

2:32

the bat. And just when you're

2:34

swinging a bat, your ribs

2:36

are involved just on that follow through.

2:40

Yeah, absolutely, Chris. So from

2:42

all that perspective, first we kind of

2:44

talked about just the diagnosis itself. Originally

2:47

had some x-rays taken that were normal.

2:49

And that's pretty common. It's hard

2:52

to see the rib fractures, especially ones that are

2:54

not displaced on x-rays. And so sometimes they'll go

2:56

to that next level if you're having that much

2:58

pain. Obviously, at the professional level, they

3:01

order way too many imaging scans. But he gets

3:03

a CT scan. It's likely what they saw. And

3:05

on the CT, they actually saw rib fractures. I'm

3:07

guessing it was a CT. That would usually be

3:09

the next step, being that it's major

3:11

leagues and they have MRI'd in as well. But

3:14

at any rate, they found the fracture. And

3:16

so from a pain perspective, yeah, these

3:18

are quite painful. And really

3:20

the big thing is you think about

3:22

the function of these. So it's hard

3:24

to get comfortable when you have one

3:26

of these in terms of sleeping, sitting.

3:28

All positions tend to irritate that area.

3:31

And the biggest thing to think about is your

3:33

ribs are involved when you expand your chest and

3:35

you breathe. So every time you breathe, you're going

3:37

to have issues there. If you cough your sneeze,

3:39

it's pretty miserable, especially early on. Other

3:43

muscular structures attached to that. So you can

3:45

think about kind of the front side of

3:47

your abdomen, some of those abdominal muscles can

3:49

attach onto the chest wall. And

3:51

obviously as you're rotating at the waist or

3:54

flexing or moving to the side, you're going

3:56

to irritate that. And then the same thing

3:58

goes like what we talked about. like a

4:00

bleak strain, those big oblique muscles attached onto

4:02

the outside, so as a throwing athlete you're

4:05

going to feel that even as you're swinging a baseball bat you're

4:07

going to feel that you swing

4:09

through and just stretch that whole

4:12

area. So pretty easy with everything

4:14

you're doing athletically, especially baseball, it's

4:16

easy to kind of re-irritate. We

4:18

talked about re-tweaking that area, absolutely.

4:20

So timetable on

4:22

these is pretty variable. He could

4:25

get back as soon as maybe two or three weeks,

4:27

maybe six months, he really wants to push it, but

4:30

typically with these it might be more like four to

4:32

six weeks before he starts to feel like he's a

4:34

little back in stride, but honestly this probably is going

4:36

to hurt for three to six months, maybe

4:39

just at an achy level, but it will

4:41

be there, you'll notice it until it's finally

4:43

healed. Dr. Brandon, this

4:45

is one of those

4:47

injuries too that you really can't

4:49

accelerate, correct? I mean you can't

4:51

accelerate through, there's really not a

4:54

rehab process, is there? No,

4:56

it's really more time. I mean obviously you

4:59

can do some local anti-inflammatory things, let it

5:01

be some ultrasound, some kind of gentle soft

5:03

tissue mobilizations, some stem, those kind of things.

5:06

You could try some of the more experimental

5:09

things in the area such as like the

5:11

PRP, we talked about that before PRP's themselves,

5:13

to see if you can't maybe speed up

5:15

healing symptoms to the area. You could obviously

5:18

go to the extreme portion of doing basically

5:21

local anesthetic to the area like some lidocaine,

5:23

the numbing shots of four games or big

5:26

workouts and kind of help at least

5:28

for a short amount of time and obviously that comes

5:30

roaring back when the numbing stuff wears off, which

5:33

in this scenario is not a great scenario

5:35

to utilize that so early in the season.

5:37

That'd be more something to think about doing

5:39

if it's world series time or big playoff

5:41

series. Is there anything protective wise that Cody

5:43

can wear whenever he steps in the box?

5:45

You think about the quarterbacks that wear the

5:47

flak jackets and football to kind of protect

5:49

that lower rib cage. Is there anything like

5:51

that that Cody Bellinger can wear in order

5:53

to protect himself whenever he does get back

5:55

on the field? Yeah,

5:58

you know, I Think that's a reasonable option. Those

6:00

are the and they do have since lower

6:02

profile ones that are out there that could

6:04

utilize with baseball activities and he might consider

6:06

doing that initially with hitting to see the

6:09

to kick a ball off at area but

6:11

they do restrict some of that basically trying

6:13

to sit rotation waste rotation portion of it

6:15

can be somewhat restrict to for that so

6:18

that will be kind of the bells for

6:20

hims trying to figure out can I were

6:22

some type of protection but still they will

6:24

generate the velocity and liberties and eat and

6:27

swing it on the disappearing. Really

6:29

misses a little bit early. Were expecting to get

6:31

some more news from because you're in the coming

6:33

days. He said that based on the fact that

6:35

the initial x rayed didn't so broken ribs, you

6:37

didn't think it was displaced. Tell me

6:39

with this fracture, what is the difference in

6:42

the recovery process as it's displaced vs as

6:44

it isn't displaced? How. Big. Of

6:46

a difference is that for for ballenger here. Yeah

6:49

and so she'll for hours from my

6:51

perspective. as that display set piece

6:53

changes. So the think about the further

6:55

a fresher go from the sitting in

6:57

the spotless supposed to be to being

7:00

kind of way out of alignment if

7:02

you will. Typically it's gonna take a

7:04

higher level for say, higher level trauma

7:06

that to a point where displaces more.

7:08

That's typically how that works law newton's

7:10

physics, they're mostly time and so's you.

7:13

Think about that for you displays that

7:15

is. the more a ton of stretches

7:17

the more those other surrounding tissues are

7:19

traumatised by that and that just syndicates

7:21

can have a longer view. Recovery course.

7:24

The Guinness Book of indicating the trauma

7:26

of obviously if you get it just

7:28

right between and have to be isolated

7:30

injury there the more non biggest now

7:32

misplaced is less display said it is

7:34

usually not the less of source the

7:36

lessons run into some Karma damage news

7:38

was critical damage and they can recover

7:40

faster. Army to know them Any to

7:42

attend a reduced even if it's a

7:45

single car with pressure. These two are

7:47

painful and annoying. For a while she's

7:49

had one well which is Watson's video

7:51

Doctor Brennan center was as a John's

7:53

dog when security. Though and your was

7:55

drifting. That drifting the tone of fumbled

7:57

the ball and and used in a

8:00

short distance crashed into the brick within

8:02

the I the the unfriendly gone fines

8:04

and it just hit must have just

8:06

been that perfect are imperfect kids editor

8:09

who did him in time for padding

8:11

and regular yes or no and fish

8:13

a threat or to take all of

8:15

old tradition such a branded only I

8:18

see just expand the warning track a

8:20

little bit out of give me a

8:22

little more to hide about the bricks

8:24

right of air assess assess This is

8:27

also a good coach mash like wow

8:29

The Dodger. Stadium Now the no chances.

8:31

Such a brand of a surgeon again

8:33

soon. Thanks for the time today. Or.

8:36

Right dollars, take care. Good

8:38

here from Doctor Bread and Seifert Nebraska

8:40

Orthopedic Said are some Assad's spinal thoughts

8:43

from us as we gear up for

8:45

a road show Thursday at the Single

8:47

Barrel with a Varsity.