Misinformation about ACL tears on this board

[marcus]

I am an M.D.

1. An orthopedist can be 99% certain of an ACL or PCL tear if the injury is severe without an MRI

2. It does not matter one bit if a player hobbles off on his own power in terms of predicting major damage


Botttom line is the orthopedist likely knows that Brady has severe damage to the ACL of his knee before the MRI if it is severely torn
The MRI just proves it beyond a shadow of any doubt or in cases where teh tear is not complete.

 

[MrBigglesWorth]

so if it's a tear what are the options? are there options? what is the time frame?

 

[DaedalusX]

Everyone keeps saying "serious damage" and "severe". What would characterize that versus a less severe ACL tear? And what kind of recovery time and end result would he be looking at? Like, will he ever be 100% again?

 

[DaBruinz]

I am an M.D.

1. An orthopedist can be 99% certain of an ACL or PCL tear if the injury is severe without an MRI

2. It does not matter one bit if a player hobbles off on his own power in terms of predicting major damage


Botttom line is the orthopedist likely knows that Brady has severe damage to the ACL of his knee before the MRI if it is severely torn
The MRI just proves it beyond a shadow of any doubt or in cases where teh tear is not complete.

1) An orthopedist can be fairly certain, but 99.999% of the time they ask for the MRI so they are 100% certain.

2a) It does matter whether the player hobbles off under his own power. As someone who had a full ACL tear and from having talked with others during my rehab who all had full ACL tears, that its like 1 in 1000 that doesn't have severe pain that prevents them from walking.

2b) If Tom had an ACL tear, I am fairly certain he wouldn't have been grabbing his tibia unless he tore it off the bone. But, then you are talking about a severe amount of pain. An amount that probably would have kept him from walking. Brady's hands were almost a full hand-span down his leg from his knee. This leads me to believe its more likely a bone bruise. But, again, anything is possible.

 

[PatsWickedPissah]

Not mentioned but possible, a hyperextended knee. I've had it happen; it's painful but far less serious. This would be a best case. Weeks to recover to brace status.

 

[Patjew]

I am an M.D.

1. An orthopedist can be 99% certain of an ACL or PCL tear if the injury is severe without an MRI

2. It does not matter one bit if a player hobbles off on his own power in terms of predicting major damage


Botttom line is the orthopedist likely knows that Brady has severe damage to the ACL of his knee before the MRI if it is severely torn
The MRI just proves it beyond a shadow of any doubt or in cases where teh tear is not complete.

Is it your speculation that it is an ACL tear in this case?

 

[marcus]

A complete tear of the ACL will mean about 9-12 months rehab time.


If the ACL is partially torn, it is more difficult to diagnose with certainty without the MRI.

Often times in addition to the ACL being torn there can be cartyilage damage to the menisci, which can also result in severe pain referred to the upper tibia.


I do not know what injury Tom has and it is speculation on my part.
However it is possible thta the team physicians can be pretty certain that he may have torn his ACL without the MRI and that they may have told Brady and BB....

 

[DaBruinz]

so if it's a tear what are the options? are there options? what is the time frame?

Well, it all depends. If its a full tear, but without the pain (ala former Steelers/Jags/Bills WR Bobby Shaw) then he could rehab it and play on.

If its a full tear with complications (meniscus or cartilege damage), then probably an full replacement will be in order. That's usually 12-18 months.

A strain or sprain (partial tear) could be taken care of with R&R and could be 4-6 weeks.

I believe that SOP is to get them into therapy ASAP to limit the amount of downtime and rehab time needed if surgery is required. That is provided that they can actually walk on the leg. If they can't, then they go right to surgery and its 2-4 weeks before they can start rehab.

Now, this information is my experience with ACL injuries and having continued to follow the field since I completely tore mine in 1997. There could be some fine points that I missed and I am sure the good doctors will correct it.

 

[Gwedd]

I agree. I have watched that hit several times and it looks to me that Brady's upper left leg is whacked by a helmet. I cannot see anywhere where his knee was actually impacted, and he is, in fact, holding his upper leg vice his knee.

The natural reaction is to grasp the injured area, and Brady does not go near his knee, just his upper leg. I strongly believe, based solely upon my observations and absolutely nothing more, that this is at most a stress fracture and more likely a bone bruise.

Yeah, Yeah, it's only my opinion, but it is what it is..

respects,

 

[emoney_33]

A complete tear of the ACL will maen about 9-12 months rehab time.


If the ACL is partially torn, it is more difficult to diagnose with certainty without the MERI.

Often times in addition to the ACL being torn there can be cartyilage damage to the menisci, which can also result in severe pain referred to the upper tibia.

Isn't it extremely unlikely to tear your ACL getting hit on the outside of your knee? Doesn't there need to be force on the back of your knee (pushing the knee back)? I would think to tear by being hit in the side of the knee it would have to look a lot worse than it did (tearing the MCL first)?

 

[DaBruinz]

Isn't it extremely unlikely to tear your ACL getting hit on the outside of your knee? Doesn't there need to be force on the back of your knee (pushing the knee back)? I would think to tear by being hit in the side of the knee it would have to look a lot worse than it did (tearing the MCL first)?

EMoney - What you describe is almost exactly what happened to me when I tore my ACL. I was running full speed while playing Dek Hockey and I cut to my left, planting all my weight on my right leg. My knee buckled inwards under my weight and, as I fell, my leg flopped around to the point where the bottom of my foot was almost at eye level (picture Joe Theismann's leg, but at the knee). It was the equivalent of someone hitting my knee from the outside and causing it to buckle inwards. Not pleasant and it resulted in a partially torn meniscus as well.

 

[RxJock1120]

I am an M.D.

1. An orthopedist can be 99% certain of an ACL or PCL tear if the injury is severe without an MRI

2. It does not matter one bit if a player hobbles off on his own power in terms of predicting major damage


Botttom line is the orthopedist likely knows that Brady has severe damage to the ACL of his knee before the MRI if it is severely torn
The MRI just proves it beyond a shadow of any doubt or in cases where teh tear is not complete.

DR. Did you ever attend a class on ACL tears. If you have you might remmember this tidbit:
"DO NOT
In the case of a serious knee injury, do not attempt to move the joint. A splint should be used to keep the knee straight until evaluation by trained medical personnel has been performed. Do not return to play until proper evaluation and treatment has taken place."
This is taken directly from my anatomy texbook. How is it that the player would be allowed to "hobble off on his own power" if the orthopedist determined that he has an ACL tear.

 

[upstater1]

One thing, AJ Price of UConn had a full tear in April.

He was running 2 months later.

Though he won't be able to cut and do the difficult things he needs to for many months, someone could be a Marino-like stand-in-the-pocket type QB 4 months after tearing it. The playoffs are 4 months away.

 

[dhamz]

I'm not a doctor. I didn't even stay at a Holiday Inn Express last night.

What I am is a football fan. In that role in recent years I have seen Donovan Mcnabb jog off the field after tearing his ACL. I also saw Phillip Rivers jog off and then back on after tearing his ACL.

 

[PittPatriot]

DR. Did you ever attend a class on ACL tears. If you have you might remmember this tidbit:
"DO NOT
In the case of a serious knee injury, do not attempt to move the joint. A splint should be used to keep the knee straight until evaluation by trained medical personnel has been performed. Do not return to play until proper evaluation and treatment has taken place."
This is taken directly from my anatomy texbook. How is it that the player would be allowed to "hobble off on his own power" if the orthopedist determined that he has an ACL tear.

I am an M.D. (too).
But Ortho is far from my specialty so I will defer to those on the board who have their own experiences in knee injuries.
The ACL/MCL/Meniscus make up the 'unhappy triad' of structures that can get injured when a lateral force strikes a planted leg.
I don't think it is useful to speculate on the extent of injury without an MRI...you'd have to have a nearly complete tear to get a positive anterior drawer sign (as they were testing on the field) and it did not appear that way.

On a bright note...the Colts are losing and the Jags and Bolts have already lost. The Pats were the only AFC Semifinalist to win today.

 

[PittPatriot]

Why must they wait to do an MRI until the morning?
There is only 1 knee ligament in the entire Northeast area of this country that may be more precious than TB's....and that is probably Roger Federer's.
I am sure their is even a leased machine somewhere in the bowel's of Gillette.
What's up with the wait?

 

[DaBruinz]

I'm not a doctor. I didn't even stay at a Holiday Inn Express last night.

What I am is a football fan. In that role in recent years I have seen Donovan Mcnabb jog off the field after tearing his ACL. I also saw Phillip Rivers jog off and then back on after tearing his ACL.

I saw McNabb's and it wasn't a full tear. Neither was Rivers... But they were severe enough to require surgery. Again, there are varying levels of this injury.

 

[BradfordPatsFan]

One thing, AJ Price of UConn had a full tear in April.

He was running 2 months later.

Though he won't be able to cut and do the difficult things he needs to for many months, someone could be a Marino-like stand-in-the-pocket type QB 4 months after tearing it. The playoffs are 4 months away.

I was going to make this comparison as well.

AJ tore his ACL in late March, had surgery with in a few days, and could have played summer pick up games in August, though the UConn staff held him out. Four months and he was ready to go. There was never any doubt he'd be ready for the start of practice in October.

Onto Brady, if he can drop back and step up in four months, which according to reports AJ Price could do, then he may not be done for the year. Here's hoping...However, even if he isn't ready and is lost for the season, next year should not be in jeopardy.

 

[MrBigglesWorth]

A complete tear of the ACL will mean about 9-12 months rehab time.


If the ACL is partially torn, it is more difficult to diagnose with certainty without the MRI.

Often times in addition to the ACL being torn there can be cartyilage damage to the menisci, which can also result in severe pain referred to the upper tibia.


I do not know what injury Tom has and it is speculation on my part.
However it is possible thta the team physicians can be pretty certain that he may have torn his ACL without the MRI and that they may have told Brady and BB....

how come cartilage is spelled "cartyyilage"? I know i'm nitpicking but it hurts your credibility in spelling.

 

[emoney_33]

EMoney - What you describe is almost exactly what happened to me when I tore my ACL. I was running full speed while playing Dek Hockey and I cut to my left, planting all my weight on my right leg. My knee buckled inwards under my weight and, as I fell, my leg flopped around to the point where the bottom of my foot was almost at eye level (picture Joe Theismann's leg, but at the knee). It was the equivalent of someone hitting my knee from the outside and causing it to buckle inwards. Not pleasant and it resulted in a partially torn meniscus as well.

Ouch, that makes me cringe just thinking about, that must have been a tough year rehabbing.