March 14, 2016 - Dr. David Chao
Monday Morning MD: The new trend
There is a new injury rehabilitation trend and it has nothing to do with actual medicine. As social media continues to blossom, posting video of one’s recovery workouts has become the norm. Le’Veon Bell, Jason Pierre-Paul and Jamaal Charles are just a few examples of NFL players who recently have joined the injury update by social media movement. Draft eligible players, like Butkus Award winner Jaylon Smith, have also participated in the “check out how well I am doing” posting craze. Athletes who share these updates typically are trying to make the point of how hard they are working or how great the rehab is going. What is usually highlighted is the best snippet of their recovery, which may not be reflective of their actual status. When news is leaked to the media, the information needs context and interpretation. Rarely is the message taken at face value. The same should be said about the injury updates. The videos need analyzing to determine their true meaning as well. Self-released Vines should be looked at with a critical eye. I am not saying the postings are staged or faked, just that they need context and interpretation. Le’Veon Bell, coming off MCL and PCL surgery, tweeted “clear to run” with a video link to prove it; however, what it showed wasn’t exactly running. Medically, it is more accurately described as jogging on an anti-gravity treadmill. https://twitter.com/ProFootballDoc/status/705080436381188100 Yes he was performing the running motion, but it was partial weight-bearing as the machine unloads body weight. In reality, it was a good sign of progress for Bell, but hardly as advertised. JPP has used social media to post his own hand X-rays from last year’s unfortunate July 4th fireworks accident. Yesterday, he tweeted “they said I wouldn’t be able to grip the bar and lift weights anymore” with a video of him bench pressing. https://twitter.com/UDWJPP/status/709072913920630784 Others may have questioned his ability to bench press, but I never did. http://footballpost.wpengine.com/monday-morning-md-10-things-to-know-about-jason-pierre-paul-fireworks-injury/ Power grip is mostly provided by the 4th and 5th fingers, therefore it is no surprise that he can bench, but that doesn't mean he will be the same dominant player. Jamaal Charles took to Twitter https://twitter.com/jcharles25/status/700780712522190848 to counter naysayers that claim he is too old and can’t come back from a second ACL surgery. His assertion of quick recovery seems to be accurate as Charles looked good to me with his agility on jump rope and balance board. I never doubted https://twitter.com/ProFootballDoc/status/700912832217374720 that he would make a successful comeback as Charles has done it before on the other side. http://www.kansascity.com/sports/nfl/kansas-city-chiefs/article60900282.html Jaylon Smith has released several videos after ACL and LCL surgery. His pre-Combine post that was meant to show off his knee progress unintentionally alerted the world of his nerve issue. https://twitter.com/ProFootballDoc/status/703010337851777024 He continues to post rehab video, https://twitter.com/thejaylonsmith/status/708414986410979328 this time doing squats. I applaud his dedication and wish him the best; however, peroneal nerve function is not required when performing squats. The key for Smith will be his nerve status at the Combine medical rechecks two weeks before the draft. http://footballpost.wpengine.com/monday-morning-md-the-most-important-draft-medical-info-still-to-come/ The previous trend was to have personal physicians make statements or write letters espousing support for an athlete’s recovery. http://footballpost.wpengine.com/monday-morning-md-7104/ Those letters had very little influence and were understandably taken as biased. Due to HIPAA confidentiality laws, a physician can’t reveal medical information without permission from the patient. What player will allow a negative report to be released? What doctor would publically claim the outcome of their surgical work wasn’t positive? With social media, the workout videos seem to have replaced those physician letters. “Selfie” rehab videos are not just limited to football. Even Tiger Woods posted a video of hitting into a virtual golf machine in response to articles that said his career was over. https://twitter.com/ProFootballDoc/status/702696670673268736 The new trend of rehab video is interesting and can be informative. It provides a small window into the recovery process. Like all data, there needs to be context and interpretation before extracting great meaning from the posts.