Stretching: The Truth

I'm planning on a series of articles to update our readers on some of the current concepts in pitcher related injuries and diagnoses that most fans have not heard much about.

We've all had our fill of reading about pitchers with rotator cuff and glenoid labrum tears. There are some interesting trends in sportsmedicine that have lead to changes in exercise programs throughout the majors and minors in an attempt to protect pitchers from a cascade of preventable injuries most fans don't know about.

Diagnoses such as:

GIRD: (Glenohumeral Internal Rotation Deficit...not to be confused with the stomach malady also known as GERD which Cubs fans get from watching too many losses). Pitching (both cocking phase and deceleration phase) leading to a tight or thickened posterior shoulder capsular ligament plus a loose anterior capsule and loss of internal rotation of the shoulder. Extra external rotation of the shoulder develops at the expense of internal rotation.

Scapular Dyskinesia: Shoulder blade weakness with altered kinematics.

Internal Impingement: Thought to be related to posterior shoulder contracture from GIRD with subsequent instability of the shoulder as the humeral head (ball of the shoulder joint) which shifts back/posteriorly and upward/superiorly). This is a different entity from subacromial or rotator cuff impingement which is more common and typically occurs from friction outside the shoulder joint.

...and finally connecting the dots, sorting out how the the injured or weakened shoulder (scapula) leads to severe strain on the elbow and tearing of the Ulnar Collateral Ligament (aka the Tommy John injury).

My attention to this topic started last summer, when  I heard a remarkable interview on XM radio with renown Orthopedic Surgeon, Dr. Craig D. Morgan with hosts Jim Memolo and Rob Dibble. The focus of the interview was Stephen Strasburg's shoulder tightness and the subsequent ulnar collateral ligament elbow injury that lead to "Tommy John" reconstruction of that ligament last summer. Dr. Morgan said that he had predicted elbow problems in Strasburg by watching the way he held his shoulder.

More on how the arm bone is connected to the...after the jump.

Strasburg went on the DL  July 29th last season for "shoulder inflammation and tightness."  He reported right shoulder stiffness that wouldn't loosen up during his warmups on July 28. Strasburg threw just eight warmup pitches and then he was shut down.

When he went on the DL for his shoulder there was a flurry of quotes about how careful the Nats were going to be about Strasburg but at least one knowledgable person threw out a red flag even as the Nationals publicly stated that all was well and they were just being cautious:

An MRI exam taken Tuesday showed Strasburg's shoulder is "totally clean," general manager Mike Rizzo said. He's been shut down since Tuesday, resting his shoulder and getting treatment.

The Nationals have said they would end Strasburg's season when he
reaches 160 innings between the majors and minors, even if that cap were
to come in late August or early September.

White Sox Pitching Guru, Don Cooper,  publically voiced his observations and concerns about Strasburg and mentioned a few ghosts from the past (also reported by ESPN and in a more detailed piece in the Washington Post), all as counterpoint to what the Nationals staff publicly said:

As he (Strasburg) loads the baseball, his elbows raise higher than
his shoulders -- forming what pitching coaches call an inverted W -- and
the back of his shoulders pinch toward one another in the "scap
loading" portion of the delivery. Such a delivery, some pitching coaches
believe, puts him at greater risk of shoulder fatigue.

Cooper called it "an upside-down arm action." One major league pitching coach
years ago told me about the exact same concern about Mark Prior -- before Prior broke down.

"The real concern is what I call an upside-down arm action," Cooper told
Sirius in the interview... Cooper compared Strasburg's issues to the
ones that disrupted the careers of former Chicago Cubs pitchers Mark Prior and Kerry Wood.

"He does something with his arm action that is difficult, in my mind, to pitch a whole lot of innings on."

Strasburg's Inverted "W"

 

 

 

 

 

 

 

 

What Don Cooper may have been describing could be attributed to the diagnosis Internal Impingement from posterior capsular tightening from GIRD and subsequent scapular weakness.

Strasburg was activated from the DL after 2 weeks, on August 10th.

Dr. Morgan's interview seemed like he was prescient. In fact, he's one of the leading orthopedic surgeons that have blazed the trail for almost two decades on the detective work that has lead to some of the important and relatively new concepts on shoulder and elbow injuries that are just getting better understood in the last few years. Dr. Morgan was attending the game in Philadelphia where Strasburg blew out his elbow ligament in the 5th inning on August 21st.

When I watched Strasburg pitch I told my wife in the first inning ... I told my wife he would be on an operating table within a week. Was I wrong?"

"I could see that his right shoulder was down compared to his right (probably a misquote and should be "compared to his left"), which means he has muscle weakness. That's the No. 1 cause of the Tommy John ligament injuries. It's all preventable."

"All elbow problems originate from the shoulder," Morgan told MLB.com

In a nutshell, Dr. Morgan's observation that Strasburg's shoulder action upon coming off of the DL showed weakness would fall into the category of what is being called Scapular Dyskinesia (the absolute experts on this are Drs. Kibler, Burkhart and Morgan). Although additional factors can make the situation more complex, the weakness often comes as a secondary phenomon from loss of internal rotation (GIRD) because it's the opposite rotational direction that pitchers need to gain velocity (external rotation which can develop in several ways including bone adaptation during growth known as humeral retroversion) but that increased external rotation (where a pitcher archs his shoulder back to cock his arm) often comes at a price. The loss of internal rotation (thought to be related to thickening of the posterior shoulder joint capsule) leads to some adverse compensatory shoulder and trunk muscle actions including forward scapular (shoulder blade) posture.

So when we hear that a pitcher is dropping his arm slot or has altered his follow-through, it should be a big red flag. I certainly recall those concerns being voiced at times regarding Carlos Zambrano. Subsequent elbow problems can develop because of the altered slot might be related to scapular weakness and GIRD (so an MRI not showing a rotator cuff or labral tear is good news but just might not be the end point of what they should be focusing on).

Many of the MLB teams throughout their minor league systems have instituted preventative exercises to keep pitchers from losing internal rotation. The one exercise in these programs is best known as the "sleeper stretch". A study by Dr. Lintner of the Astros from 2007 looking at 85 professional pitchers in their organization showed that the group on the stretching program after 3 years showed the most gains in internal rotation, so it's not a short term solution but more of a philosophical and organizational adaptation. In the XM interview that I referred to with Dr. Morgan, he mentioned that he has data that the internal rotation and scapular strengthening exercises have dramatically decreased the number of pitching injuries in one or two organizations that he's working with, after a three year period from when they were instituted.

I plan on following up this introduction to the topic with a series that will go into more detail on the individual diagnoses including info from articles from the orthopedic surgeons that have done some of the heavy lifting on this knowledge. The relevant literature includes articles from team orthopedic surgeons from the Astros (Dr. Lintner, who one of my partners, Dr. Sunil Dedhia,  did his sportsmedicine fellowship with), Rays (Dr. Andrews), Rangers (Dr. Meister), Rockies (Dr. Noonan), Diamondbacks (Dr. Lee), Angels/A's (Dr. Yokum) and several other clubs.  I'm hoping to get an interview out of one of the Cubs trainers at the major or minor league level  as I get farther into this process.

Here's a link to a listing of the orthopedic surgeons associated with individual MLB teams.

Did I forget to mention the Rob Dibble lost his broadcasting job as color analyst with the Nationals over his comments on Strasburg? Talk about how deeply ingrained old school thinking is, coming from a 1990's pitcher who's relief pitching career was cut also short by injury to his pitching arm. It's all about advancing the understanding of anatomy and pathologic conditions and then getting the correlating hypothesis proved by analysis of data. Thank you Dr. Morgan. Back in Rob Dibble's day, which isn't all that long ago, pitchers did have to suck it up until their arms fell off, and about all that doctors could offer back then was cortisone and duct tape (former Cubs from Ernie Broglio to Chad Fox say "hello").

Rob Dibble:

"So for me, a little bit has to be put back on Strasburg here," Dibble said.
"OK, you throw a pitch, it bothers your arm, and you immediately call
out the manager and the trainer? Suck it up, kid. This is your
profession. You chose to be a baseball player. You can't have the
cavalry come in and save your butt every time you feel a little stiff
shoulder, sore elbow. ... Stop crying, go out there and pitch. Period."

We all know "there's no crying in baseball", but clearly there have been major medical advances here. The beauty of this topic though is that the advances are more about correct stretching techniques and (hopefully) less about surgery.

So it seems that Mark Prior and Kerry Wood might have had Hall of Fame careers had medical research been twenty years ahead of their time. Just another case of Cubbery.

Next stop...GIRD (Glenohumeral Internal Rotation Defecit). Pre-test (pop quiz) included in this link.

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Comments

I'd really be leery of anyone who conducts their own research on their own experiment and proclaims it a success. At a very basic level, a organization that looks to bring in a guy to keep their pitchers healthier, may already be shying away from drafting pitchers with more violent motions.

Great stuff so far, really cannot wait to read more.

Tommy John, from what I can continued to do the same bad things with his motion that he did early in his career.

http://www.google.com/imgres?imgurl=http://a....

And we have a picture on of Gorz there, who has a "good" arm action, but he's already had shoulder issues. http://www.google.com/imgres?imgurl=http://ww...

Let me add some other guys of Cub's interested on the Inverted W.
Cashner is a no http://www.google.com/imgres?imgurl=http://cd...

Simpson looks like a no:
http://www.google.com/imgres?imgurl=http://ww...

or maybe a yes.. http://mlb.mlb.com/video/play.jsp?content_id=...

Chris Carpenter, now at least looks OK:
http://www.google.com/imgres?imgurl=http://ww...

Jay Jackson no:
http://www.google.com/imgres?imgurl=http://me...

McNutt looks like an inverted W late in the season... maybe that explains his extra 4 MPH
http://www.google.com/imgres?imgurl=http://fa...

Marmol is borderline, and passes the "Chris Oleary" test.
http://www.google.com/imgres?imgurl=http://bl...

Matt Garza looks OK
http://www.google.com/imgres?imgurl=http://cd...

Austin Kirk looks fine:
http://mlb.mlb.com/video/play.jsp?topic_id=49...

Fantastic post, Doc. Good job!

managed to find the time to get through it just now...agreed, good stuff.

Concur!

Good stuff Doc

found this photo that shows what Don Cooper was thinking of

http://www.google.com/imgres?imgurl=http://ww...

anyone know what's the difference between an "M" and an inverted-"W" ? I think it's Gotta be an elbow joke but I'm open to suggestions.

(insert punch line here)

I couldn't come up with a punchline, though one person did refer to it as an M. a
Anyway, this shot should put to rest the theory of the superiority of the W shoulder loading for any Cubs fan.

http://www.google.com/imgres?imgurl=http://ca...

Submitted by Cubster on Sat, 01/22/2011 - 4:52pm.

anyone know what's the difference between an "M" and an inverted-"W" ?
============================================================================

CUBSTER: It might have something to do with this.

Strasburg pics added to the article demonstrating Inverted "W"

Rob: with Carl Pavano signing with Minnesota, the TCR free agent frenzy for 2011 should be ready for a final update.

(not expecting to have done well and I forgot most of my picks except for KW).

Tomorrow in addition to important football is only 3 weeks to pitchers and catchers reporting date.

Doc-

What's your opinion on Peavey?

Sox are reporting he's throwing off the mound now.

Do you think they are kidding themselves or he will come back but not be the same pitcher?

Thanks

Peavy's injury is unique among pitchers as he completely avulsed the latissimus dorsi off it's upper humeral attachment. It was repaired using a technique that is fairly similar to what is currently used to repair a proximal or distal biceps tendon rupture. The Lat Dorsi's tendon attachment is a bit different shape (it is broad and flat rather than round like the biceps).

I think Peavy could be as good as new except that he might take much of this season to get the latissimus to be as strong as whatever is normal for him. The lat is mostly involved in deceleration of the arm during follow through. Still he's a medical series of one so this is going to be a case report. Two of these lets the surgeon say: "in my experience" and three or more will make it the definitive series.

If it was Chad Fox, they would have used duct tape and the eternal 60 day DL.

Fascinating article!

Great article, Doc. Explained a lot.

Pardon my slowness though, but I still don't have a full grasp of the difference between the internal rotation and external rotation of the arm. Could someone give a more layman's analogy of this, please?

Could someone give a more layman's analogy of this, please?
---
I'll try this one with a bit more of the basics...

step 1: If you put your arm straight out at your side (not in front of you) and have it parallel with the floor, then bend your elbow so that it's at a 90 degree angle and have your palm facing down also at the floor (then dance like an Egyptian)

step 2: keep the elbow in the same spot but bring your hand/forearm straight up so that your hand is pointing straight up at the ceiling.

Congratulations! You've just externally rotated your shoulder.

Pitchers typically have extreme external rotation so that they can continue that rotational direction to get their hand way behind their body. The farther their external rotation, the greater their torque on the pitch. Some of that external rotation came from bony adaptation (called retroversion) if they were pitching while still growing. The rest comes from stretching the shoulder joint capsule, so the capsule laxity lets them achieve greater torque via greater external rotation.

Now back to basics...

step 3: bring your hand/forearm back down (again, don't move your elbow from the initial spot) so that your fingers point at the ground

Woo! **Internal rotation of the shoulder**

Seriously, I often get patients who think they are moving their shoulder when it's really motion from their elbow (or sometimes shoulder blade, when the actual shoulder joint is stiff), so the above instruction is fixing the elbow at a location and getting the humerus/arm to be the moving part but only for rotation (locking or fixing flexion/ext and abduction/adduction). The humerus/arm is half of the shoulder joint. The other half is the glenoid/socket, which is a part of the shoulder blade/scapula but that side of the joint doesn't move as much because it's closer to the body (it does move though). Bringing your arm out at your side (with respect to the shoulder) is called abduction and across your body direction is called adduction. Bringing your arm out in front of you is called forward flexion, with the opposite direction extension.

The medical version of 6 degrees of freedom (motion).

http://en.wikipedia.org/wiki/Six_degrees_of_f...

oddly enough, using the rotational components of the 6 degrees of freedom:

yaw would be like a pitcher spinning around to make a throw at second base

roll would be a pitcher doing a cartwheel

pitch is external rotation/internal roation. Awesome! Physics gets one right!

This blog rocks my socks off. Thanks, Cubster!

Has there been any evidence linking the towel drill to improvement in pitchers' recovery? On a real note, I worry about the violence in Marmol's delivery. I'm wondering if it portends major surgery in the foreseeable future. I've also wondered whether surgery to young minor league pitching prospects are a strong indication of future disabling injuries. I'm thinking of Guzman, Brownlie and Johnson.

Maybe. It hasn't been a problem for him up to this point.

DeRosa update from a SF online paper

http://www.sfgate.com/cgi-bin/article.cgi?f=/...

Truth is, the Giants are pinning some hope (plus $6 million) on a hitter who turns 36 in February and has not taken an ordinary swing since June 30, 2009.

Go Bears!!

http://pmoy.playboy.com/wp-content/uploads/20...

SFW, maybe not in front of your wife though

Nice drive, Jay. Starts at the five yard line and ends at the two yard line. Facepalm

I pick on Jay, but it's not like anyone else on the team appears to want to play football today, either.

This is by no means Jay Cutler's fault. Green Bay is just better on both sides of the ball. They should win the Super Bowl.

Todd Collins, by far, is the WORST backup QB in the league.

Jerry Angelo should be fired for this alone. THE most important position and they do not have a decent backup.

Any slim chance of the Bears winning are now gone.

It is over I am sad to say.

Some of it's cutler's fault, like missing a wide open Hester on the first drive

Had you been listening to the flagship where tom theyer and jeff joniak stated Hester stopped on the route, you might think differently.

And, the Bears did not "have their asses kicked", but were in tje game until the last minute with their number 3 QB who hasn't seen any action this year.

What a surprise no one visits your Bears blog, lol.

What a surprise that you can still be a clueless dick sometimes, but let me put an lol at the end so it doesn't seem so offensive

Yes I am a clueless dick watching Chicago Bear games from my comfy chair in LA or Anaheim.

You have heard of the internet, right, where you could listen to many more Chicago stations, including WBBM, and get myriad Chicago resources?

You are the one who said the Bears would "get their asses kicked..." and put a smiley face after the quote so you could "soften the blow" for all of us.

The Pack's offense did not score a point in the second half, Mr. Bear Truth. Clueless? Maybe you are.

No matter. They lost. Its over, and now we get to move on the Project .500.

I've heard of the Internet, it's where I meet such charming mindless folks like you.

I thought the packers were the better team going in, but I thought it would be a close game. Doesn't take wbbm radio to tell me that.

Got too busy working and raising my kids for bear truth. Not gonna get readers if you don't write. Considering the $1 i made off it a month, not a big loss.

"And, the Bears did not "have their asses kicked", but were in tje game until the last minute with their number 3 QB who hasn't seen any action this year."

The scoreboard says the Bears did alright until the end, but my eyes told a different story. The Bears couldn't get shit going. On the other side, the Packers made plays all over the field.

This game was downright embarrassing.

Hester did stop on the route, but it was still overthrown.

Depends... it probably isn't overthrown if Hester actually ran a corner route rather than an out. We probably won't know who was at fault on that play.

Cutler didn't play well. He made some pretty bad throws. But he sure wasn't helped out by his receivers or his offensive line either.

The way I saw it, even if Hester had run full speed, he still would've have gotten to it. Had the ball been thrown better, not an issue. But I'm not a Jay hater, just pointing out that I think in this case, both points are true. Hester stopped, but the ball wasn't thrown well.

that was my take as well...

if a guy is that open, I think you just have to make sure you hit him and not try to make the perfect pass. It sure didn't look like a timing play to me.

When you expect a guy to run a certain route, you throw the ball where he should be within that route. I have seen/heard several people say that they thought that Hester ran the wrong route.

We'll probably never know.

Basing on he's been a WR for 3 years in his WHOLE CAREER and when Jay's been calling time outs this season at the line is because Hester is out of place, I'm going to blame Jay and the inventor of the forward pass.

Cutler had a crap game.

However, Mike Martz' play calling was awful. Let's abandon the pass completely and just run Forte every play. That's pretty much what it seemed like for most of the day, even before Cutler got a boo-boo.

Martz was channelling Micheal Barrett?

ruh-roh

and I guess Rodgers made "three stupid mistakes" too?

Actually... he made a least a couple. And Cutler actually didn't make many (if any?) stupid decisions. He made some bad throws, but didn't make many stupid decisions.

You must have been listening on WBBM instead of watching as well.

Any time you stand in the pocket of an NFL game for six seconds, it's a bad decision.
Putting your head down and running the ball for .5 yards on 3 and 10 when you need five yards for a field goal is a stupid decision.
Trying to throw an inside screen to your covered RB when someone has a hand on you is a poor decision.

You're incapable of being objective.

Even eagle eying the game for Rodgers mistakes - other than the Ulracher pick, what were Rodger's stupid decisions?

The fact that the third string guy gave the Bears the best chance to win, is really the only indictment of Culter you need.

So even if no one is open, there's nowhere to run, you must never stay in the pocket for 6 seconds. This is an absolute in football!!!!

Was there someone open on that run that should have been a fg attempt?

Hanie gave up a pick 6 and then got a soft defense to score an easy td and teams don't game plan much for 3rd stringers. He got a little lucky and did the best you could expect from him.

I wouldn't going calling yourself objective about Cutler. He wasn't playing well, but a lot of the shit you call out is rather absurd

"So even if no one is open, there's nowhere to run, you must never stay in the pocket for 6 seconds. This is an absolute in football!!!!"

It turns out, what quarterbacks can do is throw the football.

"Was there someone open on that run that should have been a fg attempt?"

Unless you were at the game, there's no way to be certain, since they never actually showed the play downfield, but he got tackled by two guys who presumably weren't just playing QB spy, so yeah, most likely someone was open.

"Hanie gave up a pick 6 and then got a soft defense to score an easy td and teams don't game plan much for 3rd stringers."

Hanie got a pick 6 on an exotic defensive play, that's damned hard to prepare for as a third stringer. Had Cutler been as accurate as Hanie when he was in, the Bears propbably win the game.

It turns out, what quarterbacks can do is throw the football.

quite the circuitous logic test you've installed here. If Cutler forces a throw, it's a stupid decision, but if he holds on to the ball because no one is open, it's a stupid decision. His other option is run the ball, but apparently he shouldn't do that either unless he's sure to get the right amount of yards on the play or there are magical open receivers that he should have hit perfectly in stride on 95% of his throws.

I'm not sure what Hanie needed to prepare for on the pick 6, a color blind test? Guy in yellow helmet in front of receiver, don't throw. Not like the 350 pounder came out of nowhere on that one.

Zone blitz + 3rd string QB= problems.

as I said, he did as good as you could expect from him.

You missed the game, and obviously the 12000 previous NFL games. You can throw the ball, and not have a pick and not throw it to a receiver - it's called "throwing it away". Hanie did the exact same thing in the 4th quarter.

Sometimes a sack is the best option.

I saw two of those by Hanie, one got called for intentional grounding.

Which is the same as a sack, without the fumble, right?

21 days 'till pitchers & catchers report

Thank you!

I guess if the Bears can go 11-5 and actually make it close in the NFC championship, maybe I can hope for something better than Project .500 after all. Considering I had the Bears at about 5-11 this year, I guess anything is possible.

And Hendry becomes the second worst GM in Chicago.

Has Hendry had two different teams make to the "semi-finals?"

Has any other GM in Chicago other than Kenny Williams?

he has one more, but just as many playoff berths and it's harder to get in MLB.

You really defending Jerry Angelo?

I don't love the guy. I don't hate the guy. I feel the same about Hendry.

When the Cubs get to play 70 win teams at home for all of the games in a best of five playoff series, this becomes a valid point.

Jay Cutler is nothing more than a slightly-more-talented (and much more highly paid) version of Rex Grossman. With a shitty attitude and a track record as a quitter to boot. There, I said it. Fuck him.

Urlacher on the other hand keeps the tradition alive, he kept the team in the game damn-near single-handed.

All in all, a bitter disappointment. To the goddamn Pack. The only possible worse thing for me as a sports fan would be the Cardinals beating the Cubs in an NLCS. Painful day.

You forgot that Grossman only cost the Cubs one first round draft pick.

The other thing that really stands out about Cutler is his inability to hit players moving laterally. He's pretty good (today aside) on vertical throws, but can anyone remember him hitting a receiver in stride who was moving across the field?

Yes, I feel I've seen that a lot. Can't imagine he'd be over 60% if he couldn't, Mr. Objective.

I mean in stride. Yeah he can hit them, when they have to stop to catch the ball.

Yes, when they don't drop the pass.

Happened last week against Seattle. Threw across the field and nailed the receiver in stride. Don't remember who the guy was though.

This game was lost in the trenches, like it usually is in pro football games. Bears couldn't stop Raji, Peppers was an afterthought. Although, again, he was held a lot. I guess refs in today's game just don't call holding penalties on the line much anymore. But all three QBs were rushed.

That said, Cutler played like shit. And if they don't cut Collins today they're turds.

Yes... he actually did that a couple of times yesterday. And you are asking me if I watched the game?

http://sports.espn.go.com/chicago/nfl/news/st...

Folks questioning cutler's injury, teammates supporting rather vehemently

That is a bunch of bullshit.

Not one of those players knows what happened to Cutler's knee.

As Rob said above, Cutler didn't play very well. He was uncharacteristically inaccurate. But he didn't really make bad decisions. And to question his toughness because he got hurt is simply absurd.

There's an informed group...might as well make a story out of the comments on TCR.

Considering urlacher had no problems calling out cutler in the past and If he "quit" in the biggest game of the year, I would think urlacher wouldn't go to such great lengths to defend him.

Every media outlet has been taking pot shots at Cutler all year.

No suprise it's open season on him yesterday by players.

Jay doesn't show emotion, Jay is not having fun, Jay doesn't answer questions.

I'll take that every day as he improves and wins games. You want all that emotional bs go look to Favre, Rapensberger and Vick.

I read this over at Desipio:

What he needs to do, apparently, is go the full Favre. When he was in for that first possession of the third, and he realized that his bad knee wasn’t going to allow him to back up or step into his throws he needed to crumple to the ground and force the training staff to carry him to the sidelines.

revised:

What he fucking needs to do, fucking apparently, is go the full fucking Favre. When he was fucking in for that first fucking possession of the third, and he fucking realized that his fucking bad knee wasn’t going to fucking allow him to back the fuck up or fucking step into his fucking throws he fucking needed to fucking crumple to the fucking ground and fucking force the fucking training staff to fucking carry him to the fucking sidelines. *insert 10 minutes of WOOOOOOO!! and bro-no-homo-chest-bumps*

Torn MCL for Jay.

McMahon would have hit Gault in stride and still hand off the ball to the greatest running back with that.

http://twitter.com/skjensen

torn MCL for Cutler (not official)

him and that vagina Prior need to start a support group.

/sarcasm

I know this isn't a bears blog but I'd still like to see Dr. Hecht's take on this when more details come out.

Seriously what was Todd Collins even doing on the roster??? A 5.9 QB rating, with 0 TDs and 5 picks. Oh, yeah...that gives us the best chance to win...

Sigh....c'mon Project .500

My thoughts exactly. All the attention's been on Cutler and Caleb, but if the Bears had a legit NFL 2nd QB, they might've won yesterday.

They also wasted their sixth round pick on Dan LeFevour, essentially trading Collins for him on their roster. Better to just have Hanie as your back up and LeFevour as your emergency QB. Hanie threw a couple picks but I thought he actually looked pretty good out there. I'm fine with him as a number two as long as they get rid of Collins.

It left me wondering... Collins got the ball in pretty good field position both times. What if Hanie just gets those posessions?

Yup.

Isolated MCL's need bracing for about 6 weeks
Any associated injury like a torn meniscus needs to be scoped at some point.
An Associated ACL (Anterior Cruciate) would get reconstructed and put him out till...maybe training camp in July if things went well.

An acute isolated MCL can hurt like hell.

I heard Dan Hampton on wscr this am, said he had an isolated MCL in college and he could barely walk for 2 weeks...but if it happened a 2nd time later in his career, he would have been able to cope with it better. Danimal, he of the gnarly fingers...tape em up doc and put me back in. I think this accusing Cutler of being a wimp is BS. The guy got sacked 9 times vs NYG and was multiply concussed and back in 2 weeks. But the management should have put the decision to pull Cutler on the medical staff rather than letting Cutler get hung out to dry by the media and subsequently the in the moment of emotion by the fans.

I blame the coaching/mgt for being pigheaded and pants'd by the GB coaching/management team.

Is this BS or can you tell if a MCL is partially torn by examination?

"Citing a source close to the situation, the Chicago Sun-Times reported Monday that the extent of the tear is unknown, but Cutler was scheduled to have an MRI done on the knee."

I've heard of people playing with torn MCL's/ACL's - how painful is it?

Wimp or not, the Bears were clearly in way over their heads. The better team won.

http://msn.foxsports.com/nfl/story/Jay-Cutler...

Not a grade 3... I would guess things don't go too well in Chicago for Jay from here on out.

They didn't say what grade it was, neither at the press conference or in that story.

You don't think they would have called it a "tear" if it was, you know, fully torn?

What I'm saying is what I said: They didn't specify the grade. So you're making an assumption. You may indeed be correct, I'm just pointing out that you're not basing it on the article you linked to.

Yes, I am making an assumption that they would use the same nomenclature for a tear that everyone else in the NFL and the sports world uses, in particular when there is some question in the mind of many fans about the severity of the injury. Probably what happened is they amputed the leg yesterday. Good catch.

Sean Jensen tweeted it's a grade 2 MCL tear. Perhaps you can offer your diagnosis now, Dr. D-Bag.

Perhaps you can learn to use google, Captain Blowjob? 2 = 3 now?

You said it wasn't Grade 3. I said you might be right but that it wasn't in the press conference or the story you posted. I never said that two equals three, was just posting the information (you know, information that actually contained information, not conjecture). But congrats on being right, that's surely what really matters to you.

BTW, speaking of using Google, why don't you find some links about D-Lee abandoning his charity?

Because people don't you know, adverstise that kind of thing, moron. Don't get all bitchy at me because you don't have the ability to apply logic. Complain to your teachers and your parents.

"Because people don't you know, adverstise that kind of thing, moron."

Well said.

Also, I posted something about this at the time that you claimed (without proof) that D-Lee abanoned his charity, but he and Buehrle did a wine fundraiser in 2009 for their charities. (And the fundraiser was before the "he abandoned his charity" comment.) D-Lee's 1st Touch Foundation is still working with Project 3000, which works for the condition D-Lee's daughter was initially diagnosed with.

http://www.1sttouch.org/content/project-3000

Found on Google.

"Without a specific grade of strain, it's impossible to know just how significant Cutler's injury is, unless you're Real Neal."

(Last four words not actually in story.)

http://sports.espn.go.com/nfl/playoffs/2010/n...

a tear is a sprain

Grade 2, 3-4 weeks according to Sun-Times writer

let us listen to Rotoworld for the voice of reason

Bears fans are still angry that Cutler was able to stand on the sidelines and walk around in the second half of Sunday's NFC Championship Game. In fairness to Cutler, the medical staff and coaches made the decision to sit him because he couldn't protect himself.

Just to be clear - I am in the "I don't care how hurt he was camp" - the offense did better without him.

I was pleased by the decision to put Hanie in over Collins... I just don't understand how the coaching staff couldn't recognize after half a year with Collins what the layman could tell in half a game. Do you give them credit for going to the guy who could actually throw the ball, or ding them for not realizing it?

"Do you give them credit for going to the guy who could actually throw the ball, or ding them for not realizing it?"

Both. Signing Collins at all seemed like a WTF moment at the time and having him number two even more so. But I credit them for pulling him when they did.

From reading articles it seems like Martz either doesn't like Hanie very much or is obsessed with having a "veteran" available as the number two guy, even if he sucks. And reading between the lines, and not basing it on anything other than that, I get the hunch Smith pulled Collins out and didn't give a shit what Martz thought, the same way Smith pushed Martz to stop the 9 step (or whatever) Cutler drop backs and get the run game into the offense a little more. Not to mention some of those shorter passes into the flat that started happening after the bye week.

I almost wonder if Martz is gonna be here next year. God knows Cutler needs some continuity. No matter what you think of Cutler it's not real helpful for a QB to have a new offensive coordinator every year. Martz has his flaws but he's at least no Ron Turner.

Is Smith or Martz the asshole who called TO and then called that end around?

They also were gonna draft J. Starks instead of D. LeFavour they actually
had Starks on the phone when Angelo changed his mind.

Angelo thought LeFavour was DB and not a QB.

Don't worry Uncle Jerry will take care of all of the Bears' problems this off season.

Yeah, maybe he'll find a go-to wide out and an offensive lineman like he did didn't this year.

EDIT: Actually, I guess he did okay with J'Marcus Webb (spelling?).

Webb is showing improvement, his big o-line pick from a couple years ago was left tackle Williams. He missed most of first year injured, second year they figured out he couldn't play LT and now moved him to left guard.

He picked Marc Columbo, too, but they got rid of him and he had a couple good years at Dallas. But he got hurt this year I think.

Marc Columbo had a patellar dislocation that took him about 3 yrs to recover from...thought the Bears lost hope he could recover. Not sure if it was just that the recovery took even more time than they thought or he had better doctoring in Dallas...or the Bears got frightened off by the ghost of Stan Thomas.

Tommy Harris has taken about as much patience as Columbo...will be interesting to see if someone gets something out of him next year.

James Starks of the Green Bay Packers that is

w/ regard to cutler...i'm reading 'the last boy'& the medical case is made @ one point in the book that mantle probably played a couple seasons w/ a torn acl, a torn mcl & a meniscus that wasn't where it was supposed to be after the infamous pratfall on the sprinkler head in the '51 series...he had no surgery of any kind until the 'winter of '53 [& even then the acl wan't addressed] even though a 2nd opinion was sought @ time of original injury from johns hopkins...anecdotes about him doing tricks w/ his floating kneecap for amusement of teammates in the clubhouse...some doc who's portrayed as the father of modern orthopedics referred to his likely injury as the 'unholy trifecta' or something to that effect; other docs who examined all his records say fact he played on was a testament to an incredibly high pain threshhold & also that he was ultimately done in by a skeletal/joint frame that couldn't support his extreme musculature...anyway, not an indictment of jc, but an interesting glimpse of how far orthopedics have come in the last half century & another angle on mantle who, i confess, i'm fascinated by...

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football, football football football football football.

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football football football!!!!!

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PS - in europe they call it "that's not football."

well that escalated quickly...

Wasn't that an awesome article by Dr. Hecht though?

i checked in to 70 new comments and thought the cubs signed someone or zambrano got arrested for jay walking or something.

The best and worst of TCR. Book him, Danno.

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