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Post by pedrofanforever45 on Aug 20, 2019 4:10:24 GMT -5
Sale could have a stretched ligament, which is basically a ligament with small micro-tears in it.
He could also have a small tear in itself.
This is the part we don't know, but it's pretty easy to see it's not just inflammation. People with opioid addictions opt for PRP injections because it doesn't require medication after, but there's no reason to believe that Chris Sale has a drug addiction.
In other words, there's a real reason why this treatment was done. There's real damage in that arm, which is the worst news.
The good news is that there's a example of the PRP injection working with Tanaka. Yet, there's others who come out on the other side and still have to get the surgery after the PRP didn't work. Ohtani. Richards.
We will find out by spring training if it worked. If Sale is having setbacks by then, it's not a good sign because that's a sign that it didn't work. We will see. Time will definitely tell on this injury.
Simply put, this treatment will work or it won't. There's really no inbetween here.
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Post by soxfanatic on Aug 20, 2019 5:07:29 GMT -5
This is where message board doctors who have never seen Sale's elbow or an MRI know more than James Andrews, the guy who invented the surgery. TJ surgery was actually invented by the late Frank Jobe.
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Post by redsox04071318champs on Aug 20, 2019 6:25:36 GMT -5
www.hss.edu/condition-list_prp-injections.asp"What is platelet-rich plasma (PRP) and what are PRP injections? Platelet-rich plasma (PRP) therapy uses injections of a concentration of a patient’s own platelets to accelerate the healing of injured tendons, ligaments, muscles and joints. In this way, PRP injections use each individual patient's own healing system to improve musculoskeletal problems. PRP injections are prepared by taking anywhere from one to a few tubes of your own blood and running it through a centrifuge to concentrate the platelets. These activated platelets are then injected directly into your injured or diseased body tissue. This releases growth factors that stimulate and increase the number of reparative cells your body produces. Ultrasound imaging is sometimes used to guide the injection. The photographs below illustrate a PRP injection into a patient's torn tendon. The ultrasound guidance is shown at left and the injection is shown at right." It's pretty common knowledge that if it was a mild strain, this thing would just be shut down and he would be prescribed inflammatory medicine, along with rest and rehab. Chances are that this is a grade 2 ucl strain needing further treatment than just rest, rehab, and inflammatory medicine. Thanks for digging out that information. It made this procedure much clearer in my mind. It reinforces that Sale doesn’t have a tear but, as Dr andrews and the team stated, a nasty inflammation that is being treated with the injections and rest. Inflamations can be secondary to a tear, but that is the exception not the rule. Most recent example is David Price. Until Dr. Andrews says surgery is required I feel positive, even confident, that Sale will be Sale in 2020. That doesn’t mean neither Sale nor Price won’t need TJ at some point, but it does mean they don’t need it now. The problem is what does that mean? Does this mean he'll be dominant Chris Sale? And if so, for how long? Now, in his tenure with the Red Sox, he's had a late fade of mediocrity in 2017, missed most of the second half in 2018 and wasn't himself for the most part when he pitched, and had to be shut down in the second half of 2019 after being un-Chris Sale-like in the first half. So what does that mean for 2020? The Red Sox get 125 good innings out of him before he breaks down again? It's a question that has to be asked. The Red Sox' 2020 seasons and beyond hinge a large part on their ace pitcher. If the Red Sox are to win and hang with the big boys in the AL, they need Chris Sale to be their ace for the season. Yes, in 2018, everything went so right they were able to thrive even with Sale taking a vacation for most of the second half and coming back and not being dominant - except for the last inning of the season. The Sox are in a difficult position. They have to depend on him, but they really have to hedge their bets and make sure that they have the rotation depth to withstand Sale's absence along with the medical issues that Nate Eovaldi has every year. When Johnson, Wright, and Velazquez were up to the task, they were fine. When they all failed (and Wright will never be a starter for the Sox at this point again) this year, the pitching really suffered and has shown up in the standings as that huge gap between Boston and NY (and TB) and the other strong teams in the AL. And they have to this within a limited spending budget assuming they're trying to get below the threshold.
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Post by patford on Aug 20, 2019 7:32:07 GMT -5
Sale had a PRP injection for his elbow in 2014 while he was with the White Sox.
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Post by jimed14 on Aug 20, 2019 8:14:36 GMT -5
This is where message board doctors who have never seen Sale's elbow or an MRI know more than James Andrews, the guy who invented the surgery. TJ surgery was actually invented by the late Frank Jobe. The point remains.
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Post by swingingbunt on Aug 20, 2019 8:37:00 GMT -5
Could you provide a source for that? I'm not a doctor and would rather not pretend to be one, but a quick Google search says the treatment "is known to protect tissues from inflammatory damages." Do you know for a fact that this treatment would, in no way, be used in that way? www.hss.edu/condition-list_prp-injections.asp"What is platelet-rich plasma (PRP) and what are PRP injections? Platelet-rich plasma (PRP) therapy uses injections of a concentration of a patient’s own platelets to accelerate the healing of injured tendons, ligaments, muscles and joints. In this way, PRP injections use each individual patient's own healing system to improve musculoskeletal problems. PRP injections are prepared by taking anywhere from one to a few tubes of your own blood and running it through a centrifuge to concentrate the platelets. These activated platelets are then injected directly into your injured or diseased body tissue. This releases growth factors that stimulate and increase the number of reparative cells your body produces. Ultrasound imaging is sometimes used to guide the injection. The photographs below illustrate a PRP injection into a patient's torn tendon. The ultrasound guidance is shown at left and the injection is shown at right." It's pretty common knowledge that if it was a mild strain, this thing would just be shut down and he would be prescribed inflammatory medicine, along with rest and rehab. Chances are that this is a grade 2 ucl strain needing further treatment than just rest, rehab, and inflammatory medicine. I was recently prescribed a medication that mostly deals with rapid heart beat. If I were to tell someone what medication I'm taking they would automatically assume I have a rapid heart beat...But I don't have a rapid heart beat. I have high blood pressure. The previous medications I tried weren't helping, but this one does. My previous post didn't ask you what a PRP injection COULD be used for, or even what it most likely could be used for. Your post before this one said it COULD NOT be used to combat inflammation, and you still haven't proven that was not completely made up. You've already stated what you THINK Sale's diagnosis could be. You've made that clear and we all get it. I'm not a mod, but I am respectfully asking you to stop making declarative statements ("There wouldn't be a PRP injection if it was just inflammation.") when you don't actually know for certain that's what's going on.
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Post by manfred on Aug 20, 2019 8:49:48 GMT -5
This whole discussion is idiotic. The doctors made a call. Experts. The word for now is no tear. They will look again in 6 weeks. Yet people who are armed with nothing more than WebMD are somehow able to say how things are not what they appear? All we can do is wait and see.
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Post by dmaineah on Aug 20, 2019 9:00:23 GMT -5
Seems to me that the way this is going we won't see Sale back until 2022 & the Red Sox should plan for it every way they construct, build, spend, trade & consider the roster going forward.
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Post by fenwaythehardway on Aug 20, 2019 9:05:51 GMT -5
This whole discussion is idiotic. The doctors made a call. Experts. The word for now is no tear. They will look again in 6 weeks. Yet people who are armed with nothing more than WebMD are somehow able to say how things are not what they appear? All we can do is wait and see. I mean, I do tend to believe that they wouldn't just give him a PRP injection for a diagnosis of "actually your elbow is totally fine", so on that basis I'm assuming his elbow is not totally fine. But, he's not getting TJ, so it isn't completely trashed either. I think that's about the limit of what we can say with confidence. Seems to me that the way this is going we won't see Sale back until 2022 & the Red Sox should plan for it every way they construct, build, spend, trade & consider the roster going forward. Some people are more confident.
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Post by jimed14 on Aug 20, 2019 9:09:04 GMT -5
Seems to me that the way this is going we won't see Sale back until 2022 & the Red Sox should plan for it every way they construct, build, spend, trade & consider the roster going forward. Does he have to fulfill his Navy commitment now?
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Post by Chris Hatfield on Aug 20, 2019 9:11:23 GMT -5
Seems to me that the way this is going we won't see Sale back until 2022 & the Red Sox should plan for it every way they construct, build, spend, trade & consider the roster going forward. Is this a typo or just nonsensical? Even if he needs TJ why would he miss 2 full seasons?
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Post by James Dunne on Aug 20, 2019 9:12:13 GMT -5
Seems to me that the way this is going we won't see Sale back until 2022 & the Red Sox should plan for it every way they construct, build, spend, trade & consider the roster going forward. Does he have to fulfill his Navy commitment now? At his height?
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Post by dmaineah on Aug 20, 2019 9:13:23 GMT -5
If the Red Sox build their roster with the mindset of Sale being part of the rotation for the next 2 years it's going to be inexcusable.
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Post by redsoxfan2 on Aug 20, 2019 9:13:31 GMT -5
Seems to me that the way this is going we won't see Sale back until 2022 & the Red Sox should plan for it every way they construct, build, spend, trade & consider the roster going forward. Where do you get 2022? If Andrews looks at him again in 6 WEEKS and is like, oh man, there's a tear alright. He'll be back for ST 2021. Inflammation could be anything. It could be just inflammation. It could be caused from ligament damage. We'll know for certain in six WEEKS. For now, there's no word there's a tear and, to use the Wells report verbiage, it's more probable than not that Chris Sale won't need surgery. If Andrews says, "it's honestly 50/50 and the decision is on Sale and the team to get surgery or rehab" I'm asking Sale to get surgery. Again, not saying Andrews will say that. I'm saying in a "what if" scenario where Andrews puts the option on the table, go and get it done and be ready for 2021 because rehab could be vastly more disastrous.
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Post by jimed14 on Aug 20, 2019 9:14:49 GMT -5
Hang on a second, I need to google how to build a skyscraper. Then I'll tell you what the engineers are doing wrong, despite not looking at their plans or visiting the site.
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Post by dmaineah on Aug 20, 2019 9:20:46 GMT -5
Seems to me that the way this is going we won't see Sale back until 2022 & the Red Sox should plan for it every way they construct, build, spend, trade & consider the roster going forward. Is this a typo or just nonsensical? Even if he needs TJ why would he miss 2 full seasons? Because the decision to do surgery won't be made until after he fails. I'll say the decision to do surgery won't come until June of 2020 & done in July. Then the long road back. Maybe he pitches in September of 2021. That's a realistic outcome considering the way this is going in my opinion. And what the Red Sox should be planing for. It is an inexcusable, stupid, waste of money signing by DD & he should be fired for it.
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Post by redsoxfan2 on Aug 20, 2019 9:22:59 GMT -5
Is this a typo or just nonsensical? Even if he needs TJ why would he miss 2 full seasons? Because the decision to do surgery won't be made until after he fails. I'll say the decision to do surgery won't come until June of 2020 & done in July. Then the long road back. Maybe he pitches in September of 2021. That's a realistic outcome considering the way this is going in my opinion. Dr. Andrews is reevaluating in 6 weeks when the inflammation goes down. If he needs surgery in June of 2020 then that'll be because of a new tear.
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gerry
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Post by gerry on Aug 20, 2019 9:39:31 GMT -5
Thanks for digging out that information. It made this procedure much clearer in my mind. It reinforces that Sale doesn’t have a tear but, as Dr andrews and the team stated, a nasty inflammation that is being treated with the injections and rest. Inflamations can be secondary to a tear, but that is the exception not the rule. Most recent example is David Price. Until Dr. Andrews says surgery is required I feel positive, even confident, that Sale will be Sale in 2020. That doesn’t mean neither Sale nor Price won’t need TJ at some point, but it does mean they don’t need it now. The problem is what does that mean? Does this mean he'll be dominant Chris Sale? And if so, for how long? Now, in his tenure with the Red Sox, he's had a late fade of mediocrity in 2017, missed most of the second half in 2018 and wasn't himself for the most part when he pitched, and had to be shut down in the second half of 2019 after being un-Chris Sale-like in the first half. So what does that mean for 2020? The Red Sox get 125 good innings out of him before he breaks down again? It's a question that has to be asked. The Red Sox' 2020 seasons and beyond hinge a large part on their ace pitcher. If the Red Sox are to win and hang with the big boys in the AL, they need Chris Sale to be their ace for the season. Yes, in 2018, everything went so right they were able to thrive even with Sale taking a vacation for most of the second half and coming back and not being dominant - except for the last inning of the season. The Sox are in a difficult position. They have to depend on him, but they really have to hedge their bets and make sure that they have the rotation depth to withstand Sale's absence along with the medical issues that Nate Eovaldi has every year. When Johnson, Wright, and Velazquez were up to the task, they were fine. When they all failed (and Wright will never be a starter for the Sox at this point again) this year, the pitching really suffered and has shown up in the standings as that huge gap between Boston and NY (and TB) and the other strong teams in the AL. And they have to this within a limited spending budget assuming they're trying to get below the threshold. What does this mean? It means that Sale’s diagnosed inflammation is receiving the medical treatment most likely to resolve the problem identified by the medical staff and Dr. Andrews. These experts stated specifically that surgery is not the recommended treatment; that the same PRP injections that were used to treat a similar problem earlier in his career is the correct treatment now. Additionally, ANY inflammation on ANY joint in anybody’s body requires some form of rest and/or immobilization. So Chris Sale needs downtime. Fortunately he has six months of healing and rehab before pitchers and catchers report. Unfortunately it will take one and a half of those months, six weeks, before we get a handle on the reduction of that inflammation and any underlying causes. But though the prognosis is necessarily guarded, it is also favorable. So no need to empty the half-full, half-empty glass. 2020 and beyond actually looks pretty good. The Sox will still have a top offense and solid defense. The bullpen will have finally added its longed for Acquisition plus its Lakins, Feltman and whomever. The Rotation should have a healthy Price, ERod, Eovaldi and a significant Acquisition. There will definitely not be a repeat of the slow-walked 2019 ST. We can be confident that pitchers will be ready on day one. And after this 2019 hung-over debacle, the entire team will be prepared to accelerate out of the gate. Having a healthy Sale in 2020 will insure the dominant Rotation we all expected in 2019. Without Sale, not so much, but it should still be above average. Optimistically, it is likely that Sale and the entire staff will be well rested and healthy. If there is any real problem for 2020 and beyond it is $$$, having spent to the artificial limit again in 2019. Despite $60-70M coming off the books, a combination of arbitration, Sale’s new contract, and acquiring a SP and RP will chew that up. Fortunately the Sox have a few trade chips and several MLB-ready talents emerging from AAA and AA to maintain competitiveness, balance the budget, and be worth rooting for.
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Post by Smittyw on Aug 20, 2019 10:21:03 GMT -5
Seems to me that the way this is going we won't see Sale back until 2022 & the Red Sox should plan for it every way they construct, build, spend, trade & consider the roster going forward.
Dr. Andrews had better watch out for his job...
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Post by manfred on Aug 20, 2019 10:47:26 GMT -5
Thank god there wasn’t a similar thread about George Brett in 1980. Half the posters would be discussing his colon cancer.
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Post by redsoxfan2 on Aug 20, 2019 10:54:26 GMT -5
Thank god there wasn’t a similar thread about George Brett in 1980. Half the posters would be discussing his colon cancer. I think cancer is rather left alone. Different circumstance. I don't remember the discussions on here surrounding Lester or Rizzo. I haven't seen too much in the "non-Red Sox" thread about Carrasco.
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Post by umassgrad2005 on Aug 20, 2019 10:55:49 GMT -5
Sale could have a stretched ligament, which is basically a ligament with small micro-tears in it. He could also have a small tear in itself. This is the part we don't know, but it's pretty easy to see it's not just inflammation. People with opioid addictions opt for PRP injections because it doesn't require medication after, but there's no reason to believe that Chris Sale has a drug addiction. In other words, there's a real reason why this treatment was done. There's real damage in that arm, which is the worst news. The good news is that there's a example of the PRP injection working with Tanaka. Yet, there's others who come out on the other side and still have to get the surgery after the PRP didn't work. Ohtani. Richards. We will find out by spring training if it worked. If Sale is having setbacks by then, it's not a good sign because that's a sign that it didn't work. We will see. Time will definitely tell on this injury. Simply put, this treatment will work or it won't. There's really no inbetween here. No offense but you don't really have a clue what your talking about. I've had major joint issues since I was 16, going on 21 years now. I've had so many different treatments and scans to my joints over the years. They could see tears if they were there. My doctor described a PRP injection as a high end longer lasting cortisone shot. They don't give them out as much do to cost, insurance not wanting to pay the extra cost and the fact my Rheumatologist didn't even have the ability to give me one. I would have had to go to another specialist. Once the swelling goes down then they can figure out if there is slight damage like micro tears, which if that is what it was will most likely be healed. So they certainly are an option for people with inflammation and being a drug addict has nothing to do with it. You seem to be mixing in guys that had known tears and opted for a PRP to see if it would heal on its own and it didn't so they had TJ. That isn't the only use for them though and we have no information as to Sale having any tears or even a stretched ligament. This could just be them taking the safest route and being very cautious with Sale. Given it's a lost season that makes sense. I will say we have always heard if a guy has a tear and opts for PRP over surgery. So it's very good news that we haven't heard that. The guy has had one before and had no elbow issues for 5 years. Your idea that this works or doesn't really implies he has a tear or major issues and we don't know that.
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Post by manfred on Aug 20, 2019 10:58:14 GMT -5
Thank god there wasn’t a similar thread about George Brett in 1980. Half the posters would be discussing his colon cancer. I think cancer is rather left alone. Different circumstance. I don't remember the discussions on here surrounding Lester or Rizzo. I haven't seen too much in the "non-Red Sox" thread about Carrasco. I meant that his hemorrhoids would be getting blown out of proportion.
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Post by Guidas on Aug 20, 2019 11:48:24 GMT -5
I think cancer is rather left alone. Different circumstance. I don't remember the discussions on here surrounding Lester or Rizzo. I haven't seen too much in the "non-Red Sox" thread about Carrasco. I meant that his hemorrhoids would be getting blown out of proportion. I think they were caused by pine tar.
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Post by jimed14 on Aug 20, 2019 12:40:59 GMT -5
Thank god there wasn’t a similar thread about George Brett in 1980. Half the posters would be discussing his colon cancer. I think cancer is rather left alone. Different circumstance. I don't remember the discussions on here surrounding Lester or Rizzo. I haven't seen too much in the "non-Red Sox" thread about Carrasco. Why? Everything you need to know about other people's health can be determined by group think and google, even if you've never seen him.
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