New and Improved EPS Watch/Player Form Thread

[Oakboy]

WT, does the op still involve some sort of binding (carbon fibre?)?

[Which Tyler]

WT, does the op still involve some sort of binding (carbon fibre?)?

By definition, yes.
The what and the reasoning behind choosing which option is too far outside of my wheelhouse to comment on. As an observation, glue seems to be becoming more and more common.

TBH, most of the above is outside my wheelhouse as a chiro - I see patients for other things whilst they're undergoing all of that, so my job there is to encourage the patient actually do their fucking rehab! (patients are lazy, and they often lie, probably to themselves as well - NB "I have an alarm in my phone reminding me to do my exercises 3 times a day" =/= "I do my exercises 3 times a day")

[Oakboy]

WT, does the op still involve some sort of binding (carbon fibre?)?

By definition, yes.
The what and the reasoning behind choosing which option is too far outside of my wheelhouse to comment on. As an observation, glue seems to be becoming more and more common.

TBH, most of the above is outside my wheelhouse as a chiro - I see patients for other things whilst they're undergoing all of that, so my job there is to encourage the patient actually do their fucking rehab! (patients are lazy, and they often lie, probably to themselves as well - NB "I have an alarm in my phone reminding me to do my exercises 3 times a day" =/= "I do my exercises 3 times a day")

I can relate to the lying bit! My chiro is a cracking young lad and I like to encourage him. I'm sure he sees through me but is too polite to say, "You lying old scrote!"

[Banquo]

Pretty similar - immobilise in full plantar-flexion (toes pointed). Massage of the calf to encourage the ends to meet (carefully, you're going against the venous valves), consider acupuncture or some form of electrotherapy to encourage healing. Intensive rehab to maximally regain function.
NHS protocols would be the same, but ditching the massage and acupuncture / electrotherapy and 3-4 physio sessions and trusting to do your homework, probably no-one actually touching you post-surgery.

But Ollie's a professional sportsman, so he'd have been in surgery ASAP - higher risk, but higher reward - probably rescanning it weekly, potentially even more frequently, and tailoring the rehab based on the results of each scan.


IMO: NHS option is fine for your office worker couch potato who wants to walk unaffected (hilly hiking will likely hurt and fatigue), and maybe jog once in a while.
Gold standard conservative is fine for the vast majority of low-mid level amateurs doing sport for fitness.
Your pro.s, high level amateurs (depending on sport) and those who go from 0 to full-on are going to want the surgery, but risks all the complications of cutting someone open with a sharp knife.

Which doesn't mean that a pro wouldn't be fine with gold standard, or a mid level amateur with NHS; but the more you're going to challenge and rely on it, the more certainty you want that it's a solid repair, and the more risk you're willing to take to get it.


Out of academic interest - is the acceleration gone because the repair isn't solid, because it hurts, or because you don't actually trust it, and therefore hold back?
In theory, if the ends are held together properly, then acceleration shouldn't be affected. If they're held together with shitty undifferentiated scar tissue, then there may be too much elasticity in there (and usually means the rehab wasn't completed, or attempted properly [can be "I'm young and invincible" "I didn't know / can't be arsed to do my rehab on the other 13 days between my fortnightly physio" or "my physio didn't even try to push me"]); but either one shouldn't give you much warning before snapping again. Pain and fear of reinjury would be major depressors of acceleration though, and worth addressing on a more psychological level

It’s a long time ago, but it was more pain and shitty inelastic mending I think; both Achilles are like blocks of wood now, and I can’t run for any distance on the flat without either pain around the tendons (and then limping for weeks) or pulling a calf - ironically literally just did that at the gym in a circuits class!!
Part of the acceleration problem also because a fear of pushing yourself in training, which would then compound I guess.
I remember Kirwan doing his Achilles and never being the same after. Ditto JJ maybe?

[Which Tyler]

Part of the acceleration problem also because a fear of pushing yourself in training, which would then compound I guess.
I remember Kirwan doing his Achilles and never being the same after. Ditto JJ maybe?

Kirwan was a little while ago, and things have moved on since then.
Pros will automatically go the surgical route with stupidly intensive rehab, which more-or-less guarantees good healing - there's still the risk of surgical error (snipping a nerve) but most holdbacks are likely to be not trusting the body / fearing a re-injury - which is a long and hard road to get over; and a delicate balancing act against being too desperate to challenge it again, and re-injuring it from doing too much too soon.

It’s a long time ago, but it was more pain and shitty inelastic mending I think; both Achilles are like blocks of wood now, and I can’t run for any distance on the flat without either pain around the tendons (and then limping for weeks) or pulling a calf - ironically literally just did that at the gym in a circuits class!!

Yeah, if it's inelastic mending, then sorry, you're buggered. Once it's been a couple of years, then remodelling that scar tissue is really tough.
It still shouldn't particularly hurt though - that's far more likely (not 100%) to be neuroplastic pain, rather than nociceptive pain - essentially phantom limb type pain without losing the limb. Which is complicated, requires buy-in from the patient, and a willingness to put in the (mental) effort. It's also fascinating stuff, and conversations I have with patients... probably a couple of times a month - and get the most dramatic results for (as in my star patient, told they wouldn't walk unaided again after multiple disc injuries, got them doing dog agility and running half-marathons with a couple of years of hard work on their behalf).

Here's a brief primer:


Here's a YouTube, sorry - but Lorimer IS an acknowledged expert, probably THE biggest name in the field - which probably explains the relatively low viewing figure:


Here's someone creating phantom limb pain in people with all of their limbs - note, he's REALLY good at the buy-in stuff; and whilst claiming that it's not real, it really is, it's just about psychology, not physiology:


If anyone's still interested, I have plenty more - to link or to say; but let's not spam this thread any further.

[Banquo]

Part of the acceleration problem also because a fear of pushing yourself in training, which would then compound I guess.
I remember Kirwan doing his Achilles and never being the same after. Ditto JJ maybe?

Kirwan was a little while ago, and things have moved on since then.
Pros will automatically go the surgical route with stupidly intensive rehab, which more-or-less guarantees good healing - there's still the risk of surgical error (snipping a nerve) but most holdbacks are likely to be not trusting the body / fearing a re-injury - which is a long and hard road to get over; and a delicate balancing act against being too desperate to challenge it again, and re-injuring it from doing too much too soon.

It’s a long time ago, but it was more pain and shitty inelastic mending I think; both Achilles are like blocks of wood now, and I can’t run for any distance on the flat without either pain around the tendons (and then limping for weeks) or pulling a calf - ironically literally just did that at the gym in a circuits class!!

Yeah, if it's inelastic mending, then sorry, you're buggered. Once it's been a couple of years, then remodelling that scar tissue is really tough.
It still shouldn't particularly hurt though - that's far more likely (not 100%) to be neuroplastic pain, rather than nociceptive pain - essentially phantom limb type pain without losing the limb. Which is complicated, requires buy-in from the patient, and a willingness to put in the (mental) effort. It's also fascinating stuff, and conversations I have with patients... probably a couple of times a month - and get the most dramatic results for (as in my star patient, told they wouldn't walk unaided again after multiple disc injuries, got them doing dog agility and running half-marathons with a couple of years of hard work on their behalf).

Here's a brief primer:


Here's a YouTube, sorry - but Lorimer IS an acknowledged expert, probably THE biggest name in the field - which probably explains the relatively low viewing figure:


Here's someone creating phantom limb pain in people with all of their limbs - note, he's REALLY good at the buy-in stuff; and whilst claiming that it's not real, it really is, it's just about psychology, not physiology:


If anyone's still interested, I have plenty more - to link or to say; but let's not spam this thread any further.

[Danno]

Worth a thread of its own imo

[Which Tyler]

Worth a thread of its own imo

Happy to do more / answer questions, if Puja wants to split off (better than splitting the semi final thread!)

[Danno]

Worth a thread of its own imo

(better than splitting the semi final thread!)