Fibular collateral ligament

I guess the big question mark is Mahomes, right?

Patrick Mahomes coming back from that ACL and LCL tear-

Yeah

... like, oof, so.

Or just ACL?

...

LCL.

LCL.

And I came down, and my knee went completely sideways.

And it was like, you know, like literally just completely sideways, tore my ACL, MCL, LCL, quad, meniscus, all in one shot.

[upbeat music] You're listening to the "Life Shift" podcast.

I'm your host, Matt Gilhooly.

I'll show this guy the hardest punch he's ever seen." I lit-- That's literally what I thought in my head.

And I came down and my knee went completely sideways.

And it was like, you know, like literally just completely sideways, tore my ACL, MCL, LCL, quad, meniscus all in one shot.

And like the egomaniac I was at the time, I scooted to the side and was like, "Oh, no, it's cool.

And so, um, uh, so you're a hardcore fantasy player and so my question to you is how concerned are you, Stephania Bell, and all of us should we be about drafting these players? And let's start with Patrick Mahomes who of course tore the ACL last year in week 15.

Patrick Mahomes is, you know, legendary for what he can do on the field and his work ethic off the field and I think that is what gives him an edge in this comeback from hi- not only a torn ACL but also a torn LCL.

So two of the four main stabilizing ligaments of the knee.

If you go back and catch the video of when he hurt his knee you'll see it bows to the outside.

We call that varus stress.

That's what damaged the LCL.

Uh, he had surgery in Texas with Dr. Dan Cooper and, you know, really his rehab has been incredibly focused and intense.

Uh, he's hit all the marks along the way.

But based on the other study you just mentioned, if we have some of these negative subjective complaints, so no pop, plus we also have negative special tests, pretty dang sensitive.

And I think at the end of the day, if I have a patient that comes in, that's got history of a pop and they have swelling and they have some positive tests, either for the ACL or some of the other ligaments, right? Like maybe a PCL, LCL, maybe some meniscus pathology.

I'm just going to send them to the doctor anyway, because we want to make sure we're not missing something.

Um, and you didn't mention this too much, but sometimes like an ACL ligament, kind of behaves a little bit like a meniscus or vice versa.

Some additional findings from the Porter study, 22 of 40 cross bracing patients had a pivot shift, at least one grade worse than baseline at two years, suggesting progressive instability.

And you actually see a lot of this in the conservative ligament rehab world.

So not just the ACL, but the PCL, MCL, LCL.

One of the problems with these is after rehab, once these athletes start to return back to sport, they get more progressive instability, meaning that over the course of time, it just seems that ligament gets more and more stretched over the course of time, which you saw in the results in the prior slide.

Nothing's tearing here.

Um, when you have your MCL and your LCL ligaments, those are the two ones that are, you always hear referred to as, as, uh, uh, accompanying a ACL tear, because if your knee bends like this on an ACL tear, you can see the MCL stretching, right? You can just...

You can feel that puppy about to snap, right? Well, it doesn't usually snap.

I- if it requires surgery, it's just to repair it, that you don't snap it.

The LCL, same thing.

You're not snapping that, but if your knee goes this way, you can see this sucker just stretching like crazy, right? One of these days, my model will snap, 'cause this rubber is gonna get old, and I'm, I keep pushing in on it.

And then you also, if you can see me pulling like this, you can see that this is stretching, right? You're also pinching the meniscus right here.

But

the bigger concern for us long-term for Jordan Tyson, and I take this as good news is, not bad news, is not his hamstrings, but his ACL, PCL, LCL knee injury from his college days, 2022, I believe.

He's fine now from that knee injury, but are there long-term effects that might derail a two and three contract career? Unknown.

Look, I haven't examined him, and Erin, I think you know this.

For those who saw video of his injury, that is not a surprise.

On Thursday, he is set to have left knee ACL reconstruction, plus a procedure on his LCL in his knee.

It sounds pretty significant, and as of this recording, we don't have a timeframe for whenever he could return to action, but it's, it's probably gonna be a minute.

And it does raise the question, what do the Pirates do at second base? Is he still the answer for the future? Good morning.