Emptying out the mailbag and clearing the history #8

Posted on August 26, 2015

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Other mailbags can be found hereKeep in mind a lot of this is email conversations, comment replies, or some random interesting things I’ve found. By their nature they are not as thorough or complete as a post on one topic.

Here’s what’s covered in this installment:

  • A hit to scar tissue theorists
  • Different ways of handling information
  • More exoskeletons
  • Internet of Things You Don’t Really Need
  • Tesla showing some of the robotic future
  • The potentially shifting NFL player mindset

A hit to scar tissue theorists

Below goes well with some words I’ve had on scar tissue beforeThat said, it’s not like you want scar tissue. It’s more, particularly for certain injuries, if you have some, it’s probably nothing to worry about.

No association between fibrosis on magnetic resonance imaging at return to play and hamstring reinjury risk. 

Abstract

BACKGROUND:

Connective tissue scar (fibrosis) is a common finding on magnetic resonance imaging (MRI) after recovery from acute hamstring injuries. Fibrosis has been suggested as a predisposing factor for reinjury, but evidence from clinical studies is lacking.

PURPOSE/HYPOTHESIS:

The aim of this study was to examine the association between the presence of fibrosis on MRI at return to play after an acute hamstring injury and the risk of reinjury. The hypothesis was that fibrous tissue on MRI was associated with an increased reinjury risk.

STUDY DESIGN:

Cohort study; Level of evidence, 3.

METHODS:

Magnetic resonance images were obtained from 108 consecutive athletes with modified Peetrons classification grade 1 or 2 hamstring injuries within 5 days of injury and within 7 days of return to play. The presence and extent of abnormally low signal intensity in the intramuscular tissue on MRI, suggestive of fibrosis, were assessed on both T1- and T2-weighted images. Reinjuries were recorded over a 1-year follow-up period. The association between fibrosis and reinjury risk was analyzed with a Cox proportional hazards model.

RESULTS:

The MRIs of the initial injury showed 45 (43%) grade 1 and 63 (57%) grade 2 injuries. Median time of return to play was 30 days (interquartile range [IQR], 22-42 days). At return to play, 41 athletes (38%) had fibrosis on MRI with a median longitudinal length of 5.8 cm (IQR, 3.3-12.5 cm) and a median volume of 1.5 cm3 (IQR, 1.5-3.9 cm3). In athletes with fibrosis, 24% (10/41) sustained a reinjury, and in the subjects without fibrosis, 24% (16/67) had a reinjury, resulting in a hazard ratio of 0.95 (95% CI, 0.43-2.1; P=.898).

CONCLUSION:

Fibrosis is commonly seen on MRI at return to play after grade 1 or 2 hamstring injuries but is not associated with reinjury risk.

© 2015 The Author(s).

Different ways of handling information

From here (bolding mine):

“Being an INTJ, I rely more on intuition and abstraction than on what I sense around me in the here-and-now. Scientists must do so in order to develop theoretical frameworks. I have a healthy appreciation for the concrete (experimentalist in me), but do still lean on abstraction. I have noticed that I tend to generalize situations looking for the common lesson. I like to synthesize. It’s the distilled product that sticks with me in long term memory. I am prone to make a statement based on a wide variety of inputs over the years, but when challenged to cite specific examples, I struggle to recreate them: I’ve already chucked them out in favor of the overarching principle.

I can really relate to the above. First time I’ve seen someone else state it’s how they go about things also. There’s some more interesting stuff in the post too, unrelated to the above quote.

More exoskeletons

I’ve written about this type of stuff here.

The Internet of Things You Don’t Really Need

Thought this article went well with my recent posts on technology.

Tesla showing some of the robotic future

Now, instead of having to get out of the car to pump gas or charge it -unless you live in Jersey or Oregon- you can have a robot do it for you. It’s less metabolically costly…but is that a good thing?

The potentially shifting NFL player mindset

I came across this article on a guy I actually played football with in college, Blake Costanzo. Blake played seven seasons in the NFL, along with time in NFL Europe (when it was still around). I think he won defensive player of the year when he was in the Europe league. He’s the only guy I personally played with who had a NFL career. Maybe once a year I’ll google his name to see how he’s doing.

Blake was, by far, the most insane person I ever played with. He was very well adjusted off the field, at least as far as I knew, but once be put a helmet on…I thought I was crazy for a long time; I wasn’t anything compared to him. Pregame talk in the vain of “LET’S TAKE THEIR FUCKING SOULS!” was routine. He’s the type of player who commands the biggest compliment you can give another player- you never want to play against him, but always want him on your team.

Watching him was part of what made me realize continuing with football wasn’t for me. That it was more the physical preparation element of sports I was into, opposed to the game itself. For instance, I could never get into the Xs and Os aspect of it. I just didn’t care. Then you get to college and you realize you couldn’t care less about game strategy yet you’re in meetings for hours everyday, and you are now starting to get the living shit beat out of you. If you play at the division I level in college, then in high school you were probably physically superior enough to not get too beat up. In college, you’re pretty much guaranteed to get beat up. Some will still relish it; many, like me and many teammates I had, said screw it.

I only played with Blake for one year, but I played the same position as him, so I was around him a ton that season. He also did some coaching for us while he was in and out of the NFL. I could rattle off a few stories, but it was 10 years ago. The main thing here is I’ve never seen someone more obsessed with football, less care for his body -he didn’t miss a PRACTICE in four years is what I heard from the older guys (I once saw him curse out his ankle, rather than come off the field), a person who constructed their life where football was all that existed.

I played with too many to count other guys who were just as athletic as Blake, many who were more. None of them came anywhere near the NFL career he’s had. I have no doubt Blake’s authentic lunacy once he put a helmet on, coupled with “There is no plan B” mentality, is why he stood out. He never got much time on defense, but he had a nice special teams career. There is a reason special teams is being phased out of the NFL: It’s where the most violent, primitive, play happens. It’s not a coincidence that’s where Blake made his mark.

“It wasn’t easy for the football-mad Costanzo to be away from the NFL in 2014, but the separation wasn’t as excruciating as he’d imagined. The main reason: He saw the sport’s violence from a different perspective.

“I thought it would be hard to watch, but I just watched games with my friends and was like ‘Man, we were really killing each other,’’” Costanzo said. “I obviously already knew that, but as players we really are conditioned in a way. I was so blessed to play the game as long as I did, but it put that aspect of it in perspective, in terms of my health. Now I’m reading articles about the concussion issues and brain injuries, yeah, it puts things in perspective.””

A surprising amount of players have left the game this past offseason because of the potential longterm health issues. If Blake is even thinking these things, then that tells me a huge shift in mentality may be coming. I feel confident it’s already happening with the parents, but I’ve been surprised to see current players start this shift as well.

Of course, a month later I found out Blake is still thinking of playing. He stepped down from the high school head coach position he took just in case he gets another call from the NFL. Maybe he never really believed, or cared, about the health issues. Maybe he got hurt last season, wasn’t sure if he could play, and used the health issues as justification for not trying a comeback. And now he’s feeling better than he thought, and thinks he can do it. Or maybe post-NFL life was too boring, and he’d rather go back to the insanity. I have no idea. But the fact he even temporarily questioned the health effects of the football, is still surprising.

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