Jaeger O'Meara

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Ressies runner

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Jun 13, 2016
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I see these issues far too often for them not to be viable
Interesting read, a few years back the old coach we had, seen me walking down the street past his place and i was rubbing my lower back. He asked if i was alright for the game the next day, to which i replied I'm fine just a tight lower back nothing a few voltaren won't fix.
He had played and coached in something stupid like 700 games or something. I rocked up the next day and there were a few extra players and i was dropped, when asked why, he told me we when you play with a tight lower back you'll injure either a knee or a hamstring. This same coach had let me play with 2 broken ribs, rolled ankle etc but would not let me take the field with a niggly back.
 

Rusty Brookes

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Just on the co-authoring with a University, there is a push from the Federal Government to encourage academics to publish with industry (eg people such as the OP). I'd get on to it.

Great article by the way and I truly, truly hope the OP is on the money.
 

bradrowe#32

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Pies had pick 6 and pick 10 one year. I assume they traded for at least one of them. One kid never played for them and the other has 2 or 3 games with them.

Impressive to have that level of fail inside the top 10.
One of them was compensation for Dale Thomas. Scharenberg had a previous foot injury that everyone knew would take time and from all reports that has heeled. He's had two knee reconstructions after we drafted him. Freeman was fine before we got him, but had a series of serious hamstring injuries.

Anyway, it's disgraceful for you to actually call that a fail. Really, really poor. Grow up.
 

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HairyO

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One of them was compensation for Dale Thomas. Scharenberg had a previous foot injury that everyone knew would take time and from all reports that has heeled. He's had two knee reconstructions after we drafted him. Freeman was fine before we got him, but had a series of serious hamstring injuries.

Anyway, it's disgraceful for you to actually call that a fail. Really, really poor. Grow up.
But Jaeger and Hawthorn can be mocked relentlessly for this trade?

Injuries are fair game but only for other clubs?
 

Ando727

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Hi Sven, thanks for this very interesting thread and article.

I'm just wondering how you go about separating out these two factors:

1) back tension/posture as the cause/contributor of the original degradation in the knee,

2) the patient sustains a knee injury, is in constant discomfort and mentally attuned to the problem, then engages a lot of compensatory muscles in an attempt to manage the knee injury - whether it's minimising acute pain, or as a reaction to how they mentally conceive the injury in their mind and how they think they can promote its healing by taking pressure off it.

By the time you see these people, they are significantly progressed along this problem. It must be very challenging trying to separate the causes from the reactions - especially since you can't (usually) see footage of what they were doing prior to the original injury.

I wonder if the only way to get to the bottom of it would be to have a long term study designed to determine the effects of a regular back program (whether it's massage, posture work, training with postural focus), then statistically analysing the incidence of various leg injuries years later. I don't know if they do a lot of such studies? Maybe it's commonplace, but it seems like the correlation needs to be established in order to get such programs implemented at sporting clubs.

What you're saying makes sense to me intuitively, but I can imagine it being a tough sell to some of the club doctors in the AFL.
 

sven_inc

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Dec 29, 2008
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Hi Sven, thanks for this very interesting thread and article.

I'm just wondering how you go about separating out these two factors:

1) back tension/posture as the cause/contributor of the original degradation in the knee,

2) the patient sustains a knee injury, is in constant discomfort and mentally attuned to the problem, then engages a lot of compensatory muscles in an attempt to manage the knee injury - whether it's minimising acute pain, or as a reaction to how they mentally conceive the injury in their mind and how they think they can promote its healing by taking pressure off it.

By the time you see these people, they are significantly progressed along this problem. It must be very challenging trying to separate the causes from the reactions - especially since you can't (usually) see footage of what they were doing prior to the original injury.

I wonder if the only way to get to the bottom of it would be to have a long term study designed to determine the effects of a regular back program (whether it's massage, posture work, training with postural focus), then statistically analysing the incidence of various leg injuries years later. I don't know if they do a lot of such studies? Maybe it's commonplace, but it seems like the correlation needs to be established in order to get such programs implemented at sporting clubs.

What you're saying makes sense to me intuitively, but I can imagine it being a tough sell to some of the club doctors in the AFL.
It's a great question mate thanks for taking the time to post it. Sorry to everyone who has to scroll past this btw.

In all honesty id be surprised if anyone could separate them. Itd almost be impossible unless the patient knew what to look for right from the outset, or we were robots with a log book...

I think the real positive though is that at the end of the day we may not really have to. What I'm finding so far seems pretty consistent and repeats really well in-rooms in real time.

I guess most patients' compensations would be expected to be very specific to them in a sense which means whilst one might develop a stiff back for whatever reason post injury, another might feel it more through a hip or a tighter quad. Some may get nothing if it's picked up straight away.

This is where I feel the benefit of trying to base things on immediate repeatable results comes to the fore.

I'd argue almost every patient gets better to varying degrees by freeing up the same part of their back. If that's a compensation every patient experiences thats fine, but for me the body tends to work in a "spine first" kind of way. One where spinal dysfunction is more likely to pop up first and precede arm/leg/chest mechanical issues. Because it's the centrepiece of the body it has its hooks in everything.

The hard part is - why would anyone go looking through their asymptomatic spine in the first place to prevent a Patella tendonopthy? That's why self-preemptive treatment isnt sexy because there's never a "pay off" in a sense. If it never happens it may never have happened anyway. Hard to justify treatment in that sense.

There's plenty of instances where this kind of spinal stiffness doesn't end up in crappy patella tendons, but if you have a crappy patella tendon my experience tell me youll be stiff there. Weird idea I know!

You can start to get some confidence from then treating that spot and seeing a sudden change in symptoms.
 

Wickzki

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Great post.

Surprisingly, this isn't the first time that I've heard that Jaeger's issues aren't necessarily in the knee itself but may have begun in his back. My own physio - yes, my back is screwed, - has insinuated the same. We've gotten to hang out beyond his practice and as we're both heavily into sports have watched sports together.

It's ironic that almost every sportsman that he has seen with a hinge or something upon further reflection has had some sort of 'unrelated' (more like undiagnosed) leg complaint be it the knees or the quads or the hamstring.

It's going to be people like you and he who document this type of thing that lead the way to a more scientific approach to back-related issues.

Thanks for the interesting read. Good luck with the research. Hopefully the Hawks are aware of the possibility and can analyze it given their scientific medical staff (if they haven't already).
 

sven_inc

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Great post.

Surprisingly, this isn't the first time that I've heard that Jaeger's issues aren't necessarily in the knee itself but may have begun in his back. My own physio - yes, my back is screwed, - has insinuated the same. We've gotten to hang out beyond his practice and as we're both heavily into sports have watched sports together.

It's ironic that almost every sportsman that he has seen with a hinge or something upon further reflection has had some sort of 'unrelated' (more like undiagnosed) leg complaint be it the knees or the quads or the hamstring.

It's going to be people like you and he who document this type of thing that lead the way to a more scientific approach to back-related issues.

Thanks for the interesting read. Good luck with the research. Hopefully the Hawks are aware of the possibility and can analyze it given their scientific medical staff (if they haven't already).
Great to know I'm not crazy!
 

Strahany

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Interesting thoughts here.

It would be interesting to know if the neural implications are more motor or somatosensory in nature. For example, given that the affected nerve roots innervate the knee extensors, they may have improper neuromuscular input, potentially leading to poor grading of muscle units or excessive activation. This could result in excessive tension being placed on the patellar tendon. If it's sensory in nature, then either (or both) the golgi tendon organ and muscle spindle fibres may be providing inaccurate feedback and thus making his affected musculature and tendons susceptible to injury.

Or his Lx dysfunction could have straightforward biomechanical implications. Definitely worth looking into, I feel.
 

Fetnarr

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Yeah must be what they are taught at uni. My physio is like 22 only graduated last year. Not that I'm complaining ;)
I'm a Physio and it's not what we are taught at uni unfortunately. We are taught to look at overall posture and movement quality, we are taught to look at joints above and below eg with a knee issue you need to check ankles and feet as well as the hip, then if there is an issue with the hip (or foot for that matter) to check whether the back is what's driving that.
Some physio's are lazy, others just don't see or understand the connection and others are just ordinary just like there are crap doctors, chiro's osteo's, plumbers and accountants, physio's are not immune from this. Not saying this is the case with your Physio at all but they are out there!
All the best with it, my advice is if you dont feel you are being listened to or not getting the results you want seek another opinion.
 

Fetnarr

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Great to know I'm not crazy!
you're definitely on to something mate, I see it all the time with neck and shoulder pain with localized stiffness in the thoracic spine. The number of people I have relieved upper limb symptoms with by mobilizing through the lower thoracic spine is huge. I'm actually treating a guy at the moment with numbness in his thumb and first finger, the only thing that eases it is by mobilizing is L4/5 facet joint on the same side. It makes no sense anatomically but it's working! Haha!
 

Fetnarr

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Funny how the same club has 4 top line players with chronic injuries that the players need a couple of years to get over (Swallow, Omeara, Ablett and Bennell).

While i can see the OPs point, i frankly don't believe the shit that comes out of the GC medical rooms. Their track record is dogshit.
Correct
 

Fetnarr

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95% of physios their solution to knee issues of ANY kind is essentially "you need to do more leg weights". Same issues for me and i also have a bad back so quite interesting.
I honestly think the problem is laziness. It's hard work doing manual therapy eg massage, mobilizing and stretching people all day. The easy option is to just get people to do exercise. I understand to a point that proper exercise is what the evidence says is the most effective in treating most musculoskeletal issues in the long term, however specific manual therapy following a thorough assessment really helps ease people's symptoms in the short term enabling them to then do the exercises properly thereby speeding up recovery. I think good physios get this balance right but from my experience a lot of graduates in recent years don't have that balance.
 

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