Injury frustration

[Webber 10,142]

Just finished the latest Demonland podcast, which was excellent as always from @Demonland, @george_on_the_outer, and @binman(presumably all Demonlanders who podcast are loyal listeners, and if not, shame on you), and wanted to put my two cents in on the subject of injury timelines. 
      The first thing, maybe obvious but easily forgotten, is that no injury has certainty in respect to return time. It’s a highly imperfect science. As an example, take Steven May’s PF hamstring tear last year. ‘Industry rule’ is that there’s no such thing as a ‘less than 3 week hamstring’. May had a big tear… 6 cm I think was quoted, but uncomplicated. That he returned in 2 weeks is exceptional (as were the circumstances of course), and that he didn’t worsen the tear in the game (statistically a much higher risk) also exceptional. Another situation could just as easily present a 3cm uncomplicated tear that doesn’t allow a return inside 5 weeks. That would be unexpected, but not outside normal variability. Think too about what we (the world, INCLUDING Steven May) were told, which was effectively nothing other than that he would undergo a fitness test pre-GF. Was it back-related, muscular, neuropathic, who knew? Only a select few, and nobody outside the club. It served the club and Maysie very well. This speaks to two things…..the unknowns and variables contributing to full recovery, and the need to nuance expectations. In this case it was not letting the player, his teammates, the media (can you imagine the circus?), the supporters (imagine too the meltdown) and the opposition know what he was dealing with. Again, served the club brilliantly. 
        From a rehab professional’s perspective, the path to full recovery is rarely completely linear - in obedience to expectations and thus predicted timelines. Accurate predictions happen, and we love those situations obviously, but we’re always only working from a pool of ‘like’ injuries and outcomes. On a long enough timeline, injuries/pathologies/surgical interventions fall into patterns, but their behaviours thereafter adhere only to an inevitable bell curve, regardless of expertise in treating and managing the recovery. Sad to say, but when the club says the dreaded 4-6 weeks, they really mean 3-10 (or more) to encompass the ends of the bell curve, and that’s without unexpected but possible associated complications that can arise from the initiation injuring - think a calf tear changing the weight-bearing biomechanical chain that could create a back problem. Even the most objectively definable injuries (a simple transverse fracture, let’s say mid-radius - forearm bone - which follows a 4 week bony ‘union’ and 8 week ‘consolidation’ (actually it’s not even that simple) are prone to variability and complication. That said, we love ACL reconstructions (which again are not linear) because 95% are game ready by 12 months - it’s a long timeline that allows resolution of various issues that often crop up during rehab.
       The biggest issues, and the ones I think where @binman is asking for improvement (on the podcast), are transparency in respect to diagnosis (read reason/injury), progress, and then ‘honest’ expectations of weeks to game ready. The last issue I’ve talked about. It’s essentially unknown, and there can only be a running prediction based on relative progress. This is why the club tell us when there’s a ‘test’…..means they’re getting very close. Diagnosis is tricky, particularly when it’s not simple. Initially, how much do you want to know, and do you promise to not consult Dr. Google or go reciting so-and-so who had the ‘same’ diagnosis and was a) out for the season, b) never played again, or c) was game ready earlier than the club is saying for player X? Helps nobody. All injuries are essentially unique at source, and subject to differences along the journey to recovery. It helps nobody when media/fans are scrutinising expectations and progress based on no knowledge of that player’s day to day changes (or morning to arvo changes!). It’s hard enough managing player expectations (‘indestructible’ twenty-somethings whose livelihood is being threatened) let alone the larger football world. Harry Petty had a calf corky. I’ve explained in another thread what the complication to this might have been. If you want the club to explain this in detail, and why his recovery is more protracted, then expect it to be a very fluid day to day process. Should the club provide daily updates, even when they can’t be more accurate about likely game readiness? Or should they give the best info they have about likely game return without delving into details that don’t change anything, not forgetting there are issues of privacy and a tactical need to keep some things close to their chest?
          I suspect there’s a tendency firstly to resort to feelings that sometimes the club doesn’t respect the supporters enough to offer comprehensive explanations, even when it doesn’t change the ‘4-6’ prognosis, secondly that they’re hiding some sinister weirdness about the player’s injury (wouldn’t be like supporters/media to catastrophise of course). Worse still, I’ve often read people suggesting the medicos, physios, conditioning staff must ‘not know what they’re doing’ - mostly when we’re not winning premierships 😜. In summary, there are mostly excellent, ordinary reasons for opacity around injury/return timeframes. Otherwise, put simply, you can’t please all the people all the time - even with depth and detail of information. 

          

[Wells 11 4,818]

11 minutes ago, Webber said:

Just finished the latest Demonland podcast, which was excellent as always from @Demonland, @george_on_the_outer, and @binman(presumably all Demonlanders who podcast are loyal listeners, and if not, shame on you), and wanted to put my two cents in on the subject of injury timelines. 
      The first thing, maybe obvious but easily forgotten, is that no injury has certainty in respect to return time. It’s a highly imperfect science. As an example, take Steven May’s PF hamstring tear last year. ‘Industry rule’ is that there’s no such thing as a ‘less than 3 week hamstring’. May had a big tear… 6 cm I think was quoted, but uncomplicated. That he returned in 2 weeks is exceptional (as were the circumstances of course), and that he didn’t worsen the tear in the game (statistically a much higher risk) also exceptional. Another situation could just as easily present a 3cm uncomplicated tear that doesn’t allow a return inside 5 weeks. That would be unexpected, but not outside normal variability. Think too about what we (the world, INCLUDING Steven May) were told, which was effectively nothing other than that he would undergo a fitness test pre-GF. Was it back-related, muscular, neuropathic, who knew? Only a select few, and nobody outside the club. It served the club and Maysie very well. This speaks to two things…..the unknowns and variables contributing to full recovery, and the need to nuance expectations. In this case it was not letting the player, his teammates, the media (can you imagine the circus?), the supporters (imagine too the meltdown) and the opposition know what he was dealing with. Again, served the club brilliantly. 
        From a rehab professional’s perspective, the path to full recovery is rarely completely linear - in obedience to expectations and thus predicted timelines. Accurate predictions happen, and we love those situations obviously, but we’re always only working from a pool of ‘like’ injuries and outcomes. On a long enough timeline, injuries/pathologies/surgical interventions fall into patterns, but their behaviours thereafter adhere only to an inevitable bell curve, regardless of expertise in treating and managing the recovery. Sad to say, but when the club says the dreaded 4-6 weeks, they really mean 3-10 (or more) to encompass the ends of the bell curve, and that’s without unexpected but possible associated complications that can arise from the initiation injuring - think a calf tear changing the weight-bearing biomechanical chain that could create a back problem. Even the most objectively definable injuries (a simple transverse fracture, let’s say mid-radius - forearm bone - which follows a 4 week bony ‘union’ and 8 week ‘consolidation’ (actually it’s not even that simple) are prone to variability and complication. That said, we love ACL reconstructions (which again are not linear) because 95% are game ready by 12 months - it’s a long timeline that allows resolution of various issues that often crop up during rehab.
       The biggest issues, and the ones I think where @binman is asking for improvement (on the podcast), are transparency in respect to diagnosis (read reason/injury), progress, and then ‘honest’ expectations of weeks to game ready. The last issue I’ve talked about. It’s essentially unknown, and there can only be a running prediction based on relative progress. This is why the club tell us when there’s a ‘test’…..means they’re getting very close. Diagnosis is tricky, particularly when it’s not simple. Initially, how much do you want to know, and do you promise to not consult Dr. Google or go reciting so-and-so who had the ‘same’ diagnosis and was a) out for the season, b) never played again, or c) was game ready earlier than the club is saying for player X? Helps nobody. All injuries are essentially unique at source, and subject to differences along the journey to recovery. It helps nobody when media/fans are scrutinising expectations and progress based on no knowledge of that player’s day to day changes (or morning to arvo changes!). It’s hard enough managing player expectations (‘indestructible’ twenty-somethings whose livelihood is being threatened) let alone the larger football world. Harry Petty had a calf corky. I’ve explained in another thread what the complication to this might have been. If you want the club to explain this in detail, and why his recovery is more protracted, then expect it to be a very fluid day to day process. Should the club provide daily updates, even when they can’t be more accurate about likely game readiness? Or should they give the best info they have about likely game return without delving into details that don’t change anything, not forgetting there are issues of privacy and a tactical need to keep some things close to their chest?
          I suspect there’s a tendency firstly to resort to feelings that sometimes the club doesn’t respect the supporters enough to offer comprehensive explanations, even when it doesn’t change the ‘4-6’ prognosis, secondly that they’re hiding some sinister weirdness about the player’s injury (wouldn’t be like supporters/media to catastrophise of course). Worse still, I’ve often read people suggesting the medicos, physios, conditioning staff must ‘not know what they’re doing’ - mostly when we’re not winning premierships 😜. In summary, there are mostly excellent, ordinary reasons for opacity around injury/return timeframes. Otherwise, put simply, you can’t please all the people all the time - even with depth and detail of information. 

          

Appreciated this 👌

[TRIGON 4,719]

Thanks @Webber, that was excellent. To summarise for those who are time-poor;

4 to 6.

[Engorged Onion 9,389]

magnificent stuff @Webber

[Engorged Onion 9,389]

1 minute ago, TRIGON said:

Thanks @Webber, that was excellent. To summarise for those who are time-poor;

4 to 6.

3-10 is the way to interpret 4-6 - just to set expectations.

[whatwhat say what 19,144]

i actually like the way i think it's the tigers have been doing their injury reports for the last few years; they have four types of timing listed:

• short term
• medium term
• long term
• indeterminate

no more putting 'weeks' on an injury return date

[Little Goffy 12,664]

'Foot, don't ask' should be a category of its own.

Good read, thanks for the depth. (Everyone knows I love a good screenful of text!)

 

[Cards13 9,117]

29 minutes ago, whatwhat say what said:

i actually like the way i think it's the tigers have been doing their injury reports for the last few years; they have four types of timing listed:

• short term
• medium term
• long term
• indeterminate

no more putting 'weeks' on an injury return date

Ice Hockey (again, I know!) they just say "upper body injury" or "lower body injury" and the player is "indefinitely out, week to week or day to day". Colorado's best player was announced out indefinitely earlier this week with an "upper body injury" (he hurt his hand punching the snot of out an opposition player) and he's back playing today.

The above works well I think.

[Deeoldfart 7,785]

Thanks @Webber.  I greatly value your professional input, while sharing @binman frustration.  I’m sure it’s our passion that gives rise to the frustration.

[Webber 10,142]

5 minutes ago, Deeoldfart said:

Thanks @Webber.  I greatly value your professional input, while sharing @binman frustration.  I’m sure it’s our passion that gives rise to the frustration.

And we’d be robots without either, Deeoldfart. 

[Demonland 65,652]

58 minutes ago, whatwhat say what said:

i actually like the way i think it's the tigers have been doing their injury reports for the last few years; they have four types of timing listed:

• short term
• medium term
• long term
• indeterminate

no more putting 'weeks' on an injury return date

I agree with this and would put Petty in the indeterminate category. He was 3-4 after he had his calf operation and was still 3-4 last week. He’s come down to 2-3 but I’ll bet my right pinky that he’ll be 2-3 next week too. 

[Bring-Back-Powell 13,268]

Petty's very injury prone.

He chose a fantastic year (2021) to stay injury free.

[FearTheBeard 880]

Petty Lever and Hibberd all seem to be in the 4-6 black hole. Only the club refuses to use the term 4-6 any more. Its now the "they'll be right next week" nonsense claim.

[binman 38,588]

2 hours ago, Webber said:

Just finished the latest Demonland podcast, which was excellent as always from @Demonland, @george_on_the_outer, and @binman(presumably all Demonlanders who podcast are loyal listeners, and if not, shame on you), and wanted to put my two cents in on the subject of injury timelines. 
      The first thing, maybe obvious but easily forgotten, is that no injury has certainty in respect to return time. It’s a highly imperfect science. As an example, take Steven May’s PF hamstring tear last year. ‘Industry rule’ is that there’s no such thing as a ‘less than 3 week hamstring’. May had a big tear… 6 cm I think was quoted, but uncomplicated. That he returned in 2 weeks is exceptional (as were the circumstances of course), and that he didn’t worsen the tear in the game (statistically a much higher risk) also exceptional. Another situation could just as easily present a 3cm uncomplicated tear that doesn’t allow a return inside 5 weeks. That would be unexpected, but not outside normal variability. Think too about what we (the world, INCLUDING Steven May) were told, which was effectively nothing other than that he would undergo a fitness test pre-GF. Was it back-related, muscular, neuropathic, who knew? Only a select few, and nobody outside the club. It served the club and Maysie very well. This speaks to two things…..the unknowns and variables contributing to full recovery, and the need to nuance expectations. In this case it was not letting the player, his teammates, the media (can you imagine the circus?), the supporters (imagine too the meltdown) and the opposition know what he was dealing with. Again, served the club brilliantly. 
        From a rehab professional’s perspective, the path to full recovery is rarely completely linear - in obedience to expectations and thus predicted timelines. Accurate predictions happen, and we love those situations obviously, but we’re always only working from a pool of ‘like’ injuries and outcomes. On a long enough timeline, injuries/pathologies/surgical interventions fall into patterns, but their behaviours thereafter adhere only to an inevitable bell curve, regardless of expertise in treating and managing the recovery. Sad to say, but when the club says the dreaded 4-6 weeks, they really mean 3-10 (or more) to encompass the ends of the bell curve, and that’s without unexpected but possible associated complications that can arise from the initiation injuring - think a calf tear changing the weight-bearing biomechanical chain that could create a back problem. Even the most objectively definable injuries (a simple transverse fracture, let’s say mid-radius - forearm bone - which follows a 4 week bony ‘union’ and 8 week ‘consolidation’ (actually it’s not even that simple) are prone to variability and complication. That said, we love ACL reconstructions (which again are not linear) because 95% are game ready by 12 months - it’s a long timeline that allows resolution of various issues that often crop up during rehab.
       The biggest issues, and the ones I think where @binman is asking for improvement (on the podcast), are transparency in respect to diagnosis (read reason/injury), progress, and then ‘honest’ expectations of weeks to game ready. The last issue I’ve talked about. It’s essentially unknown, and there can only be a running prediction based on relative progress. This is why the club tell us when there’s a ‘test’…..means they’re getting very close. Diagnosis is tricky, particularly when it’s not simple. Initially, how much do you want to know, and do you promise to not consult Dr. Google or go reciting so-and-so who had the ‘same’ diagnosis and was a) out for the season, b) never played again, or c) was game ready earlier than the club is saying for player X? Helps nobody. All injuries are essentially unique at source, and subject to differences along the journey to recovery. It helps nobody when media/fans are scrutinising expectations and progress based on no knowledge of that player’s day to day changes (or morning to arvo changes!). It’s hard enough managing player expectations (‘indestructible’ twenty-somethings whose livelihood is being threatened) let alone the larger football world. Harry Petty had a calf corky. I’ve explained in another thread what the complication to this might have been. If you want the club to explain this in detail, and why his recovery is more protracted, then expect it to be a very fluid day to day process. Should the club provide daily updates, even when they can’t be more accurate about likely game readiness? Or should they give the best info they have about likely game return without delving into details that don’t change anything, not forgetting there are issues of privacy and a tactical need to keep some things close to their chest?
          I suspect there’s a tendency firstly to resort to feelings that sometimes the club doesn’t respect the supporters enough to offer comprehensive explanations, even when it doesn’t change the ‘4-6’ prognosis, secondly that they’re hiding some sinister weirdness about the player’s injury (wouldn’t be like supporters/media to catastrophise of course). Worse still, I’ve often read people suggesting the medicos, physios, conditioning staff must ‘not know what they’re doing’ - mostly when we’re not winning premierships 😜. In summary, there are mostly excellent, ordinary reasons for opacity around injury/return timeframes. Otherwise, put simply, you can’t please all the people all the time - even with depth and detail of information. 

          

That's all well and good Webber, and you have high level expertise in this area.

But my gut tells me you are wrong and i will not be changing my opinion we are treated poorly as fans in terms of information about injuries. 

Jokes.

Thanks for the very thoughtful post on the topic. It has certainly shifted my thinking. 

I think for me it comes down to the management of fan's expectations - well mine i guess, seeing the majority seem to be of the quite reasonable view that the club are not obliged to share specifics about players injuries or timelines. 

Personally, i'm not hugely interested in the specifics of the injury  - I'm interested in the potential time out.

I hear what you are saying about the impossibility of being accurate about that, but i think the 4-6 week standard reporting is unhelpful becuase it is narrow range that implies some sort of certainty where as you say it does not exist.

And can feed into a sense of the club being disingenuous with information when the timeframe is not met or simply always stands as 4-6 (as is pretty much the case for Petty). 

This potentially ends up eroding confidence in the club's messaging to fans and even the club's medical team - at least for some people. 

I reckon the model like the one used by the tigers noted by whatwhat above would work well (at least for me), ie not listing weeks, but rather four types of timing listed:

• short term
• medium term
• long term
• indeterminate

[dieter 3,325]

Terrific insight. It helped me understand why I have chronic lower back pain - to do with my double Kneemonia, I.E. osteoarthritis in both knees. I've had one replaced and am looking at the other being done the sooner the better, as they say.

[mo64 5,209]

15 minutes ago, FearTheBeard said:

Petty Lever and Hibberd all seem to be in the 4-6 black hole. Only the club refuses to use the term 4-6 any more. Its now the "they'll be right next week" nonsense claim.

This is where the frustration lies. 

A week ago, Dr Laura's report said that Hibberd was rehabbing with Petty. Goody comes out and says that he's a chance to play. When the Dr says that a player is in rehab for a leg injury, it's usually at a least 1-2 weeks before they are completing full training, and another week or 2 before they'd be considered for selection. He was never a chance to play.

 

[ucanchoose 1,803]

1 hour ago, Cards13 said:

Ice Hockey (again, I know!) they just say "upper body injury" or "lower body injury" and the player is "indefinitely out, week to week or day to day". Colorado's best player was announced out indefinitely earlier this week with an "upper body injury" (he hurt his hand punching the snot of out an opposition player) and he's back playing today.

The above works well I think.

This drives me insane.   Just tell us what the injury is I say.  

[The heart beats true 16,321]

I never get that frustrated about injury timelines. I prefer to focus my frustration onto the real issues of the game - umpiring and Dwayne Russell.

[Webber 10,142]

41 minutes ago, binman said:

management of fan's expectations

herding cats comes to mind.

42 minutes ago, binman said:

• short term
• medium term
• long term
• indeterminate

I like this too, but I guarantee whatever the Tiges’ Demonland equivalent is (not gonna look, don’t care 😉) have plenty who think otherwise. See below…..

16 minutes ago, ucanchoose said:

This drives me insane.   Just tell us what the injury is I say.  

Not sure I’m advocating any model of info delivery, just an understanding of the fluidity. None of which is to say it doesn’t frustrate the hell out of me, too.

[chook fowler 18,325]

7 minutes ago, The heart beats true said:

I never get that frustrated about injury timelines. I prefer to focus my frustration onto the real issues of the game - umpiring and Dwayne Russell.

The needs to be a Royal commission looking at the relationship between the umpires and the bulldogs. Maybe Bevos gangsta mo  intimidates them.

Edited April 1, 2022 by chook fowler

[mauriesy 6,815]

1 hour ago, Demonland said:

I agree with this and would put Petty in the indeterminate category. He was 3-4 after he had his calf operation and was still 3-4 last week. He’s come down to 2-3 but I’ll bet my right pinky that he’ll be 2-3 next week too. 

That's because he's in the "3" part of 2-3 this week, and he'll be in the "2" part of 2-3 next week! ☺️

[Demonland 65,652]

The problem with the short, medium, long, indeterminate model is that it can also fall prey to the 4-6 issue where a short becomes medium or medium becomes long. It's the how long is a piece of string conundrum for some injuries.

Time heals all wounds except some wounds heal slower than others.

[Fork 'em 6,538]

I miss Burgess already.

[FritschyBusiness 1,455]

I can add this to the things that don't bother me because we keep winning. 

[Wrecker46 2,673]

If the AFL are going to take a fortune from gambling agencies they should be obliged to enforce transparency of clubs reporting on injuries.