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Old 11-02-2011   #381
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Default Re: AJ out a few weeks, has procedure

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Originally Posted by Marcus View Post
Where the hell you getting this 90-95% stuff?

He's only 70%, and unless I'm shown anything different, it's going to remain 70%. I don't think some of you are understanding what has taken place here.

To be fair, it was AJ's decision to take this gamble. Unfortunately, he lost.
So why do we have clowns saying "get rid of the trainers"?
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Old 11-02-2011   #382
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Default Re: AJ out a few weeks, has procedure

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where the hell do we get these numbers anyway? On the underside of his feet?
It was AJ himself who said he was only 70%. Correct me if I'm wrong there.
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Old 11-02-2011   #383
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Default Re: AJ out a few weeks, has procedure

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Originally Posted by Marcus View Post
It was AJ himself who said he was only 70%. Correct me if I'm wrong there.
I wasn't really being literal....I just thought it was amusing to put some absolute number on something like that...its just sports cliché stuff to me.
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Old 11-02-2011   #384
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Default Re: AJ out a few weeks, has procedure

So wait.. Kubiak tells the Cleveland press about AJ not practicing today before he tells Houston?

So this is either Kubiak trying to make them not game plan for AJ as much per previous comments about not practicing = not playing or I am sorta pissed that we wouldn't be the first to know.
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Old 11-02-2011   #385
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Default Re: AJ out a few weeks, has procedure

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Originally Posted by Marcus View Post
Where the hell you getting this 90-95% stuff?

He's only 70%, and unless I'm shown anything different, it's going to remain 70%. I don't think some of you are understanding what has taken place here.

To be fair, it was AJ's decision to take this gamble. Unfortunately, he lost.
I read that same thing and figured if he's 70% and not even fully healed maybe there was more room for improvement. Also, seeing as Andre has always given 110% maybe he could actually get back to 100%
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Old 11-02-2011   #386
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Default Re: AJ out a few weeks, has procedure

If he gives 110% of his 70% that puts him at 80%, so we are getting closer.
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Old 11-02-2011   #387
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Default Re: AJ out a few weeks, has procedure

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Originally Posted by Vinnie View Post
Reading CND's takes on Andre's injury has had me extremely worried from the time we found out what exactly the procedure was he had done. It would seem a full recovery may not be in Andre's future. Still I'd take a 90-95% Andre over most WR's in the league every day of the week.
After reading CnD's reports, it doesn't appear to me that Andre's injury is in any way similar to the "normal" hamstring injuries, where the muscle itself tears & needs time to heal.

In Andre's case, it was a ruptured tendon that was completely cut loose. So there should be no reason to believe he will re-aggravate it like a "normal" hamstring injury.

The only set back I can think of would be an infection or some kind of swelling from fluid build up.

Basically, we're just waiting for a small incision to heal, & Andre to feel comfortable with it.

Waiting an extra week, or till the bye doesn't really buy us (Andre) anything.
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Old 11-02-2011   #388
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Default Re: AJ out a few weeks, has procedure

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Originally Posted by Kthx View Post
If he gives 110% of his 70% that puts him at 80%, so we are getting closer.
"60% of the time Andre Johnson's surgically 70%-repaired hamstring "tendon-thingy" is effective 100% of the time."

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Old 11-02-2011   #389
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Default Re: AJ out a few weeks, has procedure

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Originally Posted by Kthx View Post
If he gives 110% of his 70% that puts him at 80%, so we are getting closer.
Actually, that would be 77%. We're moving back the wrong direction!
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Old 11-02-2011   #390
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Default Re: AJ out a few weeks, has procedure

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Originally Posted by ThaShark316 View Post
So why do we have clowns saying "get rid of the trainers"?
Umm....hmmm...could possibly be that those clowns don't know what the **** they're talking about? Taking a wild stab at it there.
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Old 11-02-2011   #391
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Originally Posted by Vinny View Post
I wasn't really being literal....I just thought it was amusing to put some absolute number on something like that...its just sports cliché stuff to me.
I think the 70% was measured. They had him sprint and he had only gone 28 yards in the time he previously could run 40 yards. It's all very scientific.*


*actually, I just made this all up.
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Old 11-02-2011   #392
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Default Re: AJ out a few weeks, has procedure

42.7% of all statistics are made up on the spot.

I am going back to bury my head in the sand, ignorance is BLISS!
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Old 11-02-2011   #393
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Default Re: AJ out a few weeks, has procedure

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Originally Posted by Hardcore Texan View Post
42.7% of all statistics are made up on the spot.

I am going back to bury my head in the sand, ignorance is BLISS!
Actually, if you want to be accurate only 43.6% of bliss is made up of ignorance. The rest of it is a filler material made of low-value pork trimmings, high-fructose corn syrup, and artificial pork flavor.
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Old 11-02-2011   #394
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Default Re: AJ out a few weeks, has procedure

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Originally Posted by Hervoyel View Post
Actually, if you want to be accurate only 43.6% of bliss is made up of ignorance. The rest of it is a filler material made of low-value pork trimmings, high-fructose corn syrup, and artificial pork flavor.
Don't forget some of DB's "chicken-loaf"....
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Old 11-03-2011   #395
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Default Re: Report: Johnson out a few weeks, Texans expect

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Originally Posted by CloakNNNdagger View Post
He said that he could be back in a few days or a few weeks..........will get some additional 2nd opinions.

This makes me think that the 2nd opinions are to determine whether to take a non-surgical vs surgical approach. In other words, I believe that the MRI may have already identified a subtotal tear or complete tear/avulsion of the distal hamstring tendon (or the PCL). With a distal hamstring avulsion, there has been controversy whether to surgically repair or not.

Most hamstring tears/avulsions occur more proximal as in this illustration.




(See my previous post showing the distal hamstring tendon attachments.)

One study published in the past few years reported on elite athletes with this type of injury. They found that in the nonoperative treatment group (12), 7 players recovered at an average of 10.4 weeks (range, 3-35). Five of these players (42%) failed initial nonoperative treatment (mean, 16.8 weeks) and subsequently had surgery to resect the torn tendon and surrounding scar tissue. These 5 players recovered at an average of 12.8 weeks postoperatively. In the acute [immediate] surgery group, 5 players had surgery to resect the torn tendon and scar tissue within 4 weeks of injury. The acute-phase group had an average recovery of 6.8 weeks after surgery.

I believe that this is possibly the dilemma facing AJ and the organization. Making a decision that at least gets him back before the end of the season or playoffs.

There is no mention of the PCL, but let's say that if the PCL has theoretically been shown to be completely torn, a little different situation exists but with similar decision quandary. Surgical reconstruction of the PCL is controversial, and usually only recommended for grade III PCL tears. Because of the technical difficulty of the surgery, some orthopedic surgeons do not see the benefit of PCL reconstruction. Others, however, believe PCL reconstruction can lead to improved knee stability and lower the likelihood of problems down the road. Non-surgical rehab can take 6-8 weeks........Surgical rehab 6 months.

Again, let me emphasize that I have no access to the findings, physical or radiological. But if this were just a straight forward "minor" hamstring problems, I don't believe that there would be need for several 2nd opinions.

Let me leave you with this article that appeared after an MRI was obtained in 2007 following AJ's PCL/MCL injury. You might want to compare some of the wording.



AJ ending up missing 7 games..........
Man, C-N-D, this post appears to be spot on.

I was listening to Dr. First podcast on 610 this morning and this post was almost prophetic. According to Dr. First the timetable for recovery was skewed when the Texans Dr.'s said 3-6 weeks. Because one of the procedures was done on a QB that made it back in 3 wks. The avg time that it takes a WR appears to be 6-10 wks. And this procedure was done to only 5 athletes. There's really no way of being sure when AJ will be back. Due to such a limited number of athletes that have had this procedure.

According to Dr.First the procedure was done so that once AJ got back on the field his chances of pulling/rupturing the tendon again would be lessened. Although there is a chance he could reinjure it again. What's going on with the soreness AJ is experiencing now is the hamstring muscle is firing off but because the tendon is not attched AJ's brain is telling him something is wrong with his hamstring. (hence the soreness)

C-N-D, am I interpeting this correctly and in your opinion what would be the best option for AJ, bringing him back this yr. Or letting him rehab during the offseason and hopefully getting AJ back 100% next yr. I realize that this is a hypothetical question because the study only contains 5 athletes. But I would love to get your thoughts on this study/subject.
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Old 11-03-2011   #396
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Default Re: Report: Johnson out a few weeks, Texans expect

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Originally Posted by steelbtexan View Post
Man, C-N-D, this post appears to be spot on.

I was listening to Dr. First podcast on 610 this morning and this post was almost prophetic. According to Dr. First the timetable for recovery was skewed when the Texans Dr.'s said 3-6 weeks. Because one of the procedures was done on a QB that made it back in 3 wks. The avg time that it takes a WR appears to be 6-10 wks. And this procedure was done to only 5 athletes. There's really no way of being sure when AJ will be back. Due to such a limited number of athletes that have had this procedure.

According to Dr.First the procedure was done so that once AJ got back on the field his chances of pulling/rupturing the tendon again would be lessened. Although there is a chance he could reinjure it again. What's going on with the soreness AJ is experiencing now is the hamstring muscle is firing off but because the tendon is not attched AJ's brain is telling him something is wrong with his hamstring. (hence the soreness)

C-N-D, am I interpeting this correctly and in your opinion what would be the best option for AJ, bringing him back this yr. Or letting him rehab during the offseason and hopefully getting AJ back 100% next yr. I realize that this is a hypothetical question because the study only contains 5 athletes. But I would love to get your thoughts on this study/subject.
My post which you quoted was from 4 weeks ago just before AJ's surgical procedure was performed. I referred to the study that included the five athletes treated with the approach taken for AJ. AJ's operating orthopedic surgeon had previously performed initial surgical release of partial distal hamstring tears on 5 players. As you pointed out, one was a QB. In contrast, the other 4 types of players were those that would require significant acceleration and explosiveness to perform well. And this was ONE of the reasons I was very hesitant to accept as quick a return to play as was initially put out. When you only have 5 players making up the entire pool of stats.......and the 5 AVERAGE 6.8 weeks for return........and ONE player sticks out as so much of an aberrant statistical "outlier," then you can only imagine what the return to play length would have been had only the 4 players been included in the calculations........probably closer to 8-10 weeks. Now, does that mean you can't throw a player out there whether he is truly ready or not? Obviously the answer to that is "no." A player can be released to play before he is truly prepared to play well. Yet, keep in mind, if the player doesn't even feel that his hamstring feels fine, he is likely to compensate by stressing other structures.......hence setting himself up for very increased risk for other injuries occurring.

Dr. Cooper, AJ's surgeon, is an excellent surgeon. But he himself at this point, could not tell you with certainty from the experience he has had with his other 5 players any more than "they all returned to play." This is simply too small of a sample to make any definitive predictable conclusions on ultimate outcomes. No true electromechanical measurements or performance ratings of performance levels were offered to accurately and objectively assess actual pre and postoperative differences (short-term or long-term). It is obvious that even Dr. First, who is himself an excellent orthopedic surgeon, morphed from his initial more optimistic return outlook following his review of the same study I had originally posted.

There is little doubt that AJ will at some point "return to play." However, what I believe is not entirely predictable is how much (after supposed "full healing and rehab) permanent effect having done the release rather than the re-attachment of the tendon might have on his ultimate long-term performance level.
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Old 11-03-2011   #397
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Default Re: AJ out a few weeks, has procedure

I am hoping he will be ready in time for the playoffs. Other than that he needs to take his time and make sure he is ready to play.
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Old 11-03-2011   #398
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Default Re: Report: Johnson out a few weeks, Texans expect

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Originally Posted by CloakNNNdagger View Post
There is little doubt that AJ will at some point "return to play." However, what I believe is not entirely predictable is how much (after supposed "full healing and rehab) permanent effect having done the release rather than the re-attachment of the tendon might have on his ultimate long-term performance level.
Is this the kind of work you do? Do you have experience re-attaching tendons?

I ask, because I'd like to ask:

Would you have suggested the "complete the rupture" procedure then "re-attach" the tendon as a possible course? Or would you have suggested only the repair procedure?

Is there any reason to believe re-attaching would be less successful at a later date than immediate re-attachment?
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Old 11-03-2011   #399
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Default Re: Report: Johnson out a few weeks, Texans expect

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Is this the kind of work you do? Do you have experience re-attaching tendons?

I ask, because I'd like to ask:

Would you have suggested the "complete the rupture" procedure then "re-attach" the tendon as a possible course? Or would you have suggested only the repair procedure?

Is there any reason to believe re-attaching would be less successful at a later date than immediate re-attachment?

I have personally had a good deal of experience with tendon injuries, their complications. But not this particular tendon (semitendinosus). It is a very uncommon type of injury and has very limited coverage in the medical literature. Although with tendon injuries, there are still some basic principles that apply universally and one of those is that you try to reconstruct them anatomically whenever possible to best recreat the function of the muscle of tendon. The procedure that was done for AJ was mainly in consideration of getting him back as quick as possible without the risk of re-tear if the re-attachment was performed and then stressed too early. If the goal was not limited in time of recovery, and a resignation to the typical months required for full healing of a tendon repair, in return for anatomic reconstruction, then that would have probably been the ideal. But AJ would have had to go on IR, and evidently no one wanted to take that route.

As far as reattachment LATER. I understand the surgery entailed cutting out the torn tendon. If the muscle is allowed to retract upwards with scarring over even a couple of months, even in a fairly limited fashion, it may be too short to mobilize and stretch what's left to re-attach it to the bone, or without it pulling apart because of too much tension. And if the tendon was indeed entirely cut out, a muscle to bone re-attachment is much less predictable than tendon to bone. Sometimes other procedures can be entertained, but you can see, it gets quite complicated, and again less predictable.
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Old 11-03-2011   #400
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Default Re: AJ out a few weeks, has procedure

I am not worried about Andre's ability to recuperate. I am worried about the decisions made by the coach and medical staff regarding the timeframe.
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