Injury SJOGHCIU - Offseason Edition

[ConcreteWaters]

I can’t quantify the veracity of this tweet or the credentials of the person tweeting it but seemed interesting and maybe a likely explanation of Nic’s issue and the proposed surgical resolution.

Interesting! Thank you for posting!

From what I can see in the literature, the gold standard for treatment of this would be a conservative approach, with surgery considered for patients that don't respond to this (seems like 3-6 months of conservative therapy before surgery is considered). Couldn't find exact rehab time, but probably season ending anyway ('long and structured rehab'). They would have been weighing up the options and recovery time for either playing this year with a response to non-surgical intervention, or ending the season with surgery to have a possibility of being ok in time for the start of next season should his response to surgery be positive.

Systematic review of surgical intervention- Surgical treatment for achilles tendinopathy – a systematic review - BMC Musculoskeletal Disorders
Systematic review of conservative intervention- Conservative Treatment of Chronic Achilles Tendinopathy: A Systematic Review

Functional outcomes after surgery (which sounds like what is described in the tweet with debridement of necrotic tissue)- Functional outcomes and return to sports after surgical treatment of insertional Achilles tendinopathy: Surgical approach tailored to the degree of tendon involvement
*Caveats perhaps not applicable to NN- average age of 44 (+/- 11 years), not athletes (almost half did sport >2x/week), average time between symptoms and surgery 33 months, minimum follow-up time of 12 months.

 

[Dark Sharks]

Duggan is clearly sick of the medical teams bullshit.

He's walked himself to Fiona Stanley to get away from it all.

 

[ziad]

That's crazy if true. Can't believe it. He just doesn't seem the type... a church goer who quotes the bible and with a partner and little boy. Loved his dear Mum... He never seemed to be in trouble with the police as far as we know. No spending time with colourful identities etc? Just doesn't seem to fit at all.... If it were true surely some journo would have broken the story. It's a very big deal if true!

Interesting! Thank you for posting!

From what I can see in the literature, the gold standard for treatment of this would be a conservative approach, with surgery considered for patients that don't respond to this (seems like 3-6 months of conservative therapy before surgery is considered). Couldn't find exact rehab time, but probably season ending anyway ('long and structured rehab'). They would have been weighing up the options and recovery time for either playing this year with a response to non-surgical intervention, or ending the season with surgery to have a possibility of being ok in time for the start of next season should his response to surgery be positive.

Systematic review of surgical intervention- Surgical treatment for achilles tendinopathy – a systematic review - BMC Musculoskeletal Disorders
Systematic review of conservative intervention- Conservative Treatment of Chronic Achilles Tendinopathy: A Systematic Review

Functional outcomes after surgery (which sounds like what is described in the tweet with debridement of necrotic tissue)- Functional outcomes and return to sports after surgical treatment of insertional Achilles tendinopathy: Surgical approach tailored to the degree of tendon involvement
*Caveats perhaps not applicable to NN- average age of 44 (+/- 11 years), not athletes (almost half did sport >2x/week), average time between symptoms and surgery 33 months, minimum follow-up time of 12 months.

My research showed similar. Interestingly, the surgury seems to be more about roughening the tendon to promote bleeding and healing, not at attachment as you may think. This has been described as experimental with the most likely benifit is to come from the enforced rest. A last resort.

 

[GoEaglesGoSGIO]

How do the players keep getting infections? From my - granted - limited understanding of medicine that wounds tend to get infected after being exposed to something dirty then not being cleaned afterwards.

Waterman I can understand after having digits in teammate's anuses but what are the other guys doing?

Honestly think its because the medicos dont know how to diagnose it. Suspect they just pump them full of pain medication until it turns green and then they like "Huh, why is it green for"

 

[GlennTwenty]

My research showed similar.

I had it in my top 5. So that's a good result.

 

[Trouto]

Yep, because a guy who couldn't run out a full game in his entire career, will totally, definitely and absolutely be competitive after a full season layoff, at the age of 34, carrying 110kgs and with a history of knee injuries.

yep, i agree, once he gets his ankle sorted out he can be competitive

 

[Trouto]

Interesting! Thank you for posting!

From what I can see in the literature, the gold standard for treatment of this would be a conservative approach, with surgery considered for patients that don't respond to this (seems like 3-6 months of conservative therapy before surgery is considered). Couldn't find exact rehab time, but probably season ending anyway ('long and structured rehab'). They would have been weighing up the options and recovery time for either playing this year with a response to non-surgical intervention, or ending the season with surgery to have a possibility of being ok in time for the start of next season should his response to surgery be positive.

Systematic review of surgical intervention- Surgical treatment for achilles tendinopathy – a systematic review - BMC Musculoskeletal Disorders
Systematic review of conservative intervention- Conservative Treatment of Chronic Achilles Tendinopathy: A Systematic Review

Functional outcomes after surgery (which sounds like what is described in the tweet with debridement of necrotic tissue)- Functional outcomes and return to sports after surgical treatment of insertional Achilles tendinopathy: Surgical approach tailored to the degree of tendon involvement
*Caveats perhaps not applicable to NN- average age of 44 (+/- 11 years), not athletes (almost half did sport >2x/week), average time between symptoms and surgery 33 months, minimum follow-up time of 12 months.

Yeah its really interesting and complicated, the old Achilles. I have tendonitis in both mine, and i have had a number of electro therapy treatments on them as well as been doing loading up of the ankle as part of conventional treatment. Its been 6 months of treatment and I range between "beauty, no pain, the treatment works" to "dammit, its back why am i wasting my time". This happens on a weekly basis, and from what the doctor tells me, its normal and takes months to settle down.

 

[Goldfish]

Of all the things that have happened to this team this year, at least for me, as my favourite player, this is by far the most deflating.

I did like the message, but then realised I didn't like it, I hate it but I agree with it. Such a good player to watch.

 

[Falco]

I have had Achilles Tendinopathy on both sides, at the insertion point into the heel. Its one of the hardest to treat and its taken me years to work through. I play a bit of sport, and run and cross train to keep fit. I hurt my right one in 2013, and it took me til 2020 to work through the pain and strengthen the tendon again. The left achilles was hurt in 2019 and still hurts a bit post heavy loading during and post exercise.

When they said Nic Nat has an issue similar to mine, I knew he was done. Clearly the dilemma is that they don't want to lose a marketing goldmine even though his body is cooked. But Duffield's article was on the money - we have become meek and indecisive when list management issues appear. Nic Nat won't play another game of league footy. How is he going to keep fit / keep the weight off whilst he cant run? He's 33 and already heavy. The load his achilles will have to take is much greater than mine ever did.

He should be retiring. There's nothing wrong with keeping him as an ambassador at the club but continuing to pay him knowing full well that he will likely never play again is farcical. Its tying up a spot on the list that we could try to unearth a talent with, and its taking money out of our salary cap.

The thing that irks me the most, and quite frankly has really disappointed me, is the lying to the supporters and the lack of transparency with the decisions. This isn't Simpson. This is Nisbett. Management of the club and acknowledgement that we need a rebuild supported by courageous list decisions is what we must do. But we lack the commitment to do it properly. The only way that changes is to clean house and replace the leadership. We need new ideas and new leaders willing to restore us to the top supported by a mix of new and experienced heads.

 

[twadds]

Financial.

100 percent they didn’t want to spend the money

How much clearer can it be

Definitely

 

[DanWCE]

Schoey to Mark Readings on Nic Nat out for the year:

WS: I reckon I spoke in February and said he's not playing this year
MR: I'm not sure you declared it as black and white as that
WS: Certainly the word I was getting

 

[The Dodger]

I said it last week. Classic bait and switch. They know NN puts bums on seats so he's the last person they are honest about when ruling him out for the season.

 

[ioppolo]

What was worse?
This 2022 debacle, or 'late 2017'?

 

[Keys]

So Rotham has had surgery on a broken thumb. The link is paywalled so I don’t know if there’s any details on how he broke it - the Maric debut video has Simpson mentioning that Roth has just done something to his thumb so I’m assuming a Wednesday training accident

 

[DanWCE]

So Rotham has had surgery on a broken thumb. The link is paywalled so I don’t know if there’s any details on how he broke it - the Maric debut video has Simpson mentioning that Roth has just done something to his thumb so I’m assuming a Wednesday training accident

Broke it trying to pull his thumb out after copping a spray

 

[THE A5]

Broke his thumb before he got emasculated by Fogarty and the racist

 

[LittleFires]

So Rotham has had surgery on a broken thumb. The link is paywalled so I don’t know if there’s any details on how he broke it - the Maric debut video has Simpson mentioning that Roth has just done something to his thumb so I’m assuming a Wednesday training accident

Naitanui ruled out for season

The three-time All-Australian is out of the remainder of the 2023 campaign due to his Achilles issues

www.westcoasteagles.com.au

This article from the club says it happened at training on Wednesday

 

[ziad]

So Rotham has had surgery on a broken thumb. The link is paywalled so I don’t know if there’s any details on how he broke it - the Maric debut video has Simpson mentioning that Roth has just done something to his thumb so I’m assuming a Wednesday training accident

That will dent our finals aspirations

 

[DanWCE]

Andrew Embley Suspects Nic Nat's Inactive List Delay Is Linked To Salary Cap Constraints | 929 Triple Ms Rush Hour with Embers and Katie

West Coast Has Confirmed Nic Naitanui Is Done For The 2023 Season

www.listnr.com

 

[Dark Sharks]

PriddisIsDone
SimpsonisDone
NesbittisDone

NaitanuiisDone

 

[Dylan82]

I have had Achilles Tendinopathy on both sides, at the insertion point into the heel. Its one of the hardest to treat and its taken me years to work through. I play a bit of sport, and run and cross train to keep fit. I hurt my right one in 2013, and it took me til 2020 to work through the pain and strengthen the tendon again. The left achilles was hurt in 2019 and still hurts a bit post heavy loading during and post exercise.

When they said Nic Nat has an issue similar to mine, I knew he was done. Clearly the dilemma is that they don't want to lose a marketing goldmine even though his body is cooked. But Duffield's article was on the money - we have become meek and indecisive when list management issues appear. Nic Nat won't play another game of league footy. How is he going to keep fit / keep the weight off whilst he cant run? He's 33 and already heavy. The load his achilles will have to take is much greater than mine ever did.

He should be retiring. There's nothing wrong with keeping him as an ambassador at the club but continuing to pay him knowing full well that he will likely never play again is farcical. Its tying up a spot on the list that we could try to unearth a talent with, and its taking money out of our salary cap.

The thing that irks me the most, and quite frankly has really disappointed me, is the lying to the supporters and the lack of transparency with the decisions. This isn't Simpson. This is Nisbett. Management of the club and acknowledgement that we need a rebuild supported by courageous list decisions is what we must do. But we lack the commitment to do it properly. The only way that changes is to clean house and replace the leadership. We need new ideas and new leaders willing to restore us to the top supported by a mix of new and experienced heads.

Yep this.


Severe and recurrent tendinopathy in the right Achilles immediately above the heel put an early end to me as a competitive track runner.

After seeing multiple specialists it was decided not to have surgery to remove accumulated scar tissue around the tendon due to the likelihood of complete rupture occurring as a result. Almost 20 years later and it still feels like grains of sand are under the skin in that area.

It's a difficult and frustrating injury to recover from - you take it easy managing load; feel fine; add more load; still feel fine; and then wake up the next day barely able to walk even though you felt no pain at all during the previous activity.


Now I was in my early 20s, weighed barely 60kg, never had any foot/leg/gait issues and it floored me.

It took almost 18 months to get out of that post-activity regression cycle, and then my performance never returned to the level it was pre-injury.


If Naitanui is having similar problems at 33, weighing around 115kg, with a history of significant lower leg issues - then unfortunately I don't see him coming back.



It's understandable that people are upset about it. The club is having the worst season in it's history and the most iconic player in the squad is stuck on the sidelines, seemingly getting worse with each update.


Supporters have gone from this in preseason:

Nic Naitanui is in a race against time to be fit for the season opener against North Melbourne, with coach Adam Simpson conceding the important big man was "doubtful" because of Achilles soreness.​

​

Simpson said Naitanui would play if it was late in the season, but the club was taking a cautious approach with the bigger picture in mind for its No.1 ruckman.​

​

"If this was round 15 we would play him, but it's a long year and we really want to try and get in front of it," the coach said ahead of West Coast's season launch on Thursday.​

​

"I won't put a timeline on it other than it will be small steps. It's March, so we need to take our time.​

​

"Is he right for round one? I can't answer that just yet. He is doubtful."​

To this a month later:

West Coast have confirmed veteran ruckman Nic Naitanui is likely to miss the opening half of the 2023 season as he continues to nurse a troublesome Achilles injury.​

​

The Eagles had hoped Naitanui would only miss the opening rounds of the year, however further assessment has forced West Coast to place Naitanui under a considered management program that will see ruckman sidelined until the middle of the season.​

​

West Coast football boss Gavin Bell revealed Naiatnui's rehabilitation process hasn't been as smooth as initially hoped.​

​

“Nic has not progressed from his Achilles issue as quickly as hoped and he will need a period of time before he can increase his training loads and build towards returning to play,” Bell said in a club statement,​

​

“Nic has been working hard behind the scenes in the gym to build his leg strength, particularly his calves, so that when he is ready to resume playing we see the same explosive and dynamic footballer he has always been.”​

To this, now that the opening half of the season is done:

West Coast ruckman Nic Naitanui will miss the remainder of the 2023 season.​

​

Eagles coach Adam Simpson revealed the news at a press conference on Wednesday after the ruckman had further scans on his Achilles injury.​

​

While Naitanui was originally billed to return in six to seven more weeks, Simpson says the ruckman will have further surgery on the injury early next week before having a long recovery stint.​

​

“He was tracking okay,” Simpson told a press conference.​

​

“Then he stagnated a little bit and had a follow-up scan recently and it looks like he’s going to have surgery now.​

​

“It’s time to pull the pin on the season and get that surgery that he needs.​

​

“It’s a long-term one, the recent scan we had wasn’t too good.​

​

“We had no choice unfortunately, he’ll have surgery early next week maybe.”​

Cue the torches and pitchforks...


But to be honest, given the type of injury, the player and their history of injury and the effects of the soft-cap on available resources for monitoring and maintenance of player injury, it can't be ruled out that the club genuinely were not aware of it's severity until it was too late and much of Naitanui's season compromised.

Then whilst conducting a specialised rehabilitation regime, an episode of post-activity regression has occurred, during which further degeneration has been identified from scans, ending any hope of timely return and prompting the requirement for surgical intervention.


It would seem however, rather than the injury itself, that much of the anger over this situation is with concern to how the list is being managed (or not) and the logic applied to how certain decisions regarding the list are made. Alarmingly, it is also a possible conclusion that much of the current decision-making is driven by the injury crisis borking the salary cap via match payments.

It provides a depressing parable for where the club is at this point in time.

 

[mad_eagle]

I'm sorry, what the hell did Rotham do to his thumb?

He's somehow managed to push his nail back and it's broken the bone...WTAF?!

 

[DanWCE]

I'm sorry, what the hell did Rotham do to his thumb?

He's somehow managed to push his nail back and it's broken the bone...WTAF?!

Lane kicking drill. Guess it's one of those freak marking accidents where the ball has caught him on the thumb tip and fractured it while also ripping his nail off.

Would like to know who kicked it. Must've been a dart

 

[mad_eagle]

Lane kicking drill. Guess it's one of those freak marking accidents where the ball has caught him on the thumb tip and fractured it while also ripping his nail off.

Would like to know who kicked it. Must've been a dart

Yeh I reckon, just relistened to it...not word for word, but he basically said that he ripped the nail off and when it peeled back it broke his thumb?!

 

[DanWCE]

Yeh I reckon, just relistened to it...not word for word, but he basically said that he ripped the nail off and when it peeled back it broke his thumb?!

I'm not buying into Simmos sequence of events too much, makes more sense the ball would've broken the thumb to me. But the end result is the same.