Injury issue - advice??

[Big Dave]

So one of the twins has an issue with her knee. The injury is a Plica (or plicae). Basically, last spring she had a collision at home with the catcher and banged the inside of her bent knee. After the injury she has had a few CT and MRIs and all ligs and meniscus are in great shape. I guess the best way to describe the injury is - 'scar tissue within the connective tissue of the affected area. As it rubs over the bone it causes pain and inflammation.' We went thru 6 weeks of PT and not much changed. The next thing is a cortisone shot. I little nervous about her getting one but it is usually good results. The other option is minor surgery to clean up the scar tissue which results in being out 4-12 weeks. My DD is almost 16 so I'm a little nervous about her getting one so young. This shot should last long enough to get through HS ball and summer ball. She can play full on with no worry of doing more damage, it's just a matter of pain management.

Has anyone dealt with either this type of injury or cortisone shots? Any advice or words of wisdom are appreciated!

 

[eddieq]

That's a tough one. Generally, my first advice is, "What did her doctor say". Sounds like you've gone that route and he's presented you with options.

Caveat: This should not be taken as medical advice as I am not a doctor, do not play one on TV and did not sleep in a Holiday Inn Express any time recently.

In my personal experience, the cortisone shots are a temporary solution. I've taken them in my shoulders, including when I was around your daughter's age. It hurt like an SOB for several days following the injections and felt like a million bucks for months afterwards, then the pain returned. My experience may be different, though, as the primarily affected shoulder had a tumor growing on the bone. Ultimately, that was fixed surgically and I no longer suffer from shoulder pain.

Most recently, I received cortisone injections a little lower than previously. Let's say "lower back" Again, a temporary solution. Once the pain came back, I went back to managing the pain the old fashioned way - popping ibuprofen, etc. That particular issue is better now that I've gotten a better fitness level and more flexibility. So, in my case there, physical therapy was the ultimate solution.

Six weeks of PT simply may not be enough to get her past the issue. If the doctors and PTs are telling you that surgery and/or shots are the solution, then I guess you have to pick your battles. Do you give her shots now, get her through the season and do surgery in the "off" season or do you just bite the bullet now and go for it. Ultimately, she's a young woman. You have to gauge her immediate needs (playing ball, etc.) over her future (healthy knees for the foreseeable future).

Just my 2 cents.

 

[Jquick823]

My opinion is this. Injuries happen and at 16 she still have valuable years left. I would seek the advice of professionals that deal with these injuries a lot. 12 weeks is a long time to be out, but there is still training that can be done like weights for upper body. What is the long term effects of a cortisone shot? From minor readings i believe in the long run that those are more harmful over an exteded period of use. I personnaly would get the surgery, rehab and come back pain free for my last 2-3 seasons instead of limping along on pills and shots.

Softball ends at 22 for most girls but she will need to walk forever. Just my opinion as a person who has pushed his body to the limit for the last 15 years and pays for it daily now.

 

[Amy in AZ.]

My DD had a similar injury to her shoulder. The surgeon's assistant told us she could go ahead and pitch, with a cortisone shot. The surgeon read his assistant's notes and said "if you do that to a 16 year old, you will no longer be employed here." That really got my attention. She quit pitching and played another position.

Since you have asked for advice, I would say "fix it surgically." It may be worse at 35.

 

[Little Angels Softball]

I am not a doc. This is worth what you're paying for it ....

I have had multiple cortisone shots. I have had multiple reconstructive surgeries on several joints. A few thoughts:

1. Most of my surgeries have been resounding successes. However, "success" doesn't necessarily mean I went back to pre-injury strength/range of motion. In fact, I have never gone back to 100% from any surgery .... there is always something that must be adapted to afterward.

2. I have had cortisone shots in injured joints (when I say "injured" I am talking about torn ligaments, tendons, impingements, bone spurs and the like) where the shots were a temporary solution. In all instances, the pain was back and surgery was eventually required. Steroids don't heal injuries, they just reduce inflammation and make them easier to live with.

3. I have had cortisone shots in inflamed joints, where the pain I was experiencing was due strictly to inflammation and not a tear/bone injury. I have had permanent success with these treatments.

4. I am now at a crossroads with a knee injury that will most likely require big-time surgery down the line but is pretty difficult to manage with PT or steroid injections. My doctor has recommended PRP injections to hopefully restore and heal some of the injured tendon so I might be able to avoid the traumatic surgery required to fix the injury (up to over a year in recovery/rehab). I am thinking about doing it .... heck, I've done everything else there is to do to injured joints, might as well try something new, right?

Just some food for thought. I am not giving advice or advocating any particular treatment because I am not a professional. I am just a rather well-informed patient who unfortunately has tons of experience with this stuff. Hope some of this helps.

 

[Big Dave]

I would love for her to be able to to finish the summer season but ultimately, her health is tops! Normally, she's our number 1 pitcher for our summer team but we shut her down from pitching this season until she is 100%. She's just a sophomore so she has time. We go see the specialist/surgeon again tomorrow and make a decision then. She doesn't play hoops anymore so besides fall ball, she has time to get healthy. I'm unbelievably proud of her dealing with this. I have no idea what she's feeling but doesn't always seem like fun. Somedays not too bad and some she's limping after the game. Last game of regular season is tomorrow but they have the league title wrapped up, so I would think some of the bench will be playing. I know everybody is different, but will she feel good enough to play if she gets the shot tomorrow? Thanks again guys!

 

[Big Dave]

And just to add - yes, I understand any of this is not a recommendation or the like. Probably should have put as 'opinion' and not 'advice' but that's just me. Not too literal of a person. Just looking for thoughts and experiences. This all kinda goes along with 'advice' on our DDs swings! ��

 

[eddieq]

Well, my opinion is that if she wants to play tomorrow, getting a shot today will not help that. In my experience, the shot makes it temporarily worse before it starts to feel better. Everyone responds differently, but it usually took me a couple of days until I was no longer very tender around the injection/injury site. That needle is freaking huge. I swear it was the size of a soda straw.

 

[InsidePitch]

With the shot there is no real predictor on how long relief will last. If you are using the shot to be able to play aren't you masking the injury that could lead to exaggerating it. And of course I'm not a physician.

 

[NVfishing]

Cortisone shots weaken ligaments. I know someone that received to many shots and his bicep disconnected from the bone. Be careful and seek a second opinion.