Latest / Inside the Birds: A Philadelphia Eagles Podcast / Chalk Talk on Patreon: Former Eagles Asst. Trainer Aaron Borgmann Explains Injury, Rehab For Lane Johnson, Jalen Carter

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Chalk Talk on Patreon: Former Eagles Asst. Trainer Aaron Borgmann Explains Injury, Rehab For Lane Johnson, Jalen Carter · Inside the Birds: A Philadelphia Eagles Podcast

• 0:00
  Speaker 1: The following is a shortened version of our chalk Talk
• 0:03
  Speaker 1: episode on Patreon. For our great Patreon members. To hear
• 0:08
  Speaker 1: the entire chalk Talk episode and to get other great
• 0:12
  Speaker 1: Inside the Birds bonus content, sign up and become a
• 0:16
  Speaker 1: member at patreon dot com slash Inside the Birds.
• 0:30
  Speaker 2: Hello again everyone, It's Adam Kaplet here for Inside the
• 0:33
  Speaker 2: Birds in our chalk Talk series, and we wanted to
• 0:37
  Speaker 2: bring him back with his partner, Evan Craft, but Evan's
• 0:40
  Speaker 2: not available. But Aaron Borgman is Aaron. Good to see you,
• 0:44
  Speaker 2: my friend.
• 0:45
  Speaker 3: Hey, Adam, thanks for having me this evening.
• 0:47
  Speaker 2: So Aaron, if folks don't remember, he's a four NFL
• 0:50
  Speaker 2: physical therapist and athletic trainer, you might remember him when
• 0:52
  Speaker 2: he worked.
• 0:53
  Speaker 4: For the Eagles.
• 0:54
  Speaker 2: Then he left the Eagles when Andy left and he
• 0:56
  Speaker 2: went over to the Chiefs. Aaron left the Chiefs. Stone
• 1:00
  Speaker 2: is his own rehab center, Bourbon Rehab Solutions. They started
• 1:05
  Speaker 2: a sports Med Bros. Podcast and I got to ask you, Aaron.
• 1:09
  Speaker 2: You know, typically guys like yourself, they don't get into broadcasting.
• 1:13
  Speaker 4: What was the motivation to do it?
• 1:14
  Speaker 3: Well? I think if you ask anybody that knows me,
• 1:17
  Speaker 3: especially my wife, she'll tell you how much I like
• 1:19
  Speaker 3: to talk about things, and I'm very passionate about, you know,
• 1:23
  Speaker 3: how sports injuries are taken care of, especially in football,
• 1:26
  Speaker 3: And so I had been pestering Evan for years about
• 1:29
  Speaker 3: this while he was still working in the league and
• 1:32
  Speaker 3: I was out, and then we said, you know, are
• 1:34
  Speaker 3: we going to ever do this, or we're gonna do this,
• 1:35
  Speaker 3: or we're gonna do this, and he finally got out,
• 1:38
  Speaker 3: and so then we just started it right up. And
• 1:40
  Speaker 3: you know, it's I would call it Niche of Niche
• 1:43
  Speaker 3: Adam because not everybody wants to know the nuts and
• 1:45
  Speaker 3: bolts of football injuries. But we we love doing it.
• 1:49
  Speaker 3: We love talking about random things. We're not on there
• 1:52
  Speaker 3: every day talking about, you know, the normal everyday stuff.
• 1:55
  Speaker 3: We try to pick and choose some odd things, you know,
• 1:58
  Speaker 3: that you don't see very often, some of which we're
• 2:00
  Speaker 3: going to talk about this evening. But we were having
• 2:03
  Speaker 3: a great time with it. Thanks so much for the
• 2:04
  Speaker 3: shout out.
• 2:05
  Speaker 2: Now you could find their pod on x at Sports Underscore,
• 2:10
  Speaker 2: Mad Underscore Bros.
• 2:12
  Speaker 4: And Aaron what's your Twitter or your AX? I'm sorry?
• 2:15
  Speaker 3: My ex is Rehab All Star. We're also all over
• 2:19
  Speaker 3: on Instagram. And same handle, same name, nothing crazy.
• 2:23
  Speaker 4: Gotcha, gotcha? So before we get started, tell us about
• 2:26
  Speaker 4: rehab solutions.
• 2:27
  Speaker 3: Yeah, so I started the business really not knowing what
• 2:30
  Speaker 3: I was doing seven and a half years ago. I
• 2:33
  Speaker 3: had never taken a business class, but I decided that
• 2:35
  Speaker 3: I was going to bring NFL level sports medicine care
• 2:39
  Speaker 3: to the masses, or at least to the masses here.
• 2:41
  Speaker 3: But I also travel quite a bit. I lecture quite
• 2:43
  Speaker 3: a bit, I advise, I consult, So I'm kind of
• 2:46
  Speaker 3: a mercenary these days. I don't. I'm like one hundred
• 2:49
  Speaker 3: percent mobile, except for the time now where I'm kind
• 2:52
  Speaker 3: of moonlighting at a country club here and there for
• 2:55
  Speaker 3: some golf stuff that I like to take care of.
• 2:57
  Speaker 3: But really a jack of all trades these days. But
• 3:00
  Speaker 3: still taken quite a bit of football, just because you know,
• 3:03
  Speaker 3: you can't really turn that kind of stuff off.
• 3:05
  Speaker 2: So the midfoot sprain, I learned about the list Frank injury,
• 3:10
  Speaker 2: believe this or not, when Deuce Staley had it. I'd
• 3:12
  Speaker 2: never heard of it. So let's talk about your interpretation
• 3:14
  Speaker 2: of just that type of injury and what's the rehab
• 3:17
  Speaker 2: like for in midfoot sprain.
• 3:18
  Speaker 3: Yeah, so just a real quick history just to give
• 3:20
  Speaker 3: people some background about where this is. This is right
• 3:22
  Speaker 3: in the middle of your foot, right around between where
• 3:24
  Speaker 3: your first and second foot bones meet. There's a joint
• 3:27
  Speaker 3: there called your Liz Frank joint. It got its name
• 3:30
  Speaker 3: from a French field surgeon back in the day, if
• 3:33
  Speaker 3: you can believe it or not, His name was Liz Frank.
• 3:36
  Speaker 3: What happened was people would get caught in horses and
• 3:38
  Speaker 3: get drug and they would have to amputate at that
• 3:42
  Speaker 3: joint because their foot would get caught in a stirrup.
• 3:45
  Speaker 3: So it then became known as the Liz Frank joint.
• 3:47
  Speaker 3: So it's putting that aside. What it is. It's a
• 3:50
  Speaker 3: pretty stable joint most of the time, but when you
• 3:53
  Speaker 3: get a sprain there, and a sprain being defined as
• 3:57
  Speaker 3: a disruption of your ligamentous ructures. It's not a muscular thing.
• 4:01
  Speaker 3: It's a ligament thing, much like an acl but just
• 4:03
  Speaker 3: in your foot on between a couple of tiny little
• 4:05
  Speaker 3: bones there. They measure the width of the spreading of
• 4:10
  Speaker 3: the joint. And I don't want to pin myself here
• 4:13
  Speaker 3: in a corner, but they do so under X ray
• 4:16
  Speaker 3: under weighted X ray, and it depends on how wide
• 4:20
  Speaker 3: that joint is to whether or not this becomes a
• 4:22
  Speaker 3: surgical consideration, and some players can play with it to
• 4:26
  Speaker 3: a certain degree depending upon position. Some players struggle with
• 4:30
  Speaker 3: it because it really is one of the two arches
• 4:33
  Speaker 3: of your foot. Everybody knows you have one longitudinal arch,
• 4:36
  Speaker 3: but you also have a latitudinal arch. It helps compose
• 4:40
  Speaker 3: those arch that's kind of where they meet almost, and
• 4:42
  Speaker 3: so if you have some instability there, it's really really
• 4:45
  Speaker 3: tough for anybody athletically to do anything, let alone plant, cut, pivot,
• 4:50
  Speaker 3: things of that nature. Now, when it comes to the
• 4:53
  Speaker 3: rehab of said joint, if you're not going to do
• 4:55
  Speaker 3: a surgical procedure, which some players do elect not to do,
• 5:00
  Speaker 3: depending upon again the spreading of said joint based upon
• 5:04
  Speaker 3: doctor's recommendations, it's a lot of what we call intrinsic footwork,
• 5:09
  Speaker 3: meaning the small muscles of your foot, the stuff on
• 5:12
  Speaker 3: the bottom, the things that kind of help steady you
• 5:15
  Speaker 3: during balance here, toe flexers, your toe extensors, your grabbers,
• 5:19
  Speaker 3: the things that you feel in your arch, and a
• 5:21
  Speaker 3: lot of single leg balance. Getting good at that again,
• 5:23
  Speaker 3: because what you're trying to do is you're trying to
• 5:25
  Speaker 3: get strong enough to overcome the sprain of that joint. Now,
• 5:30
  Speaker 3: because you can't fix the ligament, it might scar in
• 5:32
  Speaker 3: a little bit, but you're not going to ever close
• 5:34
  Speaker 3: that space down again unless there's a surgical procedure.
• 5:37
  Speaker 2: Right.
• 5:38
  Speaker 3: So, anybody that has a non surgical strategy for this
• 5:42
  Speaker 3: has to get super super strong. They have to get
• 5:45
  Speaker 3: really really stable. And you can do some of that,
• 5:49
  Speaker 3: not all of it, but some of that with some
• 5:51
  Speaker 3: kind of more heavy taping techniques, a lot of orthotic work,
• 5:56
  Speaker 3: different I actually believe it or not, some different shoe
• 5:59
  Speaker 3: tying techniques or to help it a little bit ty yeah, wow,
• 6:03
  Speaker 3: different ways to tie your shoes to help this out.
• 6:05
  Speaker 3: You know. I know we're going to talk about an
• 6:07
  Speaker 3: offensive lineman here in a second regarding it, but one
• 6:09
  Speaker 3: of my last big rehabs in my time in the
• 6:13
  Speaker 3: NFL was with an offensive lineman where he was kind
• 6:15
  Speaker 3: of on that borderline on whether or not he wanted
• 6:18
  Speaker 3: to have surgery or not. He elected the non surgical route.
• 6:21
  Speaker 3: We rehabbed for five or six weeks. He played a
• 6:23
  Speaker 3: couple of games, decided he couldn't do it. It just
• 6:25
  Speaker 3: wasn't effective. He was hurting the team. Then went and
• 6:28
  Speaker 3: had surgery and now he went on to have a
• 6:30
  Speaker 3: wonderful career afterwards. So it's not a you know, a
• 6:32
  Speaker 3: death sentence or anything like that, but it's kind of
• 6:34
  Speaker 3: when you're in these gray areas, you really have to
• 6:37
  Speaker 3: parse out whether or not you know it's a surgical consideration.
• 6:41
  Speaker 2: Aaron, you're wonder with Lane Johnson, and I know that
• 6:44
  Speaker 2: he's a warrior, he's tough, he comes back from injuries.
• 6:46
  Speaker 4: But you gave such a great description. We can't roll out.
• 6:50
  Speaker 2: As much as you talked about the the treatment and
• 6:54
  Speaker 2: things you can do to be able to play with it,
• 6:56
  Speaker 2: it doesn't guarantee you, as Aaron just said that it's
• 7:00
  Speaker 2: gonna work.
• 7:01
  Speaker 4: Yeah.
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  Speaker 3: And one more consideration that I'd give to this particular player, Adam,
• 7:04
  Speaker 3: is that I believe it's his right foot correct. Yes,
• 7:07
  Speaker 3: And for a right tackle, that's a big deal because
• 7:10
  Speaker 3: your foot is externally rotated and you're always planting back
• 7:14
  Speaker 3: on it every time you take a pass set. So
• 7:16
  Speaker 3: it's a little bit different outside versus inside foot. There's
• 7:19
  Speaker 3: a dynamic there that not a lot of people would
• 7:21
  Speaker 3: you know, kind of parse out and understand that that
• 7:23
  Speaker 3: actually does matter for this particular player.
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  Speaker 4: Now.
• 10:06
  Speaker 2: This one is also interesting because in our reporting, Jail
• 10:09
  Speaker 2: and Carter had shoulder problems back at Georgia that in
• 10:12
  Speaker 2: addition to the off the field concerns. But our understanding
• 10:15
  Speaker 2: was he didn't have surgery.
• 10:16
  Speaker 4: There's some sort of procedure. Yeah, what could it be? Injections?
• 10:23
  Speaker 3: Yeah, So, first of all, when I first saw the report,
• 10:24
  Speaker 3: I was very you know, like, what in the world
• 10:27
  Speaker 3: are we dealing with here? Because it's bilateral, you know,
• 10:30
  Speaker 3: you just don't see bilateral injuries acutely, like that just
• 10:33
  Speaker 3: doesn't happen in most people. And so read a little
• 10:37
  Speaker 3: bit more about the situation, heard about the fact that
• 10:40
  Speaker 3: he'd had some issues coming out and whatnot. You know,
• 10:43
  Speaker 3: I actually had some discussions with it on Twitter with
• 10:46
  Speaker 3: some very notable sports medicine people that people can go
• 10:49
  Speaker 3: back and look at. You know, listen, the consensus is
• 10:54
  Speaker 3: that this player had some sort of injection of some type. Now,
• 10:59
  Speaker 3: that could mean something called a play the rich plasma
• 11:01
  Speaker 3: injection or PRP. That could mean probably less likely a
• 11:06
  Speaker 3: stem cell injection, whatever it might be. It becomes you know,
• 11:10
  Speaker 3: I saw somebody national pundit even use the term therapeutic intervention,
• 11:14
  Speaker 3: which is just fancy speaker. You had something done right,
• 11:18
  Speaker 3: you know, listen, if it's a PRP injection. You know,
• 11:23
  Speaker 3: back in my day when we were doing these things,
• 11:26
  Speaker 3: players didn't really get those inside the joint and they
• 11:30
  Speaker 3: didn't miss much time with that. That has become more
• 11:33
  Speaker 3: in vogue now. So you know, if you're throwing darts
• 11:36
  Speaker 3: at a dartboard, you gotta think that that's probably the
• 11:39
  Speaker 3: leading candidate in the clubhouse. But other things like a
• 11:42
  Speaker 3: stem cell injection or a cortizone injection in either side
• 11:45
  Speaker 3: are also possibilities. That being said, if it's not surgery
• 11:49
  Speaker 3: and he's weak, to weak obviously, you know you're thinking
• 11:51
  Speaker 3: like it's something injectable or biologic or some medicine to
• 11:56
  Speaker 3: kind of calm things down. I think the timing is
• 11:59
  Speaker 3: kind of interesting that it must have been so much that,
• 12:03
  Speaker 3: you know, a week off of practice or limited practice
• 12:05
  Speaker 3: wasn't going to help, so they decided to shut the
• 12:07
  Speaker 3: kid down for some amount of time whatever that was.
• 12:10
  Speaker 3: That being said, you know, seems like he's going to
• 12:13
  Speaker 3: be back sooner than later because of this, as opposed
• 12:15
  Speaker 3: to a full blown procedure, if that makes makes sense.
• 12:18
  Speaker 2: Yes, So here's two questions off of that, Uh, court zone.
• 12:21
  Speaker 2: I've talked to players who have had it. It generally
• 12:24
  Speaker 2: you know better me obviously, but it could definitely work
• 12:26
  Speaker 2: and make it feel better. But how soon if it
• 12:28
  Speaker 2: was quarter zone, how quickly can you come back from that?
• 12:31
  Speaker 4: Yeah?
• 12:31
  Speaker 3: So quarter zone injections if it's you or I getting
• 12:34
  Speaker 3: a quarter zone injection, you know, I tell my patients
• 12:37
  Speaker 3: all the time, we generally don't even expect quarter zone
• 12:40
  Speaker 3: injections to work for ten days to two weeks to
• 12:43
  Speaker 3: really truly kick in. The immediate relief that you feel
• 12:46
  Speaker 3: after the injection is more from the numbing than the
• 12:48
  Speaker 3: actual medicine itself. That being said, activity is not really prohibited,
• 12:55
  Speaker 3: but more like contraindicated. We tell people to take it
• 12:57
  Speaker 3: easy for a couple of days, and a professional athlete,
• 13:00
  Speaker 3: it's not a whole lot different. You don't really do
• 13:02
  Speaker 3: a court zone injection in a professional athlete thinking that
• 13:05
  Speaker 3: it's going to be helpful in one week. You know,
• 13:08
  Speaker 3: you would do that thinking it's a long term thing.
• 13:11
  Speaker 3: So maybe he takes a week off, maybe everything kind
• 13:14
  Speaker 3: of calms down, and then the stretch run you really
• 13:17
  Speaker 3: see the benefit of that court zone injection. Perhaps that's
• 13:20
  Speaker 3: what the team's thinking. If it's you know, if that's
• 13:23
  Speaker 3: truly what it was, because guess what if he comes
• 13:25
  Speaker 3: back next week, that court zone really hasn't kicked in
• 13:28
  Speaker 3: or done its job just yet.
• 13:29
  Speaker 4: It's longer. Yeah, how about PRP? How long would that take?
• 13:33
  Speaker 3: PRP plate platelet rich plasma for those that don't know,
• 13:36
  Speaker 3: is just really your own blood and they spin it
• 13:38
  Speaker 3: down and they take all the heavy things, the cells
• 13:40
  Speaker 3: in it, and they inject it back in almost like
• 13:42
  Speaker 3: a clot, and it's supposed to help, you know, with
• 13:46
  Speaker 3: tissue healing. Some people think I think it helps mitigate inflammation.
• 13:51
  Speaker 3: Things of that nature.
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  Speaker 3: There's less good data on it. Inside a joint as
• 16:15
  Speaker 3: opposed to a tendon or a muscle, PRP is one
• 16:18
  Speaker 3: of those things that helps some of the people some
• 16:21
  Speaker 3: of the time for some things right, and so again
• 16:25
  Speaker 3: that would be more of a longer term solution as
• 16:27
  Speaker 3: opposed to a week to week solution. However, once again,
• 16:30
  Speaker 3: if you're shutting this kid down for a week and
• 16:32
  Speaker 3: letting him rest, you're getting some benefit more so from
• 16:36
  Speaker 3: that rest, and then probably doing the injection, you know,
• 16:40
  Speaker 3: as a adjunct to long term no matter what the
• 16:43
  Speaker 3: injection is.