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Markakis Scheduled For MRI


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While I'm happy to read that herniated discs are not as serious as Reimold has led us to believe, it is still concerning that Markakis has yet another injury. For awhile there I took for granted that his name would be in the lineup every single day except maybe one or two games a year. Last year seemed odd but both injuries seemed like bad luck rather than Markakis actually being injury prone. With an off season abdominal surgery and now a herniated disc the title seems to be shifting from "bad luck" to "injury prone" and I'm not a fan. Hopefully this just an extension of unfortunate circumstances and Markakis can get back to being counted on being in the lineup many more times than not being in the lineup

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Herniation does not equal tear depending on who is giving the diagnosis. It can be a simple 2mm bulge and not tear.

Not necessarily, although the term herniation does imply that the annulus fibrosis (the doughnut in above analogy) has indeed been ruptured, causing the nucleus pulposus (the jelly) to extrude from one side. I doubt a radiologist would use the terms herniated and bulging interchangeably.

In fact, you will find a much larger clinical distinction between a bulging disc (annulus intact) and herniated disc (annulus torn) than you will between a severely herniated disc and a "ruptured" disc.

bulging_disk.jpg

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The analogy I like to use is the jelly doughnut analogy. Imagine the disc is a jelly doughnut. The outside covering of the jelly donut is your fibrous material of the disc. The inner part of the jelly donut is the Nucleus of the disc. When you have a bulging disc it's like barely putting some pressure on the jelly donut and the jelly starts to bulge Toward one side. If you take the pressure off the bulge will often return back to the normal position. However, if you stomp on the jelly donut and the jelly shoot out of the donut there is no way to put it back in. As an example see Nolan Reimold and needing surgery to fix a stomped jelly donut.

Why am I hungry all of a sudden? Thanks, doc.

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Above is a good explanation. Here is what I tell my patients:

If I took an MRI of everybody who post on this board who are over 35 at least 50% of you would have a "bulging/herniated disc ". There is no guarantee that you would have pain from this bulging disc. 75 to 85% of all patients with a bulging disc will become symptom-free within six months even if you do nothing at all. Medication and rehabilitation can speed this process up and help to teach the patient how to prevent this from reoccurring in the future. But there are no guarantees that it will not come back. Once you have a spine injury you always have a spine injury. Does not mean you will always or ever have pain again though.

The analogy I like to use is the jelly doughnut analogy. Imagine the disc is a jelly doughnut. The outside covering of the jelly donut is your fibrous material of the disc. The inner part of the jelly donut is the Nucleus of the disc. When you have a bulging disc it's like barely putting some pressure on the jelly donut and the jelly starts to bulge Toward one side. If you take the pressure off the bulge will often return back to the normal position. However, if you stomp on the jelly donut and the jelly shoot out of the donut there is no way to put it back in. As an example see Nolan Reimold and needing surgery to fix a stomped jelly donut.

One other important piece of information is, if you take a physical therapist (which I am one), a chiropractor, a neurologist, a neurosureon, a orthopedic surgeon, a radiologist, and a family doctor, And ask them what a herniated disc is: There is a good chance you will get seven different answers. My interpretation of the reporting is is that it is the mild version of the jelly donut analogy for what Markakis currently has. Hope that helps.

On a separate side note, a common miscommunication in medicine is that the difference between a sprain and strain. You sprain a Ligament. You strain a muscle. The easiest way to remember that is that a muscle is connected to bone by a tendon. Strain has a "T" init just like tendon starts with the Letter "T". Hope that helps.

I apologize for any typos secondary to doing this on my iPhone at lunch.

Awesome as always. Thanks for your input.

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By the way, if Markakis ends up on the DL to start the year, this bodes well for both Chris Dickeron and Jason Pridie. If Reimold is unable to play in the field, those two have the best opportunity to fill in. My guess is that Dickerson starts to get more playing time out there in Nick's absence. LJ Hoes could also see some time more time if RF over the next week or so.

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Reimold in RF, Davis at 1B. Last year we didn't have the luxury of having Reimold.

Really, Reimold who is still building strength in his left shoulder, can't throw because of his right shoulder and is hitting < .100 in ST. Had a good day today in intra-squad game, struck out 4 times and hit into a double play.

Reimold aint the answer.

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It's hard to read the tea leaves on this one.

First, Showalter told Brittany Ghiroli of MLB.com that the Orioles don?t feel Markakis' status for Opening Day is in question.

Next, he's already been out for a week for an injury that supposedly takes 7-10 days to heal yet today, he flew back to Baltimore to be re-examined by spine specialist Lee Riley.

Sorry, but I wouldn't be surprised to see him miss OD and see this turn out to be a nagging injury that bothers him throughout the upcoming season.

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Really, Reimold who is still building strength in his left shoulder, can't throw because of his right shoulder and is hitting < .100 in ST. Had a good day today in intra-squad game, struck out 4 times and hit into a double play.

Reimold aint the answer.

Firstly, he has 3 weeks to build strength in that shoulder until opening day.

Secondly, what do you mean he can't throw? He's played 3 of his 7 games in LF.

Thirdly, I'm assuming the rest of your argument doesn't hinge on his stats in 7 ST games.

I'll need a lot more of an argument before I accept "Reimold aint the answer"

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Guest rochester

Maybe I am totally wrong and off base for saying this, but the first thing that came to mind when his neck "tightness" came back on March 8 is this statement.Markakis' neck tightened up again yesterday while he played with his kids I have no med experience (and maybe the experts can hopefully tell me I am insane) but did this activity set him back and/or made it worse? If so, wouldn't it been prudent for his time with the kids not include something that involved the neck until he was back to (at least close) to 100%. And, no, I am not anti-Nick.

March 3 - Made aware on injury, will not play (BS "neck spasm")

March 6 - Nick Markakis isn't in the lineup again today, which comes as no surprise, and he told a couple of reporters this morning that he will "probably rule out tomorrow."

Markakis was scratched from Sunday's lineup because of stiffness in his neck. "It's better," Markakis said. "I'm close. A couple days, probably, and I'll try to get back in the swing of things

March 8 - Nick Markakis said his neck is feeling better and the stiffness is "slowly moving out," but he can't say for sure that he will return to the lineup Sunday.

Later on March 8 - Orioles right fielder Nick Markakis won't be in Sunday's lineup against the Pittsburgh Pirates at Ed Smith Stadium because of continuing stiffness in his neck.

Markakis' neck tightened up again yesterday while he played with his kids, according to manager Buck Showalter. He's better today - basically back to where he was two days ago - but the Orioles aren't taking any chances.

March 9 - The Orioles have scheduled an MRI on Monday for right fielder Nick Markakis to determine the cause of his neck stiffness.

Markakis didn't show much improvement today - he wakes up each morning with the same discomfort - and the Orioles have arranged an examination.

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Maybe I am totally wrong and off base for saying this, but the first thing that came to mind when his neck "tightness" came back on March 8 is this statement.Markakis' neck tightened up again yesterday while he played with his kids I have no med experience (and maybe the experts can hopefully tell me I am insane) but did this activity set him back and/or made it worse? If so, wouldn't it been prudent for his time with the kids not include something that involved the neck until he was back to (at least close) to 100%. And, no, I am not anti-Nick.

Markakis was probably balancing them on his chin. Bends his neck back, and bam!, pulled muscle. He gets to stay home, draw checks, and bang his wife. Frankly I am appalled a father would use his children for insurance fraud like that.

We should've stuck with Jay Gibbons.

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