PA-S | Ortho bro here to explain how injuries actually work and to share other health knowledge | Mechanisms, anatomy, timelines, never an official diagnosis
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Joined January 2024
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♀️Most women who get waved off in perimenopause are not dramatic.
A lot of clinicians were barely taught this. In one survey, only about 7% of medical residents felt prepared to manage menopause. About 20% got no lectures on it at all.
If you were told it was “just stress,” that can be a training gap. Not a personality flaw.
30-50% of concussions have associated neck pain or injury as well, wonder if he just goes through protocol anyway
Zach Hyman placed on IR from this hit and reportedly has a “stiff neck”
It still could be likely that this is treated as a concussion with a neck injury of some sorts involved
I am sure they looked for signs of unstable neck injury and red flag concussion
The neck may have undergone a strain of some sorts that has been causing the stiffness mentioned
Hyman could just go through concussion protocol at the same time he is healing the neck up
Fits a lower grade MCL sprain
Likely some sort of grade 1 MCL sprain for Marchenko given the mechanism and timeline
Given at the time of injury his skate was not stuck in the ice could have prevented an ACL injury with it
Grade 1 injuries have returned to play in as little as 10 days but Kirill will probably wait till he is pain free and feels stable
Fits a suspected MCL sprain
Likely some sort of grade 1 MCL sprain for Marchenko given the mechanism and timeline
Given at the time of injury his skate was not stuck in the ice could have prevented an ACL injury with it
Grade 1 injuries have returned to play in as little as 10 days but Kirill will probably wait till he is pain free and feels stable
30-50% of concussions have associated neck pain/injury so interested to see if he goes through the protocol anyway
Zach Hyman placed on IR from this hit and reportedly has a “stiff neck”
It still could be likely that this is treated as a concussion with a neck injury of some sorts involved
I am sure they looked for signs of unstable neck injury and red flag concussion
The neck may have undergone a strain of some sorts that has been causing the stiffness mentioned
Hyman could just go through concussion protocol at the same time he is healing the neck up
Up to 54% of concussions have associated neck pain/injury so wonder if he will go through the protocol anyway
Zach Hyman placed on IR from this hit and reportedly has a “stiff neck”
It still could be likely that this is treated as a concussion with a neck injury of some sorts involved
I am sure they looked for signs of unstable neck injury and red flag concussion
The neck may have undergone a strain of some sorts that has been causing the stiffness mentioned
Hyman could just go through concussion protocol at the same time he is healing the neck up
Up to 54% of concussions have neck pain too so could go through protocol still
Otherwise good news no major concussion
Could still just go through concussion protocol and be treated as such with an associated next injury
Zach Hyman placed on IR from this hit and reportedly has a “stiff neck”
It still could be likely that this is treated as a concussion with a neck injury of some sorts involved
I am sure they looked for signs of unstable neck injury and red flag concussion
The neck may have undergone a strain of some sorts that has been causing the stiffness mentioned
Hyman could just go through concussion protocol at the same time he is healing the neck up
Likely still treating and precautioning as a concussion in protocol
Zach Hyman placed on IR from this hit and reportedly has a “stiff neck”
It still could be likely that this is treated as a concussion with a neck injury of some sorts involved
I am sure they looked for signs of unstable neck injury and red flag concussion
The neck may have undergone a strain of some sorts that has been causing the stiffness mentioned
Hyman could just go through concussion protocol at the same time he is healing the neck up
Hoping for a quick recovery
Warren Foegele left the game with assistance last night after knee on knee contact
Lauzon’s knee seemed to strike Foegele’s knee on the outside more and causing that valgus stress that is seen very commonly in MCL sprains/tears
The knee did not seem to give as much as guys like Marchenko the other day which is promising but cannot rule out any ligament or meniscus injury of the knee
Any time there is a big blow like this it is important to rule out a tibial plateau fracture (pictured below) among other fractures, so X-Rays were likely taken
A simple contusion is a diagnosis of exclusion so we will wait to see Foegele’s timeline
Warren Foegele left the game with assistance last night after knee on knee contact
Lauzon’s knee seemed to strike Foegele’s knee on the outside more and causing that valgus stress that is seen very commonly in MCL sprains/tears
The knee did not seem to give as much as guys like Marchenko the other day which is promising but cannot rule out any ligament or meniscus injury of the knee
Any time there is a big blow like this it is important to rule out a tibial plateau fracture (pictured below) among other fractures, so X-Rays were likely taken
A simple contusion is a diagnosis of exclusion so we will wait to see Foegele’s timeline
Zach Hyman placed on IR from this hit and reportedly has a “stiff neck”
It still could be likely that this is treated as a concussion with a neck injury of some sorts involved
I am sure they looked for signs of unstable neck injury and red flag concussion
The neck may have undergone a strain of some sorts that has been causing the stiffness mentioned
Hyman could just go through concussion protocol at the same time he is healing the neck up
The Body Explained | Hockey Injuries retweeted
Likely some sort of grade 1 MCL sprain for Marchenko given the mechanism and timeline
Given at the time of injury his skate was not stuck in the ice could have prevented an ACL injury with it
Grade 1 injuries have returned to play in as little as 10 days but Kirill will probably wait till he is pain free and feels stable
🚨 A group of Leafs fans bumped into Kirill Marchenko at the Calgary airport today, where he told them he was “flying back home today” and will be back in “two weeks.”
As of now, no official confirmation has been made by the Leafs (should know more tomorrow)
📸: @Alwaysbardown1
#leafs
The Body Explained | Hockey Injuries retweeted
Jack Hughes⬇️
Chipped teeth are practically a hockey rite of passage as Jack Hughes here would say 🏒🦷
But here’s the anatomy + physiology behind how they get fixed.
🦷 What Happens When a Tooth Chips?
Teeth have layers:
1.Enamel – Hard, mineralized outer shell (no nerves, no blood supply)
2.Dentin – Softer layer underneath, contains microscopic tubules connected to nerves
3.Pulp – Central core with blood vessels and nerves
If the chip is:
•Enamel only → cosmetic issue, usually painless
•Into dentin → sensitivity to air/cold (fluid shifts in dentinal tubules stimulate pulp nerves)
•Into pulp → bleeding, significant pain, infection risk
🏒 How Does It Get Fixed?
1️⃣ Evaluation
Team dentist checks depth of fracture and maybe an X-ray to assess pulp involvement.
2️⃣ Enamel/Dentin Chip
Most common in hockey.
•Smoothed or rebuilt with composite resin bonding
•Resin chemically bonds to enamel via acid etching
•Light-cured to harden
Function restored immediately.
3️⃣ If Pulp Is Exposed
•Root canal: Remove inflamed pulp, disinfect canal, fill with gutta-percha
•Crown may be placed later for structural strength
🧠 Physiology Pearl
Dentin hypersensitivity happens because exposed dentinal tubules allow fluid movement which triggers mechanoreceptors in the pulp (hydrodynamic theory).
Jack Hughes⬇️
Chipped teeth are practically a hockey rite of passage as Jack Hughes here would say 🏒🦷
But here’s the anatomy + physiology behind how they get fixed.
🦷 What Happens When a Tooth Chips?
Teeth have layers:
1.Enamel – Hard, mineralized outer shell (no nerves, no blood supply)
2.Dentin – Softer layer underneath, contains microscopic tubules connected to nerves
3.Pulp – Central core with blood vessels and nerves
If the chip is:
•Enamel only → cosmetic issue, usually painless
•Into dentin → sensitivity to air/cold (fluid shifts in dentinal tubules stimulate pulp nerves)
•Into pulp → bleeding, significant pain, infection risk
🏒 How Does It Get Fixed?
1️⃣ Evaluation
Team dentist checks depth of fracture and maybe an X-ray to assess pulp involvement.
2️⃣ Enamel/Dentin Chip
Most common in hockey.
•Smoothed or rebuilt with composite resin bonding
•Resin chemically bonds to enamel via acid etching
•Light-cured to harden
Function restored immediately.
3️⃣ If Pulp Is Exposed
•Root canal: Remove inflamed pulp, disinfect canal, fill with gutta-percha
•Crown may be placed later for structural strength
🧠 Physiology Pearl
Dentin hypersensitivity happens because exposed dentinal tubules allow fluid movement which triggers mechanoreceptors in the pulp (hydrodynamic theory).
Ah shit here we go again
Chipped teeth are practically a hockey rite of passage as Jack Hughes here would say 🏒🦷
But here’s the anatomy + physiology behind how they get fixed.
🦷 What Happens When a Tooth Chips?
Teeth have layers:
1.Enamel – Hard, mineralized outer shell (no nerves, no blood supply)
2.Dentin – Softer layer underneath, contains microscopic tubules connected to nerves
3.Pulp – Central core with blood vessels and nerves
If the chip is:
•Enamel only → cosmetic issue, usually painless
•Into dentin → sensitivity to air/cold (fluid shifts in dentinal tubules stimulate pulp nerves)
•Into pulp → bleeding, significant pain, infection risk
🏒 How Does It Get Fixed?
1️⃣ Evaluation
Team dentist checks depth of fracture and maybe an X-ray to assess pulp involvement.
2️⃣ Enamel/Dentin Chip
Most common in hockey.
•Smoothed or rebuilt with composite resin bonding
•Resin chemically bonds to enamel via acid etching
•Light-cured to harden
Function restored immediately.
3️⃣ If Pulp Is Exposed
•Root canal: Remove inflamed pulp, disinfect canal, fill with gutta-percha
•Crown may be placed later for structural strength
🧠 Physiology Pearl
Dentin hypersensitivity happens because exposed dentinal tubules allow fluid movement which triggers mechanoreceptors in the pulp (hydrodynamic theory).
Here we go again
Chipped teeth are practically a hockey rite of passage as Jack Hughes here would say 🏒🦷
But here’s the anatomy + physiology behind how they get fixed.
🦷 What Happens When a Tooth Chips?
Teeth have layers:
1.Enamel – Hard, mineralized outer shell (no nerves, no blood supply)
2.Dentin – Softer layer underneath, contains microscopic tubules connected to nerves
3.Pulp – Central core with blood vessels and nerves
If the chip is:
•Enamel only → cosmetic issue, usually painless
•Into dentin → sensitivity to air/cold (fluid shifts in dentinal tubules stimulate pulp nerves)
•Into pulp → bleeding, significant pain, infection risk
🏒 How Does It Get Fixed?
1️⃣ Evaluation
Team dentist checks depth of fracture and maybe an X-ray to assess pulp involvement.
2️⃣ Enamel/Dentin Chip
Most common in hockey.
•Smoothed or rebuilt with composite resin bonding
•Resin chemically bonds to enamel via acid etching
•Light-cured to harden
Function restored immediately.
3️⃣ If Pulp Is Exposed
•Root canal: Remove inflamed pulp, disinfect canal, fill with gutta-percha
•Crown may be placed later for structural strength
🧠 Physiology Pearl
Dentin hypersensitivity happens because exposed dentinal tubules allow fluid movement which triggers mechanoreceptors in the pulp (hydrodynamic theory).
Ah shit here we go again
Chipped teeth are practically a hockey rite of passage as Jack Hughes here would say 🏒🦷
But here’s the anatomy + physiology behind how they get fixed.
🦷 What Happens When a Tooth Chips?
Teeth have layers:
1.Enamel – Hard, mineralized outer shell (no nerves, no blood supply)
2.Dentin – Softer layer underneath, contains microscopic tubules connected to nerves
3.Pulp – Central core with blood vessels and nerves
If the chip is:
•Enamel only → cosmetic issue, usually painless
•Into dentin → sensitivity to air/cold (fluid shifts in dentinal tubules stimulate pulp nerves)
•Into pulp → bleeding, significant pain, infection risk
🏒 How Does It Get Fixed?
1️⃣ Evaluation
Team dentist checks depth of fracture and maybe an X-ray to assess pulp involvement.
2️⃣ Enamel/Dentin Chip
Most common in hockey.
•Smoothed or rebuilt with composite resin bonding
•Resin chemically bonds to enamel via acid etching
•Light-cured to harden
Function restored immediately.
3️⃣ If Pulp Is Exposed
•Root canal: Remove inflamed pulp, disinfect canal, fill with gutta-percha
•Crown may be placed later for structural strength
🧠 Physiology Pearl
Dentin hypersensitivity happens because exposed dentinal tubules allow fluid movement which triggers mechanoreceptors in the pulp (hydrodynamic theory).
Likely some sort of grade 1 MCL sprain for Marchenko given the mechanism and timeline
Given at the time of injury his skate was not stuck in the ice could have prevented an ACL injury with it
Grade 1 injuries have returned to play in as little as 10 days but Kirill will probably wait till he is pain free and feels stable
🚨 A group of Leafs fans bumped into Kirill Marchenko at the Calgary airport today, where he told them he was “flying back home today” and will be back in “two weeks.”
As of now, no official confirmation has been made by the Leafs (should know more tomorrow)
📸: @Alwaysbardown1
#leafs
The Body Explained | Hockey Injuries retweeted
Sam Steel of the Stars received an “injection as part of his treatment”
What does that mean?
It could mean several things
Most often, this means a corticosteroid injection. Corticosteroid injections switches off inflammatory genes which reduces pain and swelling. The steroid takes effect over a few days, and a "steroid flare" (more pain for 24–48 hours) can happen first. I have been giving a ton of these on my current school rotation
The trade-off is that inflammation is part of normal healing, so suppressing it may in theory slow repair.
🚨The steroid also does not reverse structural damage! An injection does not repair tissue.
Other possibilities are platelet-rich plasma (PRP) or an anesthetic-only diagnostic injection.
Diagnostic anesthetic injection involves numbing a specific spot, such as the hip joint, helps identify the pain source. If pain goes away, the joint is the likely source.
PRP is when the player's own concentrated platelets are injected to try to stimulate healing. It has been tried for adductor injuries that don't respond to rehab, but evidence is limited (@DrJesseMorse is a good follow for this stuff)
What does this tell us in Steel’s case?
Steroid injection directly into a fresh muscle tear is controversial, so this injection 2 days after an injury points to something to more than a simple tear
Bursitis or tendon irritation respond well to injections, and can lead to a return of play in as little as a week
Reviews note that a midseason corticosteroid injection may be considered specifically to speed return to play for players with recurrent pain. Steele had a hip/groin issue this March, so this is very much in play
Overall, a quick return (days to about 2 weeks) suggests the injection was used to manage pain or inflammation in a minor or chronic problem so he can keep playing.
A longer absence suggests the injection was diagnostic or supportive alongside a real structural injury.
