Tyrone Mings

[The_Steve]

28 minutes ago, Deano & Dalian's Umbrella said:

 

I swore I would never post on here about injuries again because I get so many sarcastic replies but when someone asks a question, I like to answer so:

99% of the time, this is a one-off acute injury that is not something waiting to happen.

The injury might look innocuous to you but the position that Mings' knee went in to - dynamic lower extremity valgus (knocked knee position) is the most common mechanism of injury for ACL injury.

And you can tell it is an ACL injury from how his knee joint moved out of place and then suddenly clunked back into position (called the pivot shift phenomenon)

The cases I know of where this injury was an accident waiting to happen is where people have gradually and repeatedly stretched the ACL out over time by hyperextending (over-straigthening) the knee. 

A famous case is Tiger Woods who used to purposely snap his knee into hyperextension when driving (a golf ball not a car) to get more distance and eventually it stretched out that much it was useless.

I also had a kickboxer patient who did the same on both knees.

Having said that, there are a number of proposed and not entirely well-understood risk factors that can make someone more predisposed to ACL injury (women in particular). These can involve anatomical variations and muscle imbalances and biomechanical variabilities.  

Given that FIFA have an exercise programme to try and reduce ACL injury risk that has been used with kids for years, I'm sure efforts would be made by the medical and coaching staff to minimise the risk of such injuries so I wouldn't put any blame there.

Finally, to ward off the usual sarcastic responses, I have degrees in physiotherapy and sports medicine, have worked as a physio at Villa and other clubs, and have published several papers on ACL injury in different journals including the British Journal of Sports Medicine.

I have not wanted to say this before but last time I posted about Carlos' injury and said tendon ruptures were, unlike ACL injuries, not one-off bad luck injuries but caused by overuse and degeneration, nobody would have any of it, so that is why I'm saying it now.

 

 

 

Just wanted to say thank you and appreciate your insights

[tomav84]

30 minutes ago, Deano & Dalian's Umbrella said:

 

I swore I would never post on here about injuries again because I get so many sarcastic replies but when someone asks a question, I like to answer so:

99% of the time, this is a one-off acute injury that is not something waiting to happen.

The injury might look innocuous to you but the position that Mings' knee went in to - dynamic lower extremity valgus (knocked knee position) is the most common mechanism of injury for ACL injury.

And you can tell it is an ACL injury from how his knee joint moved out of place and then suddenly clunked back into position (called the pivot shift phenomenon)

The cases I know of where this injury was an accident waiting to happen is where people have gradually and repeatedly stretched the ACL out over time by hyperextending (over-straigthening) the knee. 

A famous case is Tiger Woods who used to purposely snap his knee into hyperextension when driving (a golf ball not a car) to get more distance and eventually it stretched out that much it was useless.

I also had a kickboxer patient who did the same on both knees.

Having said that, there are a number of proposed and not entirely well-understood risk factors that can make someone more predisposed to ACL injury (women in particular). These can involve anatomical variations and muscle imbalances and biomechanical variabilities.  

Given that FIFA have an exercise programme to try and reduce ACL injury risk that has been used with kids for years, I'm sure efforts would be made by the medical and coaching staff to minimise the risk of such injuries so I wouldn't put any blame there.

Finally, to ward off the usual sarcastic responses, I have degrees in physiotherapy and sports medicine, have worked as a physio at Villa and other clubs, and have published several papers on ACL injury in different journals including the British Journal of Sports Medicine.

I have not wanted to say this before but last time I posted about Carlos' injury and said tendon ruptures were, unlike ACL injuries, not one-off bad luck injuries but caused by overuse and degeneration, nobody would have any of it, so that is why I'm saying it now.

 

 

 

really appreciate the insight. do you have any estimates of recovery time for such an injury?

[The Fun Factory]

Having been through 2 bad injuries Mings must have known it was a bad one straight away. Gutting for the lad.

[Sulberto21]

@Deano & Dalian's Umbrella thanks for your insight. 

[Deano & Dalian's Umbrella]

5 minutes ago, tomav84 said:

really appreciate the insight. do you have any estimates of recovery time for such an injury?

Although about 15 years ago people were messing about with getting people back in 4 months, it seems to have gone back to more what it was before then which is 6-8 months.

I am a bit cautious so would be aiming for back to training at 6 months and playing at 8 but people have got back in 6.

However, I was surprised by how much pain Mings was in, which could suggest he has done more than his ACL.  If other ligaments have been badly injured, it is going to be longer than that.

I would like to know how quickly his pain settled down because ACL injuries normally hurt when you do them but can settle relatively  quickly because the ligament is completely ruptured and there is nothing to "pull" when you move. . Okore is an example of many who go back on and try to continue.

The final thing is that the irony is that there are professional athletes who have coped without an ACL and didn't need surgery and came back much quicker.

In the past, there were tales of New Zealand all blacks with no ACLs and I heard from someone at Wolves that one of our ex-players in the 80s/90s went in for a small knee operation only to find out he'd ruptured his ACL at Villa and never knew. And he was pacey and a dribbler.

The problem is you can't predict accurately who doesn't need surgery and clubs won't risk several months of rehab to then have a player need surgery anyway, so all pro athletes have ACL surgery now whether they need it or not.

[Vive_La_Villa]

Like all fans gutted by this and for Mings. But from a team perspective what seemed like one of strongest areas was further strengthened by the signing of Pau Torres.  What a massive signing this could turn out to be now. 
 

[Dodgyknees]

We love him  

[GREAT_BEARD_OF_ZEUS]

19 minutes ago, Deano & Dalian's Umbrella said:

Although about 15 years ago people were messing about with getting people back in 4 months, it seems to have gone back to more what it was before then which is 6-8 months.

I am a bit cautious so would be aiming for back to training at 6 months and playing at 8 but people have got back in 6.

However, I was surprised by how much pain Mings was in, which could suggest he has done more than his ACL.  If other ligaments have been badly injured, it is going to be longer than that.

I would like to know how quickly his pain settled down because ACL injuries normally hurt when you do them but can settle relatively  quickly because the ligament is completely ruptured and there is nothing to "pull" when you move. . Okore is an example of many who go back on and try to continue.

The final thing is that the irony is that there are professional athletes who have coped without an ACL and didn't need surgery and came back much quicker.

In the past, there were tales of New Zealand all blacks with no ACLs and I heard from someone at Wolves that one of our ex-players in the 80s/90s went in for a small knee operation only to find out he'd ruptured his ACL at Villa and never knew. And he was pacey and a dribbler.

The problem is you can't predict accurately who doesn't need surgery and clubs won't risk several months of rehab to then have a player need surgery anyway, so all pro athletes have ACL surgery now whether they need it or not.

Thanks D&DU much appreciated insight as others have said.

One last question if you permit… in your professional opinion, considering Tyrones physique and age, do you think he’ll come back at the same level he was performing to pre Saturday’s injury?

 

[briny_ear]

1 hour ago, Deano & Dalian's Umbrella said:

 

I swore I would never post on here about injuries again because I get so many sarcastic replies but when someone asks a question, I like to answer so:

99% of the time, this is a one-off acute injury that is not something waiting to happen.

The injury might look innocuous to you but the position that Mings' knee went in to - dynamic lower extremity valgus (knocked knee position) is the most common mechanism of injury for ACL injury.

And you can tell it is an ACL injury from how his knee joint moved out of place and then suddenly clunked back into position (called the pivot shift phenomenon)

The cases I know of where this injury was an accident waiting to happen is where people have gradually and repeatedly stretched the ACL out over time by hyperextending (over-straigthening) the knee. 

A famous case is Tiger Woods who used to purposely snap his knee into hyperextension when driving (a golf ball not a car) to get more distance and eventually it stretched out that much it was useless.

I also had a kickboxer patient who did the same on both knees.

Having said that, there are a number of proposed and not entirely well-understood risk factors that can make someone more predisposed to ACL injury (women in particular). These can involve anatomical variations and muscle imbalances and biomechanical variabilities.  

Given that FIFA have an exercise programme to try and reduce ACL injury risk that has been used with kids for years, I'm sure efforts would be made by the medical and coaching staff to minimise the risk of such injuries so I wouldn't put any blame there.

Finally, to ward off the usual sarcastic responses, I have degrees in physiotherapy and sports medicine, have worked as a physio at Villa and other clubs, and have published several papers on ACL injury in different journals including the British Journal of Sports Medicine.

I have not wanted to say this before but last time I posted about Carlos' injury and said tendon ruptures were, unlike ACL injuries, not one-off bad luck injuries but caused by overuse and degeneration, nobody would have any of it, so that is why I'm saying it now.

 

 

 

I’m disappointed that anyone might respond to information like this with sarcasm, and puzzled really as to what form such sarcasm could take. Thanks for the info anyway.

[briny_ear]

Totally gutted for Tyrone, he is such a good guy and plays such ann important role in the team.

Fingers crossed for a successful recovery.

[ozvillafan]

Crap. Gutted for Ty.

[Deano & Dalian's Umbrella]

1 minute ago, briny_ear said:

I’m disappointed that anyone might respond to information like this with sarcasm, and puzzled really as to what form such sarcasm could take. Thanks for the info anyway.

It has normally been comments inferring that I'm just someone on an internet forum  pretending I know what I'm talking about, to the tune of "it's amazing how many sports medicine experts we have on here".

I'm not asking people to take what I say as gospel but when you're just trying to answer someone's question, it can be a bit annoying to be accused of making it up.

 

[Rightdm00]

Here's hoping the deleting of his Instagram content is the signaling of a new beginning and not something more dark. I was a very active person before I had a major knee injury and ended up having to see a therapist because football and other sports were such a key part of my life. Injuries create an obvious physical toll but the mental one can go undetected by most outside observers. I guess what im saying is every bit of positivity directed towards Mings probably helps. He has a long road back and will need each push to get through some tough times ahead. 

[YLN]

35 minutes ago, Deano & Dalian's Umbrella said:

Although about 15 years ago people were messing about with getting people back in 4 months, it seems to have gone back to more what it was before then which is 6-8 months.

I am a bit cautious so would be aiming for back to training at 6 months and playing at 8 but people have got back in 6.

However, I was surprised by how much pain Mings was in, which could suggest he has done more than his ACL.  If other ligaments have been badly injured, it is going to be longer than that.

I would like to know how quickly his pain settled down because ACL injuries normally hurt when you do them but can settle relatively  quickly because the ligament is completely ruptured and there is nothing to "pull" when you move. . Okore is an example of many who go back on and try to continue.

The final thing is that the irony is that there are professional athletes who have coped without an ACL and didn't need surgery and came back much quicker.

In the past, there were tales of New Zealand all blacks with no ACLs and I heard from someone at Wolves that one of our ex-players in the 80s/90s went in for a small knee operation only to find out he'd ruptured his ACL at Villa and never knew. And he was pacey and a dribbler.

The problem is you can't predict accurately who doesn't need surgery and clubs won't risk several months of rehab to then have a player need surgery anyway, so all pro athletes have ACL surgery now whether they need it or not.

I posted this before, but Mings' looked like Owen's. Maybe less severe. The unhappy triad. It's the injury I got skiing and my knee went over like Owen's. I also had a segond fracture. 

During my rehab I watched this video of Owen over and over and it made my stomach turn. Like licking a pizza burn on the roof of your mouth 

 

[The_Steve]

2 minutes ago, Rightdm00 said:

Here's hoping the deleting of his Instagram content is the signaling of a new beginning and not something more dark. I was a very active person before I had a major knee injury and ended up having to see a therapist because football and other sports were such a key part of my life. Injuries create an obvious physical toll but the mental one can go undetected by most outside observers. I guess what im saying is every bit of positivity directed towards Mings probably helps. He has a long road back and will need each push to get through some tough times ahead. 

He’s just posted again. Probably wanted to step back which is totally understandable. He’s thanked us and Newcastle staff on Twitter which is as classy as you’d expect from Ty. 

[Deano & Dalian's Umbrella]

20 minutes ago, GREAT_BEARD_OF_ZEUS said:

Thanks D&DU much appreciated insight as others have said.

One last question if you permit… in your professional opinion, considering Tyrones physique and age, do you think he’ll come back at the same level he was performing to pre Saturday’s injury?

 

This is a really difficult one.

I'm always amazed when people who have ACL surgery and so long out do come back at such a high level.

If you just read the "abstract" (summary) of this study, you'll see that players often do not return at the same level as before , although a word of caution is that this involves data going back to the mid 90s.

https://www.sciencedirect.com/science/article/pii/S0968016018302187

Mings' physique and fitness is a definite plus.

His age is against him in terms of it then taking time once back to try and gradually get back to where he was.

But the biggest factor will be injuries to other major structures rather than just ACL - you are then entering Wesley territory.

 

 

Edited August 14, 2023 by Deano & Dalian's Umbrella

[Robtaylor200]

I don't mean to sound stupid to those that know. But I will ask anyway. How does insurance work in this case.  Do the club make a claim to pay wages, can Tyrone claim to cover earnings and potential earnings

[Deano & Dalian's Umbrella]

18 minutes ago, YLN said:

I posted this before, but Mings' looked like Owen's. Maybe less severe. The unhappy triad. It's the injury I got skiing and my knee went over like Owen's. I also had a segond fracture. 

During my rehab I watched this video of Owen over and over and it made my stomach turn. Like licking a pizza burn on the roof of your mouth 

 

 

You are right that this is similar - you can also see the "pivot shift" mechanism here.

When you rupture the ACL, the femur (thigh bone) moves out of place on the tibia (shin bone) but the bones suddenly clunk back into place.

With Owen, his foot is still on the floor so his femur clunks forwards.

With Mings, his foot was coming off the floor so his tibia clunks backwards.

The term "pivot shift" is normally used to refer to a test that surgeons do to produce this clunk and diagnose ACL injury but the same clunk is what you are seeing here.

I'm probably going overboard here, but just in case anyone is interested, here is an article about what causes or stops a pivot shift.

https://link.springer.com/article/10.1007/s00167-011-1866-5

Edited August 14, 2023 by Deano & Dalian's Umbrella

[YLN]

1 minute ago, Deano & Dalian's Umbrella said:

 

You are right that this is similar - you can also see the "pivot shift" mechanism here.

When you rupture the ACL, the femur (thigh bone) moves out of place on the tibia (shin bone) but the bones suddenly clunk back into place.

With Owen, his foot is still on the floor so his femur clunks forwards.

With Mings, his foot was coming off the floor so his tibia clunks backwards.

The term "pivot shift" is normally used to refer to a test that surgeons do to produce this clunk and diagnose ACL injury but the same clunk is what you are seeing here.

I'm probably going overboard here, but just in case anyone is interested, here is an article about what causes or stops a pivot shift.

https://link.springer.com/article/10.1007/s00167-011-1866-5

Do you think it could be PCL then? 

[Hank Scorpio]

33 minutes ago, briny_ear said:

I’m disappointed that anyone might respond to information like this with sarcasm, and puzzled really as to what form such sarcasm could take. Thanks for the info anyway.

Because people only want to believe news when it's good.