00:00So much talk about Jaden Daniels dealing with this dislocated elbow injury
00:03to his non-throwing arm again, and there's a real conversation
00:07if you could just put a brace on it and get him back out there and play ball.
00:12I thought it would be really valuable for us to have a conversation with an expert.
00:17Dr. Akshay Garg is a double board certified interventional pain management physician.
00:25He runs the Capital Interventional Pain and Spine Center in Rockville.
00:30Doctor, how are you? Thank you for making time for us.
00:33Good, guys. How are you doing?
00:34We're good, brother.
00:35We're good, dude.
00:36So let's start with, I mean, Jaden has now suffered this injury twice in the span of about 10 months,
00:43this dislocated non-throwing arm.
00:46Every time, both times it's happened, it has looked gruesome.
00:51What do you make of this injury happening again?
00:55Yeah, it's worrisome because it's the same elbow.
00:58So, you know, when it happens the first time, it happens to a lot of players,
01:02but with the right rehab, usually they can avoid surgery and come back.
01:06But when it happens the second time, you're really worried about, you know,
01:09is this thing unstable?
01:11But they're saying there's no ligament damage, there's no fracture.
01:14Sure. So the big question that a lot of fans, and fans aren't doctors and you are,
01:19is like, what are, how possible is it that they could create some kind of brace for him
01:26that gives it some stability and he can be back on the field sooner than later?
01:32So it's not as crazy as it sounds, this, you know, Jaden's elbow has been reduced
01:37and there's no fracture and if the joint's stable, you can absolutely put him in a hinge brace,
01:43manage the pain and potentially let him play.
01:45And like you mentioned, JP, it's his non-throwing arm,
01:47so the elbow doesn't have to be perfect for him to throw the football.
01:51But, you know, you don't want him to push through or play through the pain.
01:56Pain really won't be his issue.
01:57You can treat pain, the question is, is the elbow going to be stable enough
02:01or is he going to be causing more additional damage if he plays on it?
02:05Actually, are there any braces out there that puts more, I guess, support on the joint area?
02:13Because he had a brace on last year, it was very bulky, it kept sliding, he didn't like it.
02:18And I'm sure that's, and that's why most athletes don't like stuff
02:21because they don't feel comfortable.
02:23Are there any, I mean, are there any braces out there now
02:27that are more sleek but still as strong as any?
02:32No, I mean, that's a good question.
02:34I think, you know, most of these braces, the bulkier they are,
02:37the more protection they're going to have.
02:39And, you know, the other thing with these braces, remember,
02:42is they're usually hinge braces.
02:44So if he's extending his elbow and it's starting to dislocate,
02:48they'll usually just put a hinge on that degree, let's say he's at 30 degrees,
02:52and then it'll prevent him from going past 30 degrees,
02:55which, as you can imagine, you know, Jaden being such a mobile quarterback,
02:59that can itself be an issue.
03:02You know, is he going to be able to take snaps, hand off, secure the ball,
03:05tolerate contact, protect himself?
03:08And I think in Dallas you saw that, right?
03:10On the first half he was protecting himself, sliding.
03:13I think he was doing all the right stuff.
03:15So I feel like if he were to wear a brace, he's a very smart quarterback,
03:19and I think he'd be able to, you know, handle it without an issue.
03:23So what is – it's easy for us to say pain management sitting on the sidelines.
03:28Brian played it.
03:28He knows what pain management means.
03:30Like scale of 1 to 10, 1 to 100, however you break that stuff down,
03:35what type of pain are we talking about for Jaden?
03:38Like how long does he have to sit just coming off this dislocation?
03:42And even if they – and I know Jaden well enough, he wants to play,
03:45and he will explore the fastest path to playing.
03:49But what type of pain are we talking about for this young man?
03:53So, you know, ironically, right, so I'm a pain doctor,
03:57but ironically the pain is the easy part of the discussion.
03:59Most of the pain is at that initial dislocation.
04:02So when that elbow joint pops out and yanks on the ligaments,
04:06those stretch receptors can cause quite a bit of pain.
04:09And then once you reduce it, the pain can reduce dramatically.
04:14Whatever is left over, you know, inflammation, soft tissue swelling,
04:17usually they can handle it with different anti-inflammatories.
04:21You know, if he needs an injection, then maybe they'll consider that.
04:25But the other thing to keep in mind is, you know, these elite level athletes,
04:29like JP, if you and me had an elbow dislocation, I don't know about you,
04:32I'd be out of commission for like a year, but be niche, right?
04:36They'd heal up and, you know, they bounce back pretty quickly.
04:39So it's interesting they're not placing him on IR.
04:42So you wonder, you know, do they expect he'll be back in a couple of weeks
04:46if the elbow heals up enough?
04:49How significant do you think the odds are for surgery, though?
04:53And what would, if you have to get surgery, what would that timeline be like?
04:57Yeah, that's the golden question.
05:00So, you know, does he just do surgery now if he's got a lot of ligament damage
05:05and be out for the season?
05:06Because that will take several months.
05:09Or does he brace it, handle the pain, you know, and play?
05:14And then potentially think about surgery in the offseason.
05:17I think if he does do it in the offseason, I think he'll have time to come back.
05:21We've seen it before.
05:22You know, people have had these types of elbow surgeries,
05:25which luckily are pretty successful.
05:28I think we're going to throw the doc on hold real quick because I wanted to hear
05:31that answer is just cutting it out pretty good.
05:33Yeah, I wonder, what's the normal time limit from surgery to back out there?
05:40Well, and I also wonder if it's like, if you could try this brace thing now,
05:46and whatever now is, I want to ask that.
05:49Like, does now – all right, doc, I think we've got you back.
05:52You were saying kind of the surgery could require months and months
05:56and where that would go from there, right?
06:00Yeah, yeah, that's the question.
06:03Should he – one is should he do it?
06:05You know, what does the MRI show?
06:06How bad are the ligaments?
06:07And if he does need to do it, you know, that's basically the season.
06:12So, you know, it's tough for me because I'm also a big fan,
06:16so I want my guy back out there when it's safe.
06:18But you have to ask yourself, are we thinking about, you know,
06:23the franchise quarterback, the longevity of his career?
06:26Does it get to a point where they have to have the surgery?
06:29And what – I don't know if you know or not.
06:31What goes into a surgery to stabilize it?
06:34Because I don't think there's anything you can do that can stop it from happening
06:39if it's bent the wrong way.
06:41Yeah, like would the surgery 100% prevent it from happening again?
06:44No, no, that's the thing.
06:47You're exactly right, B. Mitch.
06:48Like, if he gets surgery, whether they reconstruct or repair the tendon,
06:53if he has an awkward fall or, you know, you got 200, 300-pound linemen falling on him,
07:00it's not going to be a 100% thing.
07:02So that's the importance to think about.
07:04There's no guarantees with those.
07:07The question is, is it unstable?
07:09So if it's unstable, then I think the specialists that he's seeing may really recommend it.
07:17Talking with Dr. Akshay Garg here, who is an interventional pain management physician
07:22and kind of understands how this thing could move forward.
07:26Doc, if they're going to try the pain management technique and brace this thing,
07:32how much time does he need from that initial dislocation,
07:35from last Sunday in Philly until he's able to get on the field and try this?
07:40Because I'm sure there's swelling.
07:41Like, when you see what we saw in Dallas, when that elbow pops in the wrong way,
07:45he obviously needs some time to recuperate from that.
07:48What is that period like?
07:50Yeah, that's probably, you're looking at anywhere from two to four weeks.
07:54Similar to last year, when he had his first one.
07:56I think he was out about three weeks before he came back,
07:59and then, you know, unfortunately hurt it again.
08:02But for someone like him, I wouldn't be surprised if the swelling and pain
08:06dramatically reduces over the next month.
08:08So do you think the brace and pain management is a realistic play for where he is?
08:16Yeah, I think that, you know, if you're telling me there's no fracture
08:21and it doesn't look like theirs and the specialists think that his elbow is stable,
08:25then I think he can function in the brace.
08:27I think, you know, he might play through some discomfort, and that's medically plausible.
08:32But, you know, if you're asking me, should he use pain medication in a brace
08:36to compensate for an unstable elbow, then that's a totally different story.
08:39I don't know if I would do that.
08:42Yeah.
08:42All right, last one, Doc.
08:43And this might be a little bit of a wacky.
08:45But, like, I know my mother-in-law got a knee replacement.
08:49Like, I know people get knee and hip replacements all the time.
08:53Could he get an elbow replacement and just put, like, a new bionic joint in his left elbow?
08:57And not have to worry about this?
08:59And maybe that's in the offseason.
09:02Nah, bro.
09:03You're talking about when he's done with football.
09:04I'm asking.
09:05Oh, man.
09:06That's a living stretch, right, Jay?
09:08You seem to look crazy right there.
09:09You know, my kid said that there's one of the Avengers with the metal arm,
09:13and my kid was like, oh, can't he just do that?
09:15And he'd be unstoppable.
09:18Is that not accurate?
09:19No.
09:20You're saying I have the same idea as your child?
09:22No, no, no, no.
09:23Yeah, sort of.
09:27So that's not possible.
09:29Yeah, I think that would be – he won't need it.
09:34You know, at the most, they'll probably just repair the tendon,
09:36and those surgeries can be really successful.
09:39So he probably won't need anything crazy.
09:42So –
09:43I want the $6 million man on the team, man.
09:45And the $5 million man.
09:47B is hellbent on this notion of a magnesium brace.
09:50What does that mean?
09:52Yeah, there's some other braces that, you know, can help with inflammation and swelling,
09:58and magnesium has gotten pretty popular nowadays.
10:02I don't know if there's a ton of data behind it, but it certainly won't hurt him, you know,
10:06if they end up doing that.
10:07But his main thing is going to be hinging it.
10:10So, you know, because if he extends it and it starts popping out, that's when you're in trouble.
10:15Yeah, yeah.
10:16All right.
10:16So, I mean, in your medical opinion, and granted you haven't seen him direct,
10:19but the brace – two to four weeks, let the swelling go down, whatever it is,
10:23and then try to brace this thing seems somewhat realistic.
10:27Yeah, yeah.
10:28I think it's good news that there's no fracture,
10:32and it'll be interesting to see what the specialists say.
10:35But, you know, he's tough, and I think he's worked really hard in the offseason
10:39to get ready for this year.
10:41And I think if we're lucky, then two to four weeks,
10:46you might see him back on the field with the brace on.
10:49All right.
10:49All right, man.
10:50Doctor, thank you for the time.
10:51It'll be cool, brother.
10:51We appreciate it.
10:52All right.
10:53Yep.
10:53Thanks, guys.
