Wednesday, April 4, 2012

What Is Really Up With Chase Utley

On Tuesday, reported that Philadelphia Phillies’ second baseman Chase Utley will be leaving the club and returning to Arizona to work with his physical therapist.
Utley will be rehabbing his degenerative knees with the same therapist that he went to see earlier this spring.  Ruben Amaro Jr., Philadelphia’s General Manager, spoke on the topic.
"He's been progressing pretty well, but he has to build on the progression," Amaro said. "He's going to go back and see Brett Fischer in Arizona and then he's going to meet the club when we go out to the West Coast. I'm not sure quite how long he's going to be there, but it's kind of more intensive one-on-one work."
The West Coast trip Amaro is alluding to will run from April 16-25 when the Phils visit the Giants, Padres and Diamondbacks.
Last year Utley was limited to 103 games, his fewest since taking over full time in 2005, and did not play his first game until May 23.  Though he did miss the first month and a half, only twice after he resumed playing (once was the All-Star weekend) did he sit out more than two days.
Still, Utley’s knee problems have not gone away and seem to be getting worse with time.  Whereas last year the problems were mostly with his right knee, things have changed this year.  Last week ESPN’s Jayson Stark published an article in which Utley seemed ‘a little worried’ about his future.

While Utley expressed optimism about his long-term future, he admitted he was "disappointed, upset and not happy" about the unexpected problems that developed this spring in his left knee.

"My right knee last year was the one that bothered me and my left knee felt pretty good," he said of the injury that landed him on the disabled list for two months last season. "This year, it's the complete opposite."

Stark went on to report…

Utley also disputed that he was suffering from patellar tendonitis, despite the fact that Philadelphia's team doctor, Michael Cicotti, made that diagnosis a year ago.
Cicotti said in a statement last spring that Utley was dealing with patellar
tendonitis, chondromalacia and bone inflammation.

"I don't have patellar tendonitis," Utley said Sunday. "What it's called is chondromalacia, which is a little ruffling of the cartilage underneath the patella. And it's not that bad. It's not bad enough to have microfracture surgery," he continued. "It's not bad enough to end my career. It's an issue that I'm going to have to deal with. There's a lot of wear and tear in this game. I just have to get things around my knee to move better, to take a little pressure off my knees."

Are these reports true?  Is the Phillies' medical staff coaching Utley on what to say to the media and keeping his real problems a secret?  Only a select few know the honest answer to that question.  But, with all these medical words flying around, I decided to find out exactly what is going on with Utley and have it explained in simpler terms.
Fortunately, I have a good friend that graduated with me from the University of Pittsburgh that is well educated in these types of things.
His name is Joseph T. Rauch.  Rauch spent four years at Pitt and graduated with a BS in Athletic Training.  He later attended Widener University and received a Doctorate of Physical Therapy.  He is currently the Director of Rehabilitation and Head Baseball Athletic Trainer at the University of Cincinnati and has worked with the Bearcats for three years.
While Rauch does not have any exact knowledge of Utley’s situation, he was able to shine some light on the diagnosis of chondromalacia.
“Chondromalacia is usually found on the underside of the patella or kneecap,” said Rauch.  “Basically, it is the blistering or wearing away of the articular cartilage on the underside of the patella bone.
“At the end of all long bones, including the femur and patella, there is articular cartilage, similar to gristle on the end of the chicken bone.  This articular cartilage is what creates a healthy joint.  Any injury involving the articular cartilage can be devastating because once articular cartilage is damaged it does not grow back.”
So how does this condition affect Utley?
“A baseball swing or the rapid reaction to a hit ball can cause significant pain and, more specifically, swelling,” Rauch said.  “A human knee can hold up to 200 cc's of fluid, but at just 20 cc's the quadriceps begin to shut down.
“Your grandma has arthritis because the articular cartilage wears away.  The same thing can happen to athletes post-injury.  Basically a 32-year-old baseball player will be walking around on 50-year-old knees.”
Rauch went on to say that patellar tendonitis would only add to the problems.  Furthermore, a player with tendonitis or chondromalacia can presumably continue to play and dodge microscopic surgery as long as they can tolerate the pain.  However, if a player has cartilage issues, it could be a ‘big, big problem.'
As of now, the only treatment for chondromalacia and tendonitis is rest and physical therapy.  Unfortunately for Utley, he may never get the rest he needs until he hangs up the cleats.  For the Phils' sake, hopefully he can tough it out for a few more years.

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