[News] Nathan Horton's career may be in jeopardy

[cam_wmh]

Originally Posted by Five-hole

I don't know what you mean by "turn even non-relevent (sic) threads into the tanking (sic)" unless you're insinuating I'm peppering the board with thoughts on tanking (I'm not). I posted an offhand comment that seems to have upset you greatly, which is surprising, but I'm bored, so here we are.

I agree with most of the above, except your apparent definition of tanking. Tanking, if it occurs, occurs at the management level. Stripping your rosters of talent, moving veterans for futures, operating at or near the cap floor, and playing a great deal of rookies in prominent roles is evidence that management is not trying to win as many games as possible and is rather taking a "long view" (to be extremely euphemistic). Is this unconscionable? Not by any means -- it's the manager's job to assess short-term gain versus long-term pain, and vice versa, in making their decisions.

But if you're suggesting that all 30 managers have iced the best team they could this season, I have to strongly disagree.

This is where your missing the point becomes legendary. If you can find me any statement I made where I suggest that a top pick is undesirable as a consequence of the mere fact of the possibility of injuries, I will happily retract everything. I think I've made it pretty clear that making a top pick your objective is a poor long-term strategy as a strategy in and of itself. Sometimes abject failure is the inevitable consequence of the cycle of success/failure that nearly every franchise endures, other times it's pretty clear that management guts the team and relies on a top pick to be the savior.

If you want to have a long talk about Nathan Horton's injury, go right ahead. I fail to see how I've impeded that conversation. But "tanking", and to a greater extent the plenitude of talent at the top end of this year's draft, is a nearly ubiquitous conversation. I, apparently, exceeded your tolerance threshold for it and I sincerely* apologize.

* Not sincere

lol

[hansmoleman]

Man this forum has gotten bad. All the time a bunch of dudes bickering like little kids. Used to visit multiple times a day and now hardly ever because it's gotten so tiresome.

[TheSutterDynasty]

Originally Posted by Cali Flames Fan

Any kind of spinal degeneration at 29 is a big deal. Pretty hard to do that unless you are completely abusing your spine on a regular basis.

Degeneration is a bit of a generic term. If it's run of the mill osteoarthritis due to wear and tear, then there's no way it should keep him from playing. If it's disc degeneration then it's likely impinging on his spinal cord and causing all kinds of motor and sensation problems in his legs. Cox flexion/distraction therapy or spinal decompression is all you can do to manage it conservatively, and it takes a long time to recover. Failing that, laminectomy and fusion is necessary and he may never be cleared to play a rough contact sport like hockey after that.

Still, if Gary Roberts can come back and have a long career after a surgery like that, then Horton should be able to as well. Best of luck to him.

Several things wrong with this. First off, the article is very vague and just states "degeneration". Take imaging of anyone's back over the age of 20 and they have degeneration in their lower back. That doesn't mean it's causing pain and not normal.

Osteoarthritis and degenerative disc disease are essentially the same thing. Everyone undergoes an aging & wearing process of the discs, just like everything else in the body. The reason I say they're "the same" is because as we lose disc height/viscosity/etc, we begin to have more movement at that joint, which causes osteophyte formation as an adaptive response. "Osteoarthritis" is the wearing of cartilage. In the case of the spine, that's the discs.

We all have degeneration. We don't all have pain. And only a small portion of those with pain (even if we could reliably say it's 100% from the degenerative disc disease, which we definitely can NOT) have nerve root impingement, "sciatica". This is not the spinal cord.

There is WAY more treatment for conservative management than the things you listed. He will not have a laminectomy/fusion unless he is at the very end of the road.

I don't know anything about the injury other than the article. Just a few musings about your post, hope I didn't come across as confrontational, I just think anything that contributes to the fear of spinal pain should be addressed since it can be so crippling to an otherwise very benign injury.

(I don't know anything about Horton's injury specifically. Obviously his is bad enough to warrant this article but I guarantee it's not due to "degeneration").

[Tyler]

Originally Posted by hansmoleman

Man this forum has gotten bad. All the time a bunch of dudes bickering like little kids. Used to visit multiple times a day and now hardly ever because it's gotten so tiresome.

[trackercowe]

Originally Posted by hansmoleman

Man this forum has gotten bad. All the time a bunch of dudes bickering like little kids. Used to visit multiple times a day and now hardly ever because it's gotten so tiresome.

[manwiches]

Well since this thread has gone off the rails, if no one is going to say, I'll say it then

Nathan Horton's wife is a dime

[Cali Panthers Fan]

Originally Posted by TheSutterDynasty

Several things wrong with this. First off, the article is very vague and just states "degeneration". Take imaging of anyone's back over the age of 20 and they have degeneration in their lower back. That doesn't mean it's causing pain and not normal.

Osteoarthritis and degenerative disc disease are essentially the same thing. Everyone undergoes an aging & wearing process of the discs, just like everything else in the body. The reason I say they're "the same" is because as we lose disc height/viscosity/etc, we begin to have more movement at that joint, which causes osteophyte formation as an adaptive response. "Osteoarthritis" is the wearing of cartilage. In the case of the spine, that's the discs.

We all have degeneration. We don't all have pain. And only a small portion of those with pain (even if we could reliably say it's 100% from the degenerative disc disease, which we definitely can NOT) have nerve root impingement, "sciatica". This is not the spinal cord.

There is WAY more treatment for conservative management than the things you listed. He will not have a laminectomy/fusion unless he is at the very end of the road.

I don't know anything about the injury other than the article. Just a few musings about your post, hope I didn't come across as confrontational, I just think anything that contributes to the fear of spinal pain should be addressed since it can be so crippling to an otherwise very benign injury.

(I don't know anything about Horton's injury specifically. Obviously his is bad enough to warrant this article but I guarantee it's not due to "degeneration").

You absolutely did.

First of all, not everyone over 20 has degeneration. I don't know where you get that from. Is degenerative joint disease or osteoarthritis common? Yes. Is it normal at his age? No. I'm in my mid-30's and I don't have any degeneration in my spine at all (mostly because I get regular adjustments). I will agree that it doesn't always cause pain, but obviously in his case it is.

Osteoarthritis is different than degenerative disc disease and both have different causes. Osteoarthritis usually results from excessive motion or use, while a lack of motion is the main culprit for a loss of fluid in the disc, leading to decreased height and viscosity, and eventually annular tearing and possible protrusion of nuclear material into the spinal canal. Sometimes it's central impinging on the cord, and sometimes (more often) it's more lateral impinging on the nerve root. Sciatica refers to entrapment of the entire sciatic nerve, while disc involvement at the nerve root is referred to as radiculopathy.

Osteophyte formation occurs when there is excessive stress placed on bone, and can occur from a variety of sources. In the spine, when a disc loses height the ligaments that overlie the joint are put under greater stress, pulling on their attachments to the bone, and creating an osteophyte. Osteophytes can also occur at the zygapophyseal joints due to excessive weight bearing from poor spinal alignment. These can also cause radiculopathy if the bone growth constricting around the nerve root is extreme enough, and you rarely see that until much later in life.

I will say this about back pain: it's difficult to narrow down the cause because it's often multi-factorial. In my experience, almost any tissue can cause low back pain and it can be very difficult to treat for some, often never fully resolving or having multiple recurrences over their lifetime. I'm not saying that's the case with Horton, because I know very little about his case, but if it's bothering him this much at 29 after playing years of a very physical and painful sport, it's probably something fairly serious.

Of course there are other treatments for back pain, but I was listing the two most effective ones that I know of for disc degeneration and protrusion (if that's the case). I fully advocate conservative measures since surgeries are around a 50% success rate, but the conservative treatments take a lot longer and are not a sure thing either. Horton's career is short and he will likely opt for the surgery if the conservative approach does not make any progress over the next couple of months. That's just the way it is for athletes.

If you're going to try to make someone look stupid and say there's a lot "wrong" with what they said, make sure you have your facts straight.

[TheSutterDynasty]

Originally Posted by Cali Flames Fan

First of all, not everyone over 20 has degeneration. I don't know where you get that from. Is degenerative joint disease or osteoarthritis common? Yes. Is it normal at his age? No. I'm in my mid-30's and I don't have any degeneration in my spine at all (mostly because I get regular adjustments). I will agree that it doesn't always cause pain, but obviously in his case it is.

http://www.ncbi.nlm.nih.gov/pubmed/19770614

Almost half of young Finnish adult aged 21 years had at least one degenerated disc

(This was the first study that popped up). Degeneration is common and normal. I'm sure you'd have "degenerative changes" show up on an MRI/CT.. again, not that it means anything.

Originally Posted by Cali Flames Fan

Osteoarthritis is different than degenerative disc disease and both have different causes. Osteoarthritis usually results from excessive motion or use, while a lack of motion is the main culprit for a loss of fluid in the disc, leading to decreased height and viscosity, and eventually annular tearing and possible protrusion of nuclear material into the spinal canal. Sometimes it's central impinging on the cord, and sometimes (more often) it's more lateral impinging on the nerve root. Sciatica refers to entrapment of the entire sciatic nerve, while disc involvement at the nerve root is referred to as radiculopathy.

Here's a good article on OA in the spine.

...lesions that affect the disc tend to eventually have an effect on the facet joints, and trauma or instability of the posterior structures may in turn affect the disc. The motion segment has been best studied in the lumbar spine. In the majority of individuals, pathology begins in the disc and is followed by changes in the facet joints.
...
Degenerative disc disease and disc-space narrowing cause a marked increase in transmission of force across the facet joints, as less body weight is supported by the disc when it becomes functionally incompetent

Just as I said, the wearing of the discs leads to osteophyte formation ("arthritis") at the facet joints.

Here is a good article about DDD. Of note:

To date, however, there has been no correlation between MR disk changes and patient's symptoms.

You are right, nerve root involvement = radiculopathy, but sciatica (a misnomer) is the general term for nerve pain down the leg and can indeed by caused by piriformis syndrome, but also by nerve root impingement.

Originally Posted by Cali Flames Fan

Osteophyte formation occurs when there is excessive stress placed on bone, and can occur from a variety of sources. In the spine, when a disc loses height the ligaments that overlie the joint are put under greater stress, pulling on their attachments to the bone, and creating an osteophyte. Osteophytes can also occur at the zygapophyseal joints due to excessive weight bearing from poor spinal alignment. These can also cause radiculopathy if the bone growth constricting around the nerve root is extreme enough, and you rarely see that until much later in life.

This is essentially what you were arguing against above?

Originally Posted by Cali Flames Fan

I will say this about back pain: it's difficult to narrow down the cause because it's often multi-factorial. In my experience, almost any tissue can cause low back pain and it can be very difficult to treat for some, often never fully resolving or having multiple recurrences over their lifetime. I'm not saying that's the case with Horton, because I know very little about his case, but if it's bothering him this much at 29 after playing years of a very physical and painful sport, it's probably something fairly serious.

Of course there are other treatments for back pain, but I was listing the two most effective ones that I know of for disc degeneration and protrusion (if that's the case). I fully advocate conservative measures since surgeries are around a 50% success rate, but the conservative treatments take a lot longer and are not a sure thing either. Horton's career is short and he will likely opt for the surgery if the conservative approach does not make any progress over the next couple of months. That's just the way it is for athletes.

If you're going to try to make someone look stupid and say there's a lot "wrong" with what they said, make sure you have your facts straight.

Agreed. Again, didn't mean to come across as confrontational but I think the pervasive "my spine is degenerating" fear needs to be quelled, which is the only reason I piped up.