PA-S | Ortho bro here to explain how injuries actually work and to share other health knowledge | Mechanisms, anatomy, timelines, never an official diagnosis

United States
Joined January 2024
♀️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.
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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).
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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
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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.
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The Body Explained | Hockey Injuries retweeted
Could oxygen availability be an overlooked factor in concussion recovery? Interesting connection here to the emerging research on hyperbaric oxygen therapy (HBOT) for TBI. Commercial flying reduces oxygen pressure, while HBOT increases oxygen delivery to tissues. Given the mitochondrial dysfunction and altered energy metabolism that can follow brain injury, it’s worth asking how changes in oxygen availability influence recovery. The research remains inconclusive, but I think this is an area deserving much greater attention.
This article was not peer reviewed so take it with a couple grains of salt, but I was able to find a 2012 conference abstract on NFL and NHL players found that those who flew commercially soon after brain injury missed more games. The authors suggested postponing flights by 48–72 hours until early symptoms ease. Kirich took a big blow to the head, so likely just a precaution and is what it says Interesting find I thought I’d share!
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This angle of the Hyman hit shows his head hitting the boards Immediately looks dazed and needs to be helped off, concussion protocol is likely I remember hearing as a kid that anytime someone is grabbing at their helmet like Hyman was it probably isn’t the best news
Zach Hyman had to be helped off the ice after being hit into the boards by Andreas Englund. (via Detroit Sportsnet)
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This article was not peer reviewed so take it with a couple grains of salt, but I was able to find a 2012 conference abstract on NFL and NHL players found that those who flew commercially soon after brain injury missed more games. The authors suggested postponing flights by 48–72 hours until early symptoms ease. Kirich took a big blow to the head, so likely just a precaution and is what it says Interesting find I thought I’d share!
Per Lindy Ruff, forward Jiri Kulich “hasn’t cleared enough” in his protocol to fly west yet. More info → bufsabres.co/3WNIHbn
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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.
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Rasmus Ristolainen suffered another injury of the same hand he hurt on 10/5 from being hit with a puck He returned two days ago, so 19 days after the original injury which tells us it probably wasn’t a fracture as 19 days is too early to tolerate impact He is now suspected to miss two weeks Major concern could be a bone bruise that is now a fracture but the two weeks would still be too little, so it is likely just a reaggrevated contusion they want to fully heal X-Rays were probably redone to confirm
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The Body Explained | Hockey Injuries retweeted
Logan Thompson's injury history raises some interesting questions about his latest setback. In 2018 with Brandon (WHL), he suffered a leg injury, missed the final five regular-season games, returned for the playoffs and reinjured it in Game 2, ending his season. In February 2023 with Vegas, he suffered an apparent left-leg injury, missing 18 games. He returned in March, only to suffer another lower-body injury in his first game back. His rehabilitation subsequently stalled, with Bruce Cassidy acknowledging he wasn't responding well to the workload. He never played again that season. In April 2025, a collision forced him into the splits, leaving him unable to bear weight on his left leg. Now, another lower-body injury with apparent left-leg discomfort. We don't know whether these injuries involve the same structures, but the repeated setbacks following return to play are concerning. Is there an underlying issue with force production, load tolerance or unresolved deficits from previous injuries? Sometimes the injury isn't the entire problem. It's what remains after the athlete returns to play.
Logan Thompson left practice after 45 minutes today, which could mean nothing and just be load management It does not really confirm any diagnosis, but given the speculation of an adductor strain it could’ve been under recovered and loaded too early Pain usually goes away with these strains in a couple days but can be felt with higher level activities for a couple weeks The worst fear is a higher grade strain or insertional injury I wrote an article on adductor strains that will help below!
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Logan Thompson left practice after 45 minutes today, which could mean nothing and just be load management It does not really confirm any diagnosis, but given the speculation of an adductor strain it could’ve been under recovered and loaded too early Pain usually goes away with these strains in a couple days but can be felt with higher level activities for a couple weeks The worst fear is a higher grade strain or insertional injury I wrote an article on adductor strains that will help below!
Logan Thompson of the Capitals is DTD after seemingly tweaking something in this video He stayed in the game and the clear and most common concern in an adductor (groin) strain of some sorts Very common mechanism of it and very common in goalies He seemingly forcibly stretches that right leg into abduction with slight push off which is a common way to do this Could be a hip flexor strain too
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The Body Explained | Hockey Injuries retweeted
A Sunday quick read!
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The Body Explained | Hockey Injuries retweeted
Assuming this is where McCann was injured, the knee-on-knee contact raises concern for an MCL injury. His history is particularly relevant. In April 2025, he underwent bilateral knee surgery to remove bone spurs after prolonged quadriceps discomfort. He later described significant muscle loss, difficulty jumping, and numbness and stinging when struck in the thigh. Persistent symptoms required another procedure in April 2026. Even if this is a new traumatic injury, his previous knee problems could complicate rehabilitation and may help explain the 10-week timeline.
Great pickup. This could absolutely be where the injury happened. #SeaKraken
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Can’t really find any film of a mechanism anywhere so don’t want to speculate at all In general (not a diagnosis), 10 weeks can fit some higher grade ankle sprains, adductor strains, MCL sprains and hamstring strains Could include fibula or foot fracture too Hope McCann recovers great and gets back out there!
#SeaKraken forward Jared McCann will be out 10 weeks with a lower-body injury and has been placed on injured reserve.
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Scary play as Jake Walman goes into the boards here He thankfully returned to the game rather quickly so there shouldn’t be a concern for major injury This looks similar to William Ekland’s injury where he tore and ankle tendon which could’ve happened here as his ankle seems to take the first major blow
Jake Walman had to leave the game after this scary collision along the boards with Roslovic
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The Body Explained | Hockey Injuries retweeted
Vincent Desharnais of the Capitals underwent an appendectomy An appendectomy is surgery to remove the appendix, usually because it has become inflamed or infected causing a condition called appendicitis. It is very important to not people can live a normal, healthy life without their appendix. ❓ The appendix is a small, finger-shaped pouch attached to the beginning of the large intestine, usually in the lower-right part of the belly 😷 Appendicitis means the appendix is inflamed. Sometimes its opening becomes blocked, allowing bacteria to grow and pressure to build inside. As swelling increases, the appendix can lose its blood supply and develop a hole or burst. This can spread infection into the belly. Not everyone has these symptoms but here are some you should watch out for! 🔹Belly pain that starts near the belly button and moves toward the lower-right side 🔹Pain that gets worse with walking, coughing, or movement 🔹Loss of appetite 🔹Nausea or vomiting 🔹Fever 🔹Sometimes constipation, diarrhea, or bloating 🚨Do NOT wait for every symptom to appear Appendicitis is diagnosed through clinical signs, ultrasound, and/or CT scan There are two main surgical types to mention here as Desharnais went through it 1️⃣Laparoscopic - the surgery is done with a camera through several small cuts in the belly 2️⃣Open - the appendix is removed through one large cut Sometimes the surgery may begin laparoscopic and then become open Most patients recover very well! In an uncomplicated procedure, the patient may be able to go home the same day or the next day. All surgeries have bleeding and infection risk, and light physical activity is generally ok after 1-3 weeks, which checks out the 4-6 week timeline for Desharneis to ramp up playing hockey
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The Body Explained | Hockey Injuries retweeted
Very similar and scary situation to Jake McCabe that occurred here with Nini Niederreiter Immediate concern for an eye injury The overriding immediate concern with plays like this is a open globe injury which is a surgical emergency This mechanism can also cause eyelid lacerations, orbital fractures, hyphema (pool of blood in the front of the eye), corneal abrasion/laceration, and others Would be important to protect the eye and assess vision early
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The Body Explained | Hockey Injuries retweeted
Igor Chernyshov is “out for a while” after leaving the game due to this play That timing leads to the belief something is fractured versus just a contusion Kind of hard to tell exactly where the puck hit but he seems to grab that arm so a fracture to the radius/ulna are in play The ulna is on the outside exposed area there so a shaft fracture is possible, aka a “nightstick” fracture Return to play if that’s the case is about 6-8 weeks They seemed to know pretty quickly so X-rays pretty likely showed the fracture well which would put Cheryshov in some sort of cast
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Igor Chernyshov is “out for a while” after leaving the game due to this play That timing leads to the belief something is fractured versus just a contusion Kind of hard to tell exactly where the puck hit but he seems to grab that arm so a fracture to the radius/ulna are in play The ulna is on the outside exposed area there so a shaft fracture is possible, aka a “nightstick” fracture Return to play if that’s the case is about 6-8 weeks They seemed to know pretty quickly so X-rays pretty likely showed the fracture well which would put Cheryshov in some sort of cast
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