Marc Marquez faces six-month layoff after third surgery on arm - Page 5

p4p1 · December 11th, 2020, 09:58 PM

Quote:

Originally Posted by michaelm

As misfit says we don’t know what he was told, but what he seems to be saying is that the risks were not emphasised sufficiently. We do know that non-union was foreseeable because misfit foresaw same

Of course he made his own decision. As I’m sure you’re aware there has recently been a lot of protocols etc put in place in the AFL and other sports due to players playing with concussions etc. I think the situation is similar, the adult players made their own decision to play. Class action lawsuits etc have found management, organisational bodies and/or doctors responsible. Much like MM the players in question didn’t need anyone to encourage them to play.
In my understanding of law the risks not being emphasised sufficiently is massive, especially if the risk of non-union wasn’t explained as it should have been. I suspect if there is a law case MM will likely win.

p4p1 · December 11th, 2020, 11:11 PM

Quote:

Originally Posted by misfit

We don't know the facts. MM's comments are only one side of the story. His primary doctors, i.e., the ones who fixed his fracture should be his primary advisors about riding. They fixed the # and should be the judge of its integrity. The track doctors likely pass a rider as fit based on specific parameters. They were correct in that he could ride and that he did up until qualifying.

I completely agree that the doctors that fixed the arm should be the judge of its integrity. If it isn't already like that then something needs to change. I'm sure the track doctors as you said do have specific parameters part of the argument I am making is that it needs an overhaul.

Quote:

Originally Posted by misfit

Patients often go shopping for what they want to hear and not what they need to hear. MM sustains a broken humerus. He could go shopping for the quickest route back to the track, knowing there are risks involved or instead, for the best guarantee for healing, even it means investing in a 6 week layover. We know what he and his team were shopping/looking for from their doctors. They certainly found doctors willing to go along with that as one always can. Now that the shit has hit the fan, no one wishes to take responsibility??

While that is certainly a fact it doesn't absolve those doctors responsibility and/or duty of care. At the time I didn't think MM made the right decision but I also knew if I was in his position I would have done the same thing. IIRC Puig did say that if they knew this was a possibility they wouldn't have let him on the bike. Somewhere there has been a huge breakdown of communication. This is a multi-million dollar sport with athletes who can afford the best, there must be protocols to stop riders hiding information from their teams, doctors etc as they will if they think they can get away with it. The teams and the track doctors must have all the information before they can OK someone to ride a bike on track and from the information that we have this doesn't seem to have been the case.

Quote:

Originally Posted by misfit

MM may say he has no fear, but he has a responsibility to himself. If his focus is on his championship race and not his health and recovery, then this will certainly influence his care and how he discusses his treatment/prognosis with doctors. This is his decision/attitude and it will have its consequences. Consequences he should be aware of and take responsibility for. The only difference between his decision to ride in MotoGP iwth the recognised risks is that if he falls as he did, then there's no one else to blame. However, when doctors are involved in risky decisions to return VERY early to racing post-injury, then things become muddy. Additionally, doctors are human beings too and can be influenced as MM himself was, i.e., the doctor decides to put caution aside and be aggressive with treatment in an attempt to do as MM wishes, get him back on the bike ASAP. When both parties cash in like this, the returns could be big or the losses huge, the latter of which, we are now witnessing. The doctor/s involved should take responsibility as well if they didn't clearly define the risks to MM.

I think part of the problem is people expect athletes to be rational when there is generally nothing rational about the way they've decided to live their lives. Fans see the games but very little else. Great athletes take that irrationality to another level. What most people will never see or understand is the hours spent in an obsession from childhood, the sacrifices made to social lives, to normal childhood enjoyment, for many athletes social ramifications stemming from being a weird obsessed kid who only wants to 'ride his bike' as Stoner put it, not eating at your friends birthday party because the food is unhealthy etc. Of course the sacrifices sometimes end up being worth it, they go onto fame and fortune only few will ever experience. After retirement most athletes have no idea what to do with themselves (something I think is part of Rossi's problem at the moment) because everything up to that point has been about a singular goal and many don't know how to find any sort of joy outside of it. These guys aren't rational and as such can't be trusted to make rational decisions. After Rossi's most recent leg break he came back before it was fully healed, the risks were never unreasonable for him despite the fact they would be for most normal people.

I think we are in agreement that the doctors involved must take responsibility if they didn't correctly define the risks, which may seem to be the case. I think what does muddy it is that IMO the doctors should have known the kind of person they were dealing with. When I had my shoulder reconstruction the Dr gave me 4 months off work. I returned to training that was much more physical than the work I was doing much earlier than I returned to work. The doctor I had knew what I valued, he knew that I wanted the time off work so I could get back to training properly sooner. Even then I was on light duties at work while I was grappling every night.

Quote:

Originally Posted by misfit

It would be great to be able to accurately calculate the strength of a fixation. However, there are too many variables involved. It's even more difficult to quantify the fixation's stress tolerance. It may put up with a force 10 times, or even 50 times, but what about 150 times?? There is no guarantee, and I'd genuinely be surprised if an orthopaedic surgeon would give guarantees about the integrity of the fixation over a race weekend. Not a very sensible surgeon, if he did, but one with a LOT of hubris and to be avoided.

Interesting, I understand there is a lot of variables, I just thought that from my admittedly limited physics and engineering experience that it would be possible to calculate these things with some degree of accuracy. Maybe I am overestimating the role engineering plays in orthopaedic surgery? I don't say that to belittle anything in anyway, rather me just overthinking a scenario that basically never happens. Most people that have broken bones fixed wont be trying to compete in sport within a few days, so there really is no requirement for the kind of knowledge I am proposing. I am studying construction and we can make very accurate calculations of loads etc. Perhaps too involved but I thought that by using calculations for bone density, strength along with the engineering specs of the stuff used but as I stated above probably overthinking for a requirement that occurs once in a few million surgeries.

Quote:

Originally Posted by misfit

Finally, MM knew that he could be in serious trouble if he fell off the bike!!! With the previous arguments and this new point in mind, it could be the case that both parties very well knew that there were no guarantees. However, what they didn't properly anticipate was the real potential of a non-union if further surgery was undertaken after a plate failure. How many times have we seen riders have clavicular fractures fixed, the plate breaks after a fall and they fix it again and it's OK. This happened with Pedrosa and I think, Lorenzo.

Of course if he decides to race and crashes the responsibility is solely on MM. I would question the recklessness of allowing him to take the risks but I don't think it is something that can or even should be removed from the sport. Crashing and the consequences that come with it are part of the sport. What I object to are foreseeable, preventable consequences that occurred without crashing and realistically occurred without MM pushing the bike to the limit.

Quote:

Originally Posted by misfit

I would like to take credit for predicting what was going to happen, but they could have gotten away with it and if they did, I would have been amazed. Who knows? Maybe he could have gotten away with it. There's no 100% failure and with a high chance of failure, I think his comeback was ill-advised, especially if the consequences come with there own set of genuine risks. However, with the probability of outcomes weighing so heavily in the direction of my prediction, well.....

I thought the attempted comeback was not the best idea, I admired the courage but also required his balls to make the decision his brain should have. The fact that is problematic for me is that you were able to foresee much of this without ever being involved with MM. I think that will cause his doctors a problem as far as responsibility goes. If his doctor foresaw all of what happened and still signed off on him getting on track then he has failed his own duty of care.
As I stated previously in another post, Jordan's injury in the 80s, his self paced (against doctors orders) rehab could have easily gone the other way and ended his career before it really begun. The difference here is that the Bulls and Jordan's medical team took reasonable precautions to save Jordan from himself. Jordan went to another state and started working his way up to playing again by himself in secret. If the Bulls had have gotten the news they would have taken him back to Chicago and locked him in a hospital with doctors watching his every move. Marquez like many riders (and athletes) before him has been enabled, I worry that the Marquez/Honda team is similar to Rossi's team in that Marquez has surrounded himself with yes men as Rossi has done.

Off-topic and I have no idea if you would even have any knowledge but is stem cell research the way of the future? I was reading a few years that a Brazilian soccer player had his ACL done with stem cells and was back playing again after 6 weeks. Are stem cells going to be the answer for quicker healing to ligaments and bones in the future? Or is the medical industry opposed to stem cells because the quicker healing time etc means less jobs/money?

p4p1 · December 11th, 2020, 11:26 PM

Quote:

Originally Posted by michaelm

It seems he didn’t have the right operation initially, but as you say he probably sought the operation that would allow him the earliest return and a surgeon who would perform that operation. And if he is being quoted correctly his gripe is that doctors failed to convince him not to ride, so it sounds like he was warned of consequences but decided to take the risk which is at least partly on him. It certainly doesn’t sound like he was talked into riding by others, and he and his team have historically pretty much always gone their own way. As we both have said, he was also probably looking at the history of Edwards and Lorenzo riding with recently plated clavicular fractures and likely considered the issue to be one of tolerating pain rather than one of having a functional arm long term. Lorenzo finished 4th or 5th after circulating higher riding 2 days after his fracture, then re-fractured it and bent the plate in a crash in practice for the next race in the rain causing him to miss the next 2 or 3 races which cost him the 2013 title and made him (imo) forever wary in the rain thereafter, but didn't have any sequelae in regard to the clavicle afaik.

I agree that I think his decision came down to him being able to tolerate the pain or not rather than the possibility of much longer term consequences. Somewhere there has been a communication breakdown and if he rode against doctors advice then he shouldn't have been cleared to ride.

Quote:

Originally Posted by michaelm

I have thought the same as you in regard to him being passed fit to ride, he wasn’t concussed and his arm was functional before the plate moved, close to inevitable though that may have been which you actually said at the time, and these guys ride with injuries which in a general context would be considered quite significant all the time. As an aside whether doctors employed by sporting organisations or teams serve the sportsman primarily is a philosophical question which has long vexed me however.

I think this is something we could talk about until the cows come home. There is definitely some kind of conflict going on for the most part. I'm not sure what the answer is but this incident has certainly shone a light where I am sure FIM would prefer it wasn't.

Quote:

Originally Posted by michaelm

He fully deserved criticism when he was younger, the Willairot incident remains completely indefensible, but imo he hasn’t ridden in a fashion careless about the safety of others for years now, and I think the current character assassination is over the top, sure his judgement about his own safety/health comes into question, but as Birdman and p4p1 have said if you don’t like his mentality as a rider then you don’t like Mick Doohan and most of the other greats probably including Valentino Rossi.

What I do find interesting is that those vilifying him on Crashnet currently, some of them seemingly even taking some joy in his misfortune, were quite likely members of the same band which vilified Casey Stoner for seeking his own medical advice/finding his own doctors rather than going with the Ducati etc doctors when he was ill in 2009 and considered himself that he was unfit to ride, made psychological/psychiatric diagnoses on him, and called him a quitter when he eventually made what gave every appearance to me of being a fairly rational decision to retire.

This is without question the things that have angered me the most about the situation. The hypocrisy of the idiots. The shit that's spewed in his direction because he made a decision nearly every other athlete in the world would have made. I saw someone call it karma for trying to rush back. How does that even make sense?

MM's decision to comeback was a poor one IMO and shouldn't have been allowed by 'the adults in the room.' In just about any other season this would have likely been a non-issue. The back to back weekends are Jerez because of Covid-19 were a root cause in all of this. Normally MM would have had and extra week in which to recover which could have been key. IIRC the only reason why MM even attempted to give it a go was because they had been at Jerez the previous weekend. An unfortunate global circumstance seems to have played a major role in all of this as well.

birdman · December 12th, 2020, 12:33 AM

Quote:

Originally Posted by michaelm

Anyone as good as him at a sport like motor bike racing is totally driven, perhaps beyond the bounds of what is considered conventionally rational. Imo Birdman is right as he often is about bike racing, and the successive title win thing was likely on his mind.

It seems he didn’t have the right operation initially, but as you say he probably sought the operation that would allow him the earliest return and a surgeon who would perform that operation. And if he is being quoted correctly his gripe is that doctors failed to convince him not to ride, so it sounds like he was warned of consequences but decided to take the risk which is at least partly on him. It certainly doesn’t sound like he was talked into riding by others, and he and his team have historically pretty much always gone their own way. As we both have said, he was also probably looking at the history of Edwards and Lorenzo riding with recently plated clavicular fractures and likely considered the issue to be one of tolerating pain rather than one of having a functional arm long term. Lorenzo finished 4th or 5th after circulating higher riding 2 days after his fracture, then re-fractured it and bent the plate in a crash in practice for the next race in the rain causing him to miss the next 2 or 3 races which cost him the 2013 title and made him (imo) forever wary in the rain thereafter, but didn't have any sequelae in regard to the clavicle afaik.

I have thought the same as you in regard to him being passed fit to ride, he wasn’t concussed and his arm was functional before the plate moved, close to inevitable though that may have been which you actually said at the time, and these guys ride with injuries which in a general context would be considered quite significant all the time. As an aside whether doctors employed by sporting organisations or teams serve the sportsman primarily is a philosophical question which has long vexed me however.

He fully deserved criticism when he was younger, the Willairot incident remains completely indefensible, but imo he hasn’t ridden in a fashion careless about the safety of others for years now, and I think the current character assassination is over the top, sure his judgement about his own safety/health comes into question, but as Birdman and p4p1 have said if you don’t like his mentality as a rider then you don’t like Mick Doohan and most of the other greats probably including Valentino Rossi.

What I do find interesting is that those vilifying him on Crashnet currently, some of them seemingly even taking some joy in his misfortune, were quite likely members of the same band which vilified Casey Stoner for seeking his own medical advice/finding his own doctors rather than going with the Ducati etc doctors when he was ill in 2009 and considered himself that he was unfit to ride, made psychological/psychiatric diagnoses on him, and called him a quitter when he eventually made what gave every appearance to me of being a fairly rational decision to retire.

I didn’t know att but Ago has 7 straight so MM, with 4 in a row and a 4 year contract was perhaps gunning at 8. Make of that what you will, worth the risk or not? Obviously now not but att he didn’t know, only the arm was a simple break, it could be plated, he could in theory ride.

misfit · December 12th, 2020, 04:35 AM

Quote:

Originally Posted by p4p1

I completely agree that the doctors that fixed the arm should be the judge of its integrity. If it isn't already like that then something needs to change. I'm sure the track doctors as you said do have specific parameters part of the argument I am making is that it needs an overhaul.

The governing body could help here. What the riders and teams want is a level playing field to ensure fairness. Currently, if a rider is injured, it's really up to the team and rider to ensure that they are back and fighting for points as soon as possible. There's no mandatory layover period once a major long-bone or clavicular fracture is diagnosed. There's no mandatory layover period once a bone has been operatively fixed. A layover that's in the rule-book, the rule-book of-course, being revised as needed. If safety regulations are the same for everyone and clearly written, then it's not a problem.

In Formula 1, the introduction of the Hans and Halo devices came with a lot of opposition from drivers and teams. They were uncomfortable, obstructed the view for drivers and fans, looked ugly, hampered with getting out of the car, went against driver bravery etc. etc. The governing body went ahead and introduced it anyway and drivers have since benefitted from it.

Unlike F1, the riders in MotoGP are far more prone to injuries and there has not been much regulating of return times etc. The governing body is assuming that the doctors and rider will get it right. I never thought this to be the case since neither doctor nor rider are infallible. Unfortunately, it usually takes a major incident, as with MM, to make change as it did with Senna.

Quote:

Originally Posted by p4p1

While that is certainly a fact it doesn't absolve those doctors responsibility and/or duty of care. At the time I didn't think MM made the right decision but I also knew if I was in his position I would have done the same thing. IIRC Puig did say that if they knew this was a possibility they wouldn't have let him on the bike. Somewhere there has been a huge breakdown of communication. This is a multi-million dollar sport with athletes who can afford the best, there must be protocols to stop riders hiding information from their teams, doctors etc as they will if they think they can get away with it. The teams and the track doctors must have all the information before they can OK someone to ride a bike on track and from the information that we have this doesn't seem to have been the case.

I don't think Puig or MM are genuinely being honest with themselves in thinking that an early return could not have led to trouble. There is always trouble lurking. It's just that they felt they could have gotten away with it. The question is how much warning do they need to WAKE UP to the possibility of things not going well?

Quote:

Originally Posted by p4p1

I think part of the problem is people expect athletes to be rational when there is generally nothing rational about the way they've decided to live their lives. Fans see the games but very little else. Great athletes take that irrationality to another level. What most people will never see or understand is the hours spent in an obsession from childhood, the sacrifices made to social lives, to normal childhood enjoyment, for many athletes social ramifications stemming from being a weird obsessed kid who only wants to 'ride his bike' as Stoner put it, not eating at your friends birthday party because the food is unhealthy etc. Of course the sacrifices sometimes end up being worth it, they go onto fame and fortune only few will ever experience. After retirement most athletes have no idea what to do with themselves (something I think is part of Rossi's problem at the moment) because everything up to that point has been about a singular goal and many don't know how to find any sort of joy outside of it. These guys aren't rational and as such can't be trusted to make rational decisions. After Rossi's most recent leg break he came back before it was fully healed, the risks were never unreasonable for him despite the fact they would be for most normal people.

My point is that we all take risks in this life and if we choose to turn a blind eye to those risks, for whatever reason, then that's a choice we each make. I don't know how you would feel if you were to have that choice taken away from you, especially if it's one that doesn't endanger others. Many wouldn't take kindly to this.

There is the obvious risk of crashing and sustaining serious injury. However, there's the other layer or returning early after injury. Again, a risky business and if one chooses to engage in it, well, there is the possibility of coming out in the red. These are men and not kids.

Quote:

Originally Posted by p4p1

Interesting, I understand there is a lot of variables, I just thought that from my admittedly limited physics and engineering experience that it would be possible to calculate these things with some degree of accuracy. Maybe I am overestimating the role engineering plays in orthopaedic surgery? I don't say that to belittle anything in anyway, rather me just overthinking a scenario that basically never happens. Most people that have broken bones fixed wont be trying to compete in sport within a few days, so there really is no requirement for the kind of knowledge I am proposing. I am studying construction and we can make very accurate calculations of loads etc. Perhaps too involved but I thought that by using calculations for bone density, strength along with the engineering specs of the stuff used but as I stated above probably overthinking for a requirement that occurs once in a few million surgeries.

It's really not much different from the engineers at the factory produces what they consider to be a great bike or car. It looks great on paper, the windtunnel tests are great. Yet, on the track, the riders struggle and the bike is just not as predicted. The manufacturers can exert forces in a test and provide specifications to plate and screw strength. However, there are no specifications for MM's humerus and how it affects the strength of fixation. Not to mention the types of forces on the fixation when riding as opposed to the plate and screws being tested in a lab. I would also be alarmed if these constructs were tested for in the intention of being the sole support in competitive sport!!!

Quote:

Originally Posted by p4p1

Of course if he decides to race and crashes the responsibility is solely on MM. I would question the recklessness of allowing him to take the risks but I don't think it is something that can or even should be removed from the sport. Crashing and the consequences that come with it are part of the sport. What I object to are foreseeable, preventable consequences that occurred without crashing and realistically occurred without MM pushing the bike to the limit.

A contentious issue indeed that only the governing body can do something about with clear rules on return times after specific injury types. The riders and teams will, of course, protest that it's their choice, and this is my point. When you make it your choice, then take responsibility. Don't be in denial and helplessly claim that you can't do anything about that attitude. It's an understandable one and everyone looking on sees the reason for it. It's just another layer of risk.

Quote:

Originally Posted by p4p1

Off-topic and I have no idea if you would even have any knowledge but is stem cell research the way of the future? I was reading a few years that a Brazilian soccer player had his ACL done with stem cells and was back playing again after 6 weeks. Are stem cells going to be the answer for quicker healing to ligaments and bones in the future? Or is the medical industry opposed to stem cells because the quicker healing time etc means less jobs/money?

I am not familiar enough with the technology to comment on it with even a modicum of authority. Sorry.

Keshav · December 12th, 2020, 11:13 AM

Personally - I'm not all that invested in pinning responsibility on this or that him or her. Probably enough blame to go around. With the most recent 7 hour surgery, and the revealed infection, there seems little likelihood of MM being ready to do testing less than two months away. I don't imagine, given all the controversy, that HRC or Repsol will want MM on the bike until they have an unimpeachable statement of readiness from his surgeons, and given the high profile of the patient they are doubtless considering their reputations and fear of malpractice suits, they're under no pressure to get him back in the saddle one minute sooner.

michaelm · December 13th, 2020, 12:05 AM

Quote:

Originally Posted by birdman

I didn’t know att but Ago has 7 straight so MM, with 4 in a row and a 4 year contract was perhaps gunning at 8. Make of that what you will, worth the risk or not? Obviously now not but att he didn’t know, only the arm was a simple break, it could be plated, he could in theory ride.

I actually had an idea Ago had more successive wins, but MM may well have been going after that record set in a somewhat primeval era as well as you say; he very likely wanted to beat Rossi’s run, given that is what he does, imo as well as yours. That is gone now, I can’t see him winning 6 or more in a row from here even if he eventually fully heals his arm.

imunderandoverit · January 3rd, 2021, 11:59 AM

Lets say it like this; No marc in 2021-

JPSLotus · January 5th, 2021, 06:07 AM

Quote:

Originally Posted by imunderandoverit

Lets say it like this; No marc in 2021-

I don't agree with this claim. While I don't believe he'll be back till May at the earliest, he'll be out there at some point this year. Of course what he comes back as is an altogether different point of discussion.

Keshav · January 5th, 2021, 06:56 AM

Well I’m no doctor - but my prediction is, he’ll never play the violin again.

December 12th, 2020, 11:13 AM	#46
Keshav Senior Member Joined: Aug 2007 From: Nu Yawk City Posts: 10,197 Likes: 1760 I Ride: Triiumph Tiger XCx 800 + KTM SXF450sm + 511SMR	Personally - I'm not all that invested in pinning responsibility on this or that him or her. Probably enough blame to go around. With the most recent 7 hour surgery, and the revealed infection, there seems little likelihood of MM being ready to do testing less than two months away. I don't imagine, given all the controversy, that HRC or Repsol will want MM on the bike until they have an unimpeachable statement of readiness from his surgeons, and given the high profile of the patient they are doubtless considering their reputations and fear of malpractice suits, they're under no pressure to get him back in the saddle one minute sooner. Last edited by Keshav; December 12th, 2020 at 02:32 PM.

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January 3rd, 2021, 11:59 AM	#48
imunderandoverit Senior Member Joined: Apr 2015 From: Sometimes sweden, sometimes usa, sometimes greece. Posts: 312 Likes: 33	Lets say it like this; No marc in 2021-

January 5th, 2021, 06:56 AM	#50
Keshav Senior Member Joined: Aug 2007 From: Nu Yawk City Posts: 10,197 Likes: 1760 I Ride: Triiumph Tiger XCx 800 + KTM SXF450sm + 511SMR	Well I’m no doctor - but my prediction is, he’ll never play the violin again.