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Speaker 1: Welcome back. Since he three to sixty hour three. Rolling along,

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Speaker 1: Let's get to our friend Bob man Jean from the

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Speaker 1: University of Cincinnati and Novacare who joins us each and

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Speaker 1: every week. Bob, what's going on. How you doing this week?

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Speaker 2: Tony? Doing pretty good, you know, just getting ready for

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Speaker 2: spring golf and with the golf team, our boys are

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Speaker 2: hopefully going to qualify for the nca regionals. They're in

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Speaker 2: fifty first place in the nation, so hopefully it'll continue

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Speaker 2: that way.

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Speaker 1: So truly, no off season for Bob Manjean, Is that

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Speaker 1: what you're telling.

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Speaker 2: Me pretty much? You know, there's just no off season anymore.

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Speaker 2: You have to deal with, you know, different sports at

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Speaker 2: different times a year. Obviously, you know the basketballs in

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Speaker 2: footballs now go year round. Now the golf and the

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Speaker 2: other Olympic sports they'll have, you know, their summer seasons

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Speaker 2: off pretty much when school's over. But still the roles

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Speaker 2: of the NCAA have changed so much since two thousand

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Speaker 2: and four, you just never know he's going to be

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Speaker 2: back here by June or July to start summer conditioning

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Speaker 2: and training.

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Speaker 1: Also, before we get into our topic today, I know

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Speaker 1: that the transferred portal window for basketball opens on April seventh.

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Speaker 1: How hectic does that time get for you? If guys

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Speaker 1: are coming in or visiting and you're you're making sure

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Speaker 1: they're they're they're got the clean bill of health. What

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Speaker 1: does that look like for you when that portal does open.

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Speaker 2: Well, the poral, you're already looking. I mean, obviously there's

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Speaker 2: a lot of of you know, general managers around the

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Speaker 2: country for the different teams are already talking to agents,

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Speaker 2: you know, before the official start of the poral. You're

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Speaker 2: getting someone yeah, as far as you know who who

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Speaker 2: you might be looking at. So you're trying to get

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Speaker 2: some information on those kids. Once the portal officially hits,

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Speaker 2: and obviously the kids are in there and registered for

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Speaker 2: the portal, so now you can get better information. And again,

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Speaker 2: like our guys when they come to me and say, hey,

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Speaker 2: I think I'm going to transfer, and it's like, okay,

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Speaker 2: sign this release of information. Do what do you want

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Speaker 2: me to release? You not want me to release? But

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Speaker 2: you know, again, it follows every other hip of guideline,

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Speaker 2: you know. So it's not like I can just pick

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Speaker 2: up the phone and say oh, so and so did this,

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Speaker 2: or so and so I did that. You know, if

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Speaker 2: they don't agree for a disclosure, I just sit here

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Speaker 2: and say nothing.

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Speaker 1: I want to ask, because we could have just kind

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Speaker 1: of re ran what we talked about last week with

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Speaker 1: blisters because Nicolodolo is struggling with them again. But I

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Speaker 1: thought some other national news right now is the news

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Speaker 1: of what Tiger Woods is going through. And look, I'm

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Speaker 1: on a smaller version of this because I've gone through

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Speaker 1: many surgeries, and when surgeries happened, the amount of pain

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Speaker 1: that you're in is immense and oftentimes unbear and even

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Speaker 1: to get through a sporting event at times can become

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Speaker 1: a big challenge. So I understand the pain side of

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Speaker 1: things and that there's a threshold and sometimes the pain

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Speaker 1: exceeds that threshold, and that's where painkillers can come into

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Speaker 1: the equation. I can't imagine in your world how difficult

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Speaker 1: that is is monitoring and when a player is deemed

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Speaker 1: to be fit to be off of the painkillers. Just

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Speaker 1: walk me through the process of athletes when you do

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Speaker 1: have to prescribe painkillers and how you're keeping an eye

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Speaker 1: on that.

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Speaker 2: Well. I mean, simply put, the FDA has really as

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Speaker 2: everybody knows by you know, social media and the media itself.

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Speaker 2: The FDA is really clamped down on the use of narcops.

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Speaker 2: So let's classify one group as narcotics and those percontseets

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Speaker 2: and those type of medications. And there's many institutions now

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Speaker 2: and physicians who no longer go to that level. So

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Speaker 2: there's other combinations that can be used which are non

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Speaker 2: narcotic or lower level of narcotics, so that post surgery

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Speaker 2: obviously we watch them very carefully, but a lot of

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Speaker 2: our docs have gone to some different regiments that aren't

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Speaker 2: in that family of the percocets, hydrocoding and things like that.

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Speaker 2: But if you are prescribed those, I mean, it's usually

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Speaker 2: a big warning on the bottle, do not drive. It

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Speaker 2: may cause drowsiness, may do this, may do that. So

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Speaker 2: you know, we assist our student athletes to making sure

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Speaker 2: that they're managing whatever our physicians give them, to make

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Speaker 2: sure that they don't put themselves in a situation and certainly,

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Speaker 2: and you read some of these cases, especially in you know,

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Speaker 2: the oppera alcohol the adult athlete, you know, PGA, NFL, NBA,

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Speaker 2: where they will be like, well, you know, they not

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Speaker 2: just had a narcotic in their system that's had alcohol

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Speaker 2: or they had some other substance. Anytime you start mixing products,

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Speaker 2: you're asking for nothing but problems. And of course none

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Speaker 2: of us really know what was in you know, his system,

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Speaker 2: because we're going to keep that hipo compliant and pretty

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Speaker 2: well hushed. But again, you know, people need to get

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Speaker 2: tuned into the fact that, you know, the side effects

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Speaker 2: of narcotics are just opioids are just so bad that

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Speaker 2: you know, you've got to come up with a different

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Speaker 2: pain management strategy. And if you do go on them,

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Speaker 2: then you have to have somebody really watching them, you know,

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Speaker 2: not just hey, here's a bottle and you've been through

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Speaker 2: it with us to where you know, we help you

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Speaker 2: guide your way through it. And as soon as we

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Speaker 2: get today X, you know, hey, let's just go to

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Speaker 2: extra strength tithonol, or let's go to motrin, or let's

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Speaker 2: go to this and even those medications time and all

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Speaker 2: study several years back that if you take twelve times

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Speaker 2: in all day greater than eleven days, you can start

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Speaker 2: to see liver changes. If you take motrin in an

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Speaker 2: eight hundred level motrin for more than you know, ten days,

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Speaker 2: eleven days, fourteen days, you can start to see change

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Speaker 2: in your gastric system. And you know, I have got

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Speaker 2: my share of horror stories of athletes who won't follow

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Speaker 2: our direction and won't give them a certain medication. But

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Speaker 2: oh lo and behold, they're going to go over to

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Speaker 2: Kroger and buy a big old bottle of two hundred

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Speaker 2: and fifty milligram motrin and stop start popping you know,

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Speaker 2: six seven and eight motron a day, and so it's

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Speaker 2: going to blow your stomach out. And then the next

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Speaker 2: thing you know, you know, you're losing twenty pounds, you know,

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Speaker 2: feeling well, your stomach is you know, literally got ulcers,

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Speaker 2: so you know, and it's all over the news. You know,

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Speaker 2: the number of people who have issues with the pain

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Speaker 2: medications after certain during a lot of positions, have finally said, hey,

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Speaker 2: enough's enough. You know, here, we'll give you this, you know,

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Speaker 2: we'll give you ask and why and that combination you

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Speaker 2: know should work, you know, And it's like in how

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Speaker 2: many times you know we would offer an athlete if

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Speaker 2: they needed some sort of pain suppression on game day,

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Speaker 2: you know, combine that with emotion, with some time and all,

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Speaker 2: and you know that's it. No more, I'm a narcotic

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Speaker 2: because you can't risk that, especially during the game. That

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Speaker 2: should never ever happen in our industry because, like I said,

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Speaker 2: the F game multiple years ago has really come down

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Speaker 2: on the use of opioid's narcotic type medications during participation

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Speaker 2: because it's it's way too risking.

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Speaker 1: How do you go about if if there is an

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Speaker 1: athlete that that you can tell that is now past

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Speaker 1: that point of should be taking them and perhaps still

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Speaker 1: is and and I know it's it's obviously not easy

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Speaker 1: because addiction is not easy, But what are the steps

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Speaker 1: that that would you would take if you're kind of

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Speaker 1: over that threshold? What's an athlete and you know they're

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Speaker 1: still using those those pain killers, what kind of steps

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Speaker 1: do you have to take after that?

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Speaker 2: Well, that's where you know, athletic trainers are valuable in college,

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Speaker 2: high school level, and professional level because we hopefully know

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Speaker 2: pretty much what the athletes are taking and if we

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Speaker 2: see a situation to where we feel like it's being

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Speaker 2: used in an accessive amount, we're going to sit down

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Speaker 2: with the team physicians, orthopedic primary care and we're going

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Speaker 2: to say, look, you know, here's a strategy we need

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Speaker 2: to get off of this. We need to do that

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Speaker 2: we have used psychologists in the past, We have used

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Speaker 2: pain management physicians in the past, you know, and again

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Speaker 2: you're trying to have a team approach of people who

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Speaker 2: can help this person, you know, lean off of them,

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Speaker 2: or get an understanding of here are other options. Let's

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Speaker 2: keep a close eye on it and try these other options.

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Speaker 2: So I think you're not just going to have one

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Speaker 2: person say hey, you got to be done. This is

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Speaker 2: it, It's over. You've got to have the whole team there,

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Speaker 2: you know, wherever they're at. I mean, if it's fecial

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Speaker 2: therapists involved, and you have a sycil therapist, trainer, the

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Speaker 2: primary care team position, the orthopedic surgeon, the team's counselor

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Speaker 2: so that everybody together is pulling the boat in the

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Speaker 2: right direction and helping this person to get off them

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Speaker 2: because the reason they get hooked on them is because

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Speaker 2: you know, one we're asking to play sports. Sports is

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Speaker 2: an industry where you are going to get hurt. And

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Speaker 2: then how do we continue to have you participate us

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Speaker 2: surgical while you're still and you're going SIMI low levels

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Speaker 2: of pain or medium levels of pain. And I know

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Speaker 2: there's a lot of people out there saying, well, they

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Speaker 2: shouldn't be playing at all when there's kids who don't

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Speaker 2: even tell us what they're feeling or what they're like,

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Speaker 2: and so we're we're sometimes not sometimes most of the

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Speaker 2: time we're at the mercy of the athlete telling us

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Speaker 2: exactly what's going on. And of course we can do

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Speaker 2: blood work. We've done that blood work just to make

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Speaker 2: sure what the levels are, what your kidneys are, what

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Speaker 2: your liver is. And I tend to be a little

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Speaker 2: more aggressive with that in terms of if I feel

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Speaker 2: one of my student athletes are, you know, maybe using

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Speaker 2: something a little more than I want them to, we

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Speaker 2: can get the blood work and check different levels within

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Speaker 2: the blood, the kidney system, liver system, and make sure

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Speaker 2: that they're not causing themselves to have a problem. And

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Speaker 2: I'm also not going to say, hey, look, if we

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Speaker 2: can't manage this, you're done plan until we all come

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Speaker 2: to a plan that allows you to participate without any

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Speaker 2: of this, you know, And again that's one of the

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Speaker 2: dangers of play in sports is you're going to get hurt,

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Speaker 2: and when you get it hurt, you're going to look

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Speaker 2: for methods of relieving my quote unquote pain that yet

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Speaker 2: still compete and it's funny, Tony. It's not just the

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Speaker 2: professional athlete, the college athlete. I had a patient come

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Speaker 2: in two weeks ago while I'm playing pickleball. You know,

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Speaker 2: everybody's playing pickleball today. I love pickaball. It's making me

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Speaker 2: more patients than anything in the world right now. And

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Speaker 2: the bottom line is, you know, well, my foot's been hurting,

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Speaker 2: so I've just been loaned up on time at all

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Speaker 2: and I said, wait a minute, let's call doctor X

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Speaker 2: and you get an X ray. Sure enough, you broke

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Speaker 2: your foot, so you can take all the time at

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Speaker 2: all you want. And you've been trying to play through

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Speaker 2: it for three weeks. And the bottom line is, it's

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Speaker 2: not just professional athletes or the college athletes. It's the

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Speaker 2: day to day recreational athlete who want to treat themselves

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Speaker 2: and start taking stuff and then the next thing, you know,

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Speaker 2: they never get it diagnosed right, and now it becomes

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Speaker 2: a pretty big problem for.

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Speaker 1: Them, not too like. And to me, there's such a

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Speaker 1: fine line because it's one thing, Okay, you have a surgery,

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Speaker 1: you kind of have a roadmap of when that pain

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Speaker 1: is going to last. The hard part for me is

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Speaker 1: playing through pain for a lot of players because there

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Speaker 1: are players, and you know that's very well. You know,

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Speaker 1: there are players that don't want to diagnose an injury

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Speaker 1: or don't want to diagnose a concussion because that would

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Speaker 1: mean they're going to lose their spot while they're recovering

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Speaker 1: and they may never get that spot back. So how

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Speaker 1: difficult is that line to walk of player wants to play,

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Speaker 1: he needs something to get through the pain to play,

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Speaker 1: and you don't want to put him at risk for

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Speaker 1: a greater injury versus, yes, we can give something to

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Speaker 1: alleviate some of the pain or block some of the

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Speaker 1: pain until a certain amount of time. How hard is

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Speaker 1: that line to navigate because all of these athletes want

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Speaker 1: to go out there and compete, and you want them

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Speaker 1: to be open with you about how they feel. But

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Speaker 1: at the same time, you don't want them to seclure

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Speaker 1: to hide something because it could mean less playing time.

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Speaker 2: That's a really fine line. And you know, number one

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Speaker 2: thing we say in hell care, especially in athletics, really

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Speaker 2: throughout every level of athletics is, you know, do not

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Speaker 2: do more harm. So the bottom line is, if I've

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Speaker 2: got an athlete who, let's say, has a very minor

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Speaker 2: injury and they just need a little bit of help

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Speaker 2: getting through it. There are options at the low level,

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Speaker 2: you know, lower level type of medications. Once it gets

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Speaker 2: to the point where, hey, if we let you play today,

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Speaker 2: sure I can give you this medication, but you know

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Speaker 2: we're now going to risk making it worse. So and

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Speaker 2: again not to be you know, idealistic about it. You know,

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Speaker 2: we never want anybody to play with pain per se.

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Speaker 2: But we know that that's not the case. So you

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Speaker 2: have to work with your physicians. You have to work

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Speaker 2: with the athlete and say what's the safest medication to

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Speaker 2: give to allow them to feel comfortable to participate. But

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Speaker 2: the athlete is part of that equation, a major part

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Speaker 2: of that equation, because they might, like you said, you know,

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Speaker 2: I mean, let's be honest, I love you to death.

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Speaker 2: You're one of the toughest quarterbacks we had here, and

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Speaker 2: you'd get on my butt if I if myself or

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Speaker 2: Colismo didn't find a way to get you in the game.

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Speaker 2: And there were things that we helped you with to

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Speaker 2: get through it. And again here you are, how many

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Speaker 2: years later, being a successful radio broadcaster, and we didn't

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Speaker 2: no harm in the long run. So you know, that's

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Speaker 2: what we have to sit and do is we have

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Speaker 2: to look at what is the injury, how can we participate?

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Speaker 2: What would you like us to do, athlete? And then hey,

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Speaker 2: here are options? What level do you want to try?

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Speaker 2: But during the game, what do you think I'm doing?

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Speaker 2: I mean, how many times you and I have conferences

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Speaker 2: conversations on the field with hey, how one today? Are

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Speaker 2: you so okay? Can you do this? Can you do that?

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Speaker 2: You know, you and I remember that South Florida game,

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Speaker 2: and you know the bottom line is, you know, you

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Speaker 2: ended up having another injury. But the bottom line is

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Speaker 2: at the end of today, in the long run, you

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Speaker 2: get just fine. It's just, you know, there's always what's

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Speaker 2: my favorite other saying in athletics, my job is to

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Speaker 2: fix you up for you to go out and do

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Speaker 2: it again. Yep, okay, So but again, our number one

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Speaker 2: point is we want to find a way to put

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Speaker 2: the athletes on the field on the court successfully. Obviously

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Speaker 2: having never participate in the decision making, but to no harm.

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Speaker 1: Bob Manjean, the University of Cincinnati and novacare you're the best. Bob,

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Speaker 1: have a great weekend. We'll talk again next week. Thank you,

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Speaker 1: Thank you, Tony that is Bob Manjean, University of Cincinnati

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Speaker 1: and Novcare look Finding time for physical therapy doesn't have

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Speaker 1: to be a challenge because with over twenty three locations

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Speaker 1: throughout Greater Cincinnati, Novercare Rehabilitation makes it easy to get

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Speaker 1: the care you need where you need it. From athletics

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Speaker 1: at the University of Cincinnati to average folks looking to

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Speaker 1: live life without pain, Novacare's experts have seen it all.

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Speaker 1: Find the center near you at novacare dot com Today

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Speaker 1: plenty more still to go since he three to sixty

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Speaker 1: ESBN fifteen thirty not esports station, no scripts, no filters,

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Speaker 1: just pure sports talk Moegar today at three pm on

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Speaker 1: ESPN fifteen point thirty. When you saw