Semifinal : http://www.tournamentsoftware.com/s...23C717-226C-4AA1-BE1E-FDE19FFA0EC5&d=20171201 There will be live streaming through https://livestreaming.djarumbadminton.com/ Final : Live on Kompas TV (Saturday, 12.00 WIB) Bella didn't follow the recovery program (Exercise Therapy) as advised by PBSI's medical doctor (Michael Triangto). The way she talk to public is different with the reality. There was no reasons from her regarding escaping from exercise therapy. Mental toughness is the great problem of INA WS so far. Don't forget him (Hendrawan). My feeling said him the one.
Yup. My speculation is posted here (limitation of his responsibility). Again, it's just my simple prediction. It could be wrong
Here it is. The mistreated on her injury was blown up in media after her statement hence after that, PBSI gives the clarification (1), (2), (3). Her intention to do a surgery by her own funding but said to the media that PBSI didn't help the funding instead of it's her intention.
One of the main discrepancy of information here is at the result of the first visit to the psychologist. However, it is very possible that Bella already having problem psychologically at that point. There seemed to be a lot of miscommunication between Bella and the medical team, let alone looks like there was lack of communication between the coachinc team with the medical team. I would urge that PBSI should integrate their working system a bit more here. An athlete is already under a big pressure during injury, so it is difficult to hope them to really think clearly at all time during this period. The coaching should help to calm Bella down. The last point is that this shows how important the presence of a psychologist within the team and also work together with the coaching and medical team in helping a player during recovery.
Psychiatrist there, not psychologist. And the result of her meeting with psychiatrist told by her is also another things (different with the fact). As you said, she should have some problems. I know the reason why she got to meet psychiatrist (most case regarding malingering). Sorry to say, Sony Dwi Kuncoro have also more or less similar situation, regarding his bad performance with some back pain, which is proven medically nothing wrong with his back at all. (In this case, he used "back pain" as an excuse that make he lost. And the fact nothing to worry about his back). The problem is not the miscommunication, but more in the individual with "difficult" situation. I'm sure no one could handle this "hard" case. This "resist" wall rejecting every inputs given, close the door for every advise coming. In this kind of situation, I see that she's so calm, that's why she could said to the media as she's right and the other are totally wrong. Whenever someone have "difficult problem to solve" (e.g injury recovery), mostly will receive every suggestion and therapy given. They followed the advise because they want to recover and back in action. On the other hand, there is some individual seeking this injured status as their advantages to say, "Hey I'm injured person now. Don't asked me to win the match on court." or "Hey, I'm still in injury recovery. Don't touch my time. I need more time to stay-in national team." (the second example matched with her statement "makan gaji buta"). Her statement just revealed and show the background of her condition. When she accuse PBSI said that, in fact nothing said by PBSI (no way for PBSI accuse injured athletes like that). The way she's making that statement from her unconscious state, and the psychologist/psychiatrist will say her statement is 1 leaked finding and they will make the examination further away.
In that case, I still see there is something that should be addressed by pbsi. By default, pbsi has 2 options on what to do for Bella, exercise therapy or operation. I would say the decision to do exercise therapy comes with the assumption that the athlete follows the full program completely. Firstly, I can't imagine that Bella (and Sony as well) really do the 'advantages', especially the second one, deliberately. If yes, I would presume that she had always not do her best even before her injury in various tournaments. The presence of a psychology team (in coordination with the coaches) should take into account this mentality and directly give the proposal to do operation instead. It will be long recovery, but PBSI should create a clause on the players contract in such a long hibernation period to receive no salary whatsoever, or only half salary or such things, with hibernation period longer than a certain limit or the limit is the period for exercise therapy. Of course with that mentality (from the beginning), the coaches should know on when to let or to not let the athlete participate in important or team events as they wouldn't really give everything in those events. It may occurs to Bella unconsciously though during the process (and this is what I suspect), such that she did not do all the program well. The biggest question for me is why Bella was let to play again if the medical team knows that Bella had not done the therapy completely. This just shows how the communication between the medical team and coaching team is very poor. Had they done any test with Bella's knee before she came back? If she was indeed already at good condition to play, PBSI should not say that Bella did not do the program well. Even though she did not done it completely, why bother if the injury is already good enough to play? The reason should really be on her mental state that is still not ready to play even though the injury should already be healed. At this point, I even ignored on what Bella said that she went to 2 other specialist and the MRI result showed that her injury was already getting more severe. To be honest, I don't think she would lie (consciously or due to psychological thing) on this as the medical result can be checked easily whether that is true or not. I see a lot of fishy things as well here from the medical team part. The advantages that you mentioned should not be a problem if the issue above is clarified since the beginning: players are mentioned on how long they will rehabilitate (expectation), extra several months should still be acceptable and players should not allowed to play if they haven't recovered yet, confirmation of the condition just before the player come back.
The decision is made without assumption, medical recommendation based on medical examination and MRI result. They have advantages doesn't mean they used it every time. It will be used in their unexpected lose. A clause on the players contract are always present. It should be according to Permenaker. (Ministry of Labor Regulations) No. I don't think so. Once the players registered in the upcoming tournament it always based on the possibility of injury recovery was done. And no way the injured players force to play in those registered tournament. There is last day before departures, the coach and medical team would decide which players are okay and ready to play. It doesn't mean that she won't have another repeated injury. She didn't finish the program, it mean it started. And there should be per month evaluation to determined she could start playing again or not. But the program itself doesn't stop when she got the recommendation for playing again. Pondok Indah & Siloam could be asked to release medical summary as like as the client asking for (or it's only her assumption, without any document she had). Why she didn't show those result to medical team? No way you asking a surgery without any urgency based only assumption "I need it, not more than that". Surgery isn't a candy. Spoiler: Surgery. With or Without Surgery, it's a whole big exposure to big risk. Intra surgery risk sand post surgery risks is bigger than anything. If there are no indication of need a surgery, the surgeon wouldn't do it. ACL injury splitted into 2 types: partial rupture of ACL (ACL tear, ACL torn), and total rupture of ACL (ACL) ACL tear/torn/partial rupture doesn't need surgery at the first time, it may need a delayed surgery after. But exercise surgery is the best option. First of all, surgery won't be a first option. And if there is no indication, it won't choose as last option either. Any second opinion about medical condition should be taken with consideration by choosing a well recognized person/hospital (usually from a national hospital). Spoiler: Surgery would replace ACL with graft (another material from human body) ACL total rupture is the one who need surgery at first option. We could smells some fishy things. Maybe yes. But, let's take a look of her environment, why don't her parent try to speak to PBSI, why don't any of her friends (inside the Pelatnas) trying to re-bridging the gap (if there was a gap), why don't she speak to her coach (Bambang Supriyanto at the moment)? (3 months later she had a surgery and speaks to media) Let's made clear here. Exercise Therapy is a serial therapy, consist of several steps. When you failed to complete Step 1, you need to repeat again those step before you progress to the next step. She knows that she's given 6 month extra time. She rejecting to give the update on her progress and keep quiet until she got recommendation to meet psychiatrist, and said "She's not crazy, why meet psychiatrist?" Then she asking permission to do her own surgery overseas by her own funding. It's even a delay 3 months after she got permission to do that. What a way to accuse PBSI without any reason by her. Once player got injury, mostly will fall into a vulnerable condition. Whether it's real injury happened or malingering state. The second is always proven whenever no medical problem found during throughout medical examination. When I said no psychologist would help her, it's because of her rejection towards all inputs given, no matter it come from (coach, medical doctor, psychologist). When it completely closed, no one could help her. My concern is about when players said something against PBSI without any proven document they have. N.B: If you read my posting above about leaked findings by psychologist/psychiatrist, it's all about the technique used in conversation between the examiner and the examinee. During that examination using verbal communication, most of the time the examiner would get some datas (facts) that leaked unconsciously by the examinee. Some of those data, could be even appear in their press conference (media related thing). Off-course the result of those examination did not given to the examinee.
The decision by default was taken with the assumption. I mean, if the players do not take the program at all, or only taking/doing 50%, do you expect the player to get back to good condition? But this is minor point, as well as some other points Okay, with the assumption the medical team and therapy was still going well until Bella lost and 'hurt' again (as she said), so basically the possible scenario are 1. Bella hurt again during the match 2. Bella made up the medical result from the hospitals and was not hurt physically, only mentally (the advantage at that particular moment after the loss that you mentioned) The strange thing is Bella did not tell this directly to her coach. It is not explicitly stated whether Bella talked directly to her coach after the match about this or not, but I think this is what you believe is the case. After I read the article again (from her interview), I agree that you may be right thay Bella did not communicate this so called 'second injury' to her coach directly after the match. What we do know is she went to other doctor in those hospitals. And we also know that she in the end tell her condition again to the coach and medical team, because in the end, she was instructed to go to psychiatrist (and being talked in a rude manner, according to her). Okay, so most probably she was disappointed with her lost and poor performance, and became a bit delusional and a bit forcing (on the advantage thingy) after the lost. It was also because she did not fulfill the program within 6 months as given. That is poor one from her side, and I think this part is what you refer to as the 'difficult athlete'. That was also why her close people did not involve too much as well, trying to avoid it actually; this however was just worsening her mental state. One piece of puzzle that we don't know is the result of the MRI from those hospitals.Your call is that Bella made up the result. That may be true, depending on the information known. Even though we won't know till the end, I guess. Still though, supervising and permission should only be given after the therapy was done after 6 months. If Bella did not update her progress, that should be a red light for coaching team to not allow her to play. I think, the main flaw from PBSI site is in this part. Still that communication between the teams should be somehow improved, not to underestimate Bella's poor psychological state at that time as well though. Also again, PBSI should really emphasize more on how Bella's psychological condition is still not yet healed instead of saying that she did not complete the program, as basically Bella still was given the permission to play. This one is either a not very good public relation or really is a fishy thing. But in the end, okay, I get a better view on it. Issue occurs due to multiple events. Both made some mistakes and both also have their own fishy things here (for me at least). Thank you Mr. Bambang Roedyanto
Poor Bella. Very difficult situation. ACL surgery is not perfect - there may still be complications of scarring or meniscus damage that affect recovery. This knocks on to the athlete's self confidence. It's difficult to translate the results of ACL surgery on to the elite athlete. The ACL surgery she had might have been fine for a normal person who plays high level amateur sports. But for a person who does sport at pro level..... That's probably why Li Xuerui and Goh Liu Ying got their surgeries done in Germany.
Some nice article to read: ACL: To Operate or Not? Frobell's team randomly assigned 121 young, active adults -- many of them highly competitive, non-professional athletes -- to two different treatments. Both groups underwent a highly structured rehabilitation program in which they worked up from improving balance and coordination to knee strengthening exercises. One group underwent ACL reconstruction within 10 weeks of injury. But the other group delayed ACL reconstruction until it became obvious they needed it -- or until they healed. Two years later, both groups had good results. Neither treatment strategy was better than the other. But there was one big difference: 60% of those who delayed surgery found they never needed the operation. "A lot of people say you need ACL surgery if you want to return to sports. But our results show we might be better off if we start with rehabilitation," Frobell tells WebMD. "Then we can reduce the number of people needing surgery." Many Factors Involved in ACL Treatment Mayo Clinic orthopaedic surgeon Bruce A. Levy, MD, is full of praise for the Frobell study. But he warns that some patients risk further damage to their knees by delaying ACL reconstruction. The injury that rips the ACL may damage other parts of the knee, particularly the meniscus -- the piece of cartilage that cushions the bones of the knee. Source: https://www.webmd.com/pain-management/knee-pain/news/20100721/torn-acl-may-heal-without-surgery More article: ACL Injury: Does It Require Surgery? (from: American Academy of Orthopaedic Surgeons)
No, I think you didn't understand what's the medical treatment given to the players. When the exercise therapy given failed to be completed then it's decided what's the original problem. The original problem is partial rupture of ACL. I gave you a video about to make an illustration about what's an ACL surgery, which is explained above the new replacement of all the ACL. So, the partial rupture didn't fixed... the surgeon would take it out then replace the old ACL with the new one from the graft. Some private hospital willing to do all his customers based in their request, let's say "I want to do a surgery." Why do you need it? "I think I need it, that's all". Okay then, as far as you have enough money, the surgeon will take the surgery after. BUT, that's the wrong things happen. The surgery process having a complicated preparation, there are some contra indications, some obstacles during the operation time, bleeding didn't stop after, and when it finished. The post surgery would gives you 50%-50% result, that's mean no medical doctor/surgeon would give a guarantee that the treatment/surgery done would give 100% better result than before the surgery was done. Medical treatment always based on evidence. Evidence-based Medicine is the gold standard everywhere. We could make some prognosis about the current medical problem happened. Then the outcome will be predicted, good or bad. And there it go for the decision toward do surgery or not. There is possibility in the case of Bella, they would give the recommendation to do the surgery. The question, will it happen? It could be yes or no. When I ask you, if you could be healed without surgery, but then you could also asking a surgery. Which one do you choose? Another thing, once players have injured problem. The next situation are entering vulnerable condition and give them greater chance to have the next injury. Even you have done a surgery. Let's say the surgery result is going good. After 6-9 months post surgery recovery, you are playing again. The vulnerable condition still present there. Check, Sayaka Sato, Saina Nehwal, Li Xuerui, Nozomi Okuhara, and some Indonesian players like Dionysius Hayom Rumbaka (surgery was done), Setyana Mapasa (she choose to do non surgery treatment in Australia). Some of them could do their comeback on-court, but also the next repetition injury would come soon or later. I'm not wishing it happen, but the evidence have been studied before. The time table should be as below : • Sudirman Cup : 11 May 2015 • Taipei Master : 12 October 2015 • Warning given : after Taipei Masters (6 months after October 2015 ---> April 2016) • Out of Pelatnas : March 2016 • Surgery was done : 17 June 2016 PBSI will not allow any player to join any tournament with the condition "still injured". No way. The fact she joined Taipei Master is because she is okay to play (based on the training she'd done including early exercise therapy was given. I don't think she isn't in 'fit to play' condition if she manage to beat Wendy Chen Hsuan Yu, straight game 21-19, 21-11 and facing Sung Shuo Yun at second round before she ended her game after the score 16-15 leading a moment then retired at Taipei Masters 2015. The way she had injured in Sudirman Cup then 5 months later joining Taipei Masters, indicating the exercise therapy working at the moment. Then she had another injury condition. If Bella at that point think that she's in worse injury, she won't go to Taipei and could rejecting the request to play. The problem should be going on after Taipei Masters, so another batch of exercise therapy given after that second injury at Taipei Masters. A direct request to a psychiatrist a sign that the situation get enough attention. The summary that mentioning Bella didn't complete the exercise therapy was given at the end period (at the time PBSI give the clarification). I don't think PBSI said that before she had her first ever comeback (5 months after Sudirman Cup). You could ask him, do you think this account belong to him? [/QUOTE]
I have only read the abstract. It's a bit tricky and need to be careful. Some sports such as cycling or running might not need it. Other sports with twisting and turning might be at higher risk of further injury especially to the meniscus. If you have a highly motivated individual who can do all the rehabilitation, that is good but in real life, a sizable proportion of people don't complete the program for whatever reasons. Sometimes real world logistics get in the way.
So you said, the exercise therapy is only a decision making tool to see whether she has 'original problem' or not? Can you paraphrase it better? Or did I understand it well? So are you saying that she most probably have a secondary injury and the MRI result from the other hospitals are true? The problem is Bella did not tell it to anyone in PBSI? Or she did tell them and joined a second 'exercise therapy'? Your word here 'There is possibility in the case of Bella, they would give the recommendation to do the surgery. The question, will it happen? It could be yes or no' indicates that you think Bella did not tell it and does not a second therapy Yes. But the fact that she should have recovered well by that time according to you, means PBSI should really emphasize Bella's psychological condition instead of the uncomplete program thing when they talked to the media. This is the one that I said 'either a not very good public relation or really is a fishy thing'. Anyway, while I understand that some people tend to accuse private hospitals to be greedy (and partially agree), your points above also assume that they do the surgery purely due to Bella's request. OTOH, it is possible that they have different view than PBSI medical team on this matter, just like @Cheung said It is also interesting on how PBSI emphasizes more on therapy instead of surgery while some other countries do send their players for surgery like Li Xuerui and Goh Liu Ying
The therapy given by medical team should be under a very careful observation and without any assumption if it's failed then going to the second option which is a surgery. If it's completely done and no improvement then it goes to second option. If it's not completely done, then you couldn't directly summarize it need a surgery. That's the frame of exercise therapy and it's assessment. The second thing is about surgery. The decision of some cases need a surgery or not is basically based on the indications. Again, I said surgery isn't about you want or you don't want it. The surgery is an exposure to a technique which is having a lot of complicated things involved in. You should be aware about any kind of unpredictable result as well as any complications after the surgery was done. Therefore, it have a letter of approval of surgery before the procedure will starting. (including an agreement for accepting any probable complication happen afterwards as it should be explained before). No one giving a guarantee 100% you'll be a free from problems, we call it a prognosis and complications. It's not as simply as suturing an open wound on the skins. So, we will consider any positive advantages we'll gett from a surgery and also aware about any negative outcome which could be predicted or unpredicted outcome as well. Overall, how big the advantages you get compared with the disadvantages. You can't say one person got a surgery and then they could playing again AND you want to be liked that. No guarateed! After having a surgery you will have to do an exercise therapy as recovery process which is also need a strong commitment. Once she's back form Taipei Masters, there will be another medical examination and medical team made another latest diagnosis what's going on there. Bella said it or not, the medical team will ask her to have MRI examination to know the latest condition of her knee. As I said, PBSI catch the problem on her commitment to do the exercise therapy ('the incomplete' is an indication and as the result of her commitment's problem). That's why a request to meet a psychiatrist were made to get an objective condition of hers. (It's done at first try, it wasn't done after PBSI makes a public statement.) Why do you think is wrong if PBSI makes a clarification statement that she was not doing the exercise therapy completely? According to PBSI medical doctor, she went to the psychiatrist who has been appointed to handle the problem. Based on reports obtained from a psychiatrist, she need to do another further psychiatric tests, but until the time of clarification released by PBSI she has not come to the psychiatrist to undergo further tests. (when she talked to the media that psychiatrist said nothing wrong with her) And I said before that she wouldn't get the result of her psychiatric examination. The result should be addressed to PBSI directly as a requester client). But the fact she don't know the result could not be interpreted as she's okay. She should attending the next examination requested by the psychiatrist.
How worse their ACL injury? 20% rupture, 50% rupture, totally rupture? The rupture ACL accompanied with meniscus, cartilage and other environment surrounding them? The ACL injury itself consist of several variants. The decisions made have more variables. We have a National Sports Hospital (cost free for athletes) and RSCM (highest referral hospital). Why don't she visit that hospital instead of going to low reputation private hospital? In any case, if you feel PBSI medical team isn't giving a proper treatment and doesn't in line with her reason behind her request to do a surgery as soon as possible, why then she's running away from all possible steps that could be done? She was a well known players, she could speaks directly to Achmad Budiarto, Deputy of General Secretary of PBSI (she's done it only for asking permission for that surgery with her own funding) and turn the table after that by mentioning some accusation that PBSI didn't care of her and said PBSI didn't give the surgery funding. That's the problem! Lack of communications in her side. If she has another options, why couldn't she deliver it with a proper way. She's not 9 years old girl crying in the bench. Overall, my summary about her action was she want an instant result without any comprehensive understanding with her injury problem. In term of choosing the place where the surgery will done, using shortcut and find the nearest place where she want. If she feels deserved to have a surgery as her first option, why then she closed the communication with her coach after she left Pelatnas? FYI It's not the first time, PBSI have more players with ACL injury (including Adriyanti Firdasari which is mentioned by her). None of other injured players have a problem with PBSI medical doctor and none of them which PBSI didn't help in any funding needed to recover their injury.
Congratulation to the winners of PBSI National Championships 2017! 1. Akbar Bintang Cahyono/Winny Oktavina Kandow vs Andika Ramadiansyah/Mychelle Christine Bandaso [4] : 8-21, 22-20, 21-17 2. Ruselli Hartawan vs Dinar Dyah Ayustine [2] : 21-9, 21-18 3. Wisnu Yuli Prasetyo [3] vs Vicky Angga Saputra [2] : 21-11, 21-15 4. Tania Oktaviani Kusumah/Vania Arianti Sukoco vs Agatha Imanuela/Siti Fadia Silva Ramadhanti : 20-22, 21-17, 21-17 5. Hendra Setiawan/Mohammad Ahsan vs Frengky Wijaya Putra/Sabar Karyaman Gutama [2] : 21-13 21-17 Complete Result :http://www.tournamentsoftware.com/s...23C717-226C-4AA1-BE1E-FDE19FFA0EC5&d=20171202
