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April 20, 2011

Collateral Damage

Fools Rush In

by Corey Dawkins and Marc Normandin

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We discussed yesterday why it is important not to rush back from concussions—a viewpoint that Major League Baseball agrees with, given its new disabled list policy for concussion victims—but let's not forget that patience is a virtue when it comes to even the most basic injuries. A certain off-season acquisition of the Tigers would have done well to remember that this weekend.

Peter Moylan, ATL (Low back strain/bulging disc)
Moylan recently underwent MRI testing, and a bulging disc was found in his lower back. Bulging discs, by themselves, are not that worrisome: most active people over the age of 30 have at least some degree of bulging in the discs of their lower backs and do not even know it. If the disc does not bulge to the point of compressing the spinal cord, then treatment is more focused on physical therapy and some activity modification.

There is always something that can be adjusted in an ailing player's activities, but there will likely not be many limits placed on Moylan. If the bulging disc has reached the point where it is pushing on the spinal cord, however, then surgery may eventually need to be discussed. We don't mean to scare you—the Braves will probably try to address this through physical therapy.

Now that the Braves know Moylan has a bulging disc, they can jab him with a giant needle. Moylan can undergo an epidural steroid injection to see if the pain and inflammation in the area can be lessened. This type of injection has been around for 40-50 years, and up to three of them can be administered per year. It is important to note that these injections do not cure the bulging disc, but do take away the pain. Sometimes, with proper therapy, the bulging part of the disc can actually decrease in size and become stable. This is particularly true with younger athletes.

Victor Martinez, DET (Strained right groin)
Martinez was given Sunday off after he mildly strained his right groin in his last at-bat on Saturday, but that was all for naught, as he promptly strained the same groin—and worse—on Monday. He was placed on the 15-day DL the next day.

Any lower extremity injuries to catchers must be delicately managed, but groins and hamstrings are at the top of the list. If the injury is in the same location–and we haven't heard anything different so far–then Martinez came back too early, not giving himself enough time to calm everything down. He should be able to return in roughly the minimum time allowed, but even part-time catchers don't start getting healthier as they get older.

Dallas Braden, OAK (Stiff left shoulder)
Dr. Lewis Yocum and Dr. James Andrews should just have an airport installed at their medical centers. Dallas Braden became the latest player to visit Dr. Yocum after his stiff left shoulder forced him to the disabled list on Monday. Shoulder stiffness is such a general term that it doesn't offer any true insight into which specific structures are injured.

Rotator cuff injuries, muscle spasms, muscle strains, and labrum injuries can all lead to “stiffness” in a pitcher's shoulder one way or another. The most suspicious thing we see in Braden's case is that the lefty told reporters that he'd never experienced the discomfort in his shoulder that he was feeling at the time. By the time they reach Braden's level of experience, all pitchers have experienced general muscular soreness and stiffness at least once, so his comments could be a sign that this is something out of the ordinary. We should hear the results of the examination soon, and at that point we will have a much better idea as to his return.

J.C. Romero, PHI (Right calf strain)
Romero joined the list of casualties from Monday's games and was placed on the 15-day disabled list on Tuesday as well. Romero was hoping to get back on track this year after missing most of 2009 and some of 2010 with elbow issues and eventual surgery. One thing working in his favor is that the injured calf is on his non-dominant side. He won't have to drive off the rubber with the weakened leg, although he'll still have to withstand significant forces with his plant (right) leg. Milder calf strains usually recover quickly, and the recurrence rate is not nearly as high as it is for groin and hamstring injuries.

Allen Craig, SLN (Strained left groin)
Skip Schumaker, SLN (Strained right biceps)
Nick Punto, SLN (Sports hernia surgery)

The Cardinals may be starting to run out of room in their athletic training room after the week they've had. Less than a week after placing pitchers Bryan Augenstein and Brian Tallet on the disabled list, the hitters realized they had some catching up to do.

Craig strained his left groin while trying to steal a base on Saturday, and Schumaker suffered a strain to his right biceps after hyperextending his elbow. There was a question as to whether or not Craig would even require a move to the disabled list, so he will likely be on for only the minimum. Schumaker will probably be out for more than the minimum, but not significantly so. Because his strained biceps stemmed from a hyperextended elbow, damage to both the elbow's soft tissue and the biceps must be rehabilitated.

On the brighter, scrappier side, Punto was activated from the disabled list following surgery for his sports hernia in late February and will promptly slide back into the lineup.

Flesh Wounds: Frank Francisco and Ubaldo Jimenez were both activated off the disabled list and rejoined their teams on Tuesday... Brad Lidge was cleared to enter stage two of his recovery from a strained posterior shoulder. He will start rotator cuff strengthening but is still about two weeks way from beginning a formal throwing program… Jared Burton was transferred to the 60-day disabled list with a troublesome shoulder... Juan Francisco was placed on the disabled list with a strained left calf… After our discussion of the new MLB concussion policy on Tuesday, we hope that Shane Robinson and Andrew Brown recover quickly from their head injuries following a scary collision during a Memphis Redbirds' game. Robinson also suffered facial fractures and will need surgery to stabilize them.

Corey Dawkins is an author of Baseball Prospectus. 
Click here to see Corey's other articles. You can contact Corey by clicking here

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