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May 20, 2011

Collateral Damage

Wristy Business

by Corey Dawkins and Marc Normandin

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Brian Roberts, BAL (Concussion-like symptoms)
Chris Dickerson, NYA (Concussion)
Roberts began suffering concussion-like symptoms after a head-first slide on Monday night, and he continued to experience symptoms over the next several days, leading to a concussion diagnosis and another entry on to the new 7-day DL for the concussed.

Our ability to assess concussions has greatly improved in recent years with the advancement of ImPACT testing and even more detailed neuropsychological testing, which allows us to get an idea of just how set back a player is as a result of his concussion. Everyone can agree that Roberts started experiencing symptoms after one particular moment—his head-first slide. He will still have to progress through all the various steps necessary to get back onto the field, regardless of whether or not his condition is officially called a concussion—you have to give MLB credit for playing it safe with its players.

Dickerson is unlikely to forget how he got his concussion after he was beaned by a Mike Gonzalez pitch on Wednesday night. In some ways, he was lucky that the ball glanced off sharply after hitting him in the helmet, because much of the force was not absorbed through the helmet and skull before being transferred into the brain. In other ways, it's often not the direct force that causes the more severe concussions but instead the quick rotation–especially involuntary–of the brain inside the skull.

Looking at the replay you can see the quick rotation of the head and neck, but that was more voluntary than involuntary. If you stuck around, you also got to see the impressive bump on the side of his noggin once he took his helmet off.

Dickerson does not have to go onto the disabled list because of the concussion, although the option is there for the Yankees to use. Again, placement is not automatic if a player sustains a concussion—this isn’t a punitive list. Instead, it works just like other disabled list transactions: there is a right but not an obligation to put someone on the disabled list.

Matt Holliday, SLN (Left quad strain)
Lance Berkman, SLN (Right wrist sprain)
In the space of two innings on Wednesday, the Cardinals lost two-thirds of the middle of their order to injuries, if only for a short period of time.

Holliday was running down the first base line on a groundout in the second inning when he felt his left quad tighten up. The quad strain doesn't appear to be major, but the Cardinals are playing it conservatively. They gave Holliday a break on Thursday, keeping him out of the starting lineup.

Berkman's right wrist sprain is a little more serious than Holliday's strained quad, but an MRI ruled out any ligament tears. His wrist will likely keep him out a few more days, but wrist injuries can be a tricky thing to recover from. Berkman seems to play very poorly when dealing with injuries—see 2010 for recent evidence of this—and has been excellent in 2011 to this point (Berkman has a .404 TAv, an absurd figure on Earth, in this galaxy, and in a few hell dimensions, as well), so losing his bat (or at least the healthy version of it) could be problematic for the Cards.

Mark DeRosa, SFN (Left wrist strain)
DeRosa’s left wrist acted up yet again; this time, the pain forcing him out of Wednesday’s game. Since 2009, when his wrist saga began, DeRosa has spent over 200 days on the DL. Surgery in 2010 led the majority of the time lost, but this isn’t the first time in 2011 that we have discussed DeRosa’s wrist, even after the surgery.

There has been no timetable announced for DeRosa's current situation, but he will have to proceed with caution, given the fact that he has already missed time earlier in the year with inflammation. Our new advice is to go to the Dominican and inject stem cells into it*, because how else are we going to find out if that treatment works as well as Bartolo Colon’s fastball velocity suggests that it does?

*Kidding. Sort of. Come on, you know you're just as curious as we are.

Tyson Ross, OAK (Right oblique strain)
Ross was well on his way to coming back from a sprained UCL suffered in 2010 when he sustained a right oblique strain on Thursday. Ross, who is filling in for Dallas Braden now that Braden's shoulder capsule has failed him, has always seemed to be a health risk because of his mechanics. This latest injury is another example of the oblique “epidemic.” Ross was barely into the game on Thursday when he felt his oblique strain, and he will likely end up on the disabled list as a result. There hasn't been word yet on how severe the injury is, but the A's are definitely going to have to take it slow based on his injury history and the fact that they are already more than a man down in terms of starting pitchers.

Flesh Wounds: Vicente Padilla is back on the disabled list with right elbow/forearm discomfort... Joe Blanton will likely be placed on the disabled list with his right elbow soreness... Cesar Izturis is going to have surgery on his right elbow to address the numbness in his lower arm.

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

Related Content:  Concussion,  Quad-a

8 comments have been left for this article. (Click to hide comments)

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Dan W.

Quick question about concussions. I got knocked in the head playing basketball the other week and when I asked two doctor friends whether my lingering headaches a few days later were because I'd gotten a mild concussion, they both said "It's not a concussion if you didn't lose consciousness." Are they wrong, or is there a semantic/diagnostic point in there that someone is eliding?

May 20, 2011 08:22 AM
rating: 0
 
Bodhizefa

You do not have to lose consciousness for a concussion to occur. My little sister fell off her top bunk one time and sustained a concussion while remaining conscious the entire time. Pretty scary, though, regardless.

May 20, 2011 08:45 AM
rating: 0
 
apbadogs

Definitely don't have to lose consciousness to suffer a concussion. My 14 year old son plays ice hockey and in February got hit along the boards, his head pushed in the glass...he visited la-la land for about an hour and a half, never lost consciousness, but the hospital ER diagnosed it as a Grade III concussion. I though it should be Grade II being no loss of consciousness, but whatever, bottom line is you don't need to be knocked out.

Now, my real question is, how does Brian Roberts sustain a concussion on a head first slide? I haven't seen the supposed play.

May 20, 2011 09:15 AM
rating: 0
 
BP staff member Corey Dawkins
BP staff

i'm still trying to find the video but there are many ways to have a concussion on a head first slide. The head can shake violently from the impact on the ground, from hitting the base, from hitting another player's knee/leg/elbow etc.

May 21, 2011 07:52 AM
 
BP staff member Corey Dawkins
BP staff

Sorry for not getting back to everyone yesterday. I got stuck in clinic.

You definitely don't have to lose consciousness in order to have concussions. There was an older belief that you had to lose consciousness in order to have a concussion, but there has been a ton of research showing this isn't the case.

May 21, 2011 07:24 AM
 
Playwright22

I'm thinking you've misnamed "Flesh Wounds." Today's "Flesh Wounds" seem pretty serious.

May 20, 2011 08:58 AM
rating: 0
 
ostrowj1

Perhaps it should be renamed "I'm not dead yet" for today.

May 20, 2011 11:36 AM
rating: 1
 
Sacramento

I wonder if Billy Beane will consider picking up the DFA'd Armando Galaraga as a temporary rotation patch. He might find the friendly confines of the Coliseum more to his liking.

May 20, 2011 14:08 PM
rating: 0
 
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