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August 24, 2011

Collateral Damage

The Wall Wins Again

by Corey Dawkins and Ben Lindbergh

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B.J. Upton, TBA (Right shoulder strain) [AGL: 3 (29 DL), ATD: -.004 (+.030)] (Explanation)
According to the team, Upton was diagnosed with a mild shoulder strain after running into the wall on Monday night. In the video seen most clearly around 40 seconds in, he braces himself from the impact but ends up putting his shoulder in a vulnerable position. The arm appears to torque awkwardly, and he might or might not sublux his shoulder.

One of the key pieces of information is the fact that he said the arm suffered transient numbness when he hit the wall. This is a very common symptom with episodes of shoulder dislocation or subluxation, but not as common with simple strains. The nerves in the shoulder can be stretched out and injured, sometimes resulting in numbness that lasts for a long time. Upton reports that he was already feeling better after the game, but the shoulder started to tighten up on him, which could be indicative of a strain or a subluxation. Upton has already injured—and played through—a torn labrum in his non-throwing shoulder in 2008, for which he underwent surgery in the offseason. His pain in that instance was different and located more toward the back of the shoulder.

The true test is going to be how he responds over the next few days. Strains of the shoulder and minor subluxations often behave the same way, but subluxations tend to take longer to return from. For now, he is day-to-day, but based on his mechanism of injury and how he looked at the time, there is a possibility of a move to the disabled list.

Matt Holliday, STL (Moth in right ear) [AGL: TBD (TBD), ATD: TBD (TBD)]
In an entry for the “We can't believe this happened” department,Holliday had to leave Monday's game because a moth flew into his ear and got stuck. While you can't see the moth enter Holliday's ear, you can clearly see how much discomfort he was in before leaving the game. Holliday said that when it flew into his ear, it kept fluttering its wings and added to the discomfort. Back in the athletic training room, the medical staff first tried to get it out peacefully by turning out the lights, hoping it would come out on its own. The moth flew in headfirst, though, and was unable to exit by itself, and therefore the staff had to remove the moth with long tweezers after a few attempts. Holliday won't miss any additional time and was already back in the lineup yesterday.

Nick Blackburn, MIN (Right forearm nerve entrapment) [AGL: 57, ATD: -.031]
We got a little more information concerning Blackburn on Monday and Tuesday. The Twins placed him on the disabled list with a strain to the lateral aspect of the forearm, not the medial side, which is closer to the UCL ligament in the elbow. In terms of avoiding Tommy John surgery, this is good news. Even better news is that the injury is not a strain at all, but rather a nerve entrapment. He will rest for between one to two weeks before returning to throwing. That timetable would permit him to return this season for the Twins, certainly a much better prognosis than before.

Travis Hafner, CLE (Right foot strain) [AGL: 39, ATD: -.022]
Hafner continued to have a rough second half of the season, culminating in his move to the disabled list on Monday for a strained right foot. He first injured it in April but was able to continue playing with it until Sunday. He fouled two pitches off his foot before getting on with a single. When he was running, he felt it buckle on him, which caused him pain. The latest word coming out of Cleveland is that he may require season-ending surgery.

Given that history, it sounds like he had a partial tear earlier in the year and then completely—or almost completely—ruptured the tendon while running the bases. Any time surgery is considered, it can safely be assumed that the player will end up missing more than the minimum. That would put Hafner back in mid-September, so any delay will likely end up ending his season anyway.

Steven Pearce, PIT (Right index finger fracture) [AGL: 42, ATD: -.015]
Index fingers fracture all the time in baseball, although the fractures often involve being hit by a pitch. Pearce broke his finger by diving for a ground ball in Monday's game, when he had the ball careen off his right index finger into short left field. He stayed in the game for a little while longer, but the resulting fracture eventually caused the move to the disabled list on Tuesday. Pearce, who has been having trouble staying healthy lately, has been on the disabled list for a torn patellar tendon in the knee, a strained calf, and now the broken index finger, all since May 2010. Pearce will likely come close to missing the rest of the season now that September is right around the corner.

Kevin Correia, PIT (Left oblique strain) [AGL: 28, ATD: -.010]
Correia was placed on the disabled list with a left oblique strain—the same one he injured in 2008—but something does not quite add up. In this brief story, he described the injury as afflicting the point where the cartilage meets the ribs. This is certainly different from an oblique strain and more likely represents costochondritis or a sprain of that cartilage. If he had his terminology mixed up, and it's actually situated where the fascia blends into the ribs—sort of like tendons—then it will behave like an oblique strain. Either way, Correia will try one time to rest it up and come back in September. If he fails, he’ll shut it down for the year.

Jose Constanza, ATL (Right ankle sprain) [AGL: 2 (29DL), ATD: +.001 (-.003DL)]
It looks like the only thing that could slow down Constanza's bat was the first base bag. On Monday night, Constanza started to limp after crossing the bag and was briefly examined by the medical team before leaving the field. He suffered a mild right ankle sprain and is likely to miss at least a few days.

Flesh Wounds: Adrian Beltre was cleared to start running on Monday but will still likely be out until the beginning of September... Alex Rodriguez did not start last night's game because of a sprained left thumb... Chris Narveson had to leave his first start back from a thumb laceration with an injury to the nail on his middle finger. He does not expect to miss a start... Victor Martinez was unavailable on Monday while suffering from back spasms. He hasn't missed a significant amount of time for low back injuries in the past and is likely just day-to-day... Tommy Hanson threw a nine-pitch bullpen session on Monday and reported that was the plan all along and that he was doing well. Of course, that was before he had to cancel his bullpen session on Tuesday because of renewed soreness in his shoulder... Paul Maholm does not have any major unexpected structural damage, according to Dr. Andrews. This still means that there is some wear and tear in the shoulder, and it will likely take several weeks before the inflammation fully calms down... Scott Hairston and Jon Niese will both likely be placed on the disabled list with strained ribcage muscles/oblique strains... The Giants just can't win. As soon as Carlos Beltran was activated from the disabled list yesterday, Jonathan Sanchez took his place with a sprained right ankle... Adam Jones was taken to the hospital for evaluation after leaving last night's game with shortness of breath and chest pains. No word yet on the results.

Now the Phillies’ turn… Updating previous items, Jimmy Rollins was placed on the disabled list with a moderate groin strain and should miss about three weeks, while Cole Hamels was placed on the disabled list with left shoulder inflammation. Hamels will likely be ready for next Monday... Jose Contreras will end up having surgery for his troublesome elbow, although the team insists it is not ligament-related. He will undergo exploratory surgery, and his availability for next season depends on what is found... Ryan Howard did not start yesterday because of left heel bursitis.

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

Related Content:  Ankle Dislocation,  Shoulder,  Finger

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