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April 4, 2012

Collateral Damage

How Much Pain Could the Doctor (Up)Chuck?

by Corey Dawkins and Stephani Bee

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Andrew Bailey, Boston Red Sox (Right Thumb Surgery)
The Red Sox were not giving many details about Bailey’s thumb injury largely because they could not pinpoint when Bailey was injured. The pitcher’s visit with Dr. Graham confirmed he’ll need surgery on the ulnar collateral ligament in his thumb and will be out for several months at least.

Major acute ligament injuries in the thumb can almost always be attributed to a specific incident. The player may not remember the exact play, but in the following days there will be bruising, swelling, and/or pain. True acute injuries do not just hide and then pop back up 10 days later without something new to aggravate the injury. Bailey was apparently able to pitch a few more times before he felt pain while showering.

A subset of ulnar collateral ligament injuries in the thumb result from chronic sprains similar to the UCL in the elbow and require surgery. An acute injury then occurs, which can cause an already stretched portion of the UCL to tear and be pulled closer to the skin; it essentially gets stuck out of place. If the torn ligament is stuck in its original position, it will usually heal, but when it is pulled back, the ligament cannot heal and the thumb remains unstable. This lines up with Bailey’s complaint that squeezing a shampoo bottle caused pain; muscles will pinch the torn edge of the ligament.

Right now, what we do know is that Bailey will be out until at least the All-Star break and the bullpen has been thrown in flux.

Josh Outman, Colorado Rockies (Strained Oblique from Food Poisoning)
Outman is not the first player to pull an abdominal or trunk muscle from something other than playing baseball, and he will not be the last. All you have to do is look at Sammy Sosa and Kevin Mitchell. Sneezing and vomiting cause the abdominal and trunk muscle to violently contract, which can cause muscle strains. The strains usually are not as severe as throwing-related injuries, but they could theoretically be just as bad. Outman will likely be out for more than the minimum based on the history of other oblique injuries.

Joey Devine, Oakland Athletics (Right Elbow Soreness)
The news keeps getting worse for Devine. He is already battling biceps inflammation, and now he’s experiencing pain in his medial elbow again. He has a Tommy John surgery under his belt, and he has dealt with persistent forearm flexor tendinitis since. This recurring pain is so concerning that Devine will be evaluated by Dr. Andrews to see if there is any need for surgery, which is the worst-case scenario. He certainly will not be activated when he’s eligible on Monday.

Dallas Braden, Oakland Athletics (Left Shoulder Strain)
Braden received very encouraging news when he visited Dr. David Altchek and was diagnosed with a shoulder strain. The surgical site did not appear to be compromised, and Braden was given a PRP injection to expedite the healing process. Even though it was certainly good news, this setback could cost Braden another month or so of the season. Part of the PRP protocol is to refrain from throwing for a full three weeks; there is no way around that. Braden will likely be pushed back another four to six weeks.

Josh Beckett, Boston Red Sox (Right Thumb Soreness)
While Bailey’s news seemed to get worse by the minute, Beckett’s thumb news is starting to get a thumbs up. The righty does not need surgery, and manager Bobby Valentine expects Beckett will start the second game of the season.

Kyle Farnsworth, Tampa Bay Rays (Right Elbow Soreness)
In what feels like an exposé on the American League East, Farnsworth will most likely start the season on the disabled list for his right elbow soreness. His soreness waxed and waned throughout the spring, and he was trying to work it out before spring training finished. The pain didn’t subside, so Farnsworth was sent for an MRI. The Rays have not discussed exactly what is going on, but it appears that the righty could miss more than a month of the season. Early reports indicate surgery is possible.

Flesh Wounds
Washington officially placed Mike Morse (latissimus dorsi), Drew Storen (elbow inflammation), Rick Ankiel (quadriceps), and Chien-Ming Wang (hamstring) on the 15-day disabled list. Morse and Ankiel are expected to return around April 12, while Storen and Wang are expected to return about one week later. … Washington also officially placed Cole Kimball (recovery from rotator cuff surgery) and Chris Marrero (recovery from hamstring surgery) on the 60-day disabled list. Both are expected back around the All-Star break. … Brandon Inge was placed on the disabled list with a strained groin. The Tigers expect his stay there to be short. … Luis Marte strained his left hamstring and was placed on the 15-day disabled list. Expect him to miss a little more than the minimum. … Josh Hamilton is battling migraines and groin tightness and is day-to-day. … Chipper Jones took some swings and appears to be ahead of schedule. … Speaking of ahead of schedule, Corey Hart was able to return to game action yesterday and appears to be ready for the start of the regular season. … Cliff Pennington suffered a groin strain on Monday and is questionable for Friday. …. Yuniesky Betancourt was scratched yesterday with a sore ankle and is day-to-day. … Sean Burroughs has been out for a few days with back spasms and is day-to-day. … Neal Cotts suffered a grade two strain of his latissimus dorsi and will miss several weeks. … Sam Fuld underwent surgery to repair the extensor carpi ulnaris tendon in his wrist. He will be out for four to five months. … Frank Francisco had fluid drained from his knee and also had a cortisone injection, but his MRI was encouraging. He was reportedly available for yesterday’s game. … The Braves placed Robert Fish on the disabled list retroactive to March 26 for left elbow tendinitis, and Anthony Varvaro was officially placed on the disabled list for the pectoral strain in his chest. 

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

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