Collateral Damage: Playoff Pitch

Mark Lowe, TEX (Right hamstring strain) [AGL: 9(30 DL), ATD: -.015(-.012 DL)]  (Explanation)
Lowe injured his hamstring before the game on Wednesday, supplying further evidence that injuries can occur at any time. He suffered a Grade II strain of his hamstring while performing sprints warming up and is now expected to be out for several weeks. His availability for the playoffs is in doubt, especially the ALDS, but the Rangers are trying to speed up the healing process with a platelet rich plasma (PRP) injection.

PRP injections do not work overnight—if they work at all—so his latest treatment is not a guarantee that he will be ready in time for the playoffs. The major milestones that need to happen before he is ready include a decrease in inflammation and a restoration of normal range of motion, strength, and function of the hamstring. Until these goals are achieved, Lowe will be at risk for re-injury. The Rangers are going to have a tough decision ahead of them when arranging their playoff rosters but should have a very good idea about the part Lowe will play in one week.

C.J. Wilson, TEX (Left middle finger blister) [AGL: 5(15 DL), ATD: +.046(+.015 DL)] 
It’s starting to feel like injuries have come in pairs for teams lately. Wilson developed a blister on Wednesday night, possibly as a result of a line drive off the index finger early in September. The most likely explanation holds that the blister would have formed with or without the line drive, but anecdotal evidence suggests that grip changes can cause blisters.

The line drive caused changes in how the ball rolls off Wilson’s fingers and the pressure on his skin at that time. With the pressures distributed differently, more friction was placed on the middle finger, which caused the blister to open up on Wednesday. With the Rangers having all but wrapped up the AL West, they have the ability to rest Wilson and get him ready for the playoffs.

Scott Sizemore, OAK (Right shoulder inflammation) [AGL: 3(31 DL), ATD: +.013(-.016 DL)] 
Getting used to a new position isn’t something that can be done overnight, even by the most gifted athletes and baseball players. The ball comes off the bat at different angles depending on defensive position, and as Sizemore is finding out, throwing distance and intensity also vary.

Sizemore’s shoulder became inflamed as a result of the increased number of throws and distance involved in playing third. Controlling muscular fatigue is a balancing act that can often be too easily tipped into the pathologic range. The muscles controlling fine humeral head movements—including the rotator cuff—can fatigue, which cause the humeral head to migrate before eventually pinching underneath the acromion. Without a corticosteroid injection, the inflammation will not disappear overnight, but Sizemore could return any day.

Brett Lawrie, TOR (Right middle finger fracture) [AGL: 29, ATD: -.049]
Before Wednesday’s game, Lawrie suffered another injury to his hand/fingers and was placed on the 15-day disabled list shortly thereafter with a right middle finger fracture. Earlier in the year, Lawrie broke his left hand after getting hit by a pitch in the minors and missed 48 days. Luckily, the finger does not appear to need surgery and should be healed in about four to six weeks. Unfortunately for Lawrie, this ends his season. Barring any crazy setbacks, however, he’ll be ready well before spring training.

Tommy Hunter, BAL (Strained right groin) [AGL: 4(28 DL), ATD: +.020(-.009 DL)]
When Hunter was with Texas earlier in the year, he missed 78 days due to a strained right groin, and it appears that he’s reaggravated it yet again. This is the fourth time he has strained his groin since 2008, which should raise concerns that there is another condition present, such as a sports hernia. 

It is true that groin strains can recur, but Hunter’s is recurring too readily for it simply to be dumb (bad) luck. The underlying injury does not have to be severe; it could be something as simple as muscular imbalances throughout the peripelvic region. Hunter fully expects to make his last start of the year, but how effective he will be remains to be seen.

Phil Hughes, NYA (Back Inflammation—Herniated Disc) [AGL: 7(45 DL), ATD: -.049(-.053 DL)]
Hughes hasn’t pitched since September 12th because of inflammation in his low back resulting from an old herniated disc injury. Hughes originally injured his back in 2004, and the recent flare-up did not calm down with rest.

GM Brian Cashman was insistent that it was a minor issue and that the pain would have resolved with extended rest, which certainly was the most likely outcome. However, with the playoffs looming, the team doctors wanted the epidural in hopes that it would significantly speed up recovery. Since the Yankees clinched a playoff spot, the wisest thing would be to limit Hughes to throwing on the side or a light bullpen session in hopes that he will ready for the ALDS.

Flesh Wounds: Chien-Ming Wang has come down with a case of the flu but still expects to make his start on Saturday… Adam Wainwright is coming along very well in his recovery from Tommy John surgery and has progressed to throwing off the mound. He should be ready for 2012… Jason Kubel and his mid-foot painhave been ruled out for the rest of the season… Lucas Duda hasn’t officially been diagnosed with a concussion after running into the outfield wall Wednesday night and subsequently experiencing dizziness. However, if his symptoms continue or ImPACT testing show a cognitive deficit, his diagnosis may change… Dan Haren was able to escape with only a minor left wrist contusion after a line drive struck him on Wednesday. Given that the injury isn’t to his throwing arm, he should make his Monday start without any difficulties… With the Red Sox clinging to a playoff spot, the Red Sox confirmed that Clay Buchholz will not return as a starter this year. He hasn’t been stretched out enough to start but remains a possibility to return in a relief role this year… Josh Tomlin has officially been ruled out for the season with his strained elbow…  Hunter Pence’s MRI revealed a strain of the patellar tendon, as well as inflammation in the area. He’ll probably miss a few more days.