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Collateral Damage 

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04-01

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1

Collateral Damage: Santana's Uphill Battle
by
Corey Dawkins and Stephani Bee

02-19

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1

Collateral Damage: Pop Goes the Knee Joint
by
Corey Dawkins and Stephani Bee

02-06

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3

Collateral Damage: Barely Begun and Already Through
by
Corey Dawkins and Stephani Bee

01-23

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1

Collateral Damage: A Pain in the Hip
by
Corey Dawkins and Stephani Bee

11-16

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12

Collateral Damage: 2012 Year-End Injury Summary: AL East
by
Corey Dawkins and Stephani Bee

11-14

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Collateral Damage: 2012 Year-End Injury Summary: NL East
by
Corey Dawkins and Stephani Bee

11-12

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4

Collateral Damage: 2012 Year-End Injury Summary: AL Central
by
Corey Dawkins and Stephani Bee

11-09

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2

Collateral Damage: 2012 Year-End Injury Summary: NL Central
by
Corey Dawkins and Stephani Bee

11-07

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Collateral Damage: 2012 Year-End Injury Summary: AL West
by
Corey Dawkins and Stephani Bee

11-01

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6

Collateral Damage: NL West Year-End Injury Summary
by
Corey Dawkins and Stephani Bee

06-25

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11

Collateral Damage: The Year of the Injuries?
by
Corey Dawkins and Stephani Bee

04-04

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0

Collateral Damage: How Much Pain Could the Doctor (Up)Chuck?
by
Corey Dawkins and Stephani Bee

04-02

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3

Collateral Damage: Spring Tune-Ups
by
Corey Dawkins and Stephani Bee

03-30

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1

Collateral Damage: Let the Games Begin
by
Corey Dawkins and Stephani Bee

03-28

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4

Collateral Damage: Clearing the Air
by
Corey Dawkins and Stephani Bee

03-26

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2

Collateral Damage: The Tommy John Brotherhood
by
Corey Dawkins and Stephani Bee

03-23

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2

Collateral Damage: Spring Soreness
by
Corey Dawkins

03-21

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4

Collateral Damage: Fillet o' Philly
by
Corey Dawkins and Stephani Bee

03-19

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6

Collateral Damage: Bullpen Blowout
by
Corey Dawkins and Stephani Bee

03-16

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5

Collateral Damage: Mets Misery
by
Corey Dawkins and Stephani Bee

03-14

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7

Collateral Damage: Spring Uprising
by
Corey Dawkins and Stephani Bee

03-12

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6

Collateral Damage: Battle of the Bulge
by
Corey Dawkins and Ben Lindbergh

03-09

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10

Collateral Damage: Stairway to Heaven
by
Corey Dawkins and Stephani Bee

03-05

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9

Collateral Damage: Valley of Infections and Tears
by
Corey Dawkins and Stephani Bee

03-02

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4

Collateral Damage: Socket to Him
by
Corey Dawkins and Rebecca Glass

02-29

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2

Collateral Damage: Spring Training Injury Roundup: Don't Try This At Home
by
Corey Dawkins and Rebecca Glass

02-27

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8

Collateral Damage: Spring Training Injury Roundup: It's What's for Dinner
by
Corey Dawkins

02-24

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5

Collateral Damage: The DL Kings: Chad Fox
by
Corey Dawkins and Rebecca Glass

02-20

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3

Collateral Damage: The DL Kings: Nick Johnson
by
Corey Dawkins and Ben Lindbergh

02-17

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1

Collateral Damage: The DL Kings: Kelvim Escobar
by
Corey Dawkins

02-15

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5

Collateral Damage: The DL Kings: Alex Escobar
by
Corey Dawkins

02-13

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4

Collateral Damage: The DL Kings: Justin Duchscherer
by
Corey Dawkins

02-07

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10

Collateral Damage: The DL Kings: Chris Snelling
by
Corey Dawkins and Rebecca Glass

02-03

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6

Collateral Damage: The Disabled List: A History
by
Corey Dawkins and Rebecca Glass

01-30

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14

Collateral Damage: Rounding Up the Usual Suspects: Grand Finale
by
Corey Dawkins and Rebecca Glass

01-27

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0

Collateral Damage: Rounding Up the Usual Suspects: Abdominal/Oblique Strains
by
Corey Dawkins

01-23

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Collateral Damage: Rounding Up the Usual Suspects: Herniated Disks
by
Corey Dawkins and Ben Lindbergh

01-20

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5

Collateral Damage: Rounding Up the Usual Suspects: Hip Labrum Tears and FAI
by
Corey Dawkins and Ben Lindbergh

01-16

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9

Collateral Damage: The Latest Offseason Surgery Updates
by
Corey Dawkins and Ben Lindbergh

01-13

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6

Collateral Damage: Rounding Up the Usual Suspects: Thoracic Outlet Syndrome
by
Corey Dawkins and Ben Lindbergh

01-09

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10

Collateral Damage: Rounding Up the Usual Suspects: Sports Hernia/Athletic Pubalgia
by
Corey Dawkins and Ben Lindbergh

01-06

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4

Collateral Damage: Rounding Up the Usual Suspects: SLAP Tears
by
Corey Dawkins and Ben Lindbergh

01-02

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3

Collateral Damage: Rounding Up the Usual Suspects: Tommy John Surgery
by
Corey Dawkins and Ben Lindbergh

12-30

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7

Collateral Damage: Rounding Up the Usual Suspects: Ankle Sprains
by
Corey Dawkins and Ben Lindbergh

12-23

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1

Collateral Damage: Rounding Up the Usual Suspects: Thumb Injuries
by
Corey Dawkins and Ben Lindbergh

12-20

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2

Collateral Damage: Rounding Up the Usual Suspects: Fractures
by
Corey Dawkins and Ben Lindbergh

12-16

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8

Collateral Damage: Rounding Up the Usual Suspects: Rotator Cuff Tears
by
Corey Dawkins and Ben Lindbergh

12-13

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2

Collateral Damage: Rounding Up the Usual Suspects: Cartilage Injuries
by
Corey Dawkins and Ben Lindbergh

12-09

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8

Collateral Damage: Rounding Up the Usual Suspects: The Torn ACL
by
Corey Dawkins and Ben Lindbergh

12-05

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Collateral Damage: Rounding Up the Usual Suspects: Impingement
by
Corey Dawkins and Ben Lindbergh

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April 2, 2012 3:00 am

Collateral Damage: Spring Tune-Ups

3

Corey Dawkins and Stephani Bee

Soreness and tendinitis plague several ballplayers just before the regular season begins.

Michael Pineda, New York Yankees (Right Shoulder Tendinitis)
Pineda complained about shoulder soreness only a few days ago, and a subsequent MRI revealed right shoulder tendinitis. Pineda’s has thrown with slightly less velocity this spring, but he did not complain of any soreness until after his start last Friday. He averaged roughly 94 mph last year and sat consistently in the low 90s this spring, but had been playing it off as nothing. The good news is that there is no major structural damage, so Pineda should be able to resume throwing in about two weeks.

Josh Hamilton, Texas Rangers (Left Groin Tightness)
Hamilton’s latest injury is tightness in his left groin. He underwent sports hernia surgery in November on his left side, so any soreness or tightness this far away from the surgical date is expected, but it’s also a little concerning. It’s common to have soreness when returning to full activities following surgery, and normal soreness keeps players out for a few days. Right now, this is a day-to-day issue.



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March 30, 2012 4:33 am

Collateral Damage: Let the Games Begin

1

Corey Dawkins and Stephani Bee

The regular season kicks off, but the Mariners have already suffered multiple casualties.

B.J. Upton, Tampa Bay Rays, (Lower Back Soreness)
Upton was still feeling the effects from his collision with Desmond Jennings in the outfield two weeks ago; Tampa Bay elected to place Upton on the disabled list to allow him to fully recover. The injury is being listed as lower back soreness, but the root cause of the soreness could be related to muscle strains, ligament sprains, or even bone bruising in his spine.

Strains and sprains can last for more than a few weeks but usually heal just fine. When there is a collision between two diving fielders and soreness lingers, concern about a bone bruise in the spine rises. In severe cases, this trauma can cause small fractures, but usually the player is in a lot more pain than Upton appeared to be in. While the Rays do not believe Upton’s injury will necessitate a long recovery period, they’re refusing to nail down a timetable.


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March 28, 2012 3:00 am

Collateral Damage: Clearing the Air

4

Corey Dawkins and Stephani Bee

Joba clears up the confusion about his injury, while Logan Morrison continues to be plagued by knee troubles.

It’s mostly Flesh Wounds today, but there are a few important things to discuss.

Sam Fuld, Tampa Bay Rays (Right Wrist Inflammation)
Fuld’s wrists have not had a good spring. First, Fuld missed about a week near the start of spring training games with right wrist inflammation, but his current wrist soreness appears to be much worse. One of the tendon sheaths in his right wrist is irritated because it’s popping in and out of place. When there is tendon instability, it loses the mechanical efficiency and strength. It’s quite painful when it subluxes.


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Tommy John surgery claims several more pitchers, and Joba Chamberlain suffers an extremely gruesome ankle dislocation.

Ryan Madson, Cincinnati Reds (Tommy John Surgery)
On Friday, one of the most surprising bits of news with the greatest impact was that Madson needs Tommy John surgery. Madson had battled elbow trouble throughout the spring, but it looked like he was turning a corner as recently as last week. Unfortunately, in the few days prior to his scheduled debut, he suffered a setback and was sent to Dr. Tim Kremchek for further evaluation. Dr. Kremchek found that the ulnar collateral ligament was torn (some of it off the bone), and that the tear appeared to be recent because of the amount of bleeding present.

Madson signed a one-year deal with the Reds over the winter after his four-year deal with Philadelphia fell through. Madson’s injury throws everything in flux for the Reds’ pitching corps, but for now, Sean Marshall is the heir apparent as closer. General manager Walt Jocketty has not ruled moving Aroldis Chapman back into a bullpen role this year but insists nothing is set in stone. The only sure thing is that Madson will miss 2012 and will have a hard time convincing teams to sign him next winter as he completes his rehabilitation.


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Brian Wilson experiences more elbow soreness, Carlos Marmol's MRI comes back clean, Zach Britton gets good news about his shoulder, and Orlando Hudson's groin continues to keep him off the field.

Brian Wilson, San Francisco Giants (Right elbow soreness)
After finally appearing to be over his 2011 elbow problems, Wilson developed soreness in his right elbow, which has to have everyone concerned. He missed over a month last season due to a strain of the flexor muscle mass on the inside aspect of his elbow. In addition to contributing to force reproduction levels necessary to throw the ball in the upper 90s, the flexor mass is an important stabilizer to the ligament, made famous by Tommy John (with an assist from Dr. Frank Jobe).

Velocity is one of the factors that have been associated with injuries to this ligament in throwers. Whenever a pitcher experiences multiple bouts of elbow pain within a year’s time, there has to be concern about some underlying cause, whether it is ligament, cartilage, or tendon damage. Wilson was able to throw in a minor-league game on Thursday and kept his velocity in the upper 90s. He’s not out of the woods yet, but for now, he’s day to day.


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The Phillies are slammed by injuries to key players, and the results are in for Miguel Cabrera's busted eye socket.

Chase Utley, Philadelphia Phillies (Bilateral Knee Soreness)
Both of Utley’s knees are in pain. They likely degenerated further from his 2011 condition despite modifications to his strength and conditioning program. Last year, the second baseman dealt with chronic patellar tendinitis and trouble with the cartilage on the back of the kneecap. The patellar cartilage has very little ability to heal itself; if it generates pain, surgery is required. The surgery would most likely involve a microfracture technique, something that would put Utley out for at least several months.

The cartilage isn’t the only issue, though. The tendon undergoes changes to the point it’s not really tendon tissue any longer; it changes at the cellular level. In tendinosis, those changes lead to tendon weakening and make the tendon more prone to rupture. It’s one of the reasons why there is an increased chance of Achilles tendon ruptures with cases of chronic Achilles tendinitis.


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March 19, 2012 3:00 am

Collateral Damage: Bullpen Blowout

6

Corey Dawkins and Stephani Bee

The Royals' bullpen suffers a couple of blows, and the pain around the rest of the league is plentiful.

Carlos Quentin, San Diego Padres (Right Knee Surgery)
Quentin has had a difficult time staying healthy, and he’s starting his injury train early this year. The outfielder will undergo arthroscopic surgery today to fix a torn meniscus and remove loose bodies from his right knee. Meniscal injuries can cause pain, swelling, or a clicking sensation depending on the type, size, and location of the tear. If left untreated, meniscal tears can lead to arthritis. Loose bodies can also act as irritants and lead to arthritis.

The procedure is straightforward. The surgeon will remove the loose bodies and try to stitch the torn meniscus back together but will most likely have to trim the torn portion because the tissue is degenerated beyond repair. Standard recovery is four to six weeks, but it could vary if there are additional injuries not seen on the MRI. With the recovery expected to be four to six weeks, we should see Quentin back in mid- to late April. When Quentin returns to the outfield, his knee might flare up or swell.


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March 16, 2012 3:11 am

Collateral Damage: Mets Misery

5

Corey Dawkins and Stephani Bee

The punches keep on coming for the Mets, while other players deal with various sprains, bruises, and soreness.

David Wright, New York Mets (Partial Rectus Abdominis Tear)
Things just got worse for the Mets. After further tests, Wright was diagnosed with a partially torn rectus abdominis muscle toward the left side of his abdomen, which is in the same areas as the obliques. The treatment won’t be much different from oblique treatment; Wright will initially focus on rest and modalities like ice and gentle motion. Wright will then move to strengthening exercises and, eventually, baseball-related activities.

Wright’s soreness lingered longer than expected, so he had an ultrasound-guided injection to help calm the inflammation. The third baseman feels like he should be back in time for Opening Day, but that might be overly optimistic when you consider his comps are Ryan Zimmerman (who needed surgery) and Kevin Slowey (who didn’t). Both missed a little over two months’ time because of their partial tears, but the range of a “partial tear” is quite large. It looks like Wright will be back before the two-month mark, but we need to keep the extended timeline in mind. Both hitting and fielding can aggravate the injury, so we will have to wait and see how he responds to those activities.


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March 14, 2012 3:00 am

Collateral Damage: Spring Uprising

7

Corey Dawkins and Stephani Bee

Sprains, soreness, and surgeries abound in the latest spring action.

Taylor Teagarden, Baltimore Orioles (Low Back Soreness)
A recent MRI of Teagarden’s sore lower back raised concerns, so he visited a specialist for another opinion. A CT scan was ordered to better assess the area, but the O’s haven’t released an official diagnosis yet. MRIs can give us good information, but they don’t always give us everything we need. The CT can give a much clearer picture of the bone structure, which leads one to believe his injury may be related to the vertebra.

The good news is that there has been no talk of surgery yet. The bad news is that there is still no definitive timeline for his recovery. Some are speculating he will be out a week or so while others are speculating it will be much longer. No one really knows until we get an accurate diagnosis.


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March 12, 2012 3:00 am

Collateral Damage: Battle of the Bulge

6

Corey Dawkins and Ben Lindbergh

The Cardinals try to get through spring training with both aces intact despite Chris Carpenter's bulging disc, Kenley Jansen listens to his heartbeat and doesn't like what he hears, and Giancarlo Stanton and Nolan Reimold lose battles with balls.

Chris Carpenter, St. Louis Cardinals (Bulging disc in neck)
Carpenter has been dealing with stiffness and pain in his neck for about a week and was sent for further tests that revealed a bulging disc. That wasn’t the worst diagnosis in the world, but it could have been better.

There are multiple ways in which a bulging disc can cause pain. The muscles and tissues around the neck can become painful as they strain to stabilize the area and take pressure off the injured disc, and the bulge can be so big that it puts pressure either on the nerves exiting the spinal cord or on the spinal cord itself. By all reports, Carpenter does not have a disc that is bulging to the point where it presses on the nerves. In cases like this, physical therapy focuses on decreasing pain and inflammation as well as strengthening the area. An epidural injection may also be considered to relieve the inflammation, but that does not appear to be in the works quite yet.


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March 9, 2012 3:00 am

Collateral Damage: Stairway to Heaven

10

Corey Dawkins and Stephani Bee

David Robertson battles a staircase while other players nurse their respective wounds.

David Robertson, New York Yankees (Right Mid-Foot Sprain)
Not all injuries occur on the baseball field. Robertson was moving boxes, missed a step, and fell down a flight of stairs. He went for an x-ray Wednesday night; the result was negative. An MRI was used to confirm a mid-foot sprain, but Robertson needed further tests, including a CT scan and a weight-bearing x-ray.

This combination of testing raises the concern for a Lisfranc injury, the same one that felled Chien-Ming Wang in 2008. The CT can provide a very detailed picture of that joint, including a 3-D reconstruction. The standing x-ray is the tip-off, though. The MRI reveals a mid-foot sprain in severe Lisfranc injuries, while the CT may or may not reveal a fracture in the area. The standing x-ray most likely won’t show a fracture, but it will show if there is any increased space between the bones, indicative of instability in the area. When there is instability, there is a significant risk of severe long-term damage if the area does not heal through conservative measures or surgery. Without knowing the results of all of the tests, we cannot definitively say surgery is necessary.


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March 5, 2012 3:00 am

Collateral Damage: Valley of Infections and Tears

9

Corey Dawkins and Stephani Bee

The Mets' injury parade drags on, while the Brew Crew might lose an important hitter for the start of the season.

Ike Davis, New York Mets (Valley Fever)
Davis, who is on the mend from a 2011 ankle injury, has been diagnosed with “likely” having valley fever. Valley fever is a soil-dwelling fungus typically found in southwestern United States and northern Mexico, and it grows during rainy periods. The spores can break off and be inhaled whenever the soil is disrupted. Valley fever is generally benign, but more severe cases can include pneumonia, lung nodules, or the fungus spreading to other parts of the body. In severe cases, oral antifungal medications are used.

Davis underwent a routine chest x-ray during his spring physical, but the results were determined to be abnormal. After consulting multiple pulmonary and infectious disease specialists, he was diagnosed with a mild form of valley fever. He is not on any medications, but he must try to avoid extreme fatigue. Conor Jackson also had valley fever, but Davis is expected to make a full recovery without missing any time.


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