As the sad tale of Nick Johnson shows, a high on-base percentage doesn't help unless you can stay in the lineup
One of the most difficult aspects of injury projection is deciding how to deal with acute injuries. Athletes often acquire a “bad luck” label that follows them over the course of a season or a career, even if their injuries haven’t followed a predictable pattern. It isn’t much of a surprise that out of all the hitters in the last decade, one such injury-prone player, Nick Johnson, has missed the most days on the disabled list and the third-most of any player.
The New York Yankees drafted Johnson in the third round of the 1996 draft. Like all of the other players on the DL Kings list, when Johnson has been healthy, he’s been a productive player. In his first season in the Sally League, he displayed power, speed, and a good eye, only to improve over the next two years. He also got his first taste of the injury bug in 1998 when he dove for a ball, tore his labrum, and underwent surgery. He missed six weeks.
Al Alburquerque, Justin Smoak, and Jason Marquis come out on the losing end of confrontations with batted balls, while Mike Pelfrey and Brandon McCarthy get off easy, Xavier Nady and Derrek Lee suffer fractures from pitched balls, and Tommy Hanson hits the DL again.
Stephen Drew and Carlos Gomez break bones in the line of duty, while Grady Sizemore succumbs to another sports hernia, Carlos Gonzalez suffers more wrist problems, and Orlando Hudson passes out.
Stephen Drew, ARI (Right ankle surgery) [AGL: 65, ATD: TBD] (Explanation)
On Wednesday night, Drew's season quickly came to an end after he slid awkwardly and sustained a fracture of his right ankle/lower leg that required surgery to stabilize. In the video, as he goes into his slide, his cleats bite into the ground and force his ankle/foot into eversion as they become trapped under his left leg. Continuing to slide, the force became too great, causing the bones to snap and ending his season. Near the end of the play, you can see that the foot is turned in an unnatural position, almost completely opposite what is normal.
Even though initially the injury was thought to be from contact with the catcher's shin guards, the video clearly shows that the injury process was already in motion, as the ligaments are being sprained prior to contact. It was the continued rotational force between the ground and the body—not the compressive force of the shin guard—that caused the fracture.
Jose Bautista exits a game early, Josh Johnson still isn't allowed to start throwing, Brett Anderson finally gets a new UCL, Carlos Gonzalez nurses a sore wrist, and another oblique strain is added to the list.
Jose Bautista, TOR (Right ankle sprain) [AGL: 2 (29DL), ATD: +.001 (-.004DL)] (Explanation)
Any time one of the league's leading power hitters makes an early exit from a game, it's going to be big news. Bautista left last night's game against the Yankees with a twisted right ankle after sliding hard into third—maybe it's time for Major League Baseball to start using the Little League-style breakaway bags. (Joking.) Preliminary x-rays were negative, but the Jays will likely move on to an MRI as a precaution. He will probably miss at least a few days based on the injury description and the AGL above, but since the MRI was ordered, there is at least some chance that he’ll go on the disabled list.
Josh Johnson, FLO (Right shoulder inflammation) [AGL: 38, ATD: -.034]
Johnsonstill hasn't started throwing again after being placed on the disabled list on May 17th, and he’s looking less and less likely to do so anytime soon. The injection in late June appears to have calmed the inflammation down, but not enough for Florida to feel comfortable advancing his rehabilitation. It's apparent that the Marlins are going to be very cautious while coaxing him through each level of the throwing program.
Albert Pujols, Hunter Pence, and Matt LaPorta succumb to sprains, Tommy Hanson hurts his shoulder, the Red Sox suffer a rash of injuries, and John Danks survives a scare.
Albert Pujols, STL (Left wrist)
It seems as though hardly a week of the season has gone by without another event that causes Cardinals fans to hold their breath, starting in spring training with Adam Wainwright and continuing through the collision at first base involving Pujols. Collisions at first base happen all the time, but the ones that stick out in everyone's mind involve injuries similar to Brian Roberts’ in 2005 (dislocated elbow) and Derrek Lee’s in 2006 (broken wrist).
As Pujols was reaching up the line for the throw from second baseman Pete Kozma, he collided with Wilson Betemit. His wrist was bent backward to a disturbing degree, his elbow flexed to an odd position, and his shoulder was twisted. Pujols was clearly in immediate pain, mainly focusing on his wrist, but he also pointed to the shoulder at one point. The athletic trainers left the dugout to examine Pujols for any major fracture and quickly helped him from the field. Following the game, GM John Mozeliak described Pujols’ injury as a sprained left wrist after initial x-rays ruled out obvious fractures, but further tests will be performed on Monday.
Vicente Padilla meets the microdiscectomy, Oakland gets good news on Brett Anderson, Justin Morneau hits the DL (and little else), and a calf strain lengthens the Captain's road to 3000.
Vicente Padilla, LAN (Microdiscectomy in neck) We've discussed the debilitating nature of intervertebral disc injury and briefly talked about approaches to managing the condition. The conservative course of treatment involves exercises designed to stabilize the core and prevent the area from being subjected to too much motion. Conservative treatment doesn't always work, though, and symptoms can reach a point where surgery becomes necessary in order to restore an athlete to a high level of performance.
Both in the past and in some current cases, surgery on a herniated disc (discectomy) is performed in an open procedure through an incision. The patient is placed face-down on a special table, and an incision about three to five centimeters long—depending on the size of the patient—is made over the injured disc. Muscles, tendons, and general connective tissue all have to be cut and retracted in order to reach the spine, and spinal ligaments and small pieces of bone need to be removed in order to get to the actual disc.
Pablo Sandoval and David Freese suffer fractures, Ryan Zimmerman's return isn't close, and Carlos Lee hopes his bruised baby back ribs ribs aren't broken.
It was a bad weekend to be a third baseman in the National League. It was also a bad time to be Carlos Lee, but then again, that has been the case for much of the last two seasons.
Pablo Sandoval, SFN (Right wrist surgery—hamate)
A hitter's wrist is his lifeline, so whenever it requires surgery, there is a lot of understandable concern. Hamate fractures account for somewhere between two and five percent of all wrist fractures, and are more common in baseball and racquet sports. (Are you picturing Sandoval wearing Wimbledon whites? Mission accomplished, then.)
The Red Sox get Jacoby Ellsbury back but put Kevin Youkilis on the DL, along with other injury news from around the major leagues.
Kevin Youkilis (sprained thumb, ERD TBD) Jacoby Ellsbury (fractured ribs, ERD 8/4) If you'd asked me yesterday, I would have thought that Youkilis would be back in the lineup and that Carlos Santana would already have had surgery to repair his leg. Turns out, I was wrong on both. Youkilis is on the DL with a torn adductor muscle. This is one of the small muscles of the thumb that allows it to be such a useful digit. This particular muscle pulls the thumb in (adducts) toward the hand and is involved in the grip. When Youkilis got jammed and injured it, it was an unusual mechanism. Usually, this would be injured more in the way we saw with Chase Utley or David DeJesus, where there's a forced abduction (pulling away and back from the hand). In that case, the tendon is usually what goes, rather than the muscle itself. Because we don't know exactly where it happened and how, it's difficult to see exactly what happened that resulted in this injury... or is this the problem? Youkilis told NESN that this problem has been "going on for a while" so what we saw was the "last straw" rather than the real mechanism of injury. Youkilis is headed for tests that will determine if he needs surgery and how long he'll be out.
Some of the things Baseball Prospectus' resident injury expert ponders on a daily basis.
In the last 24 hours, I've had three men I really respect discuss three topics with me. One asked about pain and baseball. Another asked about the dangers of wall vs. player collisions. The last one asked about the cost of injuries. This is a bit of a change of pace for UTK, but it's all related, so I wanted to share the type of things I think about on a day-to-day basis.
The Fish are a man down after post-game hijinks, along with other injury news from around the majors.
Chris Coghlan (torn meniscus, ERD 9/30) Between Kendry Morales and now Coghlan, post-game celebrations might get banned this year. Coghlan had an MRI yesterday, and reports vary on what was injured. Some say that it showed a sprained MCL in his knee while most, including MLB.com, say that there's a meniscal tear. Fact is, it's likely to be both. It's said to be the result of a "pieing" on Sunday. Coghlan snuck up behind Wes Helms and got him with the shaving cream to celebrate Helms' game winning hit, but somehow torqued his knee and sprained the ligament. Coghlan heads to the DL, but there's no word yet on surgery. There's no word on how significant the sprain is (if it exists), but in most cases, the MCL isn't repaired surgically even if it's ruptured, so that shouldn't affect the timing. Reports have Coghlan out for eight weeks, which would in essence end his season, but that's the high end of the estimates. Coghlan will immediately start a rehab program, and the Marlins trainers will start looking for a brace that will protect Coghlan's knee. The Marlins' slogan of "Serious Fun" has ended up a serious injury.