Fractures are never fun, but more of them will be prevented on the field in coming years.
In this installment, it’s back to the basics as we look at how fractures heal. Baseball players suffer their fair share of fractures. Clavicles, fingers, toes, hands, feet, tibias, fibulas, forearm bones, wrists, and sometimes the humerus—hey, it’s not funny when it’s broken—are among those most commonly injured. They all heal through the same mechanisms, although some take longer than others.
Functions of bone/skeletal system Bone is a living tissue that has six major functions: support, movement, protection, blood cell production, storage, and endocrine regulation. We’re all familiar with the support and protection functions, and when we think about it, movement makes sense too. Unless you’re a worm, muscles need something to pull on to produce the force required for motion. Without bone marrow, blood cells would not be made. Bone cells secrete the hormone osteocalcin, which helps regulate blood sugars and fat deposits, and they also store calcium and ferritin, which are involved in calcium metabolism and iron metabolism, respectively.
Though the Tigers were able to chase the Rangers' Derek Holland early, it was the Rangers that went home happy.
They say good things come to those that wait, and that idiom was at least half-right on Monday night. With Game Two delayed by 20 hours due to the rain that never fell, the news cycle morphed into a discussion about which team would benefit the most from an impromptu rest day. The early returns varied, but the answer became clear by nightfall.
San Francisco faces an injury stack as Carlos Beltran is disabled, Chipper has more soreness, Chris Davis' season is over, A.J. Pierzynski pops his DL cherry, Garrett Richards goes down, Jon Rauch loses his appendix, and more.
Carlos Beltran, SFN (Right wrist strain) [AGL: 25, ATD: +.036] (Explanation)
After pulling out all the stops to try to get Beltran back in action, the Giants were forced to place him on the disabled list yesterday, along with Sergio Romo. Beltran's injury was described as a strain with resulting inflammation, not uncommon for acute injuries. On the outside of the wrist where his inflammation is—anatomically speaking, it's the inside aspect closer to the little finger—there are several structures that could be injured.
The most likely structures involved are the extensor tendons for the wrist itself. The tendons themselves can become strained, or a sheath of connective tissue covering the area and keeping the tendons in place can also be injured. This straining of the tendon is similar to Mark DeRosa's wrist, which obviously isn’t something most fans want to hear. It doesn't appear at this time to be as serious as the injury that DeRosa suffered and has continued to battle. The tearing of the sheath is similar to the injury that David Ortiz suffered back in 2008. Neither of these automatically requires surgery, but either could down the line.
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.
Juan Nicasio suffers a fractured neck, Jose Reyes' hamstring acts up again, Daniel Murphy has another knee issue, Ike Davis appears to be out for the season, Chase Headley fractures a finger, Alex Cobb has hand numbness, and Jair Jurrjens finally hits the DL.
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.
Oakland's rotation takes another hit, Hanley hits the DL, John Lackey returns but remains in the woods, and Brian Roberts and Denard Span offer additional opportunities for concussion discussion.
Brett Anderson, OAK (Left elbow soreness)
Oakland's pitching staff took another hit when Anderson went on the 15-day disabled list for soreness in his left elbow. His velocity and the bite on his breaking pitches have decreased bit in the last few weeks, causing the southpaw to fear that he might need Tommy John surgery. It's common to see a loss of velocity with ulnar collateral ligament injuries in pitchers, but usually that loss occurs over a longer period of time than just a few weeks. Anderson hasn't necessarily lost a lot of velocity since the beginning of the year, but he has lost a few miles per hour since 2009.
Anderson made multiple visits to the disabled list with elbow and forearm injuries in 2010. The first stint, for a strain of the flexor tendon, lasted a little over a month. This tendon lies directly over the ulnar collateral ligament of Tommy John fame and helps to absorb some of the forces placed upon the ligament. Anderson made two appearances after returning from that scare before heading back to the disabled list with general elbow inflammation. This time it took him almost two months to come back, but by the time he did, something had changed. His velocity was reduced from what it had been in the second half of 2009, even if his results were still good.
A medical reason for Hanley's slump surfaces, a couple Cardinals succumb to strains, two Boston hurlers suffer serious elbow problems, and Ike Davis' ankle is slow to recover.
Hanley Ramirez, FLA (Low back pain and left leg sciatica)
Usually athletes don't disclose much information about injuries during media interviews, but Ramirez's interview earlier this week was the exception. The shortstop revealed one potential reason for his decreased production so far this year: his back has been bothering him for about a month, and he has also experienced numbness and pain shooting down his left leg. That’s close to a textbook description of sciatica, a common injury to the sciatic nerve in both active and sedentary people. Approximately one-third to one-half of the general public experiences sciatic pain traveling down the leg, but less than one percent of people suffer from associated numbness or muscle weakness.
The sciatic nerve is the largest nerve in the body—approximately the width of a thumb at its widest point—and is composed of a bunch of nerves that intertwine and become the sciatic nerve at the level of the piriformis, a muscle deep in the glutes. It then pierces through the piriformis muscle before traveling down the leg and branching off to various smaller nerves. An injury to the nerve and its resulting symptoms can occur anywhere along its length, from the spine on downward.