The latest on last-minute injuries to wild card contenders (Saltalamacchia, Holliday, and Furcal), plus Mark Trumbo's foot fracture and Ryan Zimmerman's hamstring strain.
Jarrod Saltalamacchia, BOS (Bruised collarbone) [AGL: TBD (TBD DL), ATD: TBD (TBD DL)] (Explanation) There are two camps of Red Sox fans right now—those who ask how else they can squander the wild card, and those who ask what else can happen to them. Saltalamacchia’s latest injury would fall into the second camp.
With the Sox already having lost Jason Varitek to a knee injury, Saltalamacchia took a foul tip off his collarbone and had to leave the game in a lot of pain. The clavicle is the shoulder’s only bony attachment to the body itself, and any injury to it will significantly affect the shoulder’s function. Collarbone bruises can linger for a few weeks before permitting pain-free throwing.
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Nelson Cruz's old injury enemy strikes again, Darren O'Day tries to return for the stretch run, Brennan Boesch attempts to avoid surgery, Justin Morneau misses times amidst conflicting reports, Hanley Ramirez's shoulder woes could be more serious than initially believed, and the odds are against Pedro Feliciano.
Feliciano has spent the season on the disabled list trying anything possible to avoid undergoing a surgery whose previous recipients include Chien-Ming Wang, Scott Elarton, Johan Santana, and Dallas Braden. The shoulder capsule plays a role in the joint’s tensile stability during rotational movements, and it also creates a negative pressure inside the shoulder joint, further stabilizing it.
We explain how an epidural injection works (at Michael Cuddyer's expense), Kevin Youkilis and David Ortiz try to come back from nagging injuries, Jason Kipnis hopes to avoid a DL stint for a hamstring strain, and another line drive hits a pitcher's head.
Michael Cuddyer, MIN (Cervical disc herniation) [AGL: 4 (73DL), ATD: +.011 (-.011DL)] (Explanation)
Cuddyer's neck pain was the result of inflammation from a herniated disc, and he underwent an epidural injection. He’s had a bulging disc in his upper back/lower neck since at least 2004 and has dealt with the periodic flare-ups well enough. The goal of the epidural injection is to allow him to recover more quickly.
We've talked about epidural injections before, but we haven’t discussed how they are performed. An epidural is an injection of strong anti-inflammatories similar to cortisone in the area just outside the sheath surrounding the spinal cord, called the dura. Injections follow a pretty standard protocol and take between 15 and 30 minutes to perform. Often the injections are performed in a series of three or more, spread out over several weeks, in order to provide maximal benefit.
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.
The Curse of the Phillies Closer strikes again, Neftali has reason not to be Feliz, and Franklin Gutierrez is diagnosed as irritable.
Jared Burton, CIN (Right shoulder debridement surgery)
Debridement is a term that we hear at times when the word surgery pops up–usually in the upper extremities–but what does it entail? We have a general idea that it involves going in arthroscopically and cleaning up an area, but anyone with children–or in our case, past sloppy roommates–can attest, there are differing interpretations of what "cleaning up" actually means.
By definition, debridement is the act of removing dead, contaminated, adherent tissue or foreign material. This can include anything from battlefield shrapnel to the tiny pebbles in road rash. In baseball, debridement happens with everyday cuts and scrapes, but the ones that make the news involve surgeries that most often occur at the same time as other procedures (such as rotator cuff repair or labrum repairs in the hip).
A day without catastrophic trauma allows our injury analyst to discuss the lower half at length.
On the injury front, no major news is good news, especially during this time of the year, when optimism (no matter how misguided) springs forth from every camp. Fortunately, there are no major injuries to report today—something Cardinals' management and fans should be pleased about, given the scares and losses they have already had to deal with this spring—which gives us some freedom to examine some common leg injuries in detail.
Ready and rested, Will dives into dissecting a week's worth of breakdowns and injuries.
¡Hola, amigos! Acabo de regresar de una semana en Mexico - una semana de playa hermosa, la cerveza, y el beisbol no. (Mi espanol mejoro un poco tambien.) Oh, wait... English now. A week away provides a perspective, the same way that a fortieth birthday does. Being away, especially during a week where player after important player seemed to go down, reminded me why I do this every day. I see baseball through the lens of health and while sometimes, it would be a bit more accurate to wait or do something like write once a week or so, the story is lost. A player is injured-how bad is it? What is the medical staff doing? How are the players reacting? Is there a roster move? Is the team capable of filling in for the lost player? So much more happens than just the injury. Some of you missed having UTK here every day, some of you didn't, and the vast majority didn't notice, reading the rest of the content here. That's okay with me. I'm telling stories that involve injuries, not writing about injuries. It took me years to realize that and a beach. No matter ... a las lesions!
David Huff isn't worse for the wear after getting skulled, but the need for better head protection remains critical.
David Huff (concussion)
Huff is OK. That's the great takeaway from this after he was hit just over the left ear by a blazing liner. Watch the video and you'll see that the ball ricochets hard off his skull and into right field. This is actually a good sign, as the energy was still in the ball and not his skull. (Compare that to one of the worst I've seen, the similar injury to Bryce Florie.) Watch closer and you'll see his glove come very close to catching it. If the timing is a bit different, we see that one as a "web gem" and not a near-fatal injury. Yes, it's an uncommon injury to be struck by a liner. Some estimates have it as one in 50,000 over all levels, but there are a lot of near misses and let's face it, it's the one that worries me. We've had story after story this summer about this type of injury, including this great article which details not only those injuries, but some attempts to prevent them in the future. MLB players will likely fight wearing any sort of protective device, much in the way they deride the "Gazoo" helmet. I don't worry so much about Huff (who says he's against any sort of protection) as I do the kids like Cole Schesner, who's wearing a helmet now in all the worst ways. I don't have a solution, but I'd love to see MLB take the lead on this. Take a million bucks—the same they've thrown away on steroid education that hasn't happened—and put it into an "X Prize" contest for the best solution to head protection. Anything is better than nothing, which is what we have now. As for Huff, he's fine, though I'm sure he has quite the headache. He'll be monitored for post-concussion symptoms, but it's not even clear whether he'll even miss a start, let alone go on the DL. (Larry Granillo from Wezen-Ball has a great article on the history of batting helmets, which gives some needed context.)
Kyle Lohse is headed for surgery on a rare arm injury, along with other medical news from around the major leagues.
Kyle Lohse (compartment syndrome in forearm, ERD 9/1)
After reading Joe Strauss' story on Lohse, I erased most of what I had written about the Cardinals right-hander. Not because it was wrong, but because Strauss hit it out of the park, like an Albert Pujols homer. There's barely not a need to add anything here, but I have one thing that Strauss doesn't have—my injury database. There was one other pitcher with this diagnosis and it's both recent and convoluted. Noah Lowry was diagnosed with compartment syndrome, had the surgery and got no relief. Instead, he needed a second surgery for thoracic outlet syndrome. Last I heard, he was getting ready to throw back in spring training, but I'm not sure if he ever did. That's not something Lohse or the Cards are going to want to hear. Lohse's visit to the Kerlan-Jobe Clinic found him to have compartment syndrome in his forearm. I'm assuming that world-class facility both knew of Lowry's case and checked for that possibility. Still, it's hardly a surprise that it was so tough to diagnose. The recovery time from surgery is estimated at around seven weeks for motocross riders, who evidently get this from the combination of leaning on their arms, the vibration and stress, and the twisting motion of the throttle. For a pitcher, it's all guesswork. Lohse is likely headed for surgery in the very near future with little chance that he'll get back this season. I'm not ready to say "done for the season," but the Cardinals are going to have to operate under that assumption as they look in-house and out for a replacement.
Hurts strike down two of the Yankees' "Core Four" in Posada and Rivera, along with other medical news from the majors.
Jorge Posada (strained calf, ERD TBD) If you read what I told you about—or actually, passed on from Ben Wolf—on Friday, then the calf strain for Jorge Posada shouldn't come as much of a surprise. Posada's injury to the back of his right knee was in a bad spot and this kind of cascade is very predictable. The bigger cascade worry would be a knee injury, but a calf strain would be a close second. Wolf's insight doesn't help the Yankees, who now have to go with Francisco Cervelli in the meantime while hoping that Posada can heal up. The Yankees are anticipating that Posada will be ready by the end of the week, but a Grade I strain might not heal up enough for catching. They'll wait until the end of the week to make a decision on the DL, since they'll get the off-day on Thursday, but I get the sense that they don't want to go into the Boston series short-handed.
Getting hit by a pitch on the fibular head is a tough injury for Jorge Posada to shake off, along with other injury news.
It seems like it was just yesterday that I was standing on the field in Cincinnati, talking to C. Trent Rosecrans and a couple of other beat writers. It was Opening Day and the grass on Great AmericanBall Park's field was freshly cut and slightly wet. No team starts off fully healthy, but that's supposed to be the day where Bud Selig's "hope and faith" is the strongest. A couple home runs from Albert Pujols can shake the hope of any National League team, but while Pujols has been mostly healthy, the same can't be said of many others across the game. It's always at about this point in the season where people say injuries are up, or down, but in truth, it's just the first month of the season. Any random grouping of 25 days could come up with a similar number, more, or less. It's not a random process, but it is a random result. Don't read too much, if anything, into it. With that out of the way, let's get to the injuries:
A long list of injuries exacerbated or cropping up over the weekend.
If you don't already have your ticket for tonight's event, well, you're probably out of luck. It's worth checking to see if there's any space available for the Q&A with Andy MacPhail and a parliament of BP writers Monday night. Here's the link to all the details. I hope to see many of you there, but let's get to the injuries: