A.J. Burnett finds out just what it means to be a pirate, a couple players go under the knife, and various other injuries around spring training.
A.J. Burnett, PIT (Eye)
Bunting practice is usually not dangerous; occasionally a batter might injure a finger but, only rarely does something more serious happen. On Wednesday, Burnett fell into this latter category. In the video of the incident in question, the ball deflects off of Burnett’s bat and strikes him at the corner of his eye and the eye socket. He is helped by assistant athletic trainer Ben Potenziano and walks off the field with a towel to his face. After flying back to Pittsburgh for more tests, Burnett was diagnosed with an orbital bone fracture and will undergo surgery on Friday. Bones heal at a fairly predictable pace; players usually return between four and eight weeks. Burnett will have to take it easy, but assuming there is no serious trauma to the eye itself, he should be able to start getting into baseball shape before that magic number is reached. Still, Burnett will almost certainly start the season on the disabled list.
Ryan Howard, PHI (Achilles surgery)
After Howard saw Dr. Myerson, additional information came to light. He had a small procedure to clean out stitch and surrounding tissue; the stitch was an internal one but the integrity of the Achilles repair is not compromised. This is the key: if the repair was significantly compromised, Howard may not have been able to make it back this year. Fortunately, this was not the case. During the procedure, Dr. Myerson consulted with infectious disease specialists, which revealed that Howard had an infection and the first baseman was placed on antibiotics. With news that the tendon is not compromised, the biggest issue is keeping the wound clean and not infected. Recovery from Achilles surgeries are so long and have so many ups and downs that there is no true timetable on Howard’s, but this could be seen as a relatively minor blip in the process.
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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.
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.
Genetics play a role in Pujols' quicker-than-expected comeback, Jon Lester, Ryan Braun, Carlos Gonzalez, Placido Polanco, and Fausto Carmona need some more time off, and Jose Reyes and J.J. Putz confront recurring injuries.
Healing rates and genetics
On Tuesday afternoon, the baseball community was shocked by Albert Pujols’ return from a fractured distal radius after only 15 days on the shelf. Now that he's back, people are wondering what makes him so different (aside from all that hitting, we mean), since initial estimates put him out until September.
At the time of Pujols’ injury, the best information anyone had suggested a September recovery. When medical professionals provide a prognosis of four to six weeks, they do so because that's where the recovery time falls in the majority of cases. On the whole, the time required for healing has decreased over the years, as medical techniques and information have improved. However, everything associated with healing is a piece of data, and—as is the case with most data—outliers exist.
Big Z goes down with what could be a bulging disk, Erik Bedard and Chipper Jones (who else?) succumb to bum knees, and the Nationals may have to do without Jayson Werth and Jerry Hairston Jr.
Carlos Zambrano, CHN (Back stiffness)
Zambrano was pulled from Thursday's game with low back stiffness in the second inning, an ignoble end to a very wild outing. While we’re still waiting to hear an update on his condition, we do know that Zambrano was sent to a local hospital for MRI evaluation. Considering Zambrano's history of a bulging disc in 2009, concern is always present for interval worsening of the injury.
If the disc herniation becomes large enough, Zambrano could be at risk for Cauda Equina Syndrome (CES), a condition that compresses the nerve roots below the spinal cord. CES can also be caused by narrowing of the spinal canal, infections, inflammatory conditions, traumatic injuries, and tumors. CES patients can experience pain patterns similar to those of sciatica, but the condition can also involve other symptoms such as bowel or bladder incontinence. If CES is present, timely surgical intervention is required to effect a full recovery.