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.

With both Saltalamacchia and Varitek injured, the Red Sox were forced to start Ryan Lavarnway in a must-win situation, not exactly what they had in mind at the beginning of the year. Somehow, it worked out last night, when Lavarnway belted two home runs to help Boston stay tied with Tampa Bay. Saltalamacchia is supposed to be ready today—if he’s not, the Sox probably shouldn’t count on a repeat performance from their third-string backstop.

Matt Holliday, STL (Right middle finger inflammation) [AGL: 4 (TBD DL), ATD: +.091 (TBD DL)]
Locked in a desperate dogfight of their own for a playoff spot, the Cardinals need all their players healthy and available. Unfortunately, when Holliday was pulled from yesterday’s game with an aggravation of his middle finger inflammation, his season most likely came to an end.

The pulley-like interplay of various tendons in the hand is very delicate, so any minute problem can disrupt the whole system. Holliday already missed nine games earlier in the month with inflammation of a flexor tendon and aggravated it flying out in the second inning of yesterday’s game. He has a shot at playing in the postseason if the Cardinals can make it there without him.

Mark Trumbo, LAA (Stress fracture right foot) [AGL: TBD (55 DL), ATD: TBD (+.025 DL)]
Now that the Angels are eliminated from the playoffs, players are turning their attention to getting healthy without trying to get back in the lineup as soon as possible. Trumbo has been dealing with soreness in his right foot for a short period of time, and further tests revealed a stress fracture. Two of the areas in which male athletes commonly suffer stress fractures are the metatarsals in the forefoot area and the navicular in the mid-foot. Most of the time these can be treated without surgery and simply involve taking pressure off the area—in a walking boot, crutches, or both, in severe cases—and improving the player’s diet to ensure that all the proper nutrients reach the area.

Bone stimulators have also shown promise in aiding the healing of stress fractures. There are two common pathways or modalities: electrical and ultrasonic. In the electrical pathway, a micro current travels between two patches that are placed on the skin. The micro current encourages the bone to form bridges and increases cellular activity. In the ultrasonic setting, very high-frequency sound waves are transmitted by the device through the skin into the area of injury. Bone stimulators can also be used for other fractures or stress fractures throughout the body.

Usually, these injuries heal over the course of several months but they do have a tendency to recur if changes to training methods or biomechanics are not made. The good news for Trumbo is that he has the entire offseason to make some.

Ryan Zimmerman, WAS (Strained hamstring) [AGL: 9 (30 DL), ATD: -.015 (-.012 DL)]
Zimmerman’s injury-filled 2011 likely ended on Tuesday, when he started to notice his hamstring getting sorer. He has been receiving treatment on it for awhile, but it has become increasingly bothersome. The medical staff decided it would be best to hold him out of yesterday’s game, and he will probably miss Wednesday’s game as well. Zimmerman has a history of mild hamstring problems that have cost him some time here and there, but overall, the hamstrings haven’t hasn’t caused him to miss large chunks of time, unlike the abdominal surgery he had at the beginning of the 2011 season.

Rafael Furcal, STL (Strained left hamstring) [AGL: 9 (30 DL), ATD: -.015 (-.012 DL)]
Furcal was pulled from Monday night’s game with left hamstring tightness and will likely miss the last game of the regular season. Furcal has had a lot of trouble staying healthy over the last several years, sustaining injuries to his legs, back, and thumb. He’s almost 34, and it doesn’t look like he will have Omar Vizquel-type longevity over the next decade. Furcal will miss the next several games and may be able to return for the NLDS, should the Cardinals play in one.

Flesh Wounds: Plenty of other players have likely played their last games in 2011, including Yunel Escobar (elbow), JasonBay (illness), and Angel Pagan (head)… Howie Kendrick left yesterday’s game with a sprained left wrist and will most likely miss today’s game… Edwin Encarnacion is dealing with some shoulder inflammation and had to be scratched from yesterday’s game…. Nyjer Morgan fouled a few balls off his shin and missed yesterday’s game. There is a good chance that he’ll miss today’s game as well… Casey Kotchman had a scare yesterday when he had to be taken to the hospital with complaints of tightness in his chest, one of the leading complaints associated with heart attacks. Kotchman was checked out and released shortly thereafter with a clean bill of health from a cardiac standpoint… Carlos Gonzalez is still experiencing problems with his wrist and now won’t swing a bat until November 1st at the earliest… Justin Upton passed his ImPACT tests and was able to return to the lineup… Russell Mitchell had arthroscopic surgery in his left wrist to repair torn cartilage but is expected to play winter ball… Peter Moylan has chosen to undergo surgery on his torn rotator cuff and labrum.

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You guys have done an amazing job this year. Not only are the columns extremely well-written and informative in pure baseball terms, they've also been an amazing place to learn more about sports medicine. I know almost nothing about anatomy or physiology, but your clear explanations have helped me understand quite a few new things. Thank you for going beyond the obvious, and doing it very, very well.