April 6, 2011

Collateral Damage

Minor Threats

by Corey Dawkins and Marc Normandin

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Unless you enjoy seeing players get hurt (you sicko, you), you'll be happy to know that today's installment of Collateral Damage has more to do with bumps and bruises than tears and breaks. Of course, we're sure that given the slower nature of the early part of this week, the universe will cause something massive to happen to balance things out in the injury department, and then we'll have far too much to write about. That will be the fault of the guy who was upset that no one was seriously injured between Monday and Wednesday. He (or she) is a terrible person.

Jeremy Guthrie, BAL (Pneumonia)

No one likes being sick, but when your lungs feel bad enough to require hospitalization for a few days, it's just downright scary. Pneumonia, in the simplest of terms, is just an infection of the lungs that can be caused by any number of things, including various bacteria, viruses, or fungi. Millions of Americans each year are diagnosed with it, making pneumonia a rather common malady, but it requires hospitalization at a much lower rate. Typically, hospitalized patients have already suffered some prior infection that suddenly spiked when the body couldn’t contain it any longer. This is exactly what happened with Guthrie: he felt under the weather earlier on Sunday but attributed it to a run-of-the-mill viral infection similar to the flu. After he returned to Baltimore, the fever spiked; he checked himself into a hospital and the diagnosis was made. Medication was administered, and Guthrie remained in the hospital for further monitoring.

In most cases there are no long-term effects from a single bout of pneumonia (although if the infection is severe enough it can damage the lung tissue to some degree). Most commonly, initial symptoms of pneumonia include fevers, chills, difficulty catching a full breath, coughing, and chest pain. While Guthrie experienced at least some of these initial symptoms, he doesn’t appear to be at risk for any long-term damage. He will likely be out for a week to 10 days total, so Brad Bergesen will take his scheduled start today. Depending on how he responds to the rest and treatment, Guthrie may or may not be ready to make his next start early next week.

Carlos Pena, CHC (Right thumb sprain)

Pena jammed his right thumb while bracing himself from falling down after a throw on Monday and is now day-to-day. Unlike the other fingers, there are only two joints in the thumb. The one that Pena most likely injured was the metacarpal phalangeal (MCP) joint, located at the base of the thumb closest to the hand. As with any other ligament injury, the severity depends on the amount of tearing that occurred. It seems to be a mild sprain in Pena's case, since he was trying to work his way back into the lineup by letting manager Mike Quade know that his thumb was only “sore” and not necessarily in pain.

Even if the thumb is only "sore," he may rethink his self-diagnosis once he catches a ball close to the thumb rather than in the webbing, or when he picks up a bat. As the bat drags behind the wrists and hands, a force is applied to the damaged ligament, potentially stretching and spraining it further. Giving his thumb a few days off will allow the damaged area to scar enough to avoid any further issues.

Andrew Cashner, CHC (Right shoulder tightness)

Cashner has some tightness in his shoulder, but removing him from the game was more precautionary than anything else. From several different angles, it did not appear to be anything major—it's not like Cashner grabbed his shoulder and went down on a knee. Athletic Trainer Mark O’Neal saw something, though, leading to a mound trip to discuss it further. Cashner said it was just tightness, but the decision was made quickly to remove thee young hurler from the game and avoid risking further injury.

The video does show that after being asked to pinpoint the discomfort, Cashner put his hand on the top and outside part of the shoulder, very common places for referred pain from rotator cuff issues. Now, this is where Cubs fans may start to sweat a little: Cashner will be getting an MRI, but we likely won't know the full results until later today. Muscles certainly can get tight—even the small muscles like the rotator cuff—but color us a little suspicious based on where he said the pain was and the speed at which the Cubs are going to obtain an MRI. [UPDATE] Cashner was diagnosed with a mild strain in the back of his rotator cuff, and has been placed on the DL.

Flesh Wounds: Loads of little bits of news for you today. Guthrie is not the only one sick, as Jose Valverde and Miguel Cabrera have both been battling illness from what they and the team believe is a foodborne malady. ... Brian Wilson (oblique) and Casey Blake (lower back inflammation) both will probably come off the disabled list today. ... Santiago Casilla will likely go on the 15-day disabled list with right elbow inflammation. ... Josh Hamilton’s back was sore after a slide into second base on Monday, but he didn’t have any issues with it during Tuesday’s game. … As if Cincinnati fans didn’t have enough to worry about with the health of the Reds' pitchers, Brandon Phillips left Tuesday’s game with what was at first an undisclosed injury. It ended up being something very minor, as he knocked the wind out of himself on a slide and his muscles tightened up. … Alexi Ogando threw well in his first start, but he also developed a blister on his index finger. He remained in the game for another 1 1/3 innings, but it's something to watch. … Ubaldo Jimenez’s cuticle is improving, but his next start may still be skipped to ensure that this doesn’t become a season-long issue. ... Mike Stanton returned to game action on Tuesday evening as a pinch-hitter. He’s well enough to get in the batter's box, but not to run, as he was lifted for a pinch-runner. He should return to the starting lineup within the next few days.

Corey Dawkins is an author of Baseball Prospectus. Follow @CoreyDawkinsBP
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