May 16, 2011

Collateral Damage

Not As Seen on TV

by Corey Dawkins and Marc Normandin

If baseball injuries were anything like the health issues on “House," we would have something new and exciting to tell you about every day, and it would take a team of specialists—along with heavy doses of sarcasm and sexual tension—to solve the mystery each one presented. (Conversely, if baseball injuries were anything like how “Scrubs” presents things, then we would just need to sing “99 Luftballons.”)

Instead, we are left with common injuries—considered so for a reason—such as hamstring, oblique, and quad strains. The most valuable sports medicine staffs aren't necessarily the ones that find and treat that one-of-a-kind injury; the ones that can both prevent and get the common strains back on the field sooner than the rest deserve that praise. No matter how great the staffs are, though, there will be injuries. The players are not robots, despite what some of their post-game interviews may lead you to believe.

Chipper Jones, ATL (Meniscus tear right knee)
There was never any doubt that Jones would make it into Collateral Damage at some point in the season, but we are surprised that it took him so long—he is the source of the backronym for our injury projection system, after all.

Jones has 76 entries in the database since 2004 alone—averaging over 10 per year–and will probably add to that total later on in 2011. The most recent issue has been Chipper's knee, which has been barking at him—the Braves have been unable to control the inflammation because of the recently discovered meniscus tear.

Jones is going to have a cortisone injection, and he will be out of the lineup for a few days after that, but there is a chance that he could avoid surgery. If the injection doesn't knock down the inflammation enough, he might need surgery to trim out the meniscus, a series of events that would land him on the DL.

Jones was hitting well this year, though as was the case last season, he hadn't been the offensive beast he used to be (not that there is anything wrong with a .290 True Average—Jones was just so ridiculously good in the past that those figures seem disappointing in comparison). Martin Prado would likely move to third were Jones to land on the disabled list—without Omar Infante on the bench as he has been in the past, this move would cut into the Braves' depth and production a bit more significantly. Given how close the NL East is and is expected to remain, the Braves will need Chipper to avoid missing too much time.

Magglio Ordonez, DET (Right ankle weakness)
In a situation similar to Joe Mauer's, Ordonez was placed on the disabled list with continued weakness after surgery last year on his broken right ankle. That August surgery was supposed to heal and have Ordonez pain-free by now, but that is not the case. Repeated bouts of inflammation proved that his ankle was not 100 percent throughout April and now well into May.

Until Ordonez's voluntary and involuntary strength returns to normal–as well as his range of motion–he will be prone to having recurring inflammation. Ordonez is going up against science and aging, as tissues become less flexible and more prone to strains and inflammation as people get older. What may be contributing to his weakness is scar tissue in and about the ankle, although this cannot be known for sure without seeing the MRIs. We will wait and see how he reacts to rest, much as we have with Mauer, and will keep you updated on any leads on his status.

Grady Sizemore, CLE (Right knee contusion)
The Indians haven't shown too much concern about Sizemore's right knee publicly, but behind the scenes they have to be experiencing some. Saturday's light workout caused some soreness in Sizermore's knee, but not the one that was repaired by microfracture surgery.

His knee injuries the last two years had similar mechanisms: the kneecap was driven into the end of the femur, both from running into a wall in 2010 (left) and sliding into a base (right) last week.

The Indians are adamant that Sizemore won't require a move to the disabled list, and that may end up being true. It has already been six days, but mild bone bruises can easily take a week or two before improving. At worst, the Tribe could retroactively place Sizemore on the DL in order to recover some roster depth until he is ready to go again.

As we stated earlier in the year, it is too early to tell if Sizemore's knee will hold up throughout the season, but the early returns have been good. Sizemore is hitting .282/.333/.641 (a .352 Tav) to start the year—while that won't last, it's great to see, given that he struggled his way to sub-replacement production last year before shutting it down. He has felt good, other than this recent ding, so if he comes back to the lineup feeling healthy, he should keep on mashing.

Brandon Beachy, ATL (Left oblique strain)
Beachy pulled his left oblique while pitching against the Phillies on Friday night, and he will be on the disabled list for at least three weeks. With only a bout of shoulder inflammation in college to mar his record, his ability to stay healthy has been part of the reason for his success. The sensation of something tearing on his left side on a warmup pitch signaled that something was wrong, though, and another pitch confirmed that there was indeed something amiss.

His season will have to be put on hold for the time being, but at least he was producing at a high level prior to the injury—that may keep someone like Mike Minor from taking his job permanently while Beachy is sidelined.

Colby Rasmus, SLN (Right side pain)
Rasmus first developed pain underneath his right rib cage last Monday, and he has been having trouble ever since. It doesn't bother him while batting as much as it does while throwing and running, leading us to believe that it is likely not an oblique injury.

There are other muscles of the abdomen that attach on the lower borders of the ribs, as well as other connective tissue. It doesn't have to be a muscle or tendon injury; other potential injuries are less likely–such as instability of the ribs, hernias, or some nerve entrapments–but still possible.

In 2009, Rasmus was diagnosed with a hiatal hernia, where the stomach actually pushes up through the diaphram—that is not as rare as you would think. Hiatal hernias only require surgery in the most significant of cases, and are usually treated similarly to reflux disease. According to Rasmus, his current symptoms are unrelated to those felt in 2009—even if this were a recurrence, surgery would still be unlikely. Rasmus is set to be examined today, so more information, and hopefully a diagnosis, should be out soon.

Flesh Wounds: Julio Borbon strained his left hamstring on Friday and was placed on the disabled list... After being off-limits over the weekend, Rafael Soriano will throw a bullpen today in hopes of making a Wednesday return to availability... Jose Mijares was placed on the 15-day disabled list with a sore left elbow. We'll see how long he will be on the DL after an MRI...A right triceps strain landed Brandon Kintzler on the disabled list, adding to Milwaukee's injury troubles... Erick Almonte is full of firsts, becoming the first player to be transferred from the 7-Day concussion disabled list to the 15-day disabled list, as his concussion symptoms have lasted longer than 15 days... Brian Schneider could be out closer to a month after his left hamstring strain proved worse than first expected... David Aardsma will try to rehabilitate his elbow rather than opting for surgery, at least for now... Blake Hawksworth was placed on the disabled list with a right groin strain and hip impingement... Josh Geer is going to try to return to pitching in July after having a cancerous lymph node removed from the right side of his neck.

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