July 27, 2011

Collateral Damage

Keeping Up with the Jones

by Corey Dawkins and Ben Lindbergh

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Chipper Jones, ATL (Right quadriceps strain) [AGL: 4 (27DL), ATD: -.008 (+.038DL)] (Explanation)
Chipper managed to will himself back into the lineup on Monday in the wake of meniscus surgery, but he may not have been fully recovered. In the sixth inning of Monday's game, he felt his quad tighten up while fielding a slow roller. In typical Chipper fashion, he continued playing until the eighth and didn't leave the game until after hitting a home run to lead off the bottom half of the inning. (Jones did give manager Fredi Gonzalez a heads-up by telling him before the at-bat that he would need a runner if he got on.) Gonzalez still took him out of the game as a precaution, and he didn't play on Tuesday.

Coming back in two weeks following knee surgery, even a relatively simple procedure like partial meniscectomy, is pushing it. The quadriceps reflexively shuts down with swelling inside the knee joint, which occurs with almost all knee surgeries. This makes the quad more prone to injury. Even with physical therapy beginning the day after surgery, it takes time before the quad returns to normal and all the swelling inside the knee joint resolves. The nervous system also needs to recover, and the muscles have to learn how to accept the impulses coming from the nerves.

Of course, Chipper is going to do what Chipper wants to do. Even though he wasn't in the starting lineup, he was able to enter as a pinch-hitter later in last night's game. He might pinch-hit or leave early in the next several games.

Josh Johnson, FLO (Right shoulder inflammation) [AGL: 38, ATD: -.036]
As August approaches, it is looking less likely that Johnson will be able to return in 2011. He has yet to start throwing, and while each team’s throwing program is slightly different, they all include multiple stages. For moderate to severe injuries, two or three days of rest between each stage is common, with decreasing days of rest between each workout once later stages are reached. All of this depends on Johnson not experiencing any significant soreness at any step along the way. If he were to experience soreness, he’d have to repeat a stage. Johnson is likely looking at six to eight weeks at minimum before even being considered for activation.

Jason Giambi, COL (Left quadriceps strain) [AGL: 27, ATD: +.040]
Giambi didn't have surgery on his knee recently like Chipper did, but that doesn't mean his quad was completely healthy prior to Monday's game. Giambi first injured his quad a week ago while legging out a double, but was doing well until this past Monday when he re-injured it.

The large muscle groups of the lower extremity have a tendency to suffer recurrent strains, in part due to the sheer size and number of fibers. When the muscle voluntarily contracts, not all of the muscle fibers contract at once. Some are held in reserve in order to help if some fibers become fatigued or if there is an unexpected additional force applied. Throughout rehabilitation, the truly injured fibers may not be significantly stressed, because all of the other fibers take up the slack. When the player gets into a live game and is forced to use the muscle without any thought or hesitation, those injured fibers can be pushed too far again, resulting in a recurrent strain.

Giambi was placed on the disabled list on Tuesday, so he will definitely be out of commission for at least a few weeks.

Kevin Youkilis, BOS (Right hamstring tightness) [AGL: 1 (23DL), ATD: -.017 (+.018)]
After playing last week in the torturous heat wave that gripped the country, Youkilis found himself waiting 141 minutes for a rain delay to end on Monday night. Then, in the sixth inning, he stretched for first base while trying to beat out a grounder. Unsuccessful in his attempt, he ended up limping back to the dugout and started talking with the medical staff. As was the case with Chipper, he was able to stay in the game for another inning or so before being lifted with what the team “termed right hamstring tightness.” He was out of the lineup last night and is day-to-day for now.

Lance Berkman, STL (Right rotator cuff strain) [AGL: 4 (14DL), ATD: +.060 (+.012)]
In the middle of a strong season, Berkman sat out Monday's game because of a mild rotator cuff strain. During his final at-bat on Sunday, he was able to reach an outside fastball, only to feel pain in his right shoulder once he got to first base. The concern with hitters who injure their front shoulder during a swing is that there may have been a subluxation of the shoulder. In these cases, the shoulder joint slides out and back in, in essence a partial dislocation.

When this occurs, the rotator cuff muscles can strain as they try to stabilize the head of the humerus. Ligament and labrum damage can also occur. A reasonable comp for a subluxation is Richie Sexson, who ended up needing surgery but also suffered a more severe injury initially. Berkman was already back in the lineup yesterday but was taken out in the fifth inning with a reaggrevation of the shoulder. He will be evaluated today with the possibility of a cortisone injection, which would cause him to miss a few games.

Flesh Wounds: Dan Haren returned from back stiffness to dominate the Indians on Monday... Luke Scott underwent labrum surgery performed by Dr. Andrews yesterday... Gaby Sanchez was out of the lineup yesterday with a tight hamstring... Joe Blanton is dealing with nerve damage in his elbow. No word on how much longer he will be out, but returns from this injury can be slow... Tim Lincecum missed yesterday's start with the flu, and Kerry Wood is battling a case of his own...Tony Pena may undergo Tommy John surgery... Daric Barton has been diagnosed with a torn labrum in his right shoulder and will meet with Dr. Yocum... Jose Bautista was hit in the earflap yesterday and was removed from the game. He didn't exhibit any concussion-like symptoms, and he's listed as day-to-day... Brian McCann strained his left oblique and will be placed on the disabled list today.... Dustin Moseley injured his left shoulder on a swing last night. This is the same shoulder that suffered the subluxation back in June.

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