August 10, 2011

Collateral Damage

Backed into Corners

by Corey Dawkins and Ben Lindbergh

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Andres Blanco, TEX (Low back inflammation) [AGL: 45, ATD: -.053] (Explanation)
Blanco returned to the disabled list with low back inflammation on Tuesday. He missed over three weeks with a stress fracture in his low back earlier in the season and was able to make only four appearances before succumbing to another back-related ailment. Baseball requires repetitive flexion, extension, and rotation actions that place significant stresses on the low back. Even though these two back injuries are different, that does not necessarily mean they are unrelated.

Between the weaknesses preceding the stress fracture and the strengthening following therapy, forces are redistributed, and the body takes time to get used to the changes. Blanco will have an anti-inflammatory injection in hopes of soothing the symptoms faster than oral medication would. Once the pain subsides, he can resume his physical therapy program as directed.

Placido Polanco, PHI (Sports hernia) [AGL: 7 (TBD DL), ATD: +.098 (TBD DL)]
Polanco really is falling apart in front of us. The pain in his hip area was determined to be the result of a sports hernia and could end up needing surgery. This has been going on for a while, since the MRI showed scar tissue in the area—in acute or sub-acute cases, there is little to no scar tissue in the area. Polanco received an injection in hopes of calming down the inflammation enough to allow him to continue playing through the end of the season. For the most part, pain is the limiting factor with sports hernias, and Polanco is hopeful that he can avoid surgery. On Friday, he will be reexamined to determine the next course of action, including possible surgery. If surgery is necessary, he’ll be out for several weeks but still might be able to return this season.

If surgery is required, the AGL changes to 44 games lost, and the ATD moves to +.042.

Scott Baker, MIN (Right elbow strain) [AGL: 54, ATD: +.010]
This is the second time this season that Baker has been placed on the disabled list with a flexor mass strain. He returned faster than most pitchers do back in July but quickly realized that his elbow still wasn't fully recovered. The elbow has been nothing but trouble for Baker over the last year and required a cleanup procedure over the offseason. Recurrent elbow injuries raise the concern—though not a guarantee—of an underlying instability caused by ligament damage. Assuming that there is no ligament damage, he will still likely be out longer than he was last time, but he has a chance to return this season. If there is ligament damage, he will be done for the year.

Brendan Ryan, SEA (Sprained left AC joint) [AGL: 55, ATD: +.027]
Following the game last Wednesday, Ryan was diagnosed with a strained left shoulder. Further tests revealed a sprained AC joint. These injuries are painful with overhead motions and movements of the arm across the chest but almost always heal without surgery. There can be a residual cosmetic change where the distal clavicle is raised relative to the acromion, but there is no function lost. Typically, these sprains heal well within a month, especially in cases there the AC joint is not unstable. Ryan and manager Eric Wedge both believe he shortstop should be back in roughly the minimum.

Carlos Carrasco, CLE (Right elbow inflammation) [AGL: 36, ATD: -.037]
The elbow has been bothering Carrasco for some time, and like Scott Baker, this is the second time he has hiton the disabled list this season with an elbow condition. In April, he missed a little over two weeks, and he had some forearm problems in the minors last year. This many problems with the elbow and forearm in such a short time indicates an underlying issue. In similar cases, we have seen ligament damage or a bone spur that causes the inflammation. Usually, bone spurs are easily seen on x-rays and MRIs, but they remain a possibility. Regardless, like Baker, he will likely miss more time than he did at the end of April.

Carlos Beltran, SDN (Right wrist sprain) [AGL: 2 (19DL), ATD: +.027 (-.032 DL)]
Sunday afternoon, Beltran felt pain in his right wrist immediately after striking out swinging. X-rays were negative, but he woke up on Monday still in pain, so he was sent for an MRI. This showed inflammation in the top and side of the hand near the wrist, which the Giants said confirmed the initial diagnosis. He's day-to-day right now, but this could be something that lingers, especially if the pain is more on the outside than the top of the wrist.

Flesh Wounds: Low back spasms caused Aramis Ramirez to be scratched from the lineup yesterday... Logan Ondrusek was placed on the disabled list with a strained right forearm... Justin Smoak has made significant progress after jamming his left thumb last Tuesday while fielding a ball. He's available to pinch-hit and is looking to return to the starting lineup tomorrow or Friday... Twins prospect Kyle Gibson has a partial tear of the ulnar collateral ligament but will avoid Tommy John surgery for now... Anthony Slama has been diagnosed with a flexor pronator strain but will not need surgery... Pat Burrell will get another opinion on the bone spur in his right foot, which certainly doesn't sound promising... Huston Street is dealing with a latissimus dorsi injury and may be placed on the disabled list... Joe Blanton does not need surgery on his elbow, according to Dr. James Andrews... Grady Sizemore won't be back before the end of August, according to Manny Acta... Tommy Hanson is having his shoulder examined after turning in lackluster performances since being activated from a mid-June disabled list stay for rotator cuff tendinitis... The fracture in Chase Headley's little finger was confirmed by specialist Dr. Jack Hamer, and he will miss the next four to six weeks... Matt Lindstromis expected to go on the disabled list, but the exact reason is unclear. The Rockies have revealed only that he is dealing with arm soreness... Batting cleanup for the first time ever didn’t agree with Orlando Hudson, wholeft last night's game with a strained right groin... Ernesto Frieri was placed on the disabled list with a lower back strain... Lance Lynn left last night's game with a left oblique strain.

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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