September 12, 2011

Collateral Damage

And Down the Stretch They Come

by Corey Dawkins and Ben Lindbergh

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Kevin Youkilis, BOS (Sports Hernia) [AGL: 13(40 DL), ATD: TBD(+.042 DL)] (Explanation)

It's no coincidence that the Red Sox are dropping games left and right given the injuries they have been dealing with recently. Youkilis had been affected for some time by the sports hernia, which was present even before his hip bursitis first flared up earlier this year. The aching lower abdominal pain from the sports hernia has been flaring up episodically, most recently on Thursday, along with the hip bursitis.

With no proven treatments to heal sports hernias aside from surgery, Youkilis and the Red Sox will instead focus on conservative treatments such as rest and anti-inflammatory medication for the time being. After the season, Youkilis will be reevaluated to determine whether or not surgery will be required. The surgery usually costs the player about six to eight weeks, as we have seen recently with Grady Sizemore. In the interim, Youkilis is hoping that the rest and therapy will be enough to get him through the season.

Erik Bedard, BOS (Left latissimus strain) [AGL: 20(39 DL), ATD: +.204 (-.011 DL)]
Bedard's recent lat strain is yet another reason players should not pitch through pain. Already suffering from a sore left knee over his last few starts, Bedard went out there on Sunday and suffered a mild left latissimus strain. Cascade injuries almost always follow this pattern of pre-existing lower extremity injuries causing upper extremity injuries via biomechanical changes.

Bedard will try to get back into the rotation as soon as possible, but his latissimus strain will complicate Boston's decisions as they get ready for the postseason. The question of whether to trust Bedard with his multiple injuries or Lackey and his performance issues will be a difficult one. In the meantime, Bedard will continue his therapy in hopes of helping the Red Sox right the ship.

Ryan Spilborghs, COL (Right foot plantar fascia strain) [AGL: 42, ATD: +.015]
Spilborghs injured his right foot while making a play on Monday night before subsequently being placed on the 60-day disabled list. After missing 27 days with plantar fasciitis before being activated from the disabled list on September 2nd, the latest injury wasn't necessarily a true re-injury. The acute nature of the injury on Monday night represents a strain of the plantar fascia with resulting inflammation. In chronic inflammatory situations, the tendons become more prone to further injury, which likely played a role. With his placement on the 60-day disabled list, Spilborghs is officially done for the year, but he should be fine for next year.

Jeremy Affeldt, SFN (Right hand laceration surgery) [AGL: 30(62 DL), ATD: TBD (+.098 DL)]
If there is anything lucky about Affeldt puncturing his hand trying to separate frozen hamburger patties, it's that it wasn't his pitching hand. The left-hander punctured his right hand deep enough to do nerve damage, and he underwent surgery shortly thereafter. Improved nerve repair techniques, such as artificial scaffolds and biological conduits, help to regenerate nerves faster than before. Affeldt's arm was casted in order to eliminate traction on the nerve repair site as it tries to create new connections.

It's impossible to tell what limitations Affeldt will have without knowing the exact nerve injured, but the prognosis is reportedly good. Another factor is whether it is the sensory or the motor function that is involved, the non-dominant nature of the hand diminishes the effects. All indications point to Affeldt making a full recovery, but any injury involving nerves carries a greater risk than most injuries.

Francisco Cervelli, NYA (Concussion) [AGL: 3(29 DL), ATD: -.002 (-.008 DL)]
Cervelli has suffered multiple concussions throughout his career, including one in each of the last three years. Cervelli's latest concussion came on a play at the plate on Thursday, when Nick Markakis' shoulder made contact with Cervelli's head. While any concussion is concerning, it's the effects of multiple concussions that truly have people worried.

When concussion specialists evaluate a player's capacity to return to his or her sport, one of the factors they look at is how easily the concussion occurred. In Cervelli's case, his latest head injury involved forces that were greater than the ones he’s previously experienced, so it's not a surprise that he was showing concussion symptoms, including dizziness. Cervelli is back in New York undergoing further evaluation, including standard neurological tests.

Sergio Escalona, HOU (Sprained left ankle) [AGL: 21, ATD: +.018]
Proving that injuries can happen anytime, Escalona sprained his ankle on Friday after tripping over a glove in the outfield. Escalona said that he felt a pop along with the pain and stayed down for a few minutes before being loaded onto a cart and taken off the field. X-rays were negative, and the sprain was severe enough to put him on crutches. As a result, Escalona was placed on the 60-day disabled list and is officially out for the season.

Flesh Wounds: Mike Stanton can't run at full speed yet because of his right hamstring strain. He’ll likely be out for another few days... Andre Ethier has decided to undergo surgery on Wednesday after visiting several of the top sports medicine surgeons... Alex Rodriguez has been out for the last few days because of lingering soreness in his left thumb... Logan Morrison has been out for the last few days because of a right knee contusion... Troy Tulowitzki has been battling a sore left hip for the last several days. He should be able to return any day now... Wilson Valdez suffered a minor left hamstring strain. Valdez is not too worried about it and feels that he could return today... Chris Nelson is in a protective boot for his bruised left heel.

Corey Dawkins is an author of Baseball Prospectus. Follow @CoreyDawkinsBP
Click here to see Corey's other articles. You can contact Corey by clicking here
Ben Lindbergh is an author of Baseball Prospectus. Follow @benlindbergh
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