March 9, 2012

Collateral Damage

Stairway to Heaven

by Corey Dawkins and Stephani Bee

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David Robertson, New York Yankees (Right Mid-Foot Sprain)
Not all injuries occur on the baseball field. Robertson was moving boxes, missed a step, and fell down a flight of stairs. He went for an x-ray Wednesday night; the result was negative. An MRI was used to confirm a mid-foot sprain, but Robertson needed further tests, including a CT scan and a weight-bearing x-ray.

This combination of testing raises the concern for a Lisfranc injury, the same one that felled Chien-Ming Wang in 2008. The CT can provide a very detailed picture of that joint, including a 3-D reconstruction. The standing x-ray is the tip-off, though. The MRI reveals a mid-foot sprain in severe Lisfranc injuries, while the CT may or may not reveal a fracture in the area. The standing x-ray most likely won’t show a fracture, but it will show if there is any increased space between the bones, indicative of instability in the area. When there is instability, there is a significant risk of severe long-term damage if the area does not heal through conservative measures or surgery. Without knowing the results of all of the tests, we cannot definitively say surgery is necessary.

Logan Forsythe, San Diego Padres (Left Sesamoid Surgery)
Forsythe has decided to have surgery on the fractured sesamoid bone in his left foot. The surgeon will make an incision into the tendon to remove the fractured bone. Then the tendon will be sutured back together to allow that area to heal. It’ll take a few months to recover, so Forsythe is expected to be out at least eight weeks. While in college, he had a similar surgery on his right foot.

Sean Rodriguez, Tampa Bay Rays (Left Index Finger Sprain)
Rodriguez sprained his left index finger in a split-squad game while making a tag. Most players are able to return from sprained fingers fairly quickly, so it’s unlikely that Rodriguez will be out for long. Nonetheless, the Rays are going to be cautious with their shortstop. They are going to re-test him this morning to see if there is any need for further diagnostic studies, like x-rays or a CT scan.

Domonic Brown, Philadelphia Phillies (Right Thumb Sprain)
Brown sprained his thumb diving for a ball on Monday. Brown hasn’t recovered as quickly as the Phillies hoped, so they are taking a better look at his thumb with an MRI. They’ll examine the ligament and correlate what they see on a clinical exam. If it is a moderate to severe sprain of the ulnar collateral ligament of the thumb and the finger is unstable, Brown might need surgery. The Phillies have not released any news on the extent of injury as of the writing.

Pedro Beato, New York Mets (Rotator Cuff Inflammation)
Since he was pulled in the middle of Tuesday’s game, there had to be some concern regarding Beato’s arm. He was sent for an MRI, which revealed rotator cuff inflammation. It sounds bad, and sometimes it is, but Beato may actually begin some light throwing as soon as today. It appears the inflammation is mild.

Adam Moore, Seattle Mariners (Fractured Right Hand)
Some places are listing Moore’s injury as a wrist fracture, but it really involves the third metacarpal bone of the hand. He broke it while blocking a ball in the dirt; he apparently did so a little too well. These fractures usually heal well on their own, and there has not been discussion of surgery at this point. He will be placed into a cast, but the Mariners haven’t given a timeline for his return.

Corey Hart, Milwaukee Brewers (Knee Meniscus Surgery)
Hart said that he had three big tears in his meniscus and each one was repaired. He believes he can get back into games at the beginning of April. If the surgeons did tell him he would be able to avoid the disabled list this season, he almost certainly had the torn pieces trimmed out instead of sutured together. When the torn meniscus is directly repaired through sutures or other fixation devices, it takes at least a few months for a person to be able to play again. Removing the torn pieces has a much better short-term prognosis, but in the long-term, preserving as much meniscal tissue as possible is best for the athlete. Hart is expected back in three to four weeks, so there is a good chance he can avoid the disabled list.

Flesh Wounds
Filed under the “you can’t make this up” section: David Price injured his neck by toweling off too aggressively between innings of yesterday’s game. He has done it before, and he only expects to miss a few days. … Manny Ramirez is battling a stiff back. We’re not surprised. … Bryce Harper is battling a tight calf, but the Nationals do not believe it’s a serious injury. … Last year, Brandon Kintzler underwent surgery to insert a screw in his right forearm for a stress fracture that did not heal. His recovery hasn’t gone as smoothly as the Brewers hoped; he’s still experiencing soreness… Andrew Miller is battling inflammation in his triceps tendon at the elbow. He does not think it is too serious. … Evan Longoria is slowly improving. He will have to hit in the cage a few times before playing in a game. If his recovery stalls, look for a CT exam to be ordered to rule out a tiny fracture not seen on MRI. ... Just because it is a new season does not mean that Dontrelle Willis is having it easy. He is battling arm soreness and fatigue. Doctors examined him yesterday, but there’s no news on his injury. … Franklin Morales is back in Boston undergoing unspecified tests unrelated to the shoulder weakness found during his spring training physical. … Not all sprained thumbs are severe; Mark Teixeira remained in the game when he sprained his on Wednesday. … Adam LaRoche (ankle soreness) may get into his first spring training game this weekend. … After missing almost all of 2011 for right ACL surgery, Harold Garcia underwent microfracture surgery on Monday. … Mike Trout will sit out several days because of an illness.

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