March 7, 2011

Collateral Damage

Duck and Cover

by Corey Dawkins and Marc Normandin

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Not all injuries occur due to poor conditioning, abuse of a pitcher’s arm, or aging. Sometimes, random occurrences are all it takes to knock a player out of the lineup. Ask Josh Beckett, who took a ball off the head last week, or Neftali Feliz, who took a liner off his shin during batting practice recently. Neither of these players had been tagged as high injury risks, but both experienced early-season injuries just the same—it’s important to remember that for all of the projecting of injuries and risk that we can do, sometimes accidents happen.

Domonic Brown, Phillies (Right wrist surgery—hamate)

Despite what is being reported, Brown did not break his hand while taking a swing over the weekend. The hamate bone is actually a wedge-shaped bone of the wrist on the little finger side that articulates with two metacarpals (the long bones in the hand) and three other wrist bones (lunate, triquetral, and capitate). Its function is in part to protect tendons, nerves and blood vessels as they pass from the forearm through the wrist and into the hand. Hitters most often complain of pain when gripping a bat when the hamate fractures. More severe cases include weakness and injuries to the nerve, which can be compromised by a loose fragment or as a result of a crushing injury.

Hamate fractures can heal on their own but complications of non-union fractures are more common (depending on where the fracture is located) due to a relative lack of blood supply. In these cases, surgery is usually required. It is a relatively simple procedure wherein the surgeon removes the loose piece and smooths everything out. Wrist injuries have been thought to sap power but often that’s because of the short-term effect of having surgery. Any surgery causes at least a little scar tissue—even the simple ones like this—and it takes time for normal function and motions to return. There shouldn’t be any long-term decrease in function for Brown, but he is reportedly going to miss 3-6 weeks if no surgery is required. If surgery is required—which is likely—he may be out closer to 6-8 weeks, as per the similar cases in our database.

Cameron Maybin, Padres (Concussion)

Maybin is dealing with the effects of the concussion he sustained on Wednesday after hitting his head on an outfield post. We have discussed the trouble of living with a concussion and what makes the condition so difficult to understand and treat:

In order to return to the playing field following a concussion, a player must clear a succession of regimented hurdles while remaining symptom-free at every step along the way, to ensure that it’s safe to resume participation in practice and games. The process begins after the player has been symptom-free (including headaches) for a period of time, followed by light cardiovascular exercise, usually on a stationary bike. The next step involves a combination of very light weightlifting and jogging on a treadmill, which progresses to heavier weights, sprinting, and eventually baseball activities. This timeline, like the symptoms themselves, is highly individualized and must be monitored closely.

 After suffering from blurred vision and headaches for a few days, Maybin has progressed to the point of taking live batting practice on Sunday. There is a chance that he'll return on Monday; if he doesn’t, his return won’t be too far into the future.

Matt Gorgen, Diamondbacks (Tommy John surgery)
Scott Gorgen, Cardinals (Tommy John surgery)

What are the odds that twins both have Tommy John surgery less than six months apart? Matt Gorgen will undergo surgery soon while his brother Scott Gorgen recovers from his October 2010 TJ procedure. Tommy John surgery almost never happens solely because of one acute tear, rather from cumulative effects over a period of time. But that doesn’t mean that there is only one thing that you could identify as the cause. Sometimes it is workload, other times it is conditioning. With both twins requiring Tommy John surgery so close together, one has to believe a genetic component to this—while not the biggest contributor—is likely a factor. If that is the case, what are the odds that at some point down the line we start to see Mass Effect-style genetic modification to overcome these sorts of issues? It's either that or the Gorgen clan won't be allowed to pitch once the world goes all Gattaca on us.

Neftali Feliz, Rangers (Shin contusion)

Batting practice has caused quite a few injuries already, with Feliz the latest victim; Feliz was struck in the left shin by a liner. If the line drive had been a little higher things could have been disastrous for Feliz. In most cases it is simply luck or random chance that keeps pitchers out of the hospital or worse each time bat meets ball. In Feliz’s case, he walked over to the cart after lying on the ground for a few minutes and was taken off the field for x-rays as a precaution. The x-rays ruled out a clear fracture but this incident will keep him out for a few days.

Contusions to the tibia can be extremely painful due to the number of nerves in the area as well as the weight-bearing aspect of the bone—we’ve all whacked our shins on something unexpectedly, and the pain is intense. If the pain does not begin to decrease over the next few days, the Rangers could move on to either a MRI or a CT scan for a more detailed look at the area, at which point we will update you on his status.

Flesh Wounds: Looks like our concerns about Francisco Cervelli’s foot were spot-on, as it was determined that he actually suffered a fractured left foot… Chase Utley had a cortisone injection in his troublesome right knee, hopefully clearing it up and letting him get back onto the field soon... Miguel Olivo is down for a few weeks with a groin strain... We told you that we would know more about Jason Castro’s 2011 season after his surgery on Friday. The news was not good, as he had an ACL tear in addition to the large medial meniscus tear in his right knee. He is expected to miss most of the year as a result... Angels farmhand Anel De Los Santos tore a ligament in his left thumb and had surgery on Friday. He’ll be out for about 8-10 weeks.

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