Injury News and Analysis - September 21st
Evan Longoria
Well 3 HR in one game answered any questions about his wrist/forearm strength. It’s safe to assume that he is fully healthy from the fractured tip of the ulna. Technically this is different from a fractured wrist and it actually has responded differently as well despite being in the same general area. Everyone in Tampa has to be very relieved that there appears to be no long term damage.
Ben Sheets
Forearm and elbow pain are two totally different beasts and even though they are related, they have much different consequences. Sheets initially thought to have forearm pain actually had elbow pain and has had it for over a month. It was so bad he actually received a cortisone injection sometime in the last 2 or three weeks. Even though I know why they let him continue to pitch with a sore elbow (the win now mentality), there is a fine line between pitching effectively while hurt and hurting yourself further. Sheets, by pitching through pain, put his UCL and Flexor tendon/muscle mass at significant risk for injury. He’s describing the pain as a cutting sensation and that isn’t good.
The team physician says there is no structural (ligament/tendon/bone) damage but that doesn’t necessarily mean there is no tear. It means that he cannot detect a difference between the left and the right in terms of laxity (looseness) or by diagnostic tests such as x-rays and MRIs. They may have done these but the true gold standard for UCL tears is an arthrogram where they inject dye into the joint to get a better picture. I have no idea whether they have done this or not but I would love to find out.
Regardless, there is now significant reservations in my mind to expect anything out of him the rest of the way. The pain has obviously continued to get worse while trying to pitch through it and by pitching through it he’s placing his livelihood in jeopordy. He may have pitched his last game for the year.
Erik Bedard
I was right about the scope not being a good sign and while it wasn’t the rotator cuff as I thought, it was the labrum which sometimes can be worse. The Mariners and Bedard have known that he has had it since at least July although there is a chance he has had it all year. Everyone could see that he was different than he was last year and he never got going at all. He also had a cyst in the shoulder which was adding into the pain level. There are many different types of labral tears, including the common SLAP lesion, but they are not treated the same. Some procedures are relatively quick and the rehab is the same while others are extensive and the rehab is measured in the 1-2 year category. I think it’s going to end up somewhere in the middle but the 2009 season is in serious jeopordy now.
Shaun Marcum
I was also right about Marcum needing Tommy John surgery a full two days before it was even announced . This obviously puts his 2009 season in jeopordy and as we have seen with Liriano and others, even if he does return during the 2009 season he won’t be the same. Tommy John patients typically need about 18-24 months before they are back to “normal”.
Joe Saunders
After being taken to the hospital because of abdominal pain, Joe’s been diagnosed with kidney stones. This extremely painful condition puts a question mark on the last start of the season. Hopefully it’ll resolve soon and he’ll be able to rejoin the rotation.
Derek Jeter
Jeter was hit by a pitch on Saturday and had to be removed from the game. X-rays were taken and were negative. I’m glad for two reasons. It would have been something truly disappointing if Jeter wasn’t able to play today, the last game in Yankee Stadium.
Two: Even though I’m a Red Sox fan, he deserves to be there among all the Yankee greats as he truly is one.
Erik Bedard
I was right about the scope not being a good sign and while it wasn’t the rotator cuff as I thought, it was the labrum which sometimes can be worse.
Corey, I had always thought that labral tears were always worse than torn rotator cuffs. When is having a labrum problem “better” than having a tear in the rotator cuff?
Also, do you happen to know what kind of tear Aníbal Sánchez of the Marlins had? He had labrum surgery last season and was back in less than a year. What kind of lesion allows for such quick recovery?
Some labrum tears are merely at the very edge of the labrum and can therefore simply be cleaned up much like meniscus surgery. It might be very helpful to think of the labrum like the meniscus. Certain areas of the labrum, like the meniscus, can’t simply be cleaned up and thus needs more careful and extensive repair, i.e. SLAP lesions. These usually are in the central location of the labrum or involve the biceps tendon and it anchor on the labrum. Even SLAP lesions though have a lot of variance within them and thus the treatment of them is different.
Most of the time when you hear a pitcher having a labral tear it is a form of the SLAP lesion but that is about the only commonality. Everyone has different secondary symptoms or conditions which can make rehab easier (slight fraying of the rotator cuff) or harder (rotator cuff tears or biceps tendon tears). Every surgeon has his/her preference in how to repair it and every surgeon also has his/her own preference for rehab protocols.
That’s very informative. Thanks!