bautistaIt’s no surprise that many athletes suffer setbacks from returning to competition too soon after suffering injuries. The healing process can only be prodded so much, and the demands that sports place on healing structures can readily create overuse and breakdown. And then there is the inherent risk of traumatic injury.

Of the many current injuries in MLB, a number of them might have been avoided with a slower progression back to the field. Others appear to be exacerbations waiting to happen. Here are a few (amongst many) details:

The Injection – a panacea that isn’t

Arizona utility player, Willie Bloomquist, is on tap to receive an injection for his still ailing back. The Diamondbacks reportedly activated Bloomquist from the DL over the weekend in spite of knowing he still wasn’t 100 percent. Huh? Bloomquist hopes to rejoin the team on Friday, though there is no guarantee. While he is likely receiving therapy in addition to the injection, that is one quick recovery…

Oakland reliever, Jordan Norberto, was the beneficiary of a cortisone shot in his left shoulder. Norberto was placed on the disabled list last week with left shoulder tendinitis after an MRI reportedly ruled out structural damage. Norberto was previously on the DL for his left shoulder and it is thought he might rejoin the A’s this month.  Hmmm, second time around – think there might be something going on here? Something a simple shot can’t fix?

If Arizona and Oakland were in last place in their divisions, would a more cautious approach be in play? Probably.

Cortisone is a steroidal anti-inflammatory and can dramatically reduce inflammation. However, an injection of cortisone does nothing to relieve the reason the problem arose in the first place. It is a short-term solution to a bigger picture, or may be an effective adjunct to help get over the hurdle that pain and inflammation can pose to actually addressing the underlying issues. Simply feeling better, especially if not completely so, is only one piece of the recovery puzzle. Then there is also the matter of multiple injections to the same area presenting risks to the tendon over the long haul. Not the best go-to solution…

Back too soon and worse the next time around

Toronto Blue Jays outfielder, Jose Bautista, who is slated to have surgery on his left wrist, had missed a month with wrist inflammation (due to an unstable tendon) before returning to the field. He hadn’t even played two complete games before heading back to the DL after aggravating the injury. What was the rush? Toronto is replete with injuries that forced them into last place, and nothing short of a miracle could propel them into the playoffs. If the tendon was already unstable, perhaps Bautista should have had surgery in the first place – it would have meant a strong possibility that conservative management would not have been sufficient.

Reds outfielder, Michael Cuddyer, could be done for the year. Cuddyer re-injured his right oblique in his third at bat after coming off the DL, and reported that it felt like a more severe strain than the first time around. “There is a possibility” Rockies manager Jim Tracy said Sunday when asked if Cuddyer is done. “I won’t (say) that’s completely the case, but I won’t rule it out either.” Hello? What will it take to face reality here. Cuddyer commented that his oblique injuries might be due to the way he holds onto the bat with two hands during the follow-through in his swing. Perhaps the time to address that was when he felt great in rehab and before returning to action.

The Dodgers placed reliever Scott Elbert on the 15-day DL (yet again), with left elbow soreness due to scar tissue that will likely require off-season surgery. His elbow was reported to still be problematic though he had not allowed a run in his four appearances since coming off the disabled list not even two weeks ago.  Why did he pitch three times after figuring that out?

Oakland third baseman Brandon Inge will supposedly be available to pinch-hit until his shoulder goes under the knife later this week. Why? I give up! Inge reportedly exacerbated his right shoulder injury Saturday in his first game back from the disabled list.  He has previously dislocated the shoulder multiple times.

Red Sox outfielder Daniel Nava is on the 15-day disabled list with a sprained wrist. Nava missed 20 days last month with the same injury, and might be sidelined for most of this month. He has played in only 67 games this season.  It is September. Boston certainly had more than its share of injuries this season and has been imploding. Let Nava simply sit this one out.

Padres closer Huston Street is nursing his left calf once again after reportedly suffering a setback last Thursday when he tried running sprints. “We’re going day to day until we get a plan,” Street said. The Padres don’t want to take any chances. And why would they? Another last place team with no reason to push. Maybe less of a rush back would have led to a better outcome.

Rehab Exacerbations

Baltimore’s DH, Nick Johnson, is not expected back this season. He reportedly had been rehabbing his right wrist but has been sent home from the spring training complex in Florida after suffering a setback. It is thought that this time the exacerbation may threaten Johnson’s career since the wrist has been an issue for him for years (and through stints on several teams). In this case, the flare-up may have been inevitable.

Oakland starter, Dallas Braden, underwent surgery last week to repair a torn left rotator cuff. Supposedly, Braden’s rotator cuff was in tact at the time of capsule surgery last year. It has been assumed that the pitcher’s new injury occurred while rehabbing. Have to wonder – did his rehab progress too quickly? Was there a fault with the capsule repair? Are there structural issues that predispose to the new injury or are Braden’s mechanics at fault?

The power of the playoffs

Orioles’ manager Buck Showalter reportedly said that outfielder Nolan Reimold is recovering well, but that it’s too soon to tell if the outfielder might be available for postseason play. Reimold has been out following the removal of a cervical disc (neck) in June. Why even put that possibility out there? It is his neck! Don’t look for Reimold to be back until next season– even for playoffs it just doesn’t add up. Think big picture here.

Playing through?

Red Sox DH David Ortiz, who is again on the 15 day DL because of his right Achilles tendon, will reportedly get shockwave treatment after the season. For now he may have an injection (and you already know how I feel about that). USA Today reported that Ortiz would undergo the shockwave treatment now, but it requires a recovery time of 4-5 weeks and he is still hoping to return to action before the summer concludes. Gotta love the attitude, but if Ortiz needs more intensive treatments, he would best get them now and sit out the last weeks of 2012. Boston will miss him, but they need more than Big Papi’s presence to set this season straight.

Still in a walking boot due to an ankle injury, but reportedly day-to-day, is Indians starter Roberto Hernandez. Reports are that Hernandez will miss at least one more outing. Just one?

Nationals’ reliever, Sean Burnett, was said to be unavailable for the next several days because of a left elbow nerve irritation and discomfort. Burnett has reportedly battled these symptoms since the All-Star break, but he “should be able to pitch through it after a short period of rest”. Have we heard that one before? The good news – it isn’t a ligament injury. But, what about why he has a nerve irritation? Rest alone isn’t the cure.

With a cushion in the standings…

Though his knee hasn’t had a setback, it was initially thought first baseman Joey Votto might not return to the Cincinnati lineup just yet. With a sizable lead over the Cardinals in the NL Central, Dusty Baker was quoted as saying “Joey will be here. He’ll be here soon. We just can’t say when… We want him right, and we have a bit of a luxury the way guys are playing now where we don’t have to rush him back.” Yay for common sense! Wait a minute – he will be starting tomorrow (9-5) 

Read between the lines

When the Dodgers acquired outfielder Carl Crawford from the Red Sox, he was about to have Tommy John surgery. USA Today reported that Crawford will “face an uphill battle to return before spring training in February” and that he “remains as big an injury risk as anyone in MLB”. You don’t have to be a PT to know that no one comes back from a Tommy John in 5 months, and especially not one of the biggest injury risks in MLB. Not happening.

Hoping for a homerun or a strikeout?

Yankees OF Curtis Granderson struck out as a ninth inning two-out pinch-hitter in Monday’s loss to the Rays. Granderson had been on the bench with right hamstring tendinitis. It’s a good thing he struck out – what if he’d had to really run? Worth the risk?

First baseman Mark Teixeira, hasn’t played in a week because of a left calf strain. He is reportedly likely to return this week though – hopefully not too soon.  We don’t want him afraid or have to run out a shot for extra bases. I’m assuming the strain is a particularly mild one.

Let’s try to keep it that way…

Cardinals shortstop Rafael Furcal will reportedly try platelet-rich plasma therapy for his afflicted right elbow. Reports have said that Furcal has a partially torn ulnar collateral ligament that may ultimately require surgery if conservative management fails. Though initial reports had him trying to return at the end of this season, that clearly is out. Why it was ever considered is the big question.

Texas Rangers’ catcher, Mike Napoli, was testing his quad doing light running, agility drills and taking batting practice. He had hoped to begin running the bases last weekend. He wasn’t ready, and it didn’t happen. Napoli has been out since mid-August with a left quadriceps strain and the timetable for his return is now uncertain.

Follow Abby on Twitter @abcsims. 


About the author

Abby serves as the Injury Expert for CBS New York where, since 2010, her Injury Breakdown Blog examines injuries in professional sports. She also blogs on health & fitness as well as sports injuries for Huffington Post, and Recovery Physical Therapy.com, where her blog earned a top ten mention for physical therapy blogs in 2012 @ WorldWideLearn.com. In a ranking of the Top 30 Healthcare Blogs for 2012, Top Masters in Healthcare also rated Abby’s blog in the top three in Physical Therapy! Abby is the founder of Fit-Screen and she welcomes your comments and questions!

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