imagesDerek Jeter finds himself on the 15-day DL once again, this time because of a Grade 1 right quad strain that he sustained on July 11th, in his first appearance after rehabbing successive left ankle fractures. Though no one could have predicted what would fail Jeter upon his return, it seemed almost inevitable that it would happen. And, when it did, word that he might return only days later – whether before or possibly immediately after the All Star Break – repeated a pattern we’ve seen before; the expectation that an aging superstar would overachieve. It isn’t easy to bounce back from strains, even when only Grade 1. And, when you are nearing 40 instead of 20 it is generally just a little bit more difficult. Add to that the extreme level of demand that a return to competition places on healing tissue and you have a formula that doesn’t compute.

With top flight docs and trainers in the Yankee system it would seem likely that Jeter passed rigorous tests of both his left ankle as well as his overall functional ability prior to rejoining the big club. However, his immediate injury certainly leads one to speculate that perhaps he had not been tested sufficiently. Before athletes return to play, they must be able to perform all the tasks required of their sport; repeatedly and for a sustained period. For a baseball player, that obviously means sprinting, sliding, batting and, especially for those playing the field, all sorts of directional agility drills, movement drills that also require bending to the floor, as well as throwing – accurately and for the necessary distance.

I’ve not spoken with anyone managing Jeter’s medical care and have no personal knowledge of his specific rehab program or the return to field criteria to which he was held. However, the outcome gives one pause.

You might be thinking, ‘it is his right quad not the left that is injured, so it probably was just a freak thing and not related to recovery from his left ankle injuries.’ That isn’t necessarily the case. If Jeter favored his left ankle at all:

  • He was likely to place additional demands on his right side to compensate, particularly an issue with sprinting around the bases
  • He risked injuring any part of his lower body – left or right

Other issues that can adversely impact an athlete’s return to play include any deficit leaving a player shy of full capacity in:

  • Muscular strength, endurance and power
  • Range of motion (in Jeter’s case, at the left foot and ankle)
  • Flexibility
  • Agility, proprioception (position sense), and balance
  • Cardiovascular endurance

Muscle fatigue is frequently a precursor to overuse. It is why, for instance, many skiers suffer injury late in the day or toward the end of a ski vacation, when muscles no longer have the capacity to exert the necessary force or sustain that effort.

Training in the late phases of rehab focuses on enabling athletes to meet high-level functional demands – both those that are prolonged and those requiring bursts of activity. Rushing or compromising this stage and getting back out there too soon – even when pain is no longer an issue and it appears healing has been satisfactory – can prove problematic. Feeling okay and performing well are two different things.

You’ll note that it wasn’t until the eighth inning that Jeter, who was slotted at DH, left the game with his quad strain. According to WFAN’s Sweeny Murti, he’d first noted the tightness/discomfort in his third at-bat when “busting it” (unsuccessfully) to beat out the second baseman’s throw to first on a grounder up the middle. Jeter grounded out again in his final AB and didn’t run very hard down the line, making it clear something was amiss. He was removed for a pinch-hitter late in the game.

When a player is cleared to play only as a DH it is a sign that there is some reservation about his overall level of function. It is clearly a way to reintroduce, yet limit demand. However, “busting it” on the base path – though it doesn’t challenge lateral mobility and all the other skills playing shortstop would – is demanding. Only a home-run bestows absolution.

Jeter played 7 innings without incident the night prior at AAA, though I’ve no idea whether he pushed as hard on the base paths; perhaps not.

Postscript: Yankees GM, Brian Cashman, commented this evening on WFAN Radio that Jeter may not be ready to return when his term on the DL expires (he went on retroactively to July 12th). It should be noted that, though Jeter might still be able to make it back after a three week period of rest and rehab – as he did following a Grade 1 calf strain in 2011 – there are more issues at play now. Not only is he 2 years older, obviously a lot has happened in that time.

Unfortunately, the quad strain – and the rest Jeter needs to recover (along with ongoing rehab) – puts him at an even greater disadvantage with respect to the likelihood of sustaining other injuries. The benefits of whatever functional training he did prior to returning on July 11th have been compromised. This is especially important when we take into account that what he had done did not fully prepare him to play or the quad wouldn’t have been an issue.

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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