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Diamond Cuts: More Back Trouble for Oswalt

Jeff Stotts

Jeff Stotts

Jeff Stotts works as a Certified Athletic Trainer (MAT, ATC, PES, CES). He won the 2011 Best Fantasy Football Article in Print from the Fantasy Sports Trade Association.

Pitchers

Roy Oswalt

The vaunted Philadelphia rotation took a hit over the weekend when it was revealed Oswalt will be sidelined with a bulging disc in his balky back. Oswalt's back problems began in 2007 when a bulging disc causing pain into his left hip, forced him to miss his final starts of the season. His back has since flared up in 2008, 2009, and earlier this season when inflammation in the region forced him to the disabled list. A recent MRI once again revealed a bulging disc and thickening of an area surrounding one of the facet joints around his spine.

Intraverterbal disks lay in-between each vertebrae of the spine. The add stability to the spine and serve as shock absorbers for the various forces placed on and through the body. The structure of each disc slightly resembles a jelly donut. The outside of the disc consists of layers of thick fibrocartiliage known as the annulus fibrosis. The annulus is comparable to the fried dough of the donut. Inside the annulus is a softer center known as the nucleus pulposus. The nucleus has the consistency of jelly that allows it to serve as a shock absorber.

If enough constant pressure is applied to the disc or the back is violent wrenched, the nucleus can leak out in a way similar to jelly squirting out of a filled donut if you were to squeeze it in your hands. This bulge can irritate nerves in the back, resulting in shooting pain into the extremities. The severity of the injury is dependent on the amount of nucleus protruding into the spinal canal. If the bulge is incomplete it's considered prolapsed while a complete separation of nucleus from the disc is known as a sequestered disc. The reports seems to suggest Oswalt has a minor prolapsed disc in his lumbar region that is resulting in pain and weakness in his lower extremities. In the past, the pain had stopped at the hip but now the pain has carried down into his knee.

Oswalt will visit the back specialist he has worked with in the past to determine a specific course of treatment. The team physicians have suggested rest, rehab, and a series of injections to treat the pain. His season has not been ruled over and Oswalt will take three-to-five weeks off before attempting to return. A mid-August return is possible. However, if you are in a league without a DL or have a DL crowded with injured players, it may be wise to let Oswalt go.

Ryan Madson

The Phillies also lost their latest closer to injury as Madson joined one-time closers Brad Lidge and Jose Contreras on the DL. Madson suffered a bruised hand after being hit by a ball in a game against the Rangers. The contusion caused the hand to become inflamed, causing Madson problems with the various grips required to pitch. He has received a cortisone injection to address the inflammation. The move was retroactive to June 19 so his time on the DL could be brief if the cortisone effectively works. In the meantime, Antonio Bastardo is the top candidate to pick up saves with Michael Stutes next in line.

Hitters

Justin Morneau

Morneau was recently placed on the DL with a wrist sprain. However, once the wrist was immobilized it was determined that he would need surgery, not on the wrist, but to relieve a pinched nerve in his neck. Like Oswalt, Morneau's problems come from a bulging disc. Morneau's injury is more severe, as a fragmented piece of disc is impinging on a nerve in the cervical region of his spine. The issue is causing numbness into his left index finger and weakness in his arm. The decision to operate was made to insure the weakness did not become permanent. The procedure is considered non-invasive and will sideline him for at least six weeks.

On the bright side, it will give his injured wrist more time to heal and should allow Morneau to fully recover. He hopes to be ready by mid-August but with the Twins dwelling in the basement of their division, it's hard to imagine them rushing him back. Given his injury-riddled track record over the past two seasons, it would be easy to understand why frustrated fantasy owners would start to look elsewhere for the remainder of the season.

Shin-Soo Choo

The suddenly struggling Indians will be without the services of Choo for an extended period of time after surgery was required to repair his broken thumb. Choo suffered a displaced fracture and laceration after being struck by a pitch. The injury was a gruesome one as the Cleveland medical staff was forced to cut off his batting glove as blood saturated the area. The surgeon had to reduce and fixate the injury, meaning he had to put the broken pieces back in place then insert a surgical screw or plate to keep them aligned. He will be out a minimum of two months but it's likely he will need more time than that to completely recover. Thumb injuries need time, especially those that require fixation. Travis Buck has been recalled from Triple-A Columbus and started in right field in Cleveland's last two games.

Jose Tabata

The Venezuela native was placed on the 15-day DL with a strained left quadriceps muscle. He suffered the injury while attempting to beat out a bunt single against the Red Sox. He crumpled to the ground after passing first and required a cart to make it off the field. He was able to leave the locker room under his own power but was walking with a considerable limp. Tabata missed time earlier in the season with a hamstring strain but it was to his right leg and likely not related to the current injury. Fortunately, quad strains tend to have a quicker and more successful recovery rate based on the high amount of blood flow to the area. The Pirates have already said he will need a rehab assignment before he will rejoin the club.

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