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Diamond Cuts: Ellsbury's Sublexed Shoulder

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.

Jacoby Ellsbury and Carl Crawford

The Boston outfield took another hit in the team's first game in Fenway. While sliding into second, Ellsbury suffered a subluxed right shoulder after Tampa's Reid Brignac fell on top of his outstretched arm. Ellsbury instantly began writhing in pain and was helped off the field holding his elbow bent and his arm close to his chest, a classic indicator of a significant shoulder injury. The Red Sox have already placed him on the 15-day disabled list, but given the nature of the collision it could have been much worse.

For starters, a subluxation is different than a dislocation. A subluxation occurs when a joint articulation is partially displaced and is often referred to as just that, a partial dislocation. The displacement often reduces, or realigns, naturally by the supportive structures, such as muscle and ligaments, that surround the affected joint. A true dislocation occurs when the displacement of the joint is complete. The joint often must be realigned by medical personnel and is considered a much more serious injury.

In Ellsbury's case, the injured joint is the glenohumeral joint, the ball and socket joint of the shoulder. When Brignac fell on to Ellsbury, the force caused the head of the upper arm bone (the humerus) out of its normal alignment with the glenoid fossa, a cavity located on the shoulder blade (the scapula). Muscle, ligaments, and the cartilaginous ring known as the labrum reinforce the glenohumeral joint and helped pull Ellsbury's subluxed humeral head back into place. Unfortunately the force likely caused soft tissue damage in the process and an extended absence is expected. As long as the labrum didn't tear it's reasonable to assume Ellsbury can return in six to eight weeks. He will spend most of his time in physical rehabilitation, strengthening the surrounding musculature to insure the shoulder is one again strong and less likely to sublux again.

Cody Ross shifted to center to fill the void left by Ellsbury and Mike Aviles assumed the leadoff position in the batting order. Sadly Crawford will not be able to help the situation after experiencing left elbow soreness while rehabbing the wrist on the same arm. A MRI revealed a minor elbow strain but the team does not feel it is a significant injury. However it will push his return back at least a week as the team limits his throwing. Crawford is expected to resume playing in extended spring training, but only as a designated hitter. He will eventually return to the outfield as the elbow improves but he remains at least three weeks away from returning to the Sox.

Brandon Phillips

Fresh off of signing a six-year extension, Phillips remains limited by a left hamstring injury. He suffered cramps in the area on Monday and did not play again until Friday when he appeared as a pinch hitter. He received the day off Saturday and is expected back in the lineup on Sunday. The injury isn't considered serious but will likely limit his productivity on the basepath for the immediate future. I'm always leery of speedy guys and hamstring injuries so keep a close eye on him moving forward.

David Wright

A fractured right pinkie finger kept Wright out of the lineup for three consecutive games but did not appear to hamper him in his return. He finished 3-for-5 with a deep home run and two runs scored Saturday in a win over the Phillies and is now batting .588 through his first give games. The finger remains an issue and Wright will continue to wear a splint off the field. He has begun specific hand exercises designed to limit stiffness and help strengthen the area. While it's nice to see the All-Star avoid a prolonged stay on the DL, expect him to get the occasional day off and remember he remains at risk of reinjuring the digit both on the field and at the plate. 

Brian Wilson

The enigmatic Wilson is just the latest closer to go down with an ulnar collateral ligament (UCL) injury in his elbow, joining an already crowded list that includes Kansas City's Joakim Soria and Cincinnati's Ryan Madson. A MRI taken revealed structural damage and it appears he is headed for Tommy John surgery. Wilson entered the year with a bit of inherent injury risk after battling elbow issues at the tail end of last season. He never surgically addressed the bone spur in the joint causing the inflammation, opting to adjust his offseason routine to improve his flexibility. Unfortunately it appears he will not be able to avoid the knife and is likely done for the year. If Tommy John is needed, it would mark the second time in his career he would need the procedure. With Wilson out, manager Bruce Bochy said he would stick with a committee of closers that includes Sergio Romo and Santiago Casilla.

Drew Storen

Unlike Wilson, Soria and Madson, the Nationals closer is expected to return at some point this season after needing an elbow surgery of his own. Storen underwent an elbow debridement to remove a small bone chip on his right elbow. He hopes to return sometime around the All-Star break, meaning he would miss approximately two months. The injury is unfortunate for fantasy owners hoping to have the emerging star for the entire season but should be a relief to know he isn't done for the year. Furthermore the surgery allowed physicians to get an up-close look at the inside of the elbow. They discovered the integrity of the elbow looked strong and are confident Storen will not be forced to change his delivery or alter his workload moving forward. Like San Francisco, Washington will handle the absence of their closer by committee. Manager Davey Johnson will alternate between former All-Star Brad Lidge and Henry Rodriguez. Lidge seems to carry the most fantasy value but did blow his chance at his second save of the season Thursday, surrendering two runs in the ninth to the Reds.

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