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Diamond Cuts: Bloody Saturday

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.

Chris Young

Young found the one thing that could slow his red-hot start, the outfield wall. The Diamondbacks outfielder is currently hitting .410 with five home runs but is expected to miss at least two weeks with a shoulder injury sustained while crashing into the centerfield wall during a catch. A MRI performed revealed a slight tear in a ligament stabilizing the acromioclavicular (AC) joint. Better known as a separated shoulder, injuries to the AC joint are quite common.

The joint itself is located where the collarbone connects to a bony process on the shoulder blade known as the acromion. The AC joints acts as a strut, allowing the arm to be raised overhead. It is primarily stabilized by two ligaments, the acromioclavicular (AC) and coracoclavicular (CC) ligaments. Both are susceptible to injury when the tip of the acromion is forcibly pushed downward following a direct hit or collision.  

AC sprains are graded on a six-point scale. A Grade 1 sprain is considered the least severe and involves overstretching and microtearing of the ligaments. A Grade 2 sprain involves a rupture of the AC ligament while a Grade 3 injury denotes a rupture of both the AC and CC ligaments with accompanying upward movement of the clavicle. The final three grades are considered severe and each is dependent on the amount of movement of the collarbone and the damage done to the neighboring muscles.

Young's injury is likely a mild Grade 2 injury and the team plans on proceeding with non-operative treatment. Unfortunately even the slightest sprain can cause considerable amounts of pain and can give an athlete problems throwing and at the plate.  Upton will need to allow the soft tissue to heal to insure the joint is properly stabilized while focusing on preserving the range of motion in the shoulder. Pittsburgh's Andrew McCutchen missed just six games in 2010 with a minor Grade I sprain while a more significant AC sprain limited Carlos Quentin to just one game in the final five weeks of last season. Given that this is Upton's first trip to the disabled list in his six years at the Major League level, I'd anticipate he returns at the latter part of the projected recovery window, keeping him sidelined for about three weeks.

Daniel Hudson

As the Diamondbacks didn't have enough to worry about with Young, one of their top pitchers is also facing injury and has been placed on the 15-day DL. Hudson began feeling discomfort in his shoulder on April 13 but made his next start, striking out five in 7+ innings. Unfortunately the pain and discomfort persisted and a MRI was needed. No structural damage was discovered but the emerging youngster was diagnosed with right shoulder impingement.

Shoulder impingement usually occurs when a tendon of the biceps or one of the rotator cuff muscles becomes pinched or irritated as they pass through a narrow space in the shoulder. The issue must be treated seriously because if left untreated the cuff muscles can develop a tear or a labral issue can occur. Treatment generally focuses on the use of anti-inflammatory medications and rehab protocol designed to strengthen the effected and surrounding musculature. The Diamondbacks will be overly cautious with Hudson and don't be shocked if this DL trip lasts longer than the allotted 15 days.

Cliff Lee

The Phillies have placed Lee on the 15-day DL with a left oblique strain just days after the former Cy Young winner pitched 10-innings in a 1-0 loss to the Giants. Lee felt a pull in his left side during the final inning and was placed on the DL Sunday, retroactive to April 19.

Lee has a history of trunk injuries, including a sports hernia operation, but his previous abdominal injuries have all been on his right side.  However regardless of side, it's important for Lee to have healthy muscles on both sides of his trunk to help properly generate and transfer force while pitching. Let me explain.

The obliques are located on both sides of the rib cage and are divided into two groups, the external obliques and the internal obliques. The thin muscles on one side contract with the other group on the opposite side to complete trunk rotation. For a left-handed pitcher like Lee, his right internal obliques contract along with his left external obliques to complete a throwing motion. Weakness on either side can put undue stress on the opposite side and lead to significant injuries.

While reports suggest the strain is mild, the Phillies are playing it safe with Lee by protecting his previously injured right side from his now injured left. Lee is eligible to return to action May 4 and I would anticipate a return somewhere near that date.

Ryan Dempster

The Cubs most stable pitcher will be MIA for the immediate future after suffering a strained right quadriceps. The injury occurred, not in his most recent start, but in a side pitching session. A leg injury isn't as big of a setback as a shoulder or elbow injury but still must be taken seriously.

During pitching, the trail leg is most actively used in the cocking and acceleration phases of throwing, playing a key role in creating forward momentum. As the pitcher drives his arm and body forward toward the plate, energy transfers from his back leg to the lead leg. A strain like Dempster is currently dealing with would severely hinder his ability to generate the required force to efficiently deliver a pitch.

Like Lee, all indications seem to suggest the strain is minor and the DL stint is more precautionary than anything. The Cubs will be without the veteran for two or three starts but he should be able to return relatively quickly.

Adrian Beltre

Beltre is headed for a MRI Monday after straining his left hamstring over the weekend. The Gold Glove third baseman has been fairly healthy throughout his career but lower leg strains have been issue recently. The problems began in the spring of 2011 as he missed time in spring training with a strained calf. He would then miss nearly 40 games during the season with a left hamstring strain.

While Beltre insists this injury does not feel as bad as last year's, it does raise a red flag on his health for the remainder of the season. Hamstring injuries can be very problematic and can become chronic issues, just ask Jose Reyes or Beltre's teammate Nelson Cruz. Keep an eye out for the MRI results and remember his intrinsic risk will remain high for the remainder of the season.