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Diamond Cuts: Tragic Hip

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.

Clayton Kershaw

The Dodgers are in a tight playoff race and have already lost veteran Ted Lilly and Chad Billingsley to injury. The news gets worse as they may have to continue their push without their ace as well. Kershaw has been shut down indefinitely after his problematic hip once again forced him to miss a start. The reigning NL Cy Young winner pitched Tuesday after hip inflammation delayed a start by two days. Kershaw pitched extremely well, lasting seven innings allowing one unearned run on three hits in a close loss to Arizona. However the days following the start did not go as planned as a bullpen session was canceled and all activity was stopped after the inflammation persisted. He missed his start Sunday and will now travel to visit with a hip specialist to determine a course of treatment.

Kershaw's issue is with his labrum but not the labrum we are accustomed to seeing with pitchers. Most pitchers suffer tears to the labrum in their shoulder. However the hip also has a labrum that, like its shoulder counterpart, can tear. The primary joint in the hip is known as the acetabulofemoral (AF) joint. The AF joint is a ball-and-socket joint, similar to the glenohumeral joint in the shoulder. Both joints resemble a golf ball sitting on a tee. In the AF joint, the head of the large leg bone known as the femur (the golf ball) sits in the acetabulum of the pelvis (the tee) forming the AF joint. The ball (head of the femur) can freely pivot on the tee (acetabulum) allowing for a large degree of motion. To insure the ball remains on the tee but still has freedom to move, a ring made of specialized cartilage known as the labrum deepens the acetabulum. The labrum, ligaments and musculature surrounding the area work together to stabilize the joint. However a violent collision or repetitive motion can cause the labrum to fray or tear. Labral injuries are very painful and can lead to chronic instability in the hip if gone untreated.

The Dodgers have already stated Kershaw will not receive a cortisone injection to treat the injury, suggesting surgery remains a realistic option. If surgery is warranted, it will be aimed at removing any loose bodies floating in the socket of the AF joint while any labral damage present would be repaired. The procedure is carried out arthroscopically but still requires a lengthy rehabilitation of three to five months depending on the extent of damage. Kershaw owners should prepare for the worst and anticipate finishing the season without him.

Edwin Encarnacion

Encarnacion and his 40 home runs has been one of the lone bright spots in a bumpy season for the Blue Jays. Unfortunately, like every other major name on the Toronto roster, he has been slowed by injury. He has missed two of the team's last three games with two different ailments. He sat out Friday's game with a sore wrist after getting hit by a pitch the night before. He did not play Sunday due to a sore big toe on his right foot. Encarnacion has missed several other games over the course of the season with shoulder and hand issues and it sounds like this is another minor injury to add to the list. Consider him day-to-day but keep in eye out for the results of any further testing that may be carried out over the next few days.

Corey Hart

Hart continues to miss time with a lower leg injury. Initially the Brewers ruled the injury a mild ankle sprain but as the injury has progressed so too has the diagnosis. The pain Hart is experiencing in not his ankle but in the arch of his foot. He has attempted to run the bases but the pain will not let him make hard cuts. The injury has not been diagnosed as anything specific yet but the location of the pain narrows the list. Plantar fasciitis or a midfoot sprain remain possibilities but it would unwise to speculate without more information. However I think he remains an extremely risky play in weekly leagues. The team is contemplating a cortisone injection as a last option and if they do elect to utilize the anti-inflammatory medicine he will need several days off before he can return to action. The Milwaukee lineup will miss Hart's production but should benefit from the return of Ryan Braun, back from a minor wrist injury.

Austin Jackson

The Tigers made Jackson a late scratch on Sunday with a left ankle injury. The outfielder was injured during an attempted diving catch on Saturday. Jackson stayed in the game after being examined by the team's athletic trainer. The injury is likely mild and Jackson will enter the week with the always-frustrating day-to-day label. Like Encarnacion, more information should be released before Jackson plays again so wait to make a decision until all reports are in.

Chris Carpenter

The Cardinals are hoping the impending return of their veteran pitcher and emotional leader in the clubhouse will help start a run similar to last year when St. Louis bull-rushed through the playoffs in route to a World Series title. Carpenter has ye to appear in a game this season and was expected to miss the season in its entirety after the medical staff determined he would need surgery for thoracic outlet syndrome (TOS). TOS was causing numbness and weakness in Carpenter's throwing arm by impeding on a nerve in the effected area. However Carp has diligently reported for treatment and rehab and is expected back in the St. Louis rotation later this week. All reports have been encouraging but I'm still red-flagging the right-hander. Nerve injuries are always tricky and he won't have the benefit of a lengthy rehab assignment. He still may make three starts before the regular season concludes but there is no guarantee they will go smoothly. If you are desperate for starts, perhaps you can justify taking the gamble but I don't have very high hopes.