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Diamond Cuts: Pitcher Injuries in LA

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.

Zack Greinke

The impact of the Dodgers-Padres brawl will effect Los Angeles significantly more than San Diego after it will revealed Greinke suffered a fractured left collarbone that ultimately required surgery to mend. While both players are culpable in the fight, Greinke's absence will be felt much longer than Carlos Quentin's 8-game suspension. The rod inserted into the shoulder removes any randomness out of the healing process, ensuring the two pieces form a complete and properly aligned union. However Greinke will still require an extended stint on the disabled list as he spends the next few weeks basically waiting for bone to grow. He should begin throwing relatively early in recovery but will be closely monitored to prevent any biomechanical alterations that could lead to another more serious injury down the road. He will be able to maintain his conditioning allowing Greinke to return quickly, once the bone has mended. The initial eight-week timeline seems realistic but don't be shocked if he comes back a tad earlier. There shouldn't be any long-term ramifications of the injury as long bone heals nicely.

Jered Weaver

The other Los Angeles based team is also waiting for bone to heal after additional images revealed Weaver suffered a broken left elbow in his awkward fall against Texas. The good news is that the radial head remains in place and did not displace, meaning surgical intervention will be avoided. Like Greinke, the injury occurred to his non-throwing arm and should allow Weaver to continue his conditioning and even begin light toss considerably early in the rehab process. Again taking steps to avoid a disruption in his throwing mechanics will be crucial for both short term and long term recovery. If the bone heals quickly and Weaver remains patient, it seems likely he'll be ready on the early side of the four-to-six week timetable set out by the team.

Johnny Cueto

Bone injuries aren't the only thing limiting MLB pitchers as the Reds right-hander suffered a strained latissimus dorsi in a recent game against the Pirates. I've previously discussed this type of injury with Chiacgo's Matt Garza but let's do a quick review. The lat is a muscle that runs the length of the thoracic spine before inserting into a small groove of the humerus. It is plays a role in multiple shoulder motions including extension (raising your arm), internal rotation (rotation toward the body), and horizontal abduction (bringing the arm away from the body). The muscle also contributes to several back movements including side-to-side bending and backward bending in the lower back. The expansiveness of the lat makes it vulnerable to injury at multiple locations. The initial reports suggested the injury was a triceps strain, hinting that Cueto's injury could be closer to the shoulder rather than in the lower back. An injury to this area would be more problematic especially if the tendon is involved. Cueto owners should be prepared for a lengthy DL-stint.

Jose Reyes

Just as Reyes appeared ready to put his injury-riddled past behind him, the All-Star shortstop took an awkward slide into second base. The results weren't pretty as a MRI revealed a severe sprain, but luckily no fracture. Looking at the replay you can see Reyes's trail leg get caught in the dirt just as upper body rolls over the leg. The Blue Jays have yet to call it a high ankle sprain but based on the aforementioned mechanism of injury it wouldn't be shocking to hear it dubbed this down the road.

In a "garden-variety" ankle sprain the ligaments located on the either side of the ankle are sprained and damaged. However in a "high-ankle sprain", or syndesmotic sprain" the damage occurs at the distal tibiofemoral joint where the distal ends of the lower legs bones, the tibia and fibula, form the ankle mortise. Several strong ligaments including the interosseous ligament and the anterior and posterior tibiofibular ligaments stabilize the mortise but are vulnerable to injury when the ankle is twisted and forced upward, like in the case of Reyes. When these specific ligaments are over-stretched or in some cases completely torn, it is considered a high-ankle sprain. Treatment for these sprains is similar to that of a normal medial or lateral ankle sprain and it's possible to suffer both a high ankle sprain and a "normal" ankle sprain.

Regardless of the exact nature of the sprain, Reyes will have his ankle immobilized for the immediate future and will start his recovery process with a goal of minimizing swelling and inflammation. As he progresses he will shift his focus to range of motion and strengthening, before beginning baseball-related activity. The speedster is expected to be out until the All-Star break.

Michael Bourn

Bourn evaded serious injury over the weekend after pitcher Matt Thornton stepped on the outfielders' hand. Thornton's spikes opened up a laceration on Bourn's right index finger that ultimately required five stitches to close. Bourn will be sidelined for seven-to-10 days but will avoid the DL.

Mike Morse

Another outfielder named Michael suffered a hand injury last week and like Bourn, Morse appears to have dodged a bullet. Morse sustained a fractured right pinkie after getting stuck by a pitch. The fracture was small and non-displaced and Morse is hoping to play Tuesday after a day off on Monday. Morse has been red hot to start the season, slugging six home runs tying him for the league lead with Chris Davis. As long as the pain and swelling are minimal and do not alter his grip, Morse should be fine moving forward.

Erick Aybar

The Angels injuries woes are not isolated to their pitching staff as their starting shortstop is DL bound with a bruised left heel. The heel is the rear or proximal portion of the calcaneus, a primary bone of the foot and ankle. A thick fat pad exists to help absorb the constant stress and forces that the calcaneus undergoes with weight bearing. However, the heel can become contused or bruised while running or with repetitive jumping. A heel cup can be added for extra protection and to help minimize the pain but even then it can a very limiting injury. Heel injuries that go untreated can lead to the development of bone spurs, which could then subsequently lead to more serious ailments like plantar fasciitis. Hopefully rest and recovery will allow the issue to clear up, but be prepared for this to linger.