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Diamond Cuts: Longo's Foot

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.

Johnny Cueto

The Reds will send Cueto to the disabled list for the third time this season after he once again aggravated his previously strained latissimus dorsi muscle. The "lat" is a muscle located along the spine and shoulder that is involved in moving the shoulder and back in multiple directions. Lat strain diagnoses are common for pitchers with players like Cueto, Roy Halladay, Jake Peavy, and Stephen Strasburg all missing time in recent seasons with the ailment. Each individual injury, and the subsequent recovery, is dependent on the location of the injury and the resulting healing process.

In Cueto's case the location of the injury has been determined and isolated to the muscle belly of the lat. This is actually very good news. If a minor strain or more significant tear occurs in the muscle belly, individuals can anticipate a quicker and smoother recovery than if the tear was located in the tendon of the muscle. Tears in the muscle belly tend to heal quicker due to a health supply of blood that helps facilitate the process. Tendons, for the most part, don't always have this benefit and often require additional time to heal. Furthermore scar tissue is often a complication with tendon tears, further delaying recovery. However because this is the third incident, it appears Cueto is still having trouble with the developing scar tissue.

Reinjuring a strained muscle is fairly common due to the strength of the newly developed scar tissue. The healing process for muscle is divided into multiple phases that each vary in time of completion. The last two phases, the repair and the remodeling phases, are key to insuring if and when an athlete can return to activity and ultimately their sport. In the repair phase, scar tissue is produced and capillary growth is stimulated. The repair phase can take a significant period of time and is the phase doctors hope to accelerate when utilizing various treatments like therapeutic ultrasound or the more intensive platelet rich plasma (PRP) injections. In the remodeling phase, newly created scar tissue is used to fill in the gaps created by the injury. However the new tissue is still laid down in a random order and medical professionals must often take steps to help organize the body's natural healing mechanisms. Treatments like massage and joint mobilizations can help reinforce the area and enhance the integrity of the muscle.

However, as you can imagine, the strength of new scar tissue is not immediately as strong as the previous muscle tissue. Time is required to insure it is able withstand a muscle contraction or is not overpowered by healthy muscle fibers from neighboring muscles. If it is and the scar tissue fails, the entire healing process restarts. Unfortunately for Cueto owners that is exactly the situation the right-hander is facing.

Head athletic trainer Paul Lessard revealed the location of the injury occurred at the previous site and compared the failed scar tissue to picking the scab of a wound. Cueto will be sidelined for at least five weeks but given the multiple occurrences it would be wise to anticipate a longer DL-stint. The injury opens the door once again for Tony Cingrani to return to the rotation. The left-hander is currently 3-0 and a 3.42 ERA.

Evan Longoria

Longoria remains sidelined with plantar fasciitis in his right foot and hopes to avoid the DL. However the nature of the injury can be more problematic than that.

The plantar fascia is a collection of thick connective tissue that starts at the heel and runs along the bottom of the foot. It protects the bottom of the foot, and supports and stabilizes the arch. If over-stretched or torn it can become irritated and inflamed resulting in plantar fasciitis.

Plantar fasciitis is a painful injury, particularly during running and jumping. Longoria admitted the foot has been a problem for over a month now but flared up recently while running the bases. The most discouraging thing for those invested in Longoria is that there is no "cure" for plantar fasciitis and it will likely linger throughout the remainder of the season. The Rays medical staff will attempt to treat the pain and inflammation in a variety of ways but rest is the ultimate weapon. Given this information it seems he would in line for more regular days off and potential DL trip if the pain does not subside.

Check Swings

Bryce Harper: Harper will rejoin the Nationals this week and hopes to pick up where he left off before sustaining the left knee injury that has sidelined him since May 26. He has reported no additional swelling following his participation on his rehab assignment and that trend will need to continue for him to stay productive.

Adam Lind: The Jays are hoping an additional day off will help Lind get over stiffness in his mid-back. The team has yet to call the injury a strain, suggesting the issue could be mild.

Curtis Granderson: The Yankees outfielder is still having issues gripping a bat, delaying his return to the club. The fractured bone is healed but the surrounding ligaments and tendons will need time to recover from being immobilized following surgery.

Alex Avila: A left-forearm contusion sent Avila to the DL but he's eligible to return on Tuesday. The struggling catcher should be activated despite a slow start on his rehab assignment. He's been swinging the ball better and should get a chance to improve on his .172 average.

Anibal Sanchez: In addition to Avila, the Tigers are preparing for Sanchez' return. Sidelined with a sore shoulder, Sanchez reportedly felt "great" following a recent bullpen session. If he continues to progress as expected he could be in line to return on July 6 at Cleveland. Temper your expectations initially, given the lengthy list of injuries to his throwing shoulders.

Josh Beckett: The Dodgers will be without Beckett for the remainder of the season after it was revealed he would need surgery to relive a condition known as Thoracic Outlet Syndrome (TOS). TOS occurs when a bundle of nerves known as the bracial plexus is compressed in one of several locations. The results are often numbness, tingling, and weakness in the shoulder and arm.

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