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Diamond Cuts: Two For the Thumb

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.

Josh Hamilton and Ryan Zimmerman

Everyone once in awhile an injury will become prevalent for no other reason than sheer bad luck. Multiple players will succumb to the ailment though the incidents are not indicative of a larger problem. For example, in the summer of 2010 Jason Heyward, Victor Martinez, and Chase Utley all suffered significant thumb injuries that cost them big chunks of the season. The thumb pandemic has now resurfaced with Ryan Zimmerman and Josh Hamilton each suffering a major thumb injury within days of each other.

The thumb is an intricate digit capable of being injured in several locations in a variety of ways. The amount of associated recovery time depends on the spot of the injury and the severity of the damage. The thumb itself is made up of three bones, the proximal and distal phalanxes and the first metacarpal. At the base of the thumb sits the carpometacarpal joint where the metacarpal of the thumb joins with the trapezium bone of the wrist. This saddle shaped joint is the most important aspect of the thumb as it allows the thumb to move in multiple directions including an important motion known as opposition. Opposition allows the thumb to touch the tips of the other four digits and is a key component of the multiple grips required for baseball.

The next bone in the thumb is the proximal phalanx. It attaches to the metacarpal bone to form the metacarpophalangeal (MCP) joint. The MCP joint is stabilized by the ulnar collateral ligament (UCL), which attaches to the base of the proximal phalanx. Though baseball fans may associate the UCL with Tommy John surgery, the UCL of the thumb is an entirely different ligament that simply shares a common name. The UCL of the thumb is most vulnerable to injury when it is overstretched as a player gets hung up on a base or in the jersey of an opponent.

A UCL injury is exactly what Hamilton suffered when he attempted an ill-advised headfirst slide into the first base. A MRI confirmed a tear of the ligament as well as the associated capsule of the joint. Surgery was performed on the area and Hamilton is expected to miss six-to-eight weeks. The timeline is in line with others that have suffered a similar injury but there is still a cause for concern. As previously mentioned, the thumb is vital to grip strength. A limited grip can have a direct effect on a hitter's ability at the plate, particularly in terms of power. For example, Phillies second baseman Chase Utley underwent surgery to repair a torn UCL in his thumb in June of the 2010 season. He returned in mid-August but struggled down the stretch as his home run total and slugging percentage dipped. Hamilton will face a similar rehab and a comparable dip in power should be expected upon his return.

Zimmerman was also injured diving into a base but his injury was not to a ligament but to the bone itself. The Nationals third baseman suffered a fractured thumb on the play and is expected to miss the next four-to-six weeks. Unlike Hamilton, Zimmerman will avoid surgery. Instead he will be placed in a cast to immobilize the joint, creating a more suitable environment for healing. Insuring a complete union between the fragmented pieces of bone is key to his recovery. If bones fail to mend or improperly fuse together, surgery could become an option. Fortunately for Zimmerman owners bone heals faster than ligament tissue and he should be back before Hamilton. However the same effects are in play with a drop in power numbers likely.

A.J. Burnett

The Phillies veteran recently received a diagnosis on his sore groin that provides a bit of clarity while raising a few red flags. Following two erratic starts Burnett complained of groin pain. A visit with team physicians revealed a small inguinal hernia in the area. An inguinal hernia occurs when an opening in the groin, utilized for the passage of blood vessels and nerves, becomes abnormally wide. As a result the neighboring abdominal tissue begins to protrude outward. Surgery can fix the area but requires a six-to-eight week window of rehab and recovery. While the surgery does come with a high success rate, Burnett has opted to not undergo the procedure and will simply continue to pitch in pain. Doctors have informed Burnett that he is not at risk to make the injury worse if he continues to play but will have to learn to tolerate the lingering pain. Cortisone injections and other modalities will be used to manage these associated symptoms.

Burnett can rely on teammate Cole Hamels for advice as the former World Series MVP pitched a portion of the 2011 season with an inguinal hernia of his own. The hernia was eventually repaired in the offseason. However, Hamels set an unfair precedent and there is no guarantee Burnett can match those results. He will be a risky play until the issue is directly addressed and fantasy owners will need to tread carefully here.

Check Swings

Adrian Beltre: The Rangers are taking the conservative route with their veteran third basemen and have placed him on the 15-day disabled list after he suffered tightness in his quadriceps muscle. Beltre has a history of lower leg injuries and the current ailment has been diagnosed as a Grade I strain. Texas is right to err on the side of caution here and Beltre owners should benefit in the long run. In the meantime, veteran Kevin Kouzmanoff will see the majority of time at third.

Alex Cobb: The Tampa right-hander was placed on the 15-day DL after a MRI revealed a strained left oblique. The severity of the strain is being downplayed and the Rays are optimistic he can return in four-to-six weeks. That's a bit of good news considering the normal timeline for this type of injury is between six-to-eight weeks. Barring a setback, Cobb will likely return on the tail end of the initial timeline. The timing of the injury is unfortunate, as teammate Matt Moore will need Tommy John to repair a torn UCL in his throwing elbow.

Dustin Pedroia: Wrist inflammation remains the diagnosis for the former American League MVP. He hopes to rejoin the team Wednesday in Chicago. Keep a close eye on this situation for the next few weeks. Wrist injuries sometimes take awhile to develop on x-rays and MRIs and don't be surprised to see him undergo additional testing if the pain lingers.