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Getting a Grasp on the Latest Injury

There just had to be a silver lining to the dark cloud of injuries

  • Date: 8/12/2010
  • BIDMC Contact: Gary Gillis

Despite the fact that their team fielded a lineup that appeared to be held together by Band-Aids® and bubble gum at times, Red Sox fans maintained a good deal of optimism. If the Sox could do that well when things were going that badly, there just had to be a silver lining to the dark cloud of injuries.

"If they can just hang within striking distance of the Yankees and Rays until _________ gets back, (fill in the blank with your personal favorite - Jacoby Ellsbury, Josh Beckett, Dustin Pedroia, Daisuke Matsuzaka, Mike Cameron, Mike Lowell, Manny Delcarmen, Clay Buchholz, Victor Martinez, Jason Varitek) they'll be in good shape down the stretch."

Thumbs up to the positive attitude, thumbs down to the chances of a stretch run. When the Sox lost Kevin Youkilis, their All-Star, Gold Glove, heart-of-the-lineup first baseman to a torn adductor muscle in his thumb it seemed like the time might have come to hitch a ride on the "wait until next year" bandwagon.

No team goes through a season without some injury problems but the Sox seem to be on a record pace this season. And it's not just the number, but also the nature of the injuries that have folks shaking their heads.

"It's an uncommon injury." says Dr. Tamara D. Rozental, hand surgeon in the Carl J. Shapiro  Department of Orthopaedics at Beth Israel Deaconess Medical Center. "Odd in the sense that most of us in the field have never encountered it before. Most injuries to that area of the hand involve ligament tears."

In fact, it was the discovery of a tear of Mike Lowell's radial collateral ligament that caused the Rangers to call off a trade last December. More common is "skier's thumb" -- an injury to the ulnar collateral ligament that occurs when the thumb gets bent back while in an outstretched position. In published reports, Youkilis could not pinpoint an exact cause of his injury. He said he had experienced some discomfort and noticed discoloration in the area before the incident that forced him from the game and under the knife.

"When we talk about muscles there are usually three places where tears occur. The muscle belly can tear and this can be associated with bruising in the area as well as pain. Typically, these injuries will heal with immobilization and/or rehabilitation.. A gastrocnemius or calf strain would be an example of a muscle belly tear," notes Dr. Rozental.

"A tear can also occur where the tendon attaches the muscle to the bone. The tendon will tear off from the bone - sometimes with a small piece of bone still attached to the end. When that happens it's referred to as an avulsion and surgery might be advised. Injuries to the tendinous attachment of muscles are seen in muscles such as the biceps or pectoralis."

"The third area where tears happen is the musculo-tendinous junction. It's the area where the tissue transitions from muscle fibers to tendon fibers . The blood supply to these areas is sometimes referred to as the watershed area because it is not as good as in other parts of the muscle," she explains. "Common tears in this location include those seen in the Achilles tendon. Depending upon the severity of the tear it might require surgery."

Recovery and rehab are fairly straightforward. After the procedure the area will remain immobilized for about six weeks, possibly less. Then there is the rehab to build back the strength.

"For most muscle/tendon injuries we see a good return of function. This muscle is one of four muscles that power the thumb so it will have help from the muscles around it as well."

As for the Sox, they are already quite familiar with pitching in to help when a teammate goes down. They are indeed hurtin' for certain.

It's enough to tear your heart out.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

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