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MLB Injury Report – American League Central

Nic Civale is a Doctor of Physical Therapy and former NCAA Division I Baseball player. He combines his knowledge of anatomy and physiology with that of baseball mechanics to provide expectations for players who will be rehabbing this offseason. Utilize The Offseason Injury Report to start your planning for 2021 drafts and keeper decisions.

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MLB Injury Report – AL Central

Josh Donaldson

The 2020 season did not turn out anything like what the Minnesota Twins had in mind. Reoccurring injuries, slumping bats, and first-round playoffs hiccups plagued the Twins in their pursuit of improving upon 2019’s record setting campaign. Despite this, they managed to finish atop the AL Central, edging out Chicago and Cleveland by 1 game each.

The Twins’ most notable and possibly frustrating injury was Josh Donaldson’s. After an injury-riddled 2017-18, Donaldson revitalized his career with a massive 2019 in Atlanta. He proved that he still had the pop in his bat, and the chops to play a solid 3B with a .969 fielding percentage.  He earned himself a 4-year, $92 million extension with the Twins, but quickly found himself back on the IL with a right calf injury, which had also occurred in 2017. From the British Journal of Sports Medicine, in an article entitled, Calf Muscle Strain Injuries in Sport: A Systematic Review of Risk Factors For Injury, we learn some relevant data. In a study of 5397 athletes and 518 calf/lower leg injuries, the “best evidence synthesis highlights chronological age and previous history of calf strain are the strongest risk factors for future calf muscle injury.”

Donaldson will enter his age 35 season in 2021 and has now hit the IL in three separate seasons in four years due to calf injury. This is a scary statistic for the Twins, who spent such a large amount of money on their aging 3B slugger. Despite the data presented, previous calf strains are not necessarily predictive of future injuries, and the aforementioned study concluded that more research needed to be done on the matter. It would be safe to venture, however, that we could be more confident in a healthy Donaldson season if these previous injuries had not occurred.

As mentioned in one of my midseason articles, “Donaldson boasts an aggressive swing with significant torque coming from his lower body, oftentimes driving his right knee within inches of the ground as he makes contact. In this position, the right calf muscle fires violently to drive his toes firmly into the ground and support forward momentum and provide leverage to power the bat forward and redirect the incoming ball.”  With a swing like Donaldson’s, there is always risk for injury; but there are a few silver linings in terms of fantasy rosters.

We know that the Twins won’t platoon Donaldson; they’re paying him too much and his career numbers vs. RHP and LHP are very similar. The Twins have also created some positional flexibility with their non-tendering of Eddie Rosario and failure to re-sign Nelson Cruz. If this remains the situation going into the season, Donaldson may see some time at DH, or even 1B to save his legs. Minnesota will do whatever they can to keep him on the field. This may mean an occasional day off, but that should be expected for 35-year-old infielders. Draft Donaldson next year with a contingency plan. Third base can still be considered a ‘deep’ position, but seems to be overwhelmingly top-heavy. You don’t want Donaldson to be your only option at the hot corner.

Mitch Garver

Mitch Garver is one of the players I’d like to campaign for a full pardon from the 2020 season. Garver became a fantasy darling in 2019 with his career year, posting per-plate-appearance numbers that were getting comparisons to Mike Trout and Babe Ruth! Were expectations coming into 2020 a little too high? Maybe. But the fantasy community seems to be souring on the soon to be 30-year-old backstop just as quickly as they anointed him the next big thing.

Mitch Garver had hit the IL with a right intercostal strain midseason. There is no doubting Garver’s numbers and metrics looked awful in 2020, but the most important number is 72. This is the number of at-bats Garver had in the shortened season. 72 AB’s is not enough of a sample to justify a player’s worth. We are, as a fantasy community having trouble justifying statistics from players who completed the full year. How could we alter our opinions so much when Garver saw such little time on the field?

One of the most important parts of this story is the injury Garver sustained is an absolute swing killer. Intercostal muscles connect adjacent rib bones to each other. The muscles contract in a diagonal pattern to help our trunks twist, flex, extend, and stabilize. If you’ve ever sneezed and felt a pulled muscle in your rib cage area or in your mid-upper back, then you may have had an intercostal strain. And you may have considered calling out of work because you couldn’t handle sitting upright for more than 30 minutes at a time. Now imagine if your job was MLB catcher and you weigh 220 pounds and have to swing a 2-pound club many times per day. During his rehab, Garver also encountered a set-back as a foul ball ricocheted into his ribs as he was catching.

It was a season to forget for the Twins backstop, and he has prospect Ryan Jeffers waiting to take some of his time behind the plate. But as mentioned previously, the Twins have some room to move people around in and out of the DH slot. If Garver gets hot to begin next year, you want to be the one to have him on your roster.

Garrett Crochet and UCL vs. Forearm Flexor Injuries

One of MLB’s up and coming fireballers had a scary injury late in the 2020 season. Crochet suffered a forearm flexor strain after displaying 3-digit heat on a regular basis through his first few career appearances. However, after the injury, he was kept off the field in fear that the strain may have been an ominous precursor for the need for Tommy John Surgery (TJS). Good news came out of White Sox camp in mid-October, however; Crochet did not experience any Ulnar Collateral Ligament (UCL) damage and is expected to be a full-go for spring training.

Although forearm flexor strains and UCL sprains/tears often find themselves coinciding with each other, they are each very different injuries. It is important to know the difference as a Physical Therapist and Physician, but also as a fantasy manager. Too many people see “forearm injury,” and think TJS is imminent. So let’s take a closer look at the differences.

The UCL is a ligament that attaches the humerus (the long bone of the upper arm) to the ulna (the medial, or pinky-side long bone in the forearm. It is designed to prevent destabilization of the elbow during many movements, but most dynamically in the overhead throwing motion. Without the UCL, the arm elbow would take on excessive valgus force, or a force that would cause a displacement away from the midline. For reference, a valgus deformity in the knees would appear as if someone was knock-kneed, and a valgus force would create that appearance.

The overhead throwing athlete needs an intact and strong UCL to help stabilize the arm during the throwing motion. In fact, the throwing motion has been recorded as the fastest motion human bodies are capable of. Studies have shown that the rotation in the shoulder can reach speeds of 7000 degrees per second, which equals about 20 full rotations…per second. In the elbow, approximately 3000 degrees per second is attainable. The elbow requires the ligaments to store and release the immense energy created by this rotation in order to complete its task.

A forearm flexor strain can occur when one of the many forearm muscles are overworked, stressed without proper warm-up, or are compensating for poor mechanics. A flexor strain is related to a UCL tear in that the throwing motion can cause each of the two injuries, but the flexors and UCL are not physically connected- although very close to each other. Forearm flexors are meant to bend the wrist downwards (palm towards forearm), and they play a role in bending the wrist medially and laterally, as well as stabilizing the wrist in conjunction with the wrist extensors.

If the UCL appears fully intact with Crochet; soft tissue massage, stretching, strengthening and some degree of rest should help with the injury he sustained. There is no reason this particular injury should lead to TJS. However, the White Sox team of Physical Therapists will need to uncover why the forearm flexor strain happened in the first place. What about Crochet’s mechanics can be altered to prevent re-injury or UCL damage? His future certainly is bright, hopefully, he won’t need to appear on any injury-related write-ups in the coming seasons.

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