This article is part of our Fantasy Baseball Injury Report series.
Gomes' plea to Jobu appeared to fall on deaf ears as the Indians catcher exited Sunday's game with a significant shoulder injury. He fell awkwardly while running to first base and was carted off the field with his right arm in a sling. After the game, the injury was described as a "separated shoulder" with a more detailed evaluation to follow.
The team's use of the word separation, as well as the mechanism of injury, is a good indicator of the specific area of the shoulder involved in the injury. The term separation, as opposed to dislocation, is usually reserved to describe an injury to the acromioclavicular (AC) joint of the shoulder. The AC joint is formed from the distal end of the clavicle (collarbone) and a portion of the shoulder blade known as the acromion. The union serves as a strut for the arm and is fortified by the acromioclavicular (AC) and coracoclavicular (CC) ligaments.
If the tip of the shoulder is violently forced down, the ligaments are sprained. Upon examination, doctors will then assign the AC sprain a specific grade based on the amount of damage to the involved ligaments and any other supporting tissue. A mild or minor sprain receives a Grade 1 sprain and is marked by overstretching and microtearing of the ligaments. A moderate Grade 2 sprain involves a tear of the AC ligament but minimal damage to the CC ligament. A Grade 3 injury denotes a rupture of both ligaments with an
Gomes' plea to Jobu appeared to fall on deaf ears as the Indians catcher exited Sunday's game with a significant shoulder injury. He fell awkwardly while running to first base and was carted off the field with his right arm in a sling. After the game, the injury was described as a "separated shoulder" with a more detailed evaluation to follow.
The team's use of the word separation, as well as the mechanism of injury, is a good indicator of the specific area of the shoulder involved in the injury. The term separation, as opposed to dislocation, is usually reserved to describe an injury to the acromioclavicular (AC) joint of the shoulder. The AC joint is formed from the distal end of the clavicle (collarbone) and a portion of the shoulder blade known as the acromion. The union serves as a strut for the arm and is fortified by the acromioclavicular (AC) and coracoclavicular (CC) ligaments.
If the tip of the shoulder is violently forced down, the ligaments are sprained. Upon examination, doctors will then assign the AC sprain a specific grade based on the amount of damage to the involved ligaments and any other supporting tissue. A mild or minor sprain receives a Grade 1 sprain and is marked by overstretching and microtearing of the ligaments. A moderate Grade 2 sprain involves a tear of the AC ligament but minimal damage to the CC ligament. A Grade 3 injury denotes a rupture of both ligaments with an accompanying upward shift of the collarbone. The remaining three grades are considered severe with escalating movement of the collarbone and additional damage done to the surrounding musculature. A severe AC sprain often requires surgical intervention.
The severity of Gomes' injury will be revealed in the coming days but the fact that Cleveland has already placed him on the disabled list suggests it's at least a Grade 2 sprain. An injury of this nature would take longer than 15 days to heal with three weeks likely a best-case scenario, especially with the injury involving his throwing shoulder. Veteran Chris Gimenez steps in as Cleveland's starting catcher with 27-year-old Roberto Perez likely joining the big league roster.
Harvey has been slated for surgery to address thoracic outlet syndrome (TOS) in his throwing shoulder, but the All-Star break prevented me from diving into the details of the condition. TOS occurs when blood vessels and a bundle of nerves known as the brachial plexus become compressed in an area formed by the first rib, its associated thoracic vertebrae and the upper portion of the sternum. The compression often leads to numbness, tingling and weakness of the shoulder and arm, and will occasionally carry over into the back. The compression can be caused by a variety of reasons, including scar tissue, enlarged muscles or even the anatomical shape of the first rib. The success rate following surgery for TOS is mixed with players like Kenny Rogers and Matt Harrison showing modest success while others like Chris Carpenter, Josh Beckett and Shaun Marcum were never the same. Fortunately, Harvey's case of TOS is reportedly in a favorable spot and he's younger than most of the abovementioned examples. However, he will still enter next season facing an uphill battle with plenty of innate injury risk.
Hill's attempt to showcase his skills to a contending ballclub has been stalled by a blister. A common problem amongst pitchers, blisters often develop in an area of high friction. The repetitive chafing, whether from a neighboring finger or the seams of the baseball, irritates the skin and causes fluid to accumulate between the upper layers of skin. While blisters appear to be a minor injury on the surface, they can be extremely painful and susceptible to infection. Furthermore, treating a blister can prove difficult, as MLB rules prohibit a major league pitcher from taking the mound with athletic tape or Band-Aids on their hands or fingers. As a result, players managing blisters must wait until the area is completely healed before they're able to effectively pitch again. Hill's most recent outing lasted just five pitches, and his status moving forward remains unclear.
Check Swings
Shin-Soo Choo: The Texas right-fielder didn't play in the team's first series out of the All-Star break as lingering back stiffness has caused him discomfort. A MRI has ruled out a potential disc injury, and the team is listing him as day to day. Choo's absence and a road interleague series forced the Rangers to alter their lineup. Rougned Odor was moved into the leadoff spot, and Ryan Rua joined Ian Desmond and rookie Nomar Mazara in the outfield. Fortunately, Texas has just two NL road series to worry about for the remainder of the season and both are two-game matchups. Getting Choo healthy has been difficult, but his presence on the Rangers lineup is undeniable. A DL stint could be necessary and Choo remains a risky play this week.
Clayton Kershaw: The Dodgers remain noncommittal about Kershaw's return date, keeping the situation as fluid as possible. The three-time Cy Young winner hasn't pitched since June 26 as he works his way back from a mild disc herniation in his lumbar spine. He was able to complete a simulated game over the weekend, but the team plans on waiting a few days to see how his body responds to the outing. The approach is sound and allows the team to be certain their ace is healthy enough to resume his spot in the rotation. Look for Kershaw to continue treatment and maintenance upon his return to ensure the disc remains in its normal alignment.
Felix Hernandez: Seattle will welcome back Hernandez to the fold Wednesday after a strained calf has kept him off the mound since late May. Hernandez has progressed smoothly through the rehab process and looked particularly sharp in his last rehab assignment, a 5 2/3 innings appearance that included seven strikeouts. I'm cautiously optimistic about his health but will be keeping a close eye on Hernandez's first few starts to see if he displays any signs that the calf is still an issue.
Arodys Vizcaino: The Braves closer was sent to the DL with a strained right oblique. Vizcaino had missed the previous four games with an infection on his right elbow. The injury opens the door for veteran Jim Johnson to pick up saves over the next few weeks and, if he displays any type of consistency, a more permanent ninth inning role. Vizcaino has struggled recently with his walks on the rise and his ERA sitting at a robust 5.11.
