Tag Archives: mlb injuries

Joba Chamberlain returns to Yankees after ankle injury

7 Aug

Monday night was the second night of Joba Chamberlain’s return to the mound for the New York Yankees after more than a year away from the game.

joba chamberlain ny yankees

You’ll recall that last June, Chamberlain suffered a possible career ending torn ligament in his elbow which required the every-pitcher-dreads-it Tommy John surgery. Then, in March of this year, as he was only one month shy of returning to the lineup, he dislocated his ankle while playing with his son on a trampoline. It was an ugly dislocation, too – the bone broke right through the skin and Joba required surgery and physical rehab to correct it.

Yankees relief pitcher Joba Chamberlain dislocates ankle, loses life-threatening amount of blood, 2012 season and career may be over– New York Daily News, March 24, 2012

What happens when your ankle becomes dislocatedankle illustration

Three bones make up the ankle: the fibula (outer), the tibia(inner) and the talus(center). All three are held together by just one ligament, the syndesmosis. When the ankle becomes dislocated, the talus separates from what we call the “socket”, and when it comes out, there’s a good chance it will also rip the skin open, which is known as an open dislocation. This is what happened to Chamberlain. Along with opening the skin, the dislocation can also fracture or break the bones around the ankle, tear the tendons, and damage the ankle joint or the subtalar joint, which allows the foot to move in and out. It can become a big mess pretty quickly.

ankle dislocated xray

X-Ray of a dislocated ankle

Chamberlain was rushed to surgery for the open dislocation and stayed off his feet for 8 weeks, allowing the ankle and the skin around it to heal. At a physical rehab center in Tampa, he spent 8 more weeks working out, stretching, resting and healing. By July, he was pitching in minor league games to get his mojo back and to strengthen his elbow and ankle. That is an incredibly fast return from such a severe injury, considering that his Doctors were very doubtful if he would ever pitch again, much less this season, according to their statements after his ankle surgery. Yet here he is, getting back to his almost 100 mph fastball just a little over four months later. The guy is Superman.

I have to caution you that a dislocated ankle of any degree is a serious injury. Don’t be foolish and try to correct it like you’ve seen in the movies – someone pulls your leg tight and snaps it back into place. That stuff is strictly Hollywood. No matter how mild or severe you think it may be, you definitely need to see the sports injury specialists at PA Foot and Ankle Associates as soon as possible for a complete diagnosis and course of treatment.

Too gross to post

If you want to see a picture of an open dislocation of an ankle, click here. Not for weak stomachs.

Pain like “a knife in the back of my foot” – Phillies’ Carlos Ruiz

31 Jul

Phillies catcher Carlos Ruiz knew something was wrong when he woke up one June morning in Los Angeles and his left foot was giving him a little pain. After an exam by the team’s medical staff, it was determined that Ruiz had a mild case of Plantar Fasciitis. No one was too concerned about it – some stretches, a little rest, and he’d be just fine.

carlos ruiz baseball card

But last week his pain became so acute that he only played as a pinch-hitter and he did it in sneakers instead of cleats. That’s when he told the Philly sports press that “it felt like a knife in the back of my foot”. 

Ruiz is no slouch behind the plate or at bat, and considering the  injuries the Phillies endured this year, it’s crucial he stay in the lineup.

Ruiz is tied for most games played by a catcher and only three others have squatted behind home plate for more innings. He raced through the first half of the season with a .350 batting average and largely avoided the hazards of everyday catching.

Since the start of that series in Los Angeles (the beginning of his foot pain), Ruiz is hitting .267 (8 for 30) with four doubles. His season batting average is .344, which is the lowest since May 16 (.343). – Philly.com

It’s now clear that what the Phillies’ medical staff perceived as a minor injury has significantly impacted Ruiz’ performance. It’s nothing you should avoid getting checked out, either.

What is Plantar Fasciitis?

Plantar Fasciitis is a medical term for heel pain. It’s an inflammation of the band of tissue that extends from the heel to the toes and is usually caused by (in this case) overuse, obesity, or bio-mechanical problems with the foot, such as flat feet. Left untreated, plantar fasciitis can become so painful that it’s impossible to walk. It’s important that you have your feet examined as soon as it becomes apparent that rest, ice, and over the counter anti inflammatory medicines like advil or aleve aren’t making it better.

Treatment options for Plantar Fasciitis

plantar fasciitis illustration

PA Foot and Ankle’s Heel Pain Center of the Lehigh Valley specializes in treating Plantar Fasciitis. Among the treatment options which may be presented to you are:

  • Physical therapy with Robbins Rehabilitation, the official physical therapy center for East Penn Foot and Ankle
  • EPAT Therapy, which utilizes shock waves to stimulate blood flow in the affected area, accelerating the natural healing process
  • PRP (Platelet-Rich Plasma) Therapy, which uses your own blood and the body’s natural defenses to stimulate healing
  • Prolo Therapy, which uses a dextrose (sugar) solution injected into the inflamed area, helping the tissue to repair itself
  • The use of Icy Feet, a product which enables you to ice your feet every day… without ice (available at East Penn Foot and Ankle)

Plantar Fasciitis can become a serious condition if ignored. If you’re suffering heel pain of any kind, call the East Penn Foot and Ankle Heel Pain Center and schedule a thorough examination immediately.

Phillies’ Ryan Howard re-habbing with Lehigh Valley Iron Pigs

5 Jul

The Phillies are languishing in last place in the National League East with a 37-46 record, their worst start since 1997.

The preseason favorites are now twelve games behind the Nationals-that’s a lot of ground to make up. A big part of that disappointing record is due to injuries, which reads like an All-Star team lineup: Roy Halladay, Ryan Howard, Chase Utley, Vance Worley, Jim Thome, and a multitude of others.


Howard in Lehigh Valley Iron Pigs uniform


Ryan Howard still struggling with achilles tewndon injury

Ryan Howard’s last major league appearance was in the Phils’ final game of the 2011 season against St Louis. That was the dreaded night that he tore his Achilles tendon. Since then he’s been rehabbing his way back, first through the Class-A Lakeland Blue Claws and now with the Lehigh Valley Iron Pigs. Last season the leftie hit 33 home runs and knocked in 116 RBI’s for the Phils.

By all reports, Howard seems to be getting his groove back.  His main priority is to find his rhythm again with his swing and body coordination.  “A lot of it’s just getting used to the game speed and just kind of getting the reads off bats defensively and getting my feel and timing back defensively,” said Howard.

A torn Achilles tendon means a lot of downtime before the physical conditioning actually starts. Unfortunately, players tend to gain weight during this period and lose muscle tone, making the challenge of returning to fighting form even tougher.

In Ryan Howard’s case, the rehab appears to be right on schedule as he re-adjusts to the game and strengthens his muscles and playing skills a little at a time. In his third game for the Iron Pigs on Tuesday night, Howard had his best game of 2012’s rehab stint. He not only played seven innings at first base for the first time this season, but he also blasted his first home run, going 2-for-3 with the two-run homer and four RBIs. He did however exit the field in the eight inning for a pinch runner.

Patients are always anxious to get back to their pre-injury level of activity as soon as possible, and I’m sure that professional athletes are no different. Howard has yet to play a game for the Phillies in the first year of his five-year, $125 million contract. Naturally, the Phillies are anxious to get him back in the lineup… but not too fast, or he’ll risk a re-injury of his Achilles tendon, which could very well mean the end of his career.

As of today, the Phillies are hoping that Howard can return to the lineup after the All-Star break, July 9-12. But as Howard said, “It all depends how I feel and how quickly I can get back to the flow of the game. I’m just taking it one game at a time here and keep playing games.”

Yankee starting pitcher Andy Pettitte takes a line drive to the ankle!

28 Jun
pettitte pitching against indians

Pettitte pitching against the Indians

It’s a sad week for Yankee Nation. Not only is CC Sabathia out of the starting lineup with a groin injury, but now starter Andy Pettitte is out after a line drive fractured his ankle. It’s estimated that Pettitte won’t return until September.

Two starting pitchers down in one week – think manager Joe Girardi is managing a bottle of antacids right about now?

Pettitte, 40 years old, was bringing the fire against Cleveland Wednesday night, allowing only two runs on three hits and one walk. He had struck out seven of fifteen. Then, in the top of the 5th inning, Casey Kotchman hit a laser-like line drive into Pettitte’s lower left shin (see a video of the line drive to Pettitte’s ankle here). Pettitte took a step towards the ball and went down on the infield grass.

Pettitte didn’t think much of the injury at first and stayed in the game. But as soon as he threw his next game pitch, “I just had an awful lot of pain running all the way down to my foot,” he said. Out he went. Word from the Yankees is that Pettitte suffered a fracture of his left fibula, the smaller of the leg bones which connect with the ankle.

andy pettitte in the grass

Pettitte goes down

Pettitte is a left hander, so an injury to the left ankle is far more trouble than an injury to the right. All lefties use their left foot to push off the mound. The left foot pivots during the wind-up and release, which puts enormous stress on the foot, ankle and leg. If all of the parts aren’t cooperating 100%, it will impact his precision, which is one thing Pettitte has in spades.

At the moment, the Yankees plan on moving Freddy Garcia into rotation and calling up Adam Warren from the Scranton triple-A team for a few starts.

The breakdown on Pettitte’s injury

The fibula is the smaller of the long bones in the lower leg. It forms joints with the longer bone of the leg (the tibia) and the talus in the ankle. The Yankees medical staff reports that Pettitte’s injury is not a “displaced” fracture (meaning a clean break), so Pettitte won’t need surgery. He’ll be in a protective boot and walk on crutches until his shin and ankle heal. Ankle fractures are a very significant injury for athletes and without proper healing and rehabilitation, the chance of re-injury, especially at 40, can be significant.

When he can stand without pain, Pettitte will start physical therapy, which may include muscle strengthening activities, balance activities, massage, ultrasound therapy, or hydrotherapy, followed by a graduated return to pitching. Most likely you’ll see Pettitte pitch in Scranton for a few games 6-7 weeks from now as he re-conditions his leg and ankle (get your tickets now!)

Pettitte, who has a 243-141 career record, is in his 14th season with the Yanks. With Pettitte out, Derek Jeter is now the only Yankee on the field from the club’s Core Four of players who won four World Series titles from 1996-2000.

As of today, the Yanks are 1st place in the AL East, with Baltimore 5 games behind and Boston 6 games behind. With Pettitte out for 8 weeks and Sabathia out through the All Star break, what do you think the Yanks chances are of holding onto their lead?

Phillies’ Ryan Howard still struggling with Achilles tendon injury

14 Jun

Remember when Phillies first baseman and heavy hitter Ryan Howard crumpled on the field last October during a game against St Louis? He ruptured his left Achilles tendon, which required surgery soon after the injury.

ryan howard falling due to achilles tear

Ryan Howard within milliseconds of rupturing his left Achilles tendon, October, 2011. Notice how his left leg is collapsing under his weight

ryan howard achilles tendon injury

Howard had to be helped off the field

As any Phillies fan knows, Howard is still rehabbing from that injury. In part, the long rehab time is due to a second surgery he required when an infection developed at the site of the first surgery.

Trade rumors are running rampant, as Howard’s Achilles injury could permanently hamper his performance and spell the end of his amazing career. But I’m sure Charlie Manuel and the rest of the Phils’ staff won’t make any decisions on trading Howard until they see how he performs on the field.

But boy, do they need the pre-injury Ryan Howard now. The Phils have been plagued with injured superstars this year, including Chase Utley and most recently Roy “Doc” Halladay. Meanwhile, they’re in the cellar of the NL East  – 8 games behind 1st place Washington.

Today I saw this on Rotoworld, which didn’t give me any comfort:

Ryan Howard (Achilles) went 0-for-4 in a simulated game Wednesday against Yankees minor leaguers. Howard did not run the bases, but he swung freely and continues to make steady progress in his recovery from Achilles tendon surgery. Assuming no setbacks, the first baseman should be back in the majors by mid-July

July-that’s about nine months since he injured himself.

Ryan Howard was in superior physical condition when he ruptured his Achilles tendon. This shows how easily you can injure yourself and how important it is to keep your legs, feet and ankles in as good physical condition as possible. You probably won’t be putting strain on your Achilles to the degree that Howard did, but if you jump back into running, softball, basketball, touch football, tennis, skiing, or any sport after laying off for awhile, proper conditioning is absolutley critical to protecting all of your working parts.

How to protect your feet and ankles

Remember to stretch before and after physical activity – beforehand to warm up your muscles, tendons and ligaments and afterwards to cool down those same areas. Warming up helps to reduce muscle stiffness which is thought to be directly related to muscle injury and cooling down helps dissipate waste products from your muscles, reduces adrenaline, and allows your heart rate to return to its resting rate. Check out these basic stretching exercises which are really simple and effective.

As always, if you experience any pain or unusual stiffness in your feet, toes, or ankles make an appointment with PA Foot and Ankle Associates for a thorough examination and diagnosis. PAFAA is expert at treating sports injuries and will develop a custom treatment plan specific to your injury.

Phillies reliever Chad Qualls: “A knife was going at the back of my heel”

13 Apr chad qualls pitching phillies

It appears from press reports that Phillies reliever Chad Qualls did some damage to his right foot last Saturday and was benched for Sunday’s game. Even though he continued in the lineup this week, he may be playing with pain.

According to an April 9 story in the Philadelphia InquirerQualls said it felt like a “knife was going at the back of my heel” when he was walking around in his spikes Saturday afternoon. The Phil’s training staff are mum, but I believe that Qualls’ pain might point to an Achilles tendon injury, one of the less frequent injuries among MLB pitchers, but a very serious one.

chad qualls pitching philliesWhen a pitcher fires a pitch off the mound, his whole body is twisting and turning with incredible force. Qualls is a right hander, which means as he begins his pitch, his right foot is planted on the mound with his left foot leading the way. That right foot, his dominant foot, is where the pitch begins. With his weight on his right foot, he winds up, cocks his arm, and then turns his entire body towards home plate as he unloads the ball. During this turn, his right foot starts parallel to home plate, turns in sync with his upper body until his toes are pointing towards home plate, and then comes off the ground as he releases the ball. If any part of his movement is out of sync even a little, he can cause serious injury almost anywhere in his body.

From Chad’s description of his heel pain, the first thing I would look for is a strain or possible tear of the Achilles tendon. Usually the most common place of damage to the Achilles tendon occurs about 3-5 cm above where the tendon is joined to the foot at the insertion of the Achilles tendon.  This area is called the watershed area due to poor blood supply, causing it to be the weakest part of the tendon. It’s an injury similar to the one that Ryan Howard experienced last season, but not as severe.

An injury to this area can be extremely painful and if he continues to play with an injury like that, he is possibly risking serious damage to that right foot if it goes untreated and continues to be symptomatic. The most common way to correct damage to the Achilles tendon is with Rest, Ice, Elevation and strengthening of the Achilles tendon.  A review of his biomechanics during his pitching rotation would also be helpful to find the cause of his injury.

Injuries to the Achilles tendon are extremely painful and must be evaluated as soon as possible after feeling pain. Dr Adam Teichman at East Penn Foot And Ankle is expert at treating sports injuries to this area and will recommend the best course of treatment for you, with surgery only as a last resort

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