Tribe’s fate unclear after cluster of recent injuries

2015-04-22 13:08:48 by Dr. Joe Congeni - Director of Sports Medicine, as posted on the blog.

Chicago White Sox v Cleveland Indians Carlos Carrasco is helped off the field after being hit in the face by a line drive.

It's only April, a few weeks into the baseball season, and already we're hearing from local media horrific phrases like "catastrophic to our baseball team" and "fatal blow to the Indians."

Just recently we lost Yan Gomes to an MCL injury that will take him off the field for 6 to 8 weeks. Following that, Carlos Carrasco took a line drive to the face and he's suffering a contusion to the jaw area. On top of that, Michael Brantley is struggling with back spasms and can't play right now.

Last week, I spoke with 1590 WAKR morning show host Ray Horner about these injuries and how the Tribe just can't catch a break. We also discussed the recent rule changes for the safety of players and their affect on youth teams.

Below is an audio file and transcript of our discussion.

HORNER: Our good friend, Dr. Joe Congeni from Sports Medicine Center at Akron Children's Hospital, is on board with us right now. And, Joe, unfortunately, the Indians can't catch a break.

Uh, just the other day we lose Yan Gomes to a knee injury. They're saying 6 to 8 weeks. I'll let you elaborate there, but unfortunately, last night a ball to the face of Carlos Carrasco. Initial X-rays negative on the fractures, but when we talked, contusion to the jaw area. Is that a gray area? That can be quite costly, can it?

DR. CONGENI: Yeah, I think everything you said so far can be costly. I'd say that probably the Indians or Indians' fans, the last person in the world they want to talk to or hear from is a sports medicine person ...

Dr. Joe Congeni Dr. Joe Congeni

HORNER: Yeah .

DR. CONGENI: ... so, I hesitate calling in today. I mean, it's just to talk about the Tribe because, um, you said it ... at the beginning of the season, you couldn't have picked 3 more really key people than, you know, start with Yan Gomes, Michael Brantley can't play right now, Carlos Carrasco.

Yeah, I agree with ya. I think it looks like probably a contusion and a glancing blow from what they're saying, but you know ... with some of those there seems to be some psychological issues and other things that go with it. You know ... they said they didn't think a concussion to start with, so we'll have to hear about all of that.

But, the point of the matter is here media people are starting to use words in the 2nd week of April like "fatal blow to the Indians" or "an April apocalypse" or even the words of (Indians manager) Terry Francona "catastrophic to our baseball team," and it's that early in the season.

The one injury I did want to talk about that we know a bit about is the knee injury to Yan Gomes. We know more specifically as they've said in the reports and everything that it is an MCL tear.

The medial collateral ligament is that bigger, stronger ligament on the inside part of the knee -- not in the middle of the knee like the ACL. So, the good news about the MCL is that it heals on its own. It doesn't in athletes need to be operated.

People rest and wear a brace and rehabilitate and that ligament heals, but it looks in a guy like Yan Gomes with a pretty complete tear like it's in the range of 6 to 8 weeks. And, that's gonna be a significant period.

Now one more bit of good news on Yan Gomes. No surgery, No. 1. No. 2 is they have used the word "isolated" MCL and that means there's no cartilage damage, no meniscus tear.

Much of the time with a twisting injury, there can be damage to the internal structures that are important shock absorbers for the knee. If it's just a direct blow and stretch on that ligament, a lot of times it'll be just that ligament injured and apparently, in this case for Yan Gomes, it's just an isolated MCL. So, a couple bits of good news there, and 6 to 8 weeks to ride it out.

One of the things I wanted to ask you about as a youth coach is we had the rules changes last year and you know, youth baseball and high school has had this for awhile, but in the pros the 2 parts to it -- a runner attempting to score may not deviate from the direct pathway in order to initiate contact with the catcher and also, the catcher, unless they're in possession of the ball, cannot block the plate -- .

So, um, those are changes that came in last year. A lot to look at trying to protect against concussion, but those are the changes. What do you think in youth baseball as far as collisions at the plate? Are we having less of them?

HORNER: Yeah, we are, Joe. As a matter of fact, it's pretty much said, and I know coaching staffs do it and whenever you play a game, the umpire will say, "If there's a collision at the plate, he's automatically out. I don't want any of that at all."

Or, if there's a collision at another base, the player's automatically thrown from the baseball game.

So, we are seeing less of that. There is sliding, uh, there's not so much blocking. There are not a whole lot of collisions going on. Um, once again, I'm kinda new to it the last couple of years, but I haven't seen a whole lot of it, no.

DR. CONGENI: That's good and I'm glad to hear that, and I think it's true. But, in a case like Yan Gomes, there's just nothing you could do. There was nothing illegal about it.

HORNER: Right.

DR. CONGENI: There was nothing the least bit dirty or overly aggressive. You saw that he just was trying to keep his foot on the plate. He was hit on the outside part of the knee, you could see where that ligament would have stretched and it ended up tearing.

HORNER: How long can these ... I'm sorry to interrupt you, Joe. How long can these back spasms go with Brantley? What about this?

DR. CONGENI: Ah, you know back spasms are totally one of the most unpredictable areas in medicine. They really, really are difficult. You don't know, but the majority don't have anything structural like discs or arthritis or other things like that, or pinched nerves, some do have some of those structural kind of injuries, but they're totally unpredictable.

A little bit like hamstrings, so much with these big strong muscles that line the back is you can be doing really good. You go out there on a day and overstretch it and you're back at square zero and you're out for 10 days or 2 weeks again. So, uh, that one is gonna be really frustrating for us as Tribe fans to put up with with Michael Brantley.

HORNER: Alright, good stuff, Mr. Congeni. Thanks, Joe, appreciate the time.

DR. CONGENI: Alright, Ray. Have a great week. Thank you.

HORNER: You too. Dr. Joe Congeni, Sports Medicine Center at Akron Children's Hospital.

Originally aired on 1590 WAKR-AM on April 15, 2015

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