Ellsbury's injury

[jung]

For those that are thinking that Ells is gone for the year are you thinking that this is worse than a shoulder separation or are you thinking that a shoulder separation will be the end of his season?

 

I just hope they don't rush Crawford back because of this injury to Ells. Whether by his own decision or somebody else's decision it seems like every time Crawford pushes it, he ends up dinging something else and we end up with another delay.

 

Maybe this becomes a chance to look at a guy or two in the big league uniform. I would prefer that to pushing Crawford into yet another injury of some sort.

[Brown28]

For those that are thinking that Ells is gone for the year are you thinking that this is worse than a shoulder separation or are you thinking that a shoulder separation will be the end of his season?

 

I just hope they don't rush Crawford back because of this injury to Ells. Whether by his own decision or somebody else's decision it seems like every time Crawford pushes it, he ends up dinging something else and we end up with another delay.

 

Maybe this becomes a chance to look at a guy or two in the big league uniform. I would prefer that to pushing Crawford into yet another injury of some sort.

 

I think that a shoulder separation could very well end his season. Especially if there's rotator cuff damage. I like everyone else is hoping that we get him back in 6-8 weeks but it wont shock me if the next time we see him is in Fort Myers in 2013

[redsoxbeatz]

June 1st we could look a lot better.

[Gringo]

Not good. His rehab history suggests that 6 weeks is a laughable estimate...I bet you he's not back until July, and that he'll struggle the rest of the season once he's back.

 

This is a total disaster, basically.

 

One look at our OF now and I cry.

[BornToRun]

I'll bet you 20 bucks he's back in the mentioned time table and back on track within two weeks. I'm ever the optimist.

[Gringo]

I'll bet you 20 bucks he's back in the mentioned time table and back on track within two weeks. I'm ever the optimist.

 

I'm optimistic about being $20 richer

[InfernoOrangeSS]

Not good at all. I would think if at all possible, Ellsbury will try to push it to come back. Isn't this his contract year?

[BornToRun]

Not good at all. I would think if at all possible' date=' Ellsbury will try to push it to come back. Isn't this his contract year?[/quote']

 

We have him through next season too IIRC

[mvp 78]

It's nice the Sox have their very own Grady Sizemore. Still not sure why they'd bring up Lin unless they enjoy putting out an NL lineup. Yuck.

 

Just means the pitching will have to step it up.

[jacksonianmarch]

I watched the replay. I was dealing with the ballsweat of society on Friday the 13th in the pit, so I couldnt weight in yesterday. The way he looked coming off the field looked actually less like a dislocation and more like a subluxation. A subluxation is where the humeral head shifts out of the glenoid but pops right back in. A dislocation is where the humeral head pops out and stays out. He was walking off the field, but you couldnt see a deformity to his shoulder and he was able to hold his hand across his chest, which is something you almost cannot physically do if the shoulder is indeed still dislocated. Any subluxation or dislocation entails injury to the shoulder capsule. It's his non-throwing shoulder, so that shouldnt be a huge problem. The issue he will run into is if there is significant damage to the labrum or the cuff. It remains to be seen how damaged those are. If his cuff is shredded or his labrum significantly torn, then he is likely out for the season. Based on what I saw on the replay, I would have to say that is less likely since, as I said before, it looked like his shoulder was in as he was exiting the field. You are probably looking at best case, 6 weeks.

[Palodios]

I watched the replay. I was dealing with the ballsweat of society on Friday the 13th in the pit' date=' so I couldnt weight in yesterday. The way he looked coming off the field looked actually less like a dislocation and more like a subluxation. A subluxation is where the humeral head shifts out of the glenoid but pops right back in. A dislocation is where the humeral head pops out and stays out. He was walking off the field, but you couldnt see a deformity to his shoulder and he was able to hold his hand across his chest, which is something you almost cannot physically do if the shoulder is indeed still dislocated. Any subluxation or dislocation entails injury to the shoulder capsule. It's his non-throwing shoulder, so that shouldnt be a huge problem. The issue he will run into is if there is significant damage to the labrum or the cuff. It remains to be seen how damaged those are. If his cuff is shredded or his labrum significantly torn, then he is likely out for the season. Based on what I saw on the replay, I would have to say that is less likely since, as I said before, it looked like his shoulder was in as he was exiting the field. You are probably looking at best case, 6 weeks.[/quote']

 

Thanks for your expert opinion--seriously--it is always very informative, and appreciated. It sounds like you're confirming what has been reported-- either 6 weeks, or the season.

 

It is going to be interesting going into May/June how the outfield turns up. They could either end up stacked with Crawford/Ellsbury/Kalish coming off the DL, or all those players could rehurt themselves over and over again and we'll be stuck with Mcdonald playing everyday.

[Dojji]

The only thing that makes me nervous is that now his recovery is in the hands of the Red Sox medical staff.

[DwightFright]

No matter how you look at it... this is not good in any sense.

 

Making an effort to find the bright side, perhaps this will help the Sox resign Ells by delaying another monster year.

[SoxFanForsyth]

I watched the replay. I was dealing with the ballsweat of society on Friday the 13th in the pit' date=' so I couldnt weight in yesterday. The way he looked coming off the field looked actually less like a dislocation and more like a subluxation. A subluxation is where the humeral head shifts out of the glenoid but pops right back in. A dislocation is where the humeral head pops out and stays out. He was walking off the field, but you couldnt see a deformity to his shoulder and he was able to hold his hand across his chest, which is something you almost cannot physically do if the shoulder is indeed still dislocated. Any subluxation or dislocation entails injury to the shoulder capsule. It's his non-throwing shoulder, so that shouldnt be a huge problem. The issue he will run into is if there is significant damage to the labrum or the cuff. It remains to be seen how damaged those are. If his cuff is shredded or his labrum significantly torn, then he is likely out for the season. Based on what I saw on the replay, I would have to say that is less likely since, as I said before, it looked like his shoulder was in as he was exiting the field. You are probably looking at best case, 6 weeks.[/quote']

 

Jacoby Ellsbury ‏ @JacobyEllsbury

Thx for all the well wishes. Subluxed my right shoulder in yesterday's game. No timetable set, working hard to get back as soon as possible.

 

Spot on, Jackso. Well played.

 

Do they have to wait until swelling goes down to determine if there is significant damage to the labrum or rotator cuff?

[SoxSport]

I would wait for the medical diagnosis. What I've seen so far is typical media speculation.

[SoxFanForsyth]

The only thing that makes me nervous is that now his recovery is in the hands of the Red Sox medical staff.

 

Fortunately, it's a new medical staff. They canned the old medical staff.

[Mr Tibbs]

f***, f***, f***!!!!!!!!!

[The Village Idiot]

He also had spinal neck surgery in 2011.

 

Thank you, I'd overlooked this.

 

Yes, I think I stumbled in there once about 12 years ago...it's an oldie!

[jacksonianmarch]

Spot on, Jackso. Well played.

 

Do they have to wait until swelling goes down to determine if there is significant damage to the labrum or rotator cuff?

 

I am sure they MRI'd it to see if there were any complete tears, but when it comes to the shoulder, it is usually best performed after the swelling is gone. You can see inflammation on the MRI and I am sure he has some inflammation in the cuff, the capsule, and the labrum. The extent of the damage likely wont be known until they re-examine him after the swelling subsides.

[a700hitter]

Ellsbury fallout

Posted by Michael Silverman at 12:52 pm

 

The Red Sox confirmed Jacoby Ellsbury’s diagnosis of Ellsbury’s shoulder as being “subluxed.” He is undergoing further evaluations. It’s impossible to report how long he will be out but a minimum of a month appears a safe bet.

 

One bright note: “I haven’t heard the word surgery mentioned,” said manager Bobby Valentine.

^This is the most optimistic report that I have read.

 

Yaz would have missed the rest of the weekend, if that.

[VA Sox Fan]

Ellsbury may avoid surgery on shoulder

 

Posted by Peter Abraham, Globe Staff April 14, 2012 02:20 PM

 

 

The Red Sox officially placed Jacoby Ellsbury on the 15-day disabled list this afternoon. Here's the statement from the team:

 

“Jacoby injured his right shoulder during yesterday’s game. An MRI was performed and showed findings consistent with a subluxed shoulder. We are in the process of gathering further information and determining the treatment plan. Jacoby will be placed on the 15-day disabled list prior to today’s game.”

Bobby Valentine said he has not heard the word "surgery" in the team's discussions about Ellsbury.

 

Meanwhile, the Red Sox are probably not done with their roster juggling. The team will carry 13 pitchers today but it sounds like outfielder Jason Repko will be coming up on Sunday.

 

Repko, who has 355 games of major league experience, did not play for six days with Triple-A Pawtucket because of a minor injury. But he is in the lineup today in Rochester, playing center field.

[FredLynn]

I am sure they MRI'd it to see if there were any complete tears' date=' but when it comes to the shoulder, it is usually best performed after the swelling is gone. You can see inflammation on the MRI and I am sure he has some inflammation in the cuff, the capsule, and the labrum. The extent of the damage likely wont be known until they re-examine him after the swelling subsides.[/quote']

 

I sure hope they did an MRI. I don't really see the need to wait to do it as any cartilage or other soft tissue damage should be visible immediately. The resolution on MRIs is just a couple of mm; they look like a photograph of inside your joint. Pretty amazing.

If surgery is needed I would like to see that done as soon as practical to maximize any chance he could return to the lineup this year, though I doubt he would be able to do that if surgery is performed.

I dislocated my shoulder and tore the cartilage on both the head of the humerus and the labrum (different mechanism of injury however) and now its arthritic and in need of eventual replacement. If Ellsbury somehow has cartilage damage that could be career threatening. Mike Lowell had cartilage damage to his hip and and was never the same player. Lets hope Ells has better luck.

[Palodios]

Ellsbury may avoid surgery on shoulder

 

Posted by Peter Abraham, Globe Staff April 14, 2012 02:20 PM

 

 

The Red Sox officially placed Jacoby Ellsbury on the 15-day disabled list this afternoon. Here's the statement from the team:

 

“Jacoby injured his right shoulder during yesterday’s game. An MRI was performed and showed findings consistent with a subluxed shoulder. We are in the process of gathering further information and determining the treatment plan. Jacoby will be placed on the 15-day disabled list prior to today’s game.”

Bobby Valentine said he has not heard the word "surgery" in the team's discussions about Ellsbury.

 

Meanwhile, the Red Sox are probably not done with their roster juggling. The team will carry 13 pitchers today but it sounds like outfielder Jason Repko will be coming up on Sunday.

 

Repko, who has 355 games of major league experience, did not play for six days with Triple-A Pawtucket because of a minor injury. But he is in the lineup today in Rochester, playing center field.

 

The problem with the medical staff isn't the quality of the doctors. Its the approach the team takes to injuries.

 

I'm not certain on this particular instance, but this team definitely needs to put more emphasis on surgery. They go with the wait-it-out strategy, and then months later they realize it would have been the best move.

 

Lackey, Lowell, Lowrie, Crawford, Buchholz, Beckett, Jenks... I can think of considerable numbers of examples. Surgery sucks, but the wait-it-out strategy loses even more time when surgery is actually inevitable.

[FredLynn]

More information about shoulder dislocations (Ells may not have this-he could have a subluxation which is not a serious):

 

The Bankart lesion is a specific injury to a part of the shoulder joint called the labrum. The shoulder joint is a ball and socket joint, similar to the hip; however, the socket of the shoulder joint is extremely shallow, and thus inherently unstable.

To compensate for the shallow socket, the shoulder joint has a cuff of cartilage called a labrum that forms a cup for the end of the arm bone (humerus) to move within. This cuff of cartilage makes the shoulder joint much more stable, yet allows for a very wide range of movements (in fact, the range of movements your shoulder can make far exceeds any other joint in the body).

 

What is a Bankart lesion?

When the labrum of the shoulder joint is torn, the stability of the shoulder joint is compromised. A specific type of labral tear is called a Bankart lesion. A Bankart lesion occurs when an individual sustains a shoulder dislocation. As the shoulder pops out of joint, it often tears the labrum, especially in younger patients. The tear is to part of the labrum called the inferior glenohumeral ligament. When the inferior glenohumeral ligament is torn, this is called a Bankart lesion.

 

What happens after sustaining a Bankart injury?

Typical symptoms of a Bankart lesion include:

•a sense of instability

•repeat dislocations

•catching sensations

•aching of the shoulder

Often patients will complain that they cannot "trust" their shoulder, fearing it may dislocate again.

How is the diagnosis of a Bankart lesion made?

Most young patients (under the age of 30) who sustain a shoulder dislocation will sustain a Bankart lesion; therefore, there is a high suspicion of this injury whenever a patient dislocates their shoulder. On examination, patients will often have a sense their shoulder is about to dislocate if their arm is placed behind their head.

 

X-rays are sometimes normal, but they may show an injury to the bone called a Hill-Sachs lesion. This is a divot of bone that was injured when the shoulder dislocation occurred. A MRI may also be obtained in patients who are suspected of having a Bankart lesion. Bankart lesions do not always show up well on MRI scans. When a MRI is performed with an injection of contrast, a Bankart lesion is much more likely to be seen.

 

What is the treatment for a Bankart lesion?

There are two general options for the treatment of a Bankart lesion. One option is to allow the arm to rest, and the inflammation to subside with the use of a sling. This is usually followed by physical therapy to regain motion of the extremity. The potential downside of this option is that people who dislocate a shoulder once are much more likely to dislocate the shoulder again.

 

The other option is to perform surgery to repair the torn labrum. When surgery is performed, the torn labrum of the Bankart lesion is reattached to the socket of the shoulder. The results of surgery are usually very good, with over 90% of patients returning to their activities without any further dislocations. More and more commonly this surgery is being performed arthroscopically; however, there are indications in some patients who should have a Bankart repair performed through a standard incision.

[SoxFanForsyth]

The problem with the medical staff isn't the quality of the doctors. Its the approach the team takes to injuries.

 

I'm not certain on this particular instance, but this team definitely needs to put more emphasis on surgery. They go with the wait-it-out strategy, and then months later they realize it would have been the best move.

 

Lackey, Lowell, Lowrie, Crawford, Buchholz, Beckett, Jenks... I can think of considerable numbers of examples. Surgery sucks, but the wait-it-out strategy loses even more time when surgery is actually inevitable.

 

This isn't necessarily true.

 

In a lot of cases (including that of Ellsbury), surgery would knock them out of the season, so taking a "wait and see" approach at least gives them a chance to recover in the case that he doesn't need surgery

[SoxFanForsyth]

@Pumpsie Green -

 

Ellsbury has a Subluxation. He tweeted it earlier today, and it was confirmed by a Red Sox report, so it's a subluxation, not a dislocation (although from what I understand, a subluxation is just a dislocation that pops back into place rather than staying out of place).

 

If there's not a lot of labrum and/or rotator cuff tears, then he could be back by around early to mid June.

[SoxSport]

Subluxed? If it popped back in by itself, he could be back in a couple weeks. It isn't his throwing shoulder.

There should be minimal strain to the joints. It's 6-8 weeks if they have to pop it back in. More strain there.

 

The Red Sox have a history of taking forever to get guys back into the lineup--and mis-diagnosis. I hope they don't miss the boat with Ellsbury again.

[SoxSport]

^This is the most optimistic report that I have read.

 

Yaz would have missed the rest of the weekend, if that.

 

Yeah. Did you get the four week guess? The media is all over the place with speculation.

[Spudboy]

I prefer to be optimistic here.

 

I have nothing to add other than I think it's pretty cool that we have our own Doctor on this board that explains injuries and medical technology.

[FredLynn]

Subluxed? If it popped back in by itself, he could be back in a couple weeks. It isn't his throwing shoulder.

There should be minimal strain to the joints. It's 6-8 weeks if they have to pop it back in. More strain there.

 

The Red Sox have a history of taking forever to get guys back into the lineup--and mis-diagnosis. I hope they don't miss the boat with Ellsbury again.

 

Here is how subluxation is differentiated from dislocation. Its the best explanation of a confusing subject:

 

■

Dislocations

This happens when the head of the humerus completely pops out of the socket. The first few times this happens, it is usually with significant trauma (although some people can have these without any injury at all). After that, it can get easier and easier for the joint to dislocate. Most shoulder dislocations are anterior. This means that the ball pops out the front of the socket.

 

■

Subluxations

This is the feeling that the shoulder slips slightly out of socket, then immediately comes back in place. This often happens without any major trauma. Sometimes it happens in people who are very "loose-jointed". Sometimes these happen in just one direction (like out the front, or anterior), and other times they happen out multiple directions (e.g., front, anterior and back, posterior). This is called "multidirectional instability".

 

I am not an orthopedist, just a pediatrician (the disclaimer). I interpret this to mean that a subluxation is a partial dislocation and is much less serious form of trauma. Since Ellsbury is young, the odds of him having a Bankart lesion (tearing of shoulder ligaments, frequently requiring surgery to fix) with a subluxation is less than had he had a dislocation (see above: Bankart lesions are present in 90% of young people under 30 with actual dislocations), so thats really good news. This assumes that they are telling us the truth (and they are under no obligation to tell us the truth) and that they have the diagnosis right.

I think about six weeks is a good estimate for a shoulder subluxation. Keep your fingers crossed.