By Abby Sims
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Greg Bird, the Yankees’ 24-year-old first baseman, was placed on the 10-day disabled list Tuesday because of a right ankle contusion he sustained as spring training drew to a close. With the exception of missing four games shortly after the start of the season, Bird has played through since fouling a ball off his foot to cause the injury. However, his sluggish performance at the plate – a big departure from his sizzling March stats – belied an issue.
Randy Miller reported for NJ.com that manager Joe Girardi said that “in watching (Bird on Monday) and talking to (hitting coach) Alan (Cockrell) about his work, I just didn’t feel like there was a lot of explosion in his lower half.” When new MRIs this week did not show significant healing, a rest from baseball activities was prescribed.
One has to wonder if Bird had been participating in drills and other warm-up activities during the past month that entailed running or jumping. I have no idea, though in deference to his ankle injury, I suspect not. Thus it seems likely that had the injury not adversely impacted Bird’s hitting, running the bases more frequently might have exacerbated his symptoms, calling more immediate attention to the consequences of his playing hurt. Additionally, had he altered his running mechanics, he would have risked injury to other areas of the foot and onward up the chain.
In the absence of a period of sustained rest in the acute phase after the injury, pain exacerbated by running may have translated to an earlier stint on the DL. This could have accelerated healing, resulting in a delayed but more productive start.
HE SAID IT
In mid April, Brendan Kuty of NJ.com quoted Bird as saying that his injury was “in a weird spot” and that “if it was an inch higher, I think it would be just a bruise. Where it’s at, there’s a lot of movement there. At least that’s how they explained it to me. I think it’s just going to take time. I feel better. Get the cleats on and kind of see where it goes. It’s kind of a weird thing where just certain things bug it.” And now we’ve seen where it went.
Take a moment to recall Derek Jeter, who in 2012 played through an ankle contusion (though perhaps his was in a different spot or more involved) and went on to lose significant time because he then developed compensatory stress fractures.
A bone contusion is a traumatic injury that is caused by forceful impact.
A contusion is really more than just a bruise. Though not evident on an X-ray, MRIs have revealed that this pathology entails disruption to the bone marrow that rests below the joint cartilage and represents microfractures, hemorrhages and edema to the inner layers of the bone (known as cancellous bone). These do not affect the outer (cortical) layers or articular cartilage.
Research on healing time of contusions has mostly been concerned with those that occurred with knee hyperextensnion and ACL tears. Time to healing has varied and appears to also depend on the presence of other injuries. While one study showed that 48 percent of sufferers showed no evidence of injury six weeks after insult, others report up to six months as being expected. One study revealed that a percentage of sufferers showed evidence of pathology on MRI even two years post-injury.
The ankle joint is also known as the talocrural joint and is comprised of three bones connected by ligaments. The bases of the two bones of the lower leg – the larger tibia and smaller and outer fibula – form a socket (known as a mortise) at the upper portion of the joint in which the talus bone of the foot rests. This is the ankle joint. The calcaneus, or heel bone, sits below the talus, and together they form what is called the subtalar joint. The calcaneus is the largest bone in the foot.
Forces distributed to the talus are from five to ten times body weight during walking. This load increases dramatically with running. Like joint surfaces throughout the body, the surface of the talus is lined by smooth articular cartilage that can be damaged due to trauma (such as fracture or sprain) or other factors. These pathologies are known as osteochondral (osteo=bone, chondral=cartilage) lesions. Interestingly, the talus does not serve as an attachment for any muscles of the leg or foot and its blood supply is not robust.
For an in-depth understanding of ankle and subtalar anatomy take a look here and here.
Though I’ve made inquiries as to the exact location of Bird’s injury, answers have not been forthcoming. However, given references to the injury being to the bone at the ankle, one imagines it is to the talus.
Abby Sims is a licensed physical therapist with vast experience evaluating and treating orthopedic, sports and dance injuries. Follow her on Twitter @abcsims