Are the Astros Previous DL Stints a cause for Concern: Part II

Yesterday I analyzed the infielders with some previous injury history that could be cause for concern in Jason Castro, Jimmy Paredes, and Jed Lowrie. So far, my only concern in the short term is really how Jason Castro adjusts subconsciously in how how he stresses his body. I'm confident that he'll be back in time for the season, but unless he balances himself out, he could have long term overuse injuries that can mount up. Physically, his body will heal and be fine, it's how he uses it which will be the determining factor.

But, it's no secret that outfielders have to use their knees to run down ball a whole lot more than a first baseman. And, it's no secret that outfielder's with concerns are a little scary. It's also no secret that the Astros have two guys with the last name Martinez that have knee concerns. Well I'm going to take a deep look at J.D. Martinez's injury history in this post while saving Fernando for his own post.

Oh, it's also no secret that pitchers use their shoulder's a lot! Well, the Astros have one potential closer candidate that will be coming back with a significant shoulder injury, so I'll dive into that injury as well

We will start the knees of J.D. Martinez. J.D. suffers from patella tendinitis (jumper's knee) which is not fun but it is manageable. The patella tendon is the tendon that runs underneath your knee cap to the tibia. It's that tendon that doctors hit with their little triangle hammer to measure your reflexes. This structure is what connects the four quadriceps muscles to the tibia. Therefore, any tension developed by the the quadriceps muscle group or any force that pushes your lower leg backwards creates tension in the patella tendon. This is typically not a problem unless you have tendinitis or worse, tendonosis. Simply, tendinitis is inflammation in the tendon that creates pain from increased pressure when tension is applied. Tendinitis is typically not terrible and will only flare up from time to time. However, you have to keep from doing things that aggravate it., like getting in an infielder's stance that pulls on the tendon as the quads tighten up to provide stability in a squatting stance. Running typically doesn't aggravate it much since its short bouts of tension and not continuous. Therefore, the outfield stance which is more running and less squatting allows for him to manage the condition.

This should squander your fears for the short term, however tendinitis can progress into tendonosis. Tendonosis is actually holes in the tendon. Those holes get filled with scar tissue making the tendon more rigid which can limit explosiveness. This is when we start getting into serious trouble. This takes time to develop but can be very damaging. This is when J.D. would start to be forced into DH type roles. Depending on just how serious and progressive this already is coupled with how well the training staff manages it, could determine his long term future. I wouldn't doubt J.D. could play in left field for ten years without any major issues. He may not be a a stud defender out there over that time especially as he ages into his mid-30's, but he could physically do that.

He also struggled with a strained hamstring last season that seemed to nag him for several months before he broke out in July and dominated AA pitching enough for the call-up when a spot opened up. Hamstring injuries come and go and can cause some permanent scar tissue with a strain, but I wouldn't worry about it unless it creeps up again.

How about our beloved closer candidate Brandon Lyon? No matter how much we all hate his contract and do no view him as a legitimate closer in the major leagues, he is the lone pitcher on this roster that had experience at the major league level and will be given that opportunity. This article is not about how well he'll perform, but if he can. Lyon struggled with two injuries in his shoulder last season; a partially torn rotator cuff and biceps tendinitis. I'm going to break both of these down individually, even though I have a theory they are related.

The partially torn rotator cuff is the most aggravating diagnosis in the world for me, because it is the most general thing you can say. The rotator cuff is four muscles and can be torn at any location. In all likelihood, the injury is in a tendon and is probably of the supraspinatus. The supraspinatus is the one that is highest in the shoulder and the tendon crosses over the top of the humeral head and it's primary motion is to abduct the shoulder for the first thirty degrees. It's also the muscle that is supposed to keep the humeral head from moving vertically out of the socket. When the head does move out of the socket, it jams the tendon into the acromion and eventually causes tearing of the tendon. It's for this reason why I believe most rotator cuff injuries is due to mechanics and poor rotator cuff exercise that causes weak stability. Over time it can heal with rest or can heal with surgery. It can also lead to more damage with the labrum.

The biceps tendinitis was caused by the biceps tendon being out of it's groove which can only be corrected by surgery, hence the season ending surgery. The biceps has two heads, so which head was displaced? The only one that has a groove, the long head! The long head runs between the greater and lesser tubercle in the biceps groove and then runs through the shoulder capsule to the superior glenoid tubercle of the scapula. It is also held in that groove by the transverse humeral ligament. Can I put this in normal terms and how it relates to the rotator cuff injury? Sure, in order for the biceps tendon to attach to the superior glenoid tubercle, it has to go over the top of the humeral head as well. This means that when that humeral head moves vertically it stretches the biceps tendon and jams it into the acromion with the suprspinatus tendon and moves the tendon out of the groove once it stretches out the transverse humeral ligament. This means that Lyon probably has a lot of shoulder instability and without some serious shoulder stability work, I don't think he will be as effective as he once was. There is already questions surround his return since no pitcher has ever had this type of surgery so there is nobody to compare his rehab work to. Unless he can correct the instability, shoulder problems will likely continue and could eventually cause labrum damage.