Listen: The Yankees are decimated by injuries right now
"The Yankees are playing without half a dozen projected starters batting six through nine in their starting lineup. Yesterday will four players who have played Tripoli ball this season. More bid for the Yankees. This week is Gary Sanchez, replace Sobat. The on the injured list with a left calf, strain and news that the return of Luis Severino has been delayed from may to July and Dell Tanta suffered a setback. Sanchez joins Jacoby ellsbury Jordan Montgomery. Ben, Hiller, Didi, gregorius Aaron Hicks Giancarlo Stanton and Miguel and do are on the sidelines here back with us to give his diagnosis on the latest. Yankee injury news is a friend of this show. The socio professor of Orthopaedics at the NYU Langone medical center in the university of Texas del medical school, and listeners know was very bored center fielder is ROY. Roger Clements is backup in high school. Welcome to Dr Alton baron Beck on Ed Randall's talking baseball. Del Batanes is doctor has been sidelined with a shoulder. Impingement? Let's start with that. What is that for those? Who may not have heard you recently. Yeah. Thanks. It's great great to be back with you. I'll tell you what you got pun the business to talk about the. Yeah, you know, impingement is that that space that that Bursa which is a little potential space in between the rotator cuff tendons, and that bony roof on our shoulder, and that that supports our deltoid and our whole kind of the roof rush older. So it's it's rubbing underneath there. The under surface that bony roof impinges presses down on the rotator cuff based on the mechanics of the shoulder and so forth, and you know, with with these these young throwing athletes there, I it's it's usually not a big. Dramatic spur that's digging in that can grow over time. You know, when we're much older. But it's it's more. The the dynamic major the intense dynamic nature of what's going on underneath that bony groups that gets irritates that rotator cuff and presses down on and houses to hurt. And of course, they lose velocity lose control. And after take a break, we learned this week and Batista's himself. Doctor learned this week that he has a bone spur in the back of his shoulder, which has been there since he originally signed with the Yankees in two thousand six, but he has never dealt with inflammation around it until now thirteen years later. Right. So you know, any any minor repetitive? Trauma in young people can stimulate some early. It's not really arthritic bone formation. But it's reactive bones reactive to the intense stresses that they place on them. And sometimes those stresses. During creased at the end of you know, if you're when you're younger and you're rolling seven nine innings. You know, you your your rotator cuff weekends in the stretches stresses are greater on the ligaments in that constrain that that area right at the connection of the bone, and that can create these formation allow these bones bone Spurs to form, and then they can sit there and do nothing. But then later if you have another injury, or, you know, a strain that happens as as he's guys have as we can clearly see that then it becomes noticed again. And may may be a factor originally Potenza was treated for inflammation than he was shut down for a few days. Now, he's expected to miss six to seven weeks after he threw a simulated game on Thursday, and he struggled he flew back to New York on Friday for another MRI would die contrast, which regaled the inflammation near the bone spur. As the source of the euro tation. Yeah. So those kind of that kind of news as you, you know, as well better than I do follow followed so closely, and and and you become quite a diagnostician yourself. You went to school. Go ahead. Well. These things, you know, the this information that keeps being added and additional tests and so forth, you know, these can be slippery slopes. These can you know end up. I'm not by any means predicting that, but they can be well, oh, yeah. What we got this? And now we see this. And therefore, look we're going to have to do a little Arcus copy clean out, which then kicks us. You know, three more months down the road. I mean, you know, there's all sorts of scenarios and and the same to be seeing all of them and their grab bag of injuries. He eleven sonogram to try it talk about this. He's going to have a sonogram to try to destroy the spur and cortisone shots to ease the discomfort. He's going to be shut down for three weeks. And then the Yankees think he's gonna need at least another three weeks to get up to speed talk. If you will about the sonogram to try to destroy the spur, right? I mean, there's there's the best analogy is if somebody has has heard of litho trips he which is a way to use high radio frequency to actually break up kidney stone. Inside kinda dissolve them and caused them to break up, and that's not dissimilar from what what we're talking about there on the shoulder because basically the the we're talking about deposits of calcium. Calcium can be hard enough to where it can be jostled with that frequency, and then can cause them to dissolve the steroids help because any time there's an area where calcium builds up, and it happens all the time. It's quite common. It's just the most of us can deal with by, you know, not sleeping on that shoulder. But not you know, we're not trying to throw a hundred miles an hour. You know, they can the the they create those calcium deposits create a lot of inflammatory response in the body because it's have normal and abnormal location in though, the cortisone whether second by mouth or given by Jackson with an ultrasound guided needle can break that up as well. Reduce inflammation, reduce the paint. I mean, the pain is why these guys can't throw. Because there's a major structural damage. It's just that they can't throat right? Let's move from the bullpen and del dances to the starting rotation. Luis Severino with Dr Colton baron. The associate professor of peaks at NYU lingo, Severino already out with a rotator cuff inflammation has now. Also, suffered a great to latte strain. Is there any relationship between the two injuries? There's got to be there's got to be an, and, you know, talked about this many times at for is, you know, once once you are you're our brains are very smart, and they know things that we aren't even thinking about and what they know they know where an injury is. And then they start trying to accommodate for they try to adapt and use over overuse, and protect whatever that that injured area is try to protected by over working over using the surrounding muscles the accessory secondary. Muscles and the logistics is critical for controlling our shoulder blade, which is the positioning of our whole on in space. And so, you know. You have to wonder and have to worry that that that without even thinking about it unconsciously, the the overuse of the logistics, and the strain that resulted from that in this case, great to strain, you know, is is related to try to to unconsciously protect that that strained rotator cop. How how severe is a great to great to is is medium medium. Great great one is just a little bitty strain that generally goes away very quickly. Great to, you know, takes six weeks to to resolve from from, you know, a a purely biological level physiologic level, and so so that takes time, and that's obviously by pushing back significantly and now he's dealing with the two. I mean, that's okay because they can both heal together. You know, and so hopefully with good rehab and and good physical therapy. And and the rest at. Of them can come back shining some tiny slow from the man to behind home plate Sanchez had complained of tightness in his leg. Earlier this past week. But he was surprised when an MRI on Thursday revealed revealed, a small strain, but this is something I guess he wanna treat right now rather than let it linger and potentially extending his absence. Absolutely. You're so right. Because you know, what happens is all these guys are desperate to get back there. Whether it's behind the plate or on the on the mound or wherever it is field. You know, they're desperate to get back. Everybody wants him back back coached wanna back managers, and they more than anybody wanna be back. And so you've gotta be careful because you these little strains that I think he had if I'm not mistaken, I think he'd been complaining of tightness. But you know, you just keep manage fine, and you go forth, but you know, you have to wonder that when you're facing, you know, as you said a dozen of these injuries, everybody scaling crusher you've got new people in the. Field. You know, these are such a mazing teammates, and they know each other intimately well, and you have four new people who are great, and awesome, but planned together, and it just adds a level of stress and anxiety that I think, you know, we've manifest that athletes manifest that in their in their in their joints and their muscles and their muscle tendon units, and you have to wonder if that extra tightness doesn't predisposes to some extra"