David Ortiz Injury Evaluation

For those who haven't heard, David Ortiz has been diagnosed with a partially torn tendon sheath of the ECU(Extensor Carpi Ulnaris) in his left wrist resulting from a swing in Baltimore on Saturday. They are saying that he won't need surgery and that he could be back relatively quickly. Personally I don't think he'll be back in a month, I believe it'll be closer to 6-8 weeks if at all this year.

Tendons and tendon sheaths tend to heal slower than the surrounding muscle or bone because of a decreased blood supply inside that particular part of the tissue. The tendon sheath is a small amount of tissue that encapsulated the tendon itself and protects it from undue tension and wear and tear, similar to a joint capsule. Having the injury to the sheath and not the tendon itself is key because the actual tendinous fibers heal even slower than the sheath. Also the mechanical properties of the tendons are not as compromised with injuries to the sheaths.

However, these injuries tend to swell and become very painful to perform any activities associated with daily life, such as opening and closing doors, lifting milk, brushing teeth, etc. Gripping a baseball bat and swinging with it results in a tremendous amount of strain across the associated tendon. Because of this resultant force, the tendon and it's sheath must be in basically perfect health or else he risks completely rupturing that tendon and other structures of the wrist as well. He risks damage to that tendon, the bones, cartilage(TFCC), and the ligaments.

Wrist injuries in baseball tend to linger for a long time due to the demands of the sport. (Look at Derrek Lee and the fact that he is only now returning to his previous level, more than 2 years after injuring and more than 1 year after returning) His left wrist is his top hand on the bat and is used more for bat control than bat power, which is produced by his right wrist, legs, and trunk. So when he does return look for a slight loss of bat control, resulting in more strikeouts, weak grounders, and pop flys. His power should theoretically remain intact but he will have much less room for error than before.

Ultimately I think he will have surgery on his wrist, at the very least at the end of the season after returning from 6-8 weeks of rehab to clean up scar tissue. If he was someone who was drafted say outside of the top 7-8 rounds, I would say just drop him but you cannot do that with this sort of talent. Stick him on our bench, injure reserve him, whatever and keep your fingers crossed, just like I am.