MLB injury mailbag: Takes on a pair of Twins, a Lance Lynn update and more

In this mailbag: Injury takes on two Twins hitters – one pessimistic and one optimistic – gauging a return date for Lance Lynn, and more!

Inside Injuries was founded by an orthopedic radiologist, Dr. Anand Lalaji (aka Dr. A), who contributes to all of the injury write-ups. Dr. A put together a team of doctors and data scientists to create an algorithm to evaluate the impact that injuries have on a player. This algorithm powers all of Inside Injuries’ analysis and determines each player’s Injury Risk, Health Performance Factor (the level a player is expected to perform at if they return too soon, for example) and Optimal Recovery Time. This information is based on years of medical experience and historical injury research and has proven to be incredibly accurate in determining how injuries will impact a player’s performance and risk of future injuries.

A quick description of terms from our injury algorithm:

  • IRC = Injury Risk Category (Low, Elevated, High) – the overall likelihood a player will get injured
  • HPF = Health Performance Factor (Peak, Above Average, Below Average, Poor) – our metric to predict player performance
  • ORT = Optimal Recovery Time – the amount of time a player needs to fully recover from an injury (not the same as how much time they will actually miss)

Alex Kirilloff had wrist surgery during the offseason and had issues with the same wrist early this spring. He is struggling on his minor league rehab assignment. Is this the kind of injury that requires an extended period of inactivity to heal completely? – Olin D.

When Kirilloff landed on the IL three weeks ago, we covered his injury. Our algorithm’s pessimistic outlook on his wrist problems are already proving to be accurate. Kirilloff underwent surgery last July to address ligament damage, and it never felt quite right. Now he’s attempting a comeback after being activated from the IL on Friday. He hit .227 with six strikeouts, six walks and no extra base hits in 22 at-bats on his rehab assignment. That’s not exactly promising, and it looks like the Twins brought him back too soon.

Kirilloff received a cortisone injection while he was out, but that really is only temporary pain relief when dealing with a more serious issue. It can help to minimize some of the swelling, but it does not heal any damage or address the underlying cause of the inflammation. Scans on Kirilloff’s wrist revealed “no new damage,” but this is not the same as a clean scan. I believe something more serious is going on here, and another absence is in his future. Don’t be surprised if he ends up needing a follow-up surgery sometime this year.

The Twins are making this bone bruise in Carlos Correa’s finger sound like no big deal, but is that the case? Isn’t a bone bruise a lot more than what a bruise somewhere else would be? – Ryan B.

Carlos Correa received very good news when he went from thinking he fractured his finger to a CT scan showing a bone bruise. While this isn’t the same as a surface bruise or contusion, it’s a much less severe injury and comes with a shorter recovery time. There are many layers that make up the bones in the body, and a bone bruise indicates damage to the outer layers of tissue. A bone bruise will heal well on its own with rest, but it can lead to pain and inflammation that lasts weeks, or even months, depending on the severity.

The Inside Injuries algorithm has Correa’s bone bruise as a grade 2 injury. It comes with a four-week Optimal Recovery Time (the amount of time for the finger to fully heal), although he should return much sooner. For now, the Twins do not plan to place him on the IL, so he could be back in the lineup later this week. Correa’s return to the lineup will be mostly dependent on his pain tolerance. This finger injury is likely to affect him at the plate over the next few weeks as it will be painful to grip the bat.

When can we expect Mitch Haniger back? Grade 2 high ankle sprains in football take at least six weeks, I think. Same for baseball? – Bob C.

A high ankle sprain is a much trickier injury than a standard low ankle sprain. The injury is to the distal tibiofibular joint, which sits just above the ankle connecting the tibia and fibula. When a high ankle sprain occurs, the stability of the lower leg is compromised due to the potential widening of the ankle mortise, which is where the two lower leg bones meet at the ankle. The severity of the high ankle sprain depends on which ligaments were injured and how severe the damage is. The minimum Optimal Recovery Time for a high ankle sprain is three weeks, although most of these injuries take closer to eight weeks to fully heal.

The MRI on Haniger’s ankle showed a grade 2 sprain, so this a more severe high ankle injury. I’m expecting him to miss at least a month. It is easier to come back from a high ankle sprain as a baseball player than a football player, but it should still lead to a lengthy absence. High ankle sprains are especially common in sports that involve a lot of cutting and jumping like basketball. It’s much less common in baseball, but because baseball does not involve nearly as much cutting as football, Haniger could make a quicker return and come with a lower Injury Risk than a football player with a similar injury.

Any hope for Lance McCullers Jr. to be productive this season? – Dan B.

McCullers hasn’t pitched in a game since Game 4 of the ALDS and remains on the 60-day IL with a flexor tendon strain. Over the weekend, Astros GM James Click indicated that McCullers is making progress as he has been able to “ramp up the intensity of the throwing – distance, velocity and frequency.” If McCullers continues on this trajectory he could be cleared to throw off of the mound in a few weeks. While this is progress, it does not change our analysis from last month. McCullers had Tommy John surgery in 2019 and is now still dealing with a forearm issue more than six months later. He received multiple opinions to confirm that the UCL was not damaged, and it is still intact. That’s the one bit of good news here. He needs to be very careful, though, as UCL and flexor tendon injuries are often associated. If McCullers tries to return before his arm is truly 100%, he is risking another serious injury and possible surgery.

At this point, I do not expect McCullers to be ready to return before the All-Star break. Even then I’m not confident that he will be the same pitcher he was before his arm problems. Pitchers with this type of arm injury just can’t be trusted soon after they return. McCullers will continue to come with an increased Injury Risk throughout the remainder of the season.

When will Lance Lynn be back? Any impact from his injury? – Andrew H.

Lance Lynn is expected to be back in early June, which is in line with our algorithm’s projections. Lynn underwent surgery in his right knee just over a month ago, and the team initially hoped to have him back sometime in May. His injury comes with an eight-week Optimal Recovery Time, so it’s not a surprise that his comeback is a bit slower than was initially expected. I do not see any reason to be concerned about the longer recovery as this should have been the expectation all along. While I do not believe Lynn will be 100% right away, this is not an injury that should affect him throughout the rest of the season.

Because this is a lower body injury, Lynn has been able to keep up with a throwing program. He has also been throwing from the mound, an important sign of progress.

His ability to continue throwing will make his return to the rotation much quicker as the ramp up period is more about his legs getting strength back than his arm getting stretched out. The one thing he does need to look out for is a compensatory injury. If Lynn tries to return before his knee is ready then it will put more stress on his arm, increasing the risk of a new injury.

(Top photo: G Fiume / Getty Images)

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