Darwin Barney's Pacific Coast League (PCL) Sprain
Darwin Barney went on the DL this week spraining "the other" cruciate or Posterior Cruciate knee ligament. I'm sure the Cubs called Iowa Cubs manager Bill Dancy to let him know that his Pacific Coast League (PCL) Iowa team might shortly be getting another middle infielder on rehab assignment for his lineup. Barney sustained the injury to his right knee on the play at home plate on Monday night, scoring the Cubs only run in a 1-0 victory. It looked like he bounced his knee in the dirt during a head first dive and he did stumble a bit getting up from his dive. The MRI showed injury without stretch (grade 1) to his Posterior Cruciate Ligament (PCL). This is considered fairly minor but probably needs to be protected from further injury for about 2-3 weeks.
"As soon as I slid into home plate last night, I knew something was really wrong," he said. "The whole knee went numb. I had an MRI today and it revealed that Grade 1 strain in my knee." (editiorial note: ligament injuries are sprains, muscle injuries are strains)
Right now Darwin Barney can't jump, but you can. So read more after the jump.
There has been plenty of media attention paid to the Anterior Cruciate Ligament (ACL) which when torn in a high performance athlete is treated with reconstructive surgery but little is written about in the media when the posterior cruciate ligament (PCL) is injured. The Posterior Cruciate is structurally the more robust of the two cruciates and isolated PCL injuries can occur but are less frequent and usually produce more subtle symptoms. If both the Anterior and Posterior Cruciates are torn, more drastic instability can occur including knee dislocation but fortunately that is not very common. Most people hear about the fairly common patella (kneecap) dislocation but a true knee dislocation (tibia-femur) is a severe injury and acute knee dislocations can even have nerve and artery damage.
The PCL attaches behind the knee on the tibia and goes to the medial (inner) side of the central notch on the femur. The ligament prevents posterior translation of the tibia relative to the femur above and also provides central rotational stability. Here is an excellent 3D modeling video of the PCL including how the ligament works in flexion and extension of the knee. The Anterior Cruciate (ACL) attaches to the anterior tibial spine near the front of the knee and goes to the lateral (outer) part of the femoral notch. The ligaments cross (hence, cruciate) each other and protect and stabilize the knee when working in tandem from excess rotation and translation.
Before MRI imaging was available, grade 2 vs 3 PCL injuries were sometimes subtle to diagnose on exam with what was called a "posterior sag" sign with the knee extended or a "posterior drawer" sign with the knee flexed. The PCL does image well on MRI studies (see "P" on image), so seeing injury to it (because the tissue signal is altered in injury) is straightforward making even subtle grade 1 injuries possible to diagnose these days.
The most common mechanism of injury is a direct blow to the front of the upper tibia, which is what seemed to happen to Barney's leg in the head first dive at home plate.
Certainly, a grade 1 strain should respond to rest and rehab in a few weeks but when the PCL has a third degree injury and the knee has instability there are arthroscopically assisted surgical reconstructive techniques (see video) available. These have evolved and are significantly improved over the last 2 decades and much of the technology has been based on arthroscopic considerations for the ACL which is now a frequently performed surgery. Brewer ace Yovani Gallardo tore his ACL in May 2008 (against the Cubs avoiding contact with Prince Fielder on a Reed Johnson bunt) and was able to come back to pitch in late September and started a playoff game vs the Phillies that season. The injured PCL has better blood supply than the ACL and therefore can heal without subsequent instability. The PCL is much less frequently reconstructed (than the ACL) and often has several other associated injuries including the ACL and meniscal tears making any associated instability more extensive, so the results are more difficult to assess and should not be compared to the more common anterior cruciate ligament reconstruction outcomes. I don't know of any major league players that have needed PCL reconstruction although I would be interested to hear if any mlb player has had this done.
I wonder if Doc Gryzlo will recommend a few games of rehab in the PCL for Barney's PCL once the swelling and soreness improves.
I know, man. What a season. 3rd best record in all of baseball, good enough to have won any division other than the one there in.
With a win tomorrow, the Cubs will match their 2008 record. Bad omen, I know. If they do win, the most recent year in which the Cubs will have won more games would be 1945 (98-56), the last time they went to the World Series.
I'll take that omen instead...
"oh yeah, and get the fuck off my lawn. :D"
Ok, now that was funny. :)
KB 0-5 with 8 LOB. Really? He is torturing me with 99 RBI. He is also a very different hitter at home vs. road. I suspect most young hitters are.
Greinke still in for the 8th. 3 up, 3 down. After 8. 108 pitches, ERA still at 1.66 according to mlb boxscore and he's in line for a 19th win.
Greinke 95 pitches through 7. Gives up one run (solo HR to Hedges). ERA at 1.66. Doubt that they will let him give up 5 runs in the 8th.
Dodgers ahead 2-1.
96 wins with one game to go. Who woulda thunk it.
Cubs 96 wins have clinched a better record than any AL team and the NL West/East division winners too.
cubs win, pirates lose...
the curse is now yours.
cog a HR away from the cycle after a single in the 6th.
Hendricks: 15 up, 15 down.
he strongly separates his post-playing career from his playing career, though he loves to visit the barrier of player and fan. many ex-players don't put up this barrier.
he's not interested in going back to the clubhouse or pretty much anything field/game related, but he'll grab a ticket and observe with the fans and visit ex players on "neutral" ground. he's written 3 pieces for the new yorker and other pieces elsewhere. i remember one photo/bio piece he did, but don't remember where i read it (years ago).
I find your comments rather obtuse. He recognized he didn't want to pursue baseball anymore and went back to school to learn how to become a better writer - opening up a new chapter in his life.
I don't know where you find a "sad disconnection" because he is writing about his experiences? He pursued a ball career for a long time so no doubt there is some meloncholy in his tone, but I just don't know what the fuck you are talking about.
he has an almost sad disconnection from the game based on his writings. even though he's "been there" (no matter how much of a minor role) he doesn't seem to feel like he belongs or deserves to belong in the boy's club.
he seems to go to great lengths to enjoy the game from an arm's length while occasionally getting close enough for a high-5 from those who affirm him that he belongs.
I read that guy's article about why he quit baseball and it was really well done too. In terms of Rizzo, I have seen multiple references to how this is Rizzo's team just as much as Madden's and it makes that pick up that much better that we have someone that is not only a great player but a leader and all around great guy (been reading about all the charity work he does too). There is really nothing not to like about Rizzo.
Nice article on Rizzo
Written by ex teammate
JD concurred with Ariettas second at bat