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.
This place is a real downer after a loss to the Sox.
I expect they will go 5-9 games above .500 the rest of the year. 96-98 wins will win the Division.
They should have one more 2-3 week hot streak in them.
However, several players are just "average" for the last month: Zobrist, Ross, Russell, Ceasar. Montero is terrible, plus he cannot throw anyone out. -WAR. Heyward is abysmal at the plate, but a plus in the OF. Still with RISP he has been terrible. KB has not been driving in runs as of late. But Apparently the team is still above average with RISP according to S Sahadev.
I came to that realization tonight. I kept expecting them to play better, but now I realize they aren't going to. They are a .500 team now.
- They have one reliable starting pitcher. Jake's magic is gone, and it doesn't look like it's coming back. Lester has been lousy recently. Lackey's ERA goes up every time he pitches.
- Heyward has been dead weight all year. I can't remember a single series where he was a significant offensive contributor. Not one. Great defense, but but if he were hitting .270 with 10 HR and played average defense, the Cubs would be better off.
new rule...no one's allowed to throw k.bryant a changeup
Team is .500 since early May and is playing like a .500 team. Lack of offense seems to be putting a lot of pressure on the pitchers...and they aren't handling it terribly well.
.500 the rest of the way still may win the division though.
...i hate espn.
nothing like settling into a cubs game to get a few minutes cutaway for an ortiz AB in the 6th inning of the det/bos game.
oh, at least they're doing split screen now...i guess.
I'm liking this rookie Nathan.
Richard DFA'd. Meh...
Throwbacks with fashionable cutouts would be a nice touch.
The next 2 games are nationally televised. I think we dominate tonight, hitting 3 HRs off Shields. Great night for KB to end HR drought facing HR prone pitcher in one of the most hitter friendly parks in the league.
If the ball didn't deflect off the pitcher's mound, the game wouldn't have ended. Montgomery did miss his location though, but if that same contact was made and went in any of direction, good chance of ground out if it doesn't get through.
If it was 1 night later, Chapman would be out there and we probably would be going to extras.
Also, If KB wasn't robbed of a HR, perhaps we would have won. We will never know. Nice play by Melky though.
The comparison isn't Chapman replacing Rondon. It's Chapman replacing Richard (hopefully) in the pen. Chapman's better.
I'm with you, Rob. You pretty much summed up how I feel about it.
Been quite the roller-coaster the past two days -- both games, plus the Chapman kerfuffel. How about a couple of nice, comfortable wins before facing Sale? Cubs should definitely wear throwbacks for that game.
The Cubs are stronger defensively than most of the teams they play. In order to capitalize on that, they have to a) put the ball in play and b) run the bases aggressively.
That said, Cabrera has a strong, accurate arm, as witnessed by his 97 outfield assists over 12 seasons--mostly left field but also a lot of center. Bryant is rarely thrown out, but I guess you have to know who's throwing the ball.
On the other hand, Pries won his first start for Iowa, only giving up two HRs in the process. This trade has got some legs yet!