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.
Manny Rondon faced 13 batters ... and got 10 to K. Not a bad day's work.
With several other Cubs hitters bailing out on curves today I think overall it wasn't being seen well. It for sure looked silly but a good breaking pitch coming at you and then breaking down isn't the easiest thing to see and has made many hitters look silly. Also Soler should have more walks this year but for quite a few called strikes that were actual balls and even the called strike he bailed on was borderline.
it's not like we're talking about a guy who's never had issues with pitch selection and seeing the ball over here. we're talking about a guy who has some rather legendary swing-and-misses at breaking stuff who's been exploited low. going forward it's worth paying attention to seeing if he can be exploited inside, too. he seriously bailed out of the box on a called strike. sure it was a good curve, but he obviously didn't see that well at all.
It would seem like he is figuring it out now and it's really coming together. Really happy for him. Joe was really protecting him from the 3rd time through the order, but as you allude to, he is earning trust to go deeper.
Wondering if has potential to become a #3 pitcher? His current stats certainly support it.
That doesn't count b/c CRUNCH didn't see it on his 60" HDTV 5 times in replay.
I have seen many players "bail out" when the ball looked like it was gonna hit them.
Especially with the advent of the splitter and pitchers that can really get the ball to dance. Marmol, Sutter, Pedro Martinez, Curt Schilling, Derek Lowe, Smoltz, Arrietta...
These guys have made the best bail out only for the ball to come over the plate and be called a strike.
No shame in that. The same way players whiff hard enough to cause them to drill a hole in the ground from spinning.
a 60" TV with slow-motion replay and multiple looks on that replay helps...a lot...
it's one thing to shy away like he did the 2nd time, it's another to bail out of the box on a called strike. that happened in the 1st one he pulled away from. he misjudged that one by a foot or so...
Good Hendricks sure is fun to watch. He was hitting all his corners today and the Phillies couldn't do anything with his changeup.
Bryant and I believe Zobrist both did that too.
Soler BB acumen and plate awareness is excellent. Not unusual for even the best players to react as if they were about to hit them, "even though they weren't that close" from your vantage point sitting on your deck, or wherever.
soler vs inside breaking balls is scary.
he's had 2 inside curve balls today where he reacted as if they were about to hit him even though they weren't that close...one he bailed out of the box on, it was a called strike.
j.urias optioned back to AAA...guess we wont be seeing him in the LAD series.
so is him actually getting 2 hits in a game (2 doubles!)...first time he's even been on base 2 times in a game since 9 games ago on his 3/4, 1bb day.
im ready for him to at least look like a 2-slot hitter since he's gonna be slotted there no matter what he does.
That Heyward move to avoid Bryant's ball hit at him was a thing of beauty too.
9 pitches in and this game already rules.
HR, double...bryant's turn (who came out to a Kris Kross song for some horrible, horrible reason).
...2 run inning...zoobrest hitting streak at 14.
First time I saw Herrera was yesterday. He took like 100 pitches, fouled off a ton off Lester.
Very nice young player and perfect leadoff guy.
Obviously not Phil. But he mentioned this on Wednesday.
"Dominican Summer League (DSL) Opening Day is Saturday June 4th, so probably about 8-10 pitchers and position players presently at EXST in Mesa will be sent to the Cubs Dominican Academy (probably sometime this week) and be assigned to either DSL Cubs #1 or DSL Cubs #2."
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