Wrist injury plagues Gonzalez, again

Last Friday, we said it wouldn't be a surprise if Colorado Rockies outfielder Carlos Gonzalez rested through the weekend. Well, he didn't. He rejoined the team Saturday, hit a home run on Tuesday and the game-winning RBI on Wednesday. Out of the woods, right? Not exactly.

During Thursday's game against the Atlanta Braves, Gonzalez started off well by delivering another home run. In the fifth inning, however, he gave his team a scare. After fouling a ball back, he released his right hand immediately from the bat and appeared to be in significant pain. He walked toward the dugout, then squatted down, still supporting his wrist, while being attended to by the medical staff. Gonzalez was sent for an MRI, and on Friday the team called his injury a wrist strain. The Rockies' official Twitter feed states that Gonzalez will be on the plane with the team when they travel to Arizona for a weekend series. According to the Rockies' website, Gonzalez will be re-evaluated Friday, at which point the team will have a better ideas as to how much time he will miss. It stands to reason that he will be sidelined for a lengthier period after this latest episode given the recurrent symptoms he is experiencing, but there is no official indication as to whether that will be the case.

Just to recap, prior to Thursday's incident, Gonzalez injured his right wrist on July 3 after colliding with the outfield wall. He subsequently missed several games, but they were not consecutive. After sitting out five days, Gonzalez returned to the starting lineup on July 8 but appeared to aggravate his wrist in that game. According to the Rockies' website, Gonzalez experienced pain twice during that game, once during a strikeout and again while diving in an attempt to make a defensive play. By the eighth inning he was forced to bunt because it was too painful to perform a normal swing. However, Gonzalez appeared as a defensive replacement late in games the next two days. On July 11, he underwent an MRI, which revealed a deep bone bruise, and he was then placed in a removable splint and a cortisone shot was administered to his wrist. By last Saturday, he was back in the lineup again and, well, six days later he was getting a repeat MRI.

It's worth noting that this is the same wrist that gave Gonzalez trouble late last season. Initially painful after fouling off a pitch in August, Gonzalez acknowledged that even while trying to play through the injury for another month, it affected the power and strength of his swing.

The wrist is a tricky joint. Where the two forearm bones (radius and ulna) end, they are met by two rows of small carpal (wrist) bones, four in each row, which then articulate with the long bones of the hand (metacarpals). The carpal bones are held together by a number of ligaments. The tendons that anchor to the bones of the fingers, controlling their motion, cross both sides of the wrist. In other words, there are a lot of structures that coexist within a fairly small space which collectively contribute to very complex motions, especially when it comes to torsional or twisting movements (like swinging a bat). The presence of inflammation takes up real estate in this already constricted area, making movement more difficult and often painful. Pain and swelling impair strength, so grip is often impacted when there is inflammation in the wrist. One of the keys to reducing inflammation, beyond oral medication or injection or modalities such as ice or electrical stimulation, typically includes immobilizing the area to prevent excessive motion, along with that universal healer that tests everyone's patience: rest. Sometimes the only way to judge if an area has healed to the point of tolerating activity is to try the activity. When the body doesn't respond, it is often a signal that more downtime is warranted. Although it's impossible to assess all the elements of any specific injury from a distance, it would certainly appear that the pattern for Gonzalez and his ailing wrist hints at more extended downtime in his near future.

• The Cleveland Indians' Grady Sizemore is getting extended downtime after aggravating his right knee injury when running the bases last Sunday. He was placed on the DL on Monday, but on Thursday, we learned that he had undergone surgery to repair a sports hernia (his second such surgery but unrelated to the first, which happened in 2009). The recovery time for the sports hernia was projected at four to six weeks, which automatically ensures that Sizemore's knee will get some additional time off.

According to the Cleveland Plain-Dealer, there are a couple of silver-lining notes to this story. First, Indians head athletic trainer Lonnie Soloff indicated that a repeat MRI of Sizemore's right knee "is unchanged from 10 weeks ago." In other words, there has been no progression of pathology within the joint. Given Sizemore's initial reaction as to how the latest injury felt similar to what he experienced in his left knee last year -- which ultimately led to microfracture surgery -- this is encouraging.

Soloff also indicated with regards to the sports hernia surgery, "This is a similar procedure, but not as extensive as the 2009 injury," another plus in terms of recovery. Dr. Bill Meyers, the surgeon renowned in the area of sports hernia surgery, performed the procedure. He performed a similar surgery earlier this year on Washington Nationals third baseman Ryan Zimmerman, who was out for six weeks following the procedure. Although no two procedures or recoveries are identical, it's safe to say no one will be rushing Sizemore back into service given his overall history.

• And to end on a happy note, New York Mets third baseman David Wright is expected to rejoin his team Friday when they face the Florida Marlins. Wright is returning from a stress fracture in his lower back and has had a solid week of rehab game play. His presence will undoubtedly lift his team and he should be able to hit the ground running, literally. Wright played through the injury for a month before going on the DL. The rest and lengthy, intensive rehabilitation targeted at strengthening some of the key abdominal stabilizing muscles should only serve to enhance his performance in the second half.