Injury update: Joey Votto

Will Reds 1B Joey Votto be back after the minimum DL stint? Maybe not. AP Photo/Al Behrman

After a period of wait-and-see (which may have been just as much about waiting to see if outfielder Jay Bruce was ready to return from his knee injury) the Cincinnati Reds made the move to slide first baseman Joey Votto over to the disabled list. Although the team initially appeared hopeful that Votto would be able to return within a few days, his DL stint was able to be backdated to May 15, meaning he could return in another week. But will he?

Not necessarily.

When the news of Votto having an ailing left knee first surfaced, there were immediate concerns that this injury was related to his meniscus injury of 2012. Two years ago, Votto tore his medial meniscus on a slide into third base, and struggled initially with his recovery from surgery. A second procedure was ultimately required, and it was a near two-month absence before Votto was able to return to the lineup. When Votto’s knee became an issue this year, it was natural to wonder whether there had been a subsequent meniscus injury, or some other joint-related issue. It turns out the injury is reported as a distal quad strain, or a strain of the quadriceps muscle (the large muscle on the front of the thigh) in the distal (far) portion. In other words, the involved area of the muscle (or even where the muscle and tendon meet) is the area closest to the knee.

It’s easy to see why this may have been initially described as a knee injury, but there is a significant difference between a soft tissue injury of a structure around the knee versus an articular (joint) problem inside the knee. If it were another joint problem for Votto it would raise some flags about the health of the inner workings of the knee joint, and perhaps indicate concern of associated degenerative changes. While a quad strain is not something to be dismissed, it has a better chance of complete resolution and, on the surface, is less serious.

The decision to place him on the DL is still a wise one given Votto’s knee history. Attempting to push or play through a quad strain could ultimately prove problematic, not only because it could extend his overall recovery time but also because it could create other problems for the knee. Now that Votto has been placed on the DL, it would not be surprising if he actually requires a few extra days before he returns. After all, the history with his knee warrants the caution. As Reds manager Bryan Price told reporters last week, “I want him to play confidently on that knee and that leg for the rest of the season and the rest of his career going forward.”

Thankfully for the Reds, Bruce’s rehabilitation following meniscus surgery in his left knee was smooth sailing. Jogging just a week after the operation, even commenting how good his knee felt, Bruce beat out a three- to four-week projected timetable to return after the minimum DL stay.