After injury-wracked 2013, can Derek Jeter hold up in final year?

Sports Illustrated—February 24, 2014

For Derek Jeter, the past 16 months have represented the most miserable period -- perhaps the only miserable period -- of a career that has by and large seemed like the result of a Mephistophelean pact.

Can a player who will turn 40 in June, with his particular set of recent maladies, play an effective 150 games at his sport's most athletically demanding position?

To try to answer that question, I turned to a pair of physicians at New York City's Hospital for Special Surgery, Dr. Rock Positano and Dr. Josh Dines. While it must be emphasized that neither Positano nor Dines has examined nor treated Jeter, both know baseball, and both know feet. Positano is a renowned foot specialist who in the 1990s finally cured Joe DiMaggio of the heel pain that had plagued him late in his career, and ended it prematurely. That Positano is the founder and director of HSS' Joe DiMaggio Sports Medicine Foot and Ankle Center is one indication of the Yankee Clipper's gratitude. Dines is an orthopedic surgeon and an assistant team doctor for the Mets, and recently collaborated with Positano and two other physicians on a textbook called Foot and Ankle Sports Medicine. The doctors agree that, as far as the integrity of Jeter's ankle, past events are not indicative of future results. That Jeter suffered a new crack in the joint last spring, when he resumed baseball activities less than five months after sustaining the initial injury, does not mean that he is in any particular danger of re-fracturing it in 2014. Jeter's competitive drive could have worked against him during his first attempt at a comeback a year ago, as he seems to have attempted to do too much, too soon.

Positano and Dines have little doubt that the cascade of injuries Jeter suffered during his multiple aborted comeback attempts last year all stemmed from his still weakened ankle, and could also have resulted from his eagerness to return to the field. "The foot and the ankle are primarily shock absorbers, and protect everything above them," Positano said. "When a person has a compromised biomechanical situation, there's a direct effect on what happens above it."

Adds Dines, "Your body wants to protect what was injured, but the stresses are simply redistributed elsewhere, which can lead to imbalances and then injuries due to compensation." Such as, say, to the opposing quadriceps and calf.

Jeter's ankle injury might have some latent impact on certain elements of his play, such as his already diminished lateral movement at short and, perhaps, his most famous hitting technique. "It could affect his ability to hit to the opposite field with precision and power, because less-than-perfect left foot and ankle strength and mechanics could have an effect on balance and strength when driving the ball to right," Positano said. Still, it is unlikely to hamper Jeter severely as he tries to make it through last season.

Many of the body's structures have become less elastic by the time a person reaches Jeter's age, and less resilient to a grueling athletic schedule. Positano is particularly concerned about Jeter's plantar fascia and Achilles tendon. "The problem with the Achilles is that after age 30, the blood supply to it is reduced by an additional third," he said. "It's the largest tendon in the body, takes the most abuse, has the least blood supply and the least elasticity."

Added Dines, "By nature of his age, he's going to be at a high risk for overuse injuries, which also include meniscus tears and hamstring pulls -- little thing that are annoying, but happen, and now he won't recover as quickly. The ankle fracture isn't going to help him, but he's had enough time to heal, and he should be good, generally. Now he has to deal with the fact that he's 40 years old and playing a full season. He knows what he's in for."

Even so, both doctors believe that if anyone can beat the odds, it is Jeter. "Knowing the type of care he's gotten, I think he's going to come back very strong," Positano said. "He's going to shut a lot of people up. I think you're going to see a resiliency here that this person's always had. To have that type of success in professional sports requires unbelievable focus and dedication. He's going to apply that to his rehabilitation, to maintaining the strength and stability he needs to become effective again."

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