Rash of Oblique Strains Lands Some of Game's Biggest Names on Disabled List

News Talk 610 CKTB—July 23, 2011

The piercing twinge Minnesota Twins reliever Glen Perkins experienced each time he threw to the plate almost felt like a knife being plunged into his rib cage — and twisted.

What started as mild discomfort in his right side as he warmed up in the bullpen had exploded into full fury after a few pitches on the mound.

Plenty of players know exactly what he went through.

There's been an outbreak of oblique strains this season that has landed some of the game's most familiar names on the disabled list, including Evan Longoria, Brian Wilson, Rafael Furcal, Travis Hafner and Jim Thome.

The oblique muscles run along the ribs and allow the torso to bend and twist. Pitchers usually injure the side opposite their throwing arm, possibly as a result of the torque created from the coil of the delivery. 

They're tricky to prevent and even tougher to treat, mostly requiring old-fashioned rest.

Dr. Joshua Dines of Hospital for Special Surgery in New York has been looking into the recent rash of core injuries. An orthopedic surgeon specializing in sports medicine and a consultant for the Dodgers, Dines just submitted a paper to the American Journal of Sports Medicine that examines all things associated with the oblique.

The core may just hold the key to solving the puzzling. The tighter the core muscles, the tougher it may be to tweak. But that's a delicate balance, Dines said, because an athlete doesn't want those muscles to lose elasticity.

"There are multiple reasons to explain the same outcome," said Dines, whose study concluded there was an increase of abdominal muscle strains over the last two decades. "That's why we don't know what the cause is."

Typically, position players average about 26.7 days on the disabled list with the injury, while pitchers need 35.4 days to recover. Most of the down time involves rest since the injury is so sensitive to movement.

Once cleared, players slowly start a battery of stretching exercises, careful to not overdo it.

In their study, the medical team found that about 12 per cent of the players re-injured their oblique within the first year.

One potential way to cut a player's time on the DL may be using platelet-rich plasma treatments, a therapy that Kobe Bryant reportedly had in Germany this spring to try to strengthen his right knee.

In the PRP procedure, a small amount of blood is drawn from the patient and spun in a centrifuge for about 20 minutes to isolate platelets. The platelets are then injected into the injured area to try to stimulate tissue repair.

So far, Dines hasn't witnessed any significant breakthroughs with the approach. But he's not dismissing it just yet.

"Maybe if we do PRP, maybe athletes will heal with better tissue as opposed to scar tissue and the re-injury rate will decrease," Dines said. "I think there might be some long-term benefit to it that we haven't seen. Maybe it will save them a day."

Every little bit helps.

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