MLB Injuries

Mitch Haniger is getting close to a return, should you care?-Dr. Morse

Photographer: Chris Williams/Icon Sportswire

Seattle Mariners outfielder Mitch Haniger is returning from a strained right oblique, unknown severity but likely grade 2 since it has sidelined him for almost 6 weeks now. He was just starting to heat up just before his injury occurred. Over 21 games Haniger hit 4 home runs, 16 RBIs, a BB to K ratio of 13:20, 2 stolen bases, posting a strong 0.338 average, .600 slugging, and 1.042 OPS. This injury could not have come at a worse time for Haniger; hopefully this oblique injury won’t sideline his breakout season.

Let’s briefly talk about the anatomy of the oblique muscles. The oblique muscles are comprised of two different parts, the external and the internal obliques, and they basically overlap each other. They make up the sides of your abdomen and are described as broad, thin and irregularly quadrilateral muscles. On each side of the abdomen the obliques arise from eight digitations, each from one of the external surfaces and the inferior borders of the fifth through twelfth ribs. The blood supply of the oblique muscles is from the lower intercostal arteries, and they are innervated by the thoracoabdominal nerves ( T7-T11) and the subcostal nerve (T12). The main purpose of the obliques is to represent the contralateral rotation of torso, essentially twisting, which is vital in not only everyday activities but they are especially important in many of the sports movements.

Unfortunately oblique injuries are notorious for taking a long time to fully recover. Oblique strains are very common injuries, especially in baseball as they are very important in both generating power on one side while helping to stabilize the other. The obliques help to transfer the energy generated in the legs and hips up to the core, chest and to the arms. Swinging the bat, throwing the ball both are require substantial amount of oblique involvement. Pitchers often depend on their obliques to generate power in their pitches, helping to create that ‘whip’ effect. In both batters and pitchers oblique strains can affect the contralateral external oblique and possibly even the same-sided internal oblique as well.

Even a simple grade one oblique strain can set either a pitcher or hitter back several weeks because these muscles are so important within baseball. Re-injuring them is quite easy to do. Adequate healing is vital in order to help prevent re-injury and longer DL stints. Sometimes MRIs are used to determine the severity of the strain. Grade 1 strains can heal in 1-3 weeks, whereas grade 2 strains can take anywhere from 2-4 weeks. Grade 3 strains often involve complete rupture of either the internal or external oblique muscle, and require 2-3 months to completely recover from.

Treatment requires rest, anti-inflammatories (NSAIDs), massage, core strengthening exercises, sometimes ice and even electrotherapy. It is important to not only target both the internal and external obliques in your rehab, but also the muscles that oppose the obliques as well. These muscles include the lats, lower traps, the serratus posterior muscles, spinal extensors, glutes as well as the hip abductor muscles.

Since Haniger is tolerating his rehabilitation well and has not suffered any setbacks, I expect him to be fully able to return this weekend or early next week to the starting RF for the Mariners, sending Ben Gamel back to a reserve role. His power should return once he feels comfortable that the oblique is fully healed. Please be cognizant of the fact that these injuries have a tendency to reoccur and he is at increased risk for re-injuring this oblique at any given time or during any given swing. If you can get him for cheap, or pick him up off the wire you should do so now as he has a potential to be a very important piece for the remainder of the year.

This was written for the @TheFantasyDRS by Dr. Jesse Morse. I am a Family Medicine trained physician, and I will be beginning a Sports Medicine Fellowship at the University of South Florida in Tampa next month. If you have any questions or comments, you can contact me directly at @DrJesseMorse.

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