The Opposable, Not Disposable Thumb

 

Little Jack Horner

Sat in the corner, eating a Christmas pie;
He put in his thumb, and pulled out a plum...

Just to take our minds off the train wreck that the 2010 season has become, I'm going to tangent into just what made Aramis Ramirez so miserable this year. His left thumb injury (diagnosed as a deep bone bruise) may or not have been related to his season long slump or it just may have prevented him from coming out of it as the weather warmed up. He's been 'missing', even when present for most of 2010 which is somewhat different than his absence last season, starting on May 9th, 2009 from what happened at a similar point in the season, when he dislocated his left shoulder diving for a ball on May 8th in Milwaukee.

From a Gordon Wittenmeyer, Sun-Times article:

Ramirez, mired in a two-month slump, first hurt the hand on a swing-and-miss May 9 in Cincinnati. When it got worse two weeks later, the Cubs considered putting him on the DL, ''but I didn't want to do it because I thought I was good enough to play,'' said Ramirez, who got a cortisone shot instead. Manipulating his bat handle to take pressure off the top of the left hand also didn't work because it was uncomfortable, he said.

''This is the right time to do it. This is the right thing to do,'' he said.

He'll be eligible to return June 23 in Seattle, but a return then is anything but certain considering the down time that'll require before he is even allowed to resume normal baseball activities.

Supposedly, his injury was a deep bone bruise. I have not read any reports about an injured ligament. He has tried to play through the soreness but his thumb kept getting re-traumatized from his attempts at hitting. He didn't want to go on the DL until it was clear he couldn't shake the injury.

This does remind me of the way the Cubs handled Soriano's knee problems last year. Supposedly Soriano's knee was injured around April 22nd but he/they kept playing him with an injury that wasn't dramatic enough to take him out of the lineup. It took months of underperformance compared to his career stats (.241/.303/.423/.726 vs. .278/.327/ .511/.838) to  finally acknowledge it was his knee that was the problem. Maybe they learned something, since it took only a month of struggling with this Ramirez injury before he hit the DL vs. Soriano's 4 month struggle. I believe that some of these situations develop because a team can not put a player on the DL unless he agrees or the team gets the medical staff to document that it's not medically advisable for a player to be on the field. Hockey-like warrior mentality doesn't seem to work in modern baseball, at least not as far as the Cubs are concerned.

The opposable thumb may have been, regarding humanity, the single most important evolutionary development.

When the hands developed dexterity advantages, that freed the front limbs from four limb gait. The opposable thumb literally gripped the development of tools, hence civilization and...dare I ultimately conclude, Baseball.

An animal species is said to have opposable thumbs if the thumb is capable of bending in such a way that it can touch all the other digits on the hand. Most species do not have opposable thumbs. Opposable thumbs are a signature feature of the primate family, and played a large role in the ancient humans' invention and use of tools.

Thumb anatomy is unique when using comparative anatomy to the other fingers and certainly the human big toe. The thumb can be rotated (opposed) from around 50 degrees at rest to as much as 110 degrees of rotation when in a position of opposition against the other digits.

There are unique sets of muscles and tendons (abductor, adductor, flexor, opponens and interosseus of the thumb) that accomplish thumb opposition. This is a complex of movements that include what is called pronation, radial deviation and adduction/abduction and specific muscles match the individual movements required. The bones at the base of the thumb (first metacarpal, trapezoid and trapezium and proximal to them, the carpal navicular/scaphoid bone) have developed to accomplish this opposible movement and the type of joint is called a sellar joint.

Thumb functions include pinch and grasp but the rotation that opposition creates makes it possible to make grip have advanced functionality. There are three types of pinch grips, key (digit side by side, as in holding a key), tip (the end of the digit, where opposition is possible) and palmar pinch (thumbless grasp).Two aspects of grip help hold a baseball bat, span grip and power grip.

There are many common injuries around the thumb. A bone bruise is just what the term sounds like, it's not a fracture but the injury to the bone involves damaged bone cells without structural disruption. A fracture implies there is a definable structural crack/disruption that bridges one of the bones of the thumb (first metacarpal, proximal and distal phalanx). There are many fracture patterns and if a fracture involves an adjacent joint (CMC, MCP or IP joints), it usually is a more serious problem. If an X-Ray shows a fracture, an MRI isn't often needed but when the X-Ray is normal an MRI can be very helpful. Nowadays, MRI imaging can see signal changes in a bone and adjacent soft tissues (ligaments, joint capsule and tendons) that indicate there is damage to the bone and/or soft tissues. Even a bone bruise sets off a healing reaction until the bone structure returns to normal, essentially a "fracture-lite", but still painful and can last many weeks. Other significant thumb injuries involve soft tissue damage. One well known injury is called Gamekeepers Thumb. It involves a torn or stretched ulnar collateral ligament of the metacarpal-phalangeal joint or MCP joint (at the base of the web space, the thumb equivalent of the Tommy John elbow injury). This can be treated conservatively unless the ligament is fully torn or significantly stretched so that the thumb pinch activities become painful. There are surgical repair/reconstruction options when that situation is diagnosed (watch out if you are squeemish, this link is a surgical video).

So when one compares small joint/bone injuries to big joints, Aramis Ramirez has got them covered. If his thumb becomes a lingering problem, the sellar joint of his thumb just might be a major cause of the Cubs entering a seller market.

Comments

Jack Horner is missing a finger. Clearly a highly touted Cub prospect waiting a call up from Iowa.

"The opposable thumb may have been, regarding humanity, the single most important evolutionary development."

That was one thing that pissed me off about the movie District 9. The aliens had claws. How the hell do you build stuff if you have claws? Even if they found a way, I bet they were lousy baseball players.

@CarrieMuskat: #Cubs lineup Sun nite is 2b riot, rf colvin, cf byrd, 1b lee, lf sori, 3b tracy, c hill, ss castro, p lilly

http://www.cubworld.com/c=6UsBabxvxIykudBHpIa...

webcam, streets look wet (4:15pm) but no umbrellas

WGN weather says thunderstorms...

http://www.chicagoweathercenter.com/

well if you can't beat 'em...eh, postpone the game?

CarrieMuskat: #Cubs manager Lou Piniella says time is right to have Tyler Colvin play and "we want to see this kid in the lineup more."

...who is "we", Lou and Stoney?

he's been saying that for 2 months now...

That maybe true Rob, but come on, let me get this straight. Steve Stone comes out and BLASTS Lou for not playing Colvin. Lou blasts right back, essentially saying Stoney has no idea what he's talking about because he's never managed. Lou then proceeds THE NEXT DAY to start Colvin and talk about how Colvin is going to see some more pt because he's earned it.... Somewhere Steve Stone is laughing to himself, and I don't blame him.

again... lou has been saying this for 2 months. one game does not make a trend.

Ya easy for Lou to say on a day it looks like they may get rained out.

Ironic...By a wide margin MLB players say Jim Joyce is the best Ump.
The worst? C.B. Bucknor and Joe "the hook" West.

http://sports.espn.go.com/mlb/news/story?id=5...

they were talking about it on XM radio and it was something like Joe West just has a huge attitude and a jerk, but Bucknor tries hard and is nice and all, but he's just a terrible ump.

I'm not sure which is worse...

Aaron Heilman gets one step closer to being the Dbacks closer as Qualls blows another save.

Jake Fox DFA'd.

Relive the humor of the comments the day he was traded.

http://www.thecubreporter.com/2009/12/03/aaro...

That shit's funny.

With all that was going on with Fox and Miles, my only comment in the whole post was about how Chad Gaudin's wife or girlfriend was smuggling midgets! DOH!!

Your legacy will not be forgotten

How much does ESPN wish they had flex scheduling and could have picked the Nats/Indians game for tonight?

Lou get canned tomorrow on an off-day if Cubs get swept?

even if they win?

Fingers-crossed.

Not in your wildest dreams. That said, I too am beginning to believe it's time. I tell you what though, I'd just as soon see Lee, Sori and Fuk gone in July and dust off my 'Wait Till Next Year' T-shirt...(and actually, throw in Z while I'm rebuilding, I'm sick of head cases).

Actually trying to think about the Lou thing for a minute. IF the Rickettses are such huge fans of the game, they no doubt have seen and heard the unwritten rule about managers, that if you fire one sometime mid-season the team often goes on a miraculous tear. That'd also be a lot quicker and easier (although more expensive) than trading the guys I listed above (if that'd even be possible, which it may not).

Makes me wonder just how safe Lou's job may (or may not) be right now.......

(Does anyone have Eric Wedge's number? Or does Ryno take over mid season? They don't go with Trammel, do they??)

Rob, I don't know if you have the game on, but Jon Miller is making wanna go all MB on his ass...

what a game...

what near-Cubbery....

That was a excellent game.

As we get closer to deadline could the cubs ask Lilly about
extension before they try to trade him.

Lilly scares me a lot. I don't really understand how he's pitched well the last year or so. Seems to have lost a lot of velocity, and the changeup and curve don't impress me as much either. They'd be better off just seeing what they can get, I think, and being happy that they managed to have him under contract for the best years of his career.

Hendry should be on the phone tomorrow trying to trade Lilly. Especially since Jimbo doesn't seem to understand the arbitration/draft pick thing very well. He could try 1-800-RANGERS. I live in Austin, TX and also follow the Rangers in passing. They really need some pitching, surprise, Harden is on the DL and isn't really fitting into the Nolan Ryan mantra of pitching deep into games.

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  • Mine has been really slow to load -- on different computers from different locations.

    JoePepitone 18 min 9 sec ago view
  • Anybody else have issues accessing the site this afternoon/evening?

    Eric S 1 hour 19 min ago view
  • Boras is 63, maybe he'll be retired or dead by the time Bryant, Russell, Almora, Albertos all hit free agency. Doubt he will be before Jake hits there though.

    cubbies.4ever 4 hours 39 min ago view
  • Interesting choices when guys get healthy.

    LaStella, Fowler & Soler replace Coghlan, Almora and Sczcur? I assume they don't want Almora to sit.

    Despite MIggy's demise, I assume they keep him around to mentor Contreras?

    billybucks 5 hours 53 min ago view
  • I believe Willson now has more CS than MIggy. The kid has an arm. Also, Russell is amazingly good on those plays at 2nd.

    billybucks 7 hours 4 min ago view
  • oh yeah...thanks joe/billy.

    poor outing, still got the win, go cubs.

    crunch 7 hours 42 min ago view
  • Although it felt like it, Jake didn't lose to them -- he got the W. (Assuming you are referring to Monday's game)

    billybucks 9 hours 23 min ago view
  • Arrieta didn't lose to the Reds. He got the win -- he just didn't pitch like we expect him to.

    JoePepitone 9 hours 24 min ago view
  • almora's 1st HR!

    crunch 9 hours 31 min ago view
  • it's not like this CIN team is lost-cause horrible, but aside from defense and power this is a truly horrible team.

    kinda crazy arrieta lost to them and yesterday's game had to go 15 innings for the cubs win.

    crunch 9 hours 47 min ago view
  • It looked like Hamilton got screened by Duvall and that Duvall just barely deflected the ball off of his glove--redirecting it slightly without taking away much of its momentum.

    At least it didn't turn into a Schwarber/Fowler situation. Hamilton and Duvall are both pretty important youngish players for the Reds.

    Charlie 9 hours 55 min ago view
  • he walked off the field on his own. aside from a concussion watch and some attention to his leg/knee that buckled a bit under him, the biggest thing hurt was probably his pride after the ball knocked off his skull.

    crunch 10 hours 14 min ago view
  • After last night, an inside-the-park HR seems kind of run-of-the-mill somehow.

    Sounds bad for Hamilton. Hope he's okay--listening on the radio.

    Brick 10 hours 31 min ago view
  • SHOW ME THE MONEY: Jose Albertos has signed with Mega-Agent Scott Boras.

    Albertos has already received his signing bonus and won't see any additional significant money until he reaches the big leagues, so this is a long-term investment for the Boras Corporation.  

    Other Cubs represented by Boras include Jake Arrieta, Kris Bryant, Addison Russell, and Albert Almora Jr. 

    Arizona Phil 10 hours 37 min ago view
  • I am glad Joe is managing this team and not Old and Blue!

    Hagsag 12 hours 59 min ago view
  • Baez had Maddon's ass last night. I didn't hear the reason for taking Contreras out last night but whatever game management thingy it was, you don't take out your second hottest hitter. Or is he third? Anyway, you don't take him out. The guy can probably play anywhere in the field, anyway. Did anybody see that nice catch in left he made? I don't think he got a late start on that, just tracked it damn well for a catcher.

    Old and Blue 14 hours 55 min ago view