Article: The Aces Are Down: What Recovery Looks Like for Brandon Woodruff, Corbin Burnes, and When They Could Be Back

[Jake McKibbin]

Both of the Brewers' co-aces are suddenly question marks, after a week of rough injury news that makes the team's excellent start to the season feel a bit fragile. Let's dig more into the specific injuries with which both Corbin Burnes and Brandon Woodruff appear to be dealing.

Image courtesy of © Stephen Brashear-USA TODAY Sports

Corbin Burnes

Burnes left the field early during the 6th inning, citing a tightening feeling in his chest, and noticing his velocity start to drop against Julio Rodriguez, along with an inability to locate, describing the feeling as akin to cramping. After the game, Craig Counsell commented that it was minor, and that it occurred during the tag on Eugenio Suarez to end the fourth inning.

What is a pectoral strain?

The pectoral muscle is the large muscle in your chest used in the majority of upper body “push” movements, i.e. moving your arms forward and away from the body. It is a relatively sturdy muscle, and most of these injuries occur in higher intensity movements pushing too fast or too far (in the concentric contraction), usually on the dominant throwing or hitting side. The higher-intensity movement can lead to a higher chance of a full rupture, but because Burnes merely overstretched attempting a tag, stretching too sharply in a lower-intensity movement during the eccentric contraction, it’s likely the strain is just a small tear. As such, resting the muscle for a short period should suffice, as well as hot/cold treatment.

Recovery Prognosis

Low-grade strains (which are minor muscle tears) carry a recovery period for the average joe of a few weeks, and as such, it’s likely that Burnes will miss his next start–if only in the name of caution, given the mounting number of injuries the Brewers currently have. If it turns out to be a high-grade strain (known as a full thickness tear, or muscle rupture) then the return period is much longer, around six months. That could sideline Burnes for the remainder of the season.

Current Player Examples

Eloy Jimenez

While leaping for a home-run robbery (stretching out with his glove arm like Burnes), Jiménez ruptured his left pectoral muscle, leaving him out for four months (a much faster recovery than expected) from late March to July 20, 2021.

Sonny Gray

Injured his right pectoralis while pitching on May 30, 2022. It was a minor strain, and he returned to pitch five innings of scoreless baseball on June 15.

Brandon Woodruff

There’s been a lot of discussion on the forum about the severity of Woodruff’s shoulder injury, so what exactly is the injury, and how can we expect him to come back from it? 

What is a Subscapular injury?

The subscapularis is a large, triangular muscle underneath the scapula, part of the four-muscle group forming the “rotator cuff”. It’s the largest and strongest of the four, connecting the humerus bone to the front of the shoulder capsule, with its primary function being the internal rotation of the humerus (this is when your hand rotates clockwise). The muscle itself plays a key role in the stabilization of the shoulder, an incredibly complex task given the variety of ways in which the shoulder moves. The main symptoms occur when the arm is raised above shoulder height, with an overworked subscapularis making it feel as though you are unable to lift your arm. The most common symptoms in pitchers are either pain, or a decrease in velocity, the latter of which Woodruff demonstrated in his last outing after his first inning of work. 

Recovery Process

The treatment of subscapularis tears depends on the severity of the injury, ideally not requiring surgery. The good news about Brandon Woodruff is that he has been diagnosed with a “mild” Grade II strain, which is a distinct lesion of over 25% of the craniocaudal diameter, but, crucially, the muscle is still attached to the bone. Therefore, the process for recovery will be simpler, likely involving hot/cold treatment and non-steroidal anti-inflammatory medication such as Ibuprofen, as well as physical therapy to prevent frozen shoulder during the recovery process.

Timeline

A survey performed on one unnamed professional baseball organization over the course of five years found 10 clinical findings (using MRIs) of subscapularis strains of various degrees of severity (four Grade I, four Grade II and two Grade III), all of which were treated without surgery. The average number of days without throwing activity was 27 days (the range was 11-61 days). The majority of these injuries were rehabbed with no lasting performance drop.

Current Player Examples

Corey Kluber

Diagnosed with a subscapularis strain in late May 2021, he was shut down for four weeks, and took a further four weeks to build up again. The original prognosis was off by a month, and he didn’t return until August 30.

Daniel Espino 

With a Grade III strain (torn off the bone), Espino was put on the 60-day injured list and shut down for a minimum of eight weeks, though it is important to stress this is a more severe form of Woodruff’s injury.

Shane Bieber

Initially upon diagnosis in May 2021, Bieber was shut down for two weeks, and re-evaluated after that on June 13. He didn’t return to action until three months later, on the September 24.

Mark Melancon

Currently on the 60-day injured list for an undetermined length of time.

Kluber and Bieber are the most comparable out of these injuries, as both were Grade II tears, and each took around three months to return to the mound. With that in mind, it seems likely that the Milwaukee Brewers won’t see Woodruff back until just after the All-Star break.

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[nate82]

From what I could find the peck injuries are usually 20 days or so.

[Jake McKibbin]

37 minutes ago, nate82 said:

From what I could find the peck injuries are usually 20 days or so.

So a grade one tear, which is very minor, return to play is around a week, grade two is in the 2-6 week range, and grade three is much longer. The question is if he played through it for the fifth inning and part of the sixth, did he do any extra damage to take it past the grade one threshold 

[Brewcrew82]

Honestly, I think Corbin is going to make his next start. Not really what I would do, but with the way CC and Corbin talked about it last night (“cramp”, “tightness”) I think that’s where we’re headed.

[Jake McKibbin]

2 hours ago, Brewcrew82 said:

Honestly, I think Corbin is going to make his next start. Not really what I would do, but with the way CC and Corbin talked about it last night (“cramp”, “tightness”) I think that’s where we’re headed.

The bullpen he throws in a few days is probably going to be the indicator, if the velocity or command aren't where they expect , or there's any tightness lingering, I think he'll skip it, but I think they plan on him missing just the one at most at this point

[KeithStone53151]

I tend to agree that i think Burnes makes his next start. MLB athletes receive world class treatment on any injuries. It seemed he strained it during the run down and pitched through it for a bit. I'll agree that if it's a problem during his bullpen session maybe they push him back, but with the treatment he's getting and preparation for it pre-game...I suspect he'll be fine. Worst case most likely is they push him back a couple days or skip one start. I think a trip to the DL is extremely unlikely.

[Jake McKibbin]

Just to clarify with Burnes latest comments that its just his ribs or sternum:

 

Given there was no impact to create bruising, and no broken bone, then this is till a pectoral strain of the tendons connecting the muscle to the bone. That would potentially be more worrisome, as the injury is more problematic if the tendons detach from the bone. As such, it's still a muscle strain, but hopefully just a grade one outlook.

I'm slightly concerned he's set on making every start again this season to boost his value, and ignoring his body with comments like this, which certainly haven't come from the team doctor as they make no sense.

[homer]

 

 

[markedman5]