UM expert weighs in on Iglesias' injury
MAR 17, 2014 4:54p ET
When speculation started that Tigers shortstop Jose Iglesias could miss the entire season, people were taken aback.
How could a case of shin splints, no matter how severe, cause that?
Iglesias told reporters in Lakeland Monday that he has stress fractures in both of his legs.
"Stress fractures is a term used for a lot of things," said Dr. James Carpenter, chair of orthopaedic surgery at the University of Michigan. "It usually happens early on from a relatively rapid increase in activity level."
It makes sense that Iglesias had time to rest the injury during the offseason but then aggravated it early in camp when he was participating in more workouts and drills.
Iglesias is headed to Colorado Tuesday to visit Dr. Thomas Clanton to figure out the best plan of action.
Iglesias revealed that he has been dealing with this problem since last spring training with the Boston Red Sox.
"Last year I played through the pain all year long," Iglesias told MLB.com. "Sometimes (Red Sox manager John) Farrell had to give me some days the same as (former Tigers manager) Jim Leyland here. He had to give me some days or take me out of the game because the pain was so bad. And I was like, 'Man, I don't know what to do to get rid of it.' And I never found out until right now that it was a fracture."
Dr. Carpenter said that Iglesias' injury is likely something that has built up over time.
"You can have a low-grade problem," Dr. Carpenter said. "Bones are good at healing, you recover and go back at it. As long as the healing capacity is greater or equal to the injury rate, you can heal, but especially with someone very active, like a professional playing a lot, you can create an imbalance where you only have partial healing, then another injury.
"In a mechanical sense, the body can't keep up with repairing the bone. It probably goes on a while before you have symptoms."
Dr. Carpenter said he's seen this injury most often in runners, soccer players and field hockey players who are spending a lot of time starting and stopping. He said it's less common in baseball players.
What is frustrating for Iglesias, the Tigers and the fans is that it's difficult to put a timetable on when he could return.
"Everyone wants a definitive date of return," Dr. Carpenter said. "It's not one of those injuries you can say with a lot of confidence. There aren't any hard and fast rules. You don't need complete healing but you need more healing than damage.
"The bone has to catch up and not keep getting reinsured."
Dr. Carpenter said the athletes he has dealt with usually have to rest and then gradually ramp up their activity short of playing and see where the pain level is.
"If it hurts right away, it probably needs more time," Dr. Carpenter said. "If you can do some things without pain, but you're not able to ramp up, it's maybe still too much."
The Tigers have done just that with Iglesias, backing him off since Feb. 26. They have tried orthotics to take the pressure off of his legs.
Dr. Carpenter said some people are just more prone to such injuries.
"It can be caused a little bit by genetics but more how you're put together," Dr. Carpenter said. "The shape of the tibia can have more curve, which can put more stress on it. Someone else can do the same exact things and never get this."
Dr. Carpenter said in about 20 years, he has only seen one or two cases that were severe enough to require surgery, which meant a three to six-month recovery time.
Although Dr. Carpenter has not seen Iglesias, he said, "I would be a little more optimistic that it could be managed and he could get back."
That's what the Tigers and their fans are hoping for, that they can find a way for Iglesias to heal enough so he can play this season.