Angel Pagan and Jason Bay got off easy with Florida rehab stints for their oblique injuries. Two decades ago, in treating similar conditions, doctors would prescribe bed rest or a body cast. Such is the precarious nature of the interconnecting muscles that control the core of a person's body.
"Now we know that you can't do that," said Dr. Bal Raj, an orthopedic surgeon based in Beverly Hills. "You have to keep people active in their recovery."
Last week, in speaking about Pagan's trip to the disabled list, Terry Collins was surprised by what seemed like a rash of oblique injuries. On that Friday, Pagan went on the DL in the afternoon and Ronny Paulino -- working his way back from anemia -- left his game for Triple-A Buffalo that night because of tightness in the oblique area.
"It's amazing," Collins said, "because 25 years ago, nobody heard of this injury. It didn't even exist. But we also know that it's something that can linger and linger and linger if it's not taken care of."
Truth is, the injury is not really new. As Raj explains, it's just that the technology and protocol for identifying the oblique strain is more advanced than when Collins played during the late 1970s. Now there is extensive MRI testing and a better understanding of how to treat the player.
The tricky part is preventing them. In baseball, because of its unique activities, there is greater potential for damage, even among the more highly conditioned players. By repetitively using the muscles along the torso, with a stressful twisting motion, it increases risk. "When you swing a bat or throw a ball," Raj said, "it's more likely to isolate the oblique muscles."
Jerry Manuel scratched him from that night's game and at first, Reyes was upset, believing the discomfort was something he could play through. But as his body cooled down in the air-conditioned clubhouse, Reyes was hurting too much to complain. "Oh, bro, I couldn't even laugh," Reyes said, recalling the sharp pain in his side. "It was bad."
Further complicating matters was the Mets' reluctance to put Reyes on the DL. Initially, he missed a week, but the problem never went away. He aggravated it at in late August on a throw, and it wasn't until the offseason that he allowed it to heal by doing "nothing" for two months.
"It affected me in everything that I do," Reyes said. "Running, sliding, swinging, throwing. I never had the opportunity to rest it."
Once Reyes fully recovered during the winter, he began a more rigorous program to protect the area. It's a routine he stays with now -- just as he makes sure to maintain his hamstrings daily. It's not unusual in some of the smaller clubhouses to see Reyes doing his core exercises by whipping a weighted ball against the wall in a back-and-forth twisting motion.
Reyes and Pagan are two of the Mets' more highly tuned athletes, but Raj disagreed with the notion the oblique injuries are related to the greater focus on conditioning the core these days.
In fact, he said it's the best defense against oblique injuries -- for a sport that's prone to them -- and Reyes' proactive approach seems to be working. Or at least it seems to be a better strategy than what Collins believes protected the players of the past. He said with a smile, "We were too fat before."