The Yankees’ 1st baseman Mark Teixeira fouled a ball off his right shin during Monday’s win over the Twins. The X-rays revealed to be negative for a fracture, but his continued pain prompted the team to obtain a CT-scan and an MRI. These tests, reportedly, revealed a deep bone bruise to the tibia (shin bone). He has been unavailable to play since the injury and the questions are how much longer will he be out and will it affect his performance when he returns.
Teixeira has been enjoying a rejuvenation of his career after having multiple injury plagued years that have limited his play and performance. This year he has been, finally, healthy and he has proven to be one of the most productive players in the game. He has been an integral part of the Yankees’ success this year. Now that the Yankees are in a heated pennant race, his absence is glaring in the middle of their order.
A bone bruise is, essentially, a micro-fracture of the inner soft layer of bone but not extending to the outer hard cortical layer. Unlike a complete fracture, a bone bruise cannot be visualized on a plain X-ray. The trauma causes a collection of blood in the bone marrow and this mobilization of fluid and change in density can be identified on an MRI. Bone bruises can occur when two bones impact upon each other, such as in a ligament tear. This commonly occurs in ACL (anterior cruciate ligament) tears in the knee or in severe ankle sprains. Bone bruises can also occur as a result of a direct blow, such as in Mark Teixeira’s case. Bone bruises of the shin also commonly occur as sports injuries in soccer, football and martial arts.
The symptoms include severe pain, soft tissue bruising, and, often, swelling. The anterior tibia (shin bone) is, particularly, susceptible because of the limited soft tissue in the front of the bone. Treatment includes ice, elevation and rest. Typically, limited weight bearing is recommended to promote healing. Range of motion sports therapy above and below the joint may be helpful in preparation for return to play. Symptoms can begin to diminish within 2 to 3 days but may persist for months. Often the symptoms may resolve before all the bone marrow edema disappears on an MRI. If the bone bruise is within a joint (as a result of an ACL tear) then the injury may extend to the articular cartilage (the cartilage lining on the surface of the bones). This may have long term detrimental effects. The long term significance of a bone bruise far from the articular cartilage is still unclear.
Therefore, Mark Teixeira’s leg may begin to feel improvement within a few days but his pain may not completely resolve for weeks or, even, months. If his symptoms persist he may benefit from extended rest and a stint on the Disabled List. There is still an excellent chance he will return promptly but, because some of his symptoms may persist throughout the rest of the season and playoffs, how that will affect his performance and the Yankees pennant race will remain to be seen.