An avulsion fracture involving the costochondral cartilage of the 11th rib.
That’s a mouthful.
Pirates center fielder Andrew McCutchen handled the medical jargon well when he announced the injury to the media Tuesday. He even spelled “costochondral” correctly off the top of his head.
Being able to spell it doesn’t make Mr. McCutchen an expert. But even so, he might have put the injury in the simplest of terms: “It’s a little piece of cartilage torn off a rib.”
It occurs when some of the muscle along the abdomen twists or turns violently — such as when swinging a baseball bat — and tears a tiny piece of bone or cartilage away from the rib.
That’s what Mr. McCutchen felt as he ran to first base Sunday after a sacrifice fly left his bat in the eighth inning against the Arizona Diamondbacks.
In his case, it’s the 11th rib, in the back at about the same height as the belly button.
Mr. McCutchen was out of the Pirates’ lineup Tuesday and Wednesday against the Miami Marlins, but he has not been placed on the disabled list.
“Right now it’s just keep evaluating me and see how I feel,” Mr. McCutchen said. “We don’t want to make a decision yet. We don’t want to put me on the DL right away because there’s a possibility I can be better before 15 days are up.”
Bryson Lesniak, a UPMC orthopedic surgeon and former member of the Marlins medical staff, said a typical injury of Mr. McCutchen’s nature could take two to four weeks in recovery time. He said a recovery time of four to 10 days is “a pretty accelerated return,” and he would be surprised to see a player back so soon.
Dr. Lesniak said trainers likely would have a better understanding four or five days after the injury of how long Mr. McCutchen would be out. There is little risk of worsening the injury, but playing through it could prolong the pain.
“Ultimately it’s going to be how I feel,” Mr. McCutchen said. “There’s a gray area in the doctor realm because everybody’s body’s different.”
Dr. Lesniak said Mr. McCutchen likely was in a lot of pain in the days immediately following the injury. Mr. McCutchen confirmed as much, saying he originally found it hard to put on his shoes.
“It would be painful any time you breathe deep, anything to contract the abdominal muscles,” Dr. Lesniak said. “Doing a sit-up would be nearly impossible.”
Mr. McCutchen said Tuesday he had improved dramatically. He had ice wrapped around his midsection when he first addressed the media, but he appeared to be in high spirits.
Avulsion fractures in athletics are most common in kids and younger teens. With kicking motions in soccer, sometimes the quad muscle can pull out a tiny piece of the pelvis. They also are fairly common in the ankle.
Avulsion fractures of the ribs are not highly common, but they do happen from time to time.
“It does happen [in pro sports], with baseball players almost more than anybody else,” Dr. Lesniak said.
There was speculation that Mr. McCutchen getting hit by a pitch against the Diamondbacks on Saturday had something to do with the injury. Dr. Lesniak doubted that was a direct cause of the injury.
“There’s no way the baseball hitting his back created this fracture,” Dr. Lesniak said.
If Mr. McCutchen felt discomfort or stiffness after getting hit, and if his mechanics were off because of it, it is possible getting hit by the pitch indirectly caused the injury. But Dr. Lesniak said it is “probably more than likely coincidence.”
“Maybe it could have had something to do with it,” Mr. McCutchen said. “But at the same time, we don’t know.”
The fact of the matter is that it doesn’t matter what caused the injury. The Pirates need their top player back as the division race comes down the home stretch. For now, the plan for Mr. McCutchen will be to rest. But the timetable remains unclear.
“It’s just enough to where I don’t have to think about it,” he said. “So when I’m out there — throwing, playing, running, sliding — when I’m not thinking about it, that’s when I’m good.”
Sean Hammond: firstname.lastname@example.org, 412-263-1466 or Twitter @sean_hammond.