Josh Donaldson's Injury History: Calf Strains Sully Otherwise Clean Record

[Lucas Seehafer PT]

Unlike fellow off-season acquisition Rich Hill, new Minnesota Twins’ third baseman Josh Donaldson’s injury track record isn’t eye-popping. There are no quasi-experimental surgeries, no double-digit trips to the injured list, and no potential career-defining injuries.For a player that has accumulated nearly eight seasons of service time, Donaldson’s injury history is fairly clean. Donaldson — who debuted in 2010 but did not stick in the big leagues permanently until 2013 — did not suffer a significant injury until a right calf strain landed him on the 10-day disabled list in 2017; he would ultimately miss 38 games, though he would still go on to hit 33 home runs with an accompanying slash-line of .270/.385/.559 for the Toronto Blue Jays.

 

The following season, however, was an abject disaster. Donaldson battled right shoulder inflammation as well as a major left calf strain that ultimately limited him to a mere 52 games between Toronto and the Cleveland Indians. The severity of Donaldson’s injuries, particularly of the calf, led many to wonder whether or not they would rear their ugly heads — either directly as another flare up or indirectly as a “compensation” injury located elsewhere — during what would be his lone season with the Atlanta Braves in 2019. Luckily for Donaldson and the Braves this proved not to be the case, as he appeared in all but seven games, including the postseason, with numbers resembling his three-season run of terror during the mid-2010s in Toronto.

 

A big question on the minds of many Twins’ fans — and also likely the Twins, at least to some extent — is whether or not his relatively healthy track record will carry over to the 2020 season and beyond. He recently turned 34 after all and players tend to get injured more frequently — and performance tends to decline more quickly — as age increases. To put it simply: Will Donaldson’s 2020 campaign look more like that of 2016 (All-Star, Silver Slugger, MVP votes) or 2018 (Did I mention it was a disaster)?

 

Let’s first start by discussing the calf.

 

The calf is a muscle group — also known as the triceps surae — that is mainly comprised of the superficial gastrocnemius and the deeper soleus. These two muscles join together near the ankle to form the Achilles tendon and control plantar flexion (pointing the foot down), which leads them to be major force producers as well as attenuators during activities such as running and jumping. The gastrocnemius also assists the hamstrings in flexing the knee as its two heads cross the tibio-femoral (knee) joint; the soleus, on the other hand, only crosses the ankle joint.

 

The calf is one of the most commonly injured muscle groups due in large part to the vast amount of force it produces and is subjected to during athletic activity. Much like the Achilles tendon, the calf muscles are most frequently injured when the contraction they are undergoing quickly changes from eccentric to concentric, especially when the knee is straight and the ankle is dorsiflexed (foot pointing up). An eccentric contraction involves the muscle tensing while it lengthens, whereas a concentric contraction causes the muscle to shorten due to it tensing. This action and positioning are most commonly seen in baseball when the athlete is sprinting or moving laterally while fielding.

 

A difficult aspect when discussing Donaldson’s calf injuries and their risk for recurrence is that very little research has been conducted on all athletes, never mind professional baseball players, when it comes to this type of injury. A 2017 study published in the British Journal of Sports Medicine found that age and previous calf injury were the most prominent links to the occurrence of future calf injuries. However, the systematic review was based on 10 studies with more than 5,000 total participating athletes who played football, rugby, basketball, and triathlon. In addition, all the included studies were deemed to have a high risk for bias. The authors of the article concluded that “the overall paucity of evidence and the trend for studies of a high risk of bias show that further research needs to be undertaken.”

 

So are Donaldson’s calf injuries likely to recur? It would be truly difficult to say with any level of certainty. As the previously linked article alludes, an injured muscle will have a greater risk for injury compared to an uninjured counterpart. How long that increased risk lasts is largely unknown. Again, the research surrounding calf muscle strains is significantly limited. However, a previous study published in 2010 found that the recurrence rate for hamstring strains — a muscle group that is similarly susceptible to strains — hovered around 14% in track and field athletes over a two year period. Caution should be taken when interpreting these results and trying to apply the concepts to Donaldson, as the sample size was microscopic (165 athletes over a nine year period), the injured muscle group was not the calf, and the sport in question was not baseball.

 

It would be unfair to expect Donaldson to appear in all 162 games this upcoming, or any future season for that matter, not only because he has yet to do so at any point during his career, but also because the Twins are fairly progressive when it comes to providing days off for their athletes. While there is some debate about whether or not scheduled rest days actually decrease an athlete's risk for injury (just google “Load Management” and you’ll understand), the current evidence suggests that they may be helpful. It would likely be wise for the Twins to continue with their progressive approach toward rest and recovery to help put Donaldson and the rest of the team in the best place to succeed, both in the short and long-term.

 

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[strumdatjaguar]

At least one of the next four seasons will be mostly lost to injury or injuries. That’s part of signing a long term contract with an older player who missed much of a recent season.

[Lucas Seehafer PT]

At least one of the next four seasons will be mostly lost to injury or injuries. That’s part of signing a long term contract with an older player who missed much of a recent season.

"Will be" is a little strong, in my opinion. Injuries, especially those muscular in nature, are just too unpredictable. Is it possible? Yes. But is it likely? Depends on your interpretation of the ~14% recurrence rate data point. I'm not sure we can say one way or the other.

[DocBauer]

One thing I have really wondered about in regard to the modern day athlete, baseball and Donaldson included, in regard to muscle injuries, is the use of yoga and/or Pilates. While weight training and aerobics are important for general strength and conditioning, I have often wondered if athletic training still remains behind the times in regard to these activities to focus on core strength and flexibility.

[cardsfan]

Back in 2018 JD indicated he had a rupture which is way more serious than a strain. The trade to Cleveland was riding on him being off of the DL before Sept. 1 as I recall.

 

4 year contract is long for his age.

[Lucas Seehafer PT]

One thing I have really wondered about in regard to the modern day athlete, baseball and Donaldson included, in regard to muscle injuries, is the use of yoga and/or Pilates. While weight training and aerobics are important for general strength and conditioning, I have often wondered if athletic training still remains behind the times in regard to these activities to focus on core strength and flexibility.

 

I've worked with a few athletic training and strength/conditioning staffs and I would say they are much more progressive than they were even 5-10 years ago, especially at the collegiate level, but the biggest thing holding them back is a lack of resources/funding. You're right on that the benefits of yoga, pilates, etc can be a boon for athletes, but a lot of the times athletes need to do it on their own time.

[BrianTrottier]

 

One thing I have really wondered about in regard to the modern day athlete, baseball and Donaldson included, in regard to muscle injuries, is the use of yoga and/or Pilates. While weight training and aerobics are important for general strength and conditioning, I have often wondered if athletic training still remains behind the times in regard to these activities to focus on core strength and flexibility.

I recall Joe Mauer getting skewered around these parts for his focus on flexibility training in his offseason regimen.

[Heezy1323]

Chris Camp from Mayo Clinic (along with a number of others) put together an outstanding review of baseball injuries (MLB and MiLB) from 2011-2016 here:

 

https://journals.sagepub.com/doi/10.1177/0363546518765158 (full text only available with subscription- sorry)

 

Gastrocnemius strain was the 19th most common injury, resulting in a mean of 11.6 days missed (median 4 days). There were 419 recorded injuries during this time. None required surgery. Only 1.4% (6) were repeat injuries. From this data, I think it’s reasonable to suggest that the likelihood of repeat injury is low.

 

FWIW, hamstring injury was the most common injury during this time frame (3,337 injuries) with a re-injury rate of 2.6%.

 

No one can predict the future, obviously. But I believe this injury is likely to be among those with the lowest recurrence likelihood. I was not aware of the ‘rupture’ report as noted above by another post- though a gastroc strain and a gastroc rupture are similar entities (with rupture obviously being a more severe variation). I don’t know of any data specifically regarding reinjury risk for gastroc ‘rupture’.

 

Let’s hope none of it becomes important, and JD anchors the middle of the lineup for like 150 games.

 

Here's a link to the page for gastroc strains that I put in my gallery:

 

http://twinsdaily.com/gallery/image/2694-gastroc-strains/

[Lucas Seehafer PT]

 

Chris Camp from Mayo Clinic (along with a number of others) put together an outstanding review of baseball injuries (MLB and MiLB) from 2011-2016 here: https://journals.sagepub.com/doi/10.1177/0363546518765158 (full text only available with subscription- sorry) Gastrocnemius strain was the 19th most common injury, resulting in a mean of 11.6 days missed (median 4 days). There were 419 recorded injuries during this time. None required surgery. Only 1.4% (6) were repeat injuries. From this data, I think it’s reasonable to suggest that the likelihood of repeat injury is low. FWIW, hamstring injury was the most common injury during this time frame (3,337 injuries) with a re-injury rate of 2.6%. No one can predict the future, obviously. But I believe this injury is likely to be among those with the lowest recurrence likelihood. I was not aware of the ‘rupture’ report as noted above by another post- though a gastroc strain and a gastroc rupture are similar entities (with rupture obviously being a more severe variation). I don’t know of any data specifically regarding reinjury risk for gastroc ‘rupture’. Let’s hope none of it becomes important, and JD anchors the middle of the lineup for like 150 games.

Thanks for sharing this! I was looking for an article like this and couldn't find one. I figured AJSM had something, must have been using the wrong key words. Good to see that the re-injury risk was so low. I wasn't aware of the rupture report either, though I have seen some studies - regarding other muscular locations - suggest that full rupture injuries are actually less likely to recur than grade 1-2 strains mostly due to the fact that those injuries are more likely to require surgical intervention.