Royce Lewis Suffers A Bone Bruise In His Knee

[Lucas Seehafer PT]

The Minnesota Twins announced on Sunday evening that top prospect Royce Lewis suffered a bone bruise in his right knee after slamming into the wall while making an incredible catch during the team’s 7-3 win over the Kansas City Royals.

While Lewis making a trip to the 10-day IL is less than ideal, in the grand scheme, the news he and the Twins received after the game is relatively good. Or, at least, as good as could be expected.

Bone bruises fall on the fracture spectrum and are so named because of the dark spot they create on MRI. The ends of long bones—such as the femur of the thigh and the tibia and fibula of the lower leg—are comprised of cancellous bone, which is relatively porous and filled with blood. When a small portion of the spiderweb-like matrix inside the cancellous bone fractures, a dark image appears on MRI and is diagnosed as a bone bruise. 

Like most fractures, bone bruises typically heal within a matter of weeks, and rarely do they progress to a more severe injury. As such, the primary factor when determining a return-to-play is the amount of pain the athlete is experiencing, as well as their ability to tolerate said pain. 

According to Baseball Prospectus’s Recovery Dashboard, three MLB players have suffered a bone bruise in their knee since 2017, with the median number of days missed settling in at 27. The median days missed jumps to 28 when considering bone bruises in general, regardless of body region.

The Twins will continue to assess Lewis’s knee in the coming days as the swelling decreases and the holiday weekend comes to a close. But for now, it would appear as if he—and the Twins—dodged a major bullet. 

Share your thoughts in the COMMENTS. 

 

View full article

[D.C Twins]

Ugh.... severe bone bruises can take longer than a few weeks to heal... let's hope that this one is on the more mild end of the spectrum. 

[adorduan]

I guess his nickname can be Buck Jr.........

[blindeke]

All the folks that wanted to rush Lewis back from his injury from last year might want to look in the mirror tonight... 

[bean5302]

22 minutes ago, blindeke said:

All the folks that wanted to rush Lewis back from his injury from last year might want to look in the mirror tonight... 

Wait... what? Are you saying Royce Lewis' crashing into a wall and bruising his knee is related to him not playing last year while he recovered from a torn ACL? For the record, Lewis returned to action about as quick as possible from surgery last year. I can't remember anybody suggesting the Twins were holding him back unreasonably and should have taken chances with Lewis' recovery, but maybe my memory isn't perfect.

[VivaBomboRivera!]

Maybe the club needs to look into improving the wall padding's ability to absorb impact? 

[bean5302]

2 hours ago, VivaBomboRivera! said:

Maybe the club needs to look into improving the wall padding's ability to absorb impact? 

The Twins increased the padding thickness in 2014 in response to Aaron Hicks and Sam Fuld giving themselves concussions by running into the center field wall. The new padding was thicker (4") than most stadiums so I'm skeptical the padding on it's own is the issue. Running at high speed into the wall and hitting it at an awkward angle is going have risk of injuries. Perhaps the wall construction itself behind the padding is stiffer than other stadiums, though, necessitating special order extra, extra thick stuff.

[glunn]

14 minutes ago, bean5302 said:

The Twins increased the padding thickness in 2014 in response to Aaron Hicks and Sam Fuld giving themselves concussions by running into the center field wall. The new padding was thicker (4") than most stadiums so I'm skeptical the padding on it's own is the issue. Running at high speed into the wall and hitting it at an awkward angle is going have risk of injuries. Perhaps the wall construction itself behind the padding is stiffer than other stadiums, though, necessitating special order extra, extra thick stuff.

My research suggests that padding ranges between 2" and 4". Do you think that he injury would have been equally severe if the padding had been 6" or 8".  What if there was a 5" very soft level of padding placed over the existing padding?

[VivaBomboRivera!]

How about what gymnasts use for high dismounts/falls?

[rwilfong86]

Hopefully Royce will bounce back and not have any hesitancy about playing center and chasing balls near the wall. I've seen guys do things like that and never be aggressive going near the wall again. 

[mikelink45]

Years ago I suffered a bone bruise from a car accident.  It was terrible.  I still remember a doctor telling me I might have been better off with a break.  Don't underestimate this injury, especially since it is on the knee where flex is essential.  We need Celestino back quickly.

[Lucas Seehafer PT]

6 hours ago, VivaBomboRivera! said:

Maybe the club needs to look into improving the wall padding's ability to absorb impact? 

I don't think the injury occurred from hitting the wall. If I had to guess-and it's just a guess-it occured when he jumped off his right leg to catch the ball. His left side hit the wall.

[FlyingFinn]

Not sure playing one game in CF in St. Paul prepared an overzealous rookie to play there for the Twins. Just like Buxton, he's great. He made the catch. But now he is out for an extended time. Will the Twins just decide to play him at SS in St. Paul the rest of the year as he will be the Twins SS next year IMO?

[Doctor Gast]

Thank you Lucas for giving us such an specific explanation of what happened. This was a very scary accident, one that shouldn't have happened. We are loaded in the OF why risk Lewis's knees out there. Wasn't it because of Arraez's knees that they removed him from the OF? and CF is much more demanding.

[Steve71]

I have not seen a side angle of the collision with the wall.  However, it looks like he was running full speed and then slammed his left shoulder into the wall while his weight was loaded on his right leg and knee.  This transmitted tons of force down on the tibial plateau (the floor of the knee joint formed by the union of the tibula and fibula).

Think of it this way.  When you simply walk up a flight of stairs you are putting 4-5 times your body weight worth of force on your knees with each stop.  Multiply that by many more when running full speed and then hitting a basically immovable object.

Hope he heals fully and quickly, but it will be July until he is going to be playing again in all likelihood.  Hope it is sooner!

[Franz]

Thanks, Lucas, for providing that background on bone bruise injuries. I agree that the injury appeared to be not caused by the knee striking the wall; either it came on the jump or on the landing as he rebounded.

Much as I dislike seeing players at unfamiliar positions, I'm not convinced this was a case of injury caused by inexperience in the outfield. On a ball hit hard and almost directly over an outfielder's head, there is little chance to get back to find the wall. It's either focus on the ball and make the catch or give up early and play the carom. For what it's worth I say this was just one of those bad luck injuries incidental to playing the game.

[USAFChief]

Thanks as always for the information, Lucas.

[wabene]

15 minutes ago, Steve71 said:

I have not seen a side angle of the collision with the wall.  However, it looks like he was running full speed and then slammed his left shoulder into the wall while his weight was loaded on his right leg and knee.  This transmitted tons of force down on the tibial plateau (the floor of the knee joint formed by the union of the tibula and fibula).

Think of it this way.  When you simply walk up a flight of stairs you are putting 4-5 times your body weight worth of force on your knees with each stop.  Multiply that by many more when running full speed and then hitting a basically immovable object.

Hope he heals fully and quickly, but it will be July until he is going to be playing again in all likelihood.  Hope it is sooner!

This is what I was thinking, you just said it better. When you watch the video you can see his knee shudder at impact. Just like blocking kicks in MMA, you get your foot off the ground so the impact gets dispersed. If he was in the air with his right foot off the ground, the impact wouldn't have been compounded by the ground. 

[Dave The Dastardly]

1 hour ago, mikelink45 said:

Years ago I suffered a bone bruise from a car accident.  It was terrible.  I still remember a doctor telling me I might have been better off with a break.  Don't underestimate this injury, especially since it is on the knee where flex is essential.  We need Celestino back quickly.

Concur. I got one from a motorcycle accident when the end of the handlebar got slammed into my hip. Took forever to heal. The pain from a sneeze would damn near cause me to blackout. Had to quick brace myself against a wall whenever I felt a sneeze coming on. But I was the lucky one. The black lab I hit went to that Big Kennel in the Sky. What's it going to take for the Twins to increase the padding? Gotta be cheaper than putting your millionaire players on the IL for weeks at a time.

[LA VIkes Fan]

Thanks for the interesting information. Sounds like we’ll see him again after the AS break between healing and a rehab assignment.

the other thing I find interesting is the search for someone to blame. The FO, the manager. Maybe the team made a perfectly reasonable move with a guy who played CF in the Arizona fall league, who was hitting and showed great promise, and we just got unlucky? It happens. Let’s focus on the game and the team rather than blaming guys doing their job fairly well this year. Not every bad thing is someone’s fault. 

[Lucas Seehafer PT]

9 minutes ago, LA VIkes Fan said:

Thanks for the interesting information. Sounds like we’ll see him again after the AS break between healing and a rehab assignment.

the other thing I find interesting is the search for someone to blame. The FO, the manager. Maybe the team made a perfectly reasonable move with a guy who played CF in the Arizona fall league, who was hitting and showed great promise, and we just got unlucky? It happens. Let’s focus on the game and the team rather than blaming guys doing their job fairly well this year. Not every bad thing is someone’s fault. 

I agree. More often than not injuries are unlucky occurrences. People run into the wall frequently and end up ok. This time they didn't. Sometimes **** happens. It's not a fun answer, but it's often the correct one.

[snotboogie]

5 hours ago, glunn said:

My research suggests that padding ranges between 2" and 4". Do you think that he injury would have been equally severe if the padding had been 6" or 8".  What if there was a 5" very soft level of padding placed over the existing padding?

Are there other parks with thick, soft padding?  Would outfielders have to adjust to balls hit off the wall since they wouldn't carom as far?

[strumdatjag]

Jake Cave is in the midst of an eleven game hitting streak.  Yesterday, he hit the walk-off single that drove in the winning run for the Saints.  Just sayin’!!!! 

[Mike h]

Mr. Pohlad, tear down that wall!

[roger]

32 minutes ago, LA VIkes Fan said:

Thanks for the interesting information. Sounds like we’ll see him again after the AS break between healing and a rehab assignment.

the other thing I find interesting is the search for someone to blame. The FO, the manager. Maybe the team made a perfectly reasonable move with a guy who played CF in the Arizona fall league, who was hitting and showed great promise, and we just got unlucky? It happens. Let’s focus on the game and the team rather than blaming guys doing their job fairly well this year. Not every bad thing is someone’s fault. 

Thanks LA Vikes Fan for your reasonable comment, was exactly what I was thinking.  Yes, bone bruises hurt like h...., but I take this as good news.  When I watched the play and heard he was taken for tests, my first thought was surgery and he was out for the year.  This is a much better result.

Edited May 30, 2022 by roger

[Melissa Berman]

Great insight and analysis, really nice to have a PT on the TD staff to evaluate things like this

[heresthething]

Anyone else think it looked like he was playing kind of shallow?  This is exactly what used to get Buc into trouble because he would race back to get that ball and hit the wall.  Can't recall where I read or heard it but generally speaking it looks like outfielders are playing deeper to 1) avoid the gap balls with the extra benefit of 2) reduce injuries from hitting the wall at full speed.

Feel bad for him, hope he heals quickly.

[Mike Sixel]

Sometimes, often, stuff happens and it isn't anyone's fault. Why is this so hard to understand? Not just in baseball...

[operation mindcrime]

Was this the same knee he tore his ACL?

[Linus]

48 minutes ago, operation mindcrime said:

Was this the same knee he tore his ACL?

Yes