Miguel Cabrera’s 2018 season is officially over. With the sub .500 Tigers, Detroit Tigers’ All-Star first baseman ruptured his left biceps tendon on Tuesday evening against the Minnesota Twins.
BREAKING: Miguel Cabrera will have season-ending surgery for a ruptured biceps tendon that he suffered on this play during the Tigers' 6-4 loss to the Twins. pic.twitter.com/QwQc2msRxA
— Stadium (@Stadium) June 13, 2018
While his 2018 season hasn’t been void of injury with stints on the disabled list with: hamstring, shoulder, elbow, and low back. But a ruptured left biceps will end a season.
How the Injury Occurs:
A tendon tear can be either:
Partial
Complete
Suffering a rupture would fall into the complete [tear] category (clearly). What’s unique about the Biceps is that it has an opportunity to be damaged at two different ends because of where it attaches in the body. The tendon could be damaged at the shoulder or at the elbow. In the photo below, Cabrera is grabbing closer to his elbow.
Tendon tears can occur when the elbow is forcedly extended. The biceps or brachialis could not withstand the force going through the muscle. The tendons at that moment weren’t strong enough to withstand the force generated from his swing.
Anatomy Review:
There are two major elbow flexors to consider. The biceps brachii and the brachialis. While the reports highlight the torn biceps, the MRI will show if there has been any involvement with the brachialis.
Both muscles attach below the elbow. They don’t share a common attachment tendon either. There is a chance only one tendon was torn or both could be damaged. An MRI would confirm if there was further sustained tissue damage.
The Brachialis is strictly an elbow flexor. The Biceps Brachii is an elbow flexor and also is flexor of the shoulder.
What Rehabilitation Can Look Like:
Rehabilitation is going to take time. Since he will be braced up for several weeks to a month, the initial portion of treatment is going to done primarily by the physical therapist.
Passive range of motion of the shoulder, elbow, and wrist will start. Because the biceps brachii crosses two joints, it’s important to include shoulder function in rehab. Also because there are other muscles that assist with elbow flexion that act on the wrist, strengthening the elbow, indirectly, by working wrist function is also an important part of rehabilitation.
Following passive range of motion, he’s going to work active range of motion but with the least amount of resistance possible (gravity included). Then active range of motion against gravity. Again making sure he doesn’t have any setbacks in the next phase.
Rehabilitation is going to take at least six months. That’s assuming he doesn’t have any major setbacks and progresses has anticipated. Where I can help [right now] is working on the muscles, manually. To help decrease the contractures that have developed in the muscle. Working his shoulder, arm, elbow, forearm, and wrist. Tissue health and pliability are going to be important as he goes through his rehabilitation.
Outlook:
He’s out for the season, that’s obvious. He should be back for the start of the 2019 season. While it can take at least three months of the tendon to completely heal, he’s not back to heavy and athletic movement for several more months as he continues to strengthen his elbow, which may take another three months and then getting into baseball shape once the winter starts.
The question is not is he going to play, because he will play next season. He has plenty of time to rehab, to get into shape, to get into baseball shape, and get strong. The question is how effective he’ll be once 2019 hits.
2018:
38 games played (out of 68 games)
40 hits (134 plate appearances)
.299 batting average
3 home runs
