Hamstring injuries and David Wright's road to recovery

David Wright has resumed baseball activities for the first time since April 14, when he injured his right hamstring while sliding into second base. This primer explains the nature of Wright's injury and his road to recovery from it.

What is the injury?

The hamstring is a group of three muscles that start at the ischial tuberoscity (the bony part of your butt). Two of these muscles connect to the tibia (the shin bone), while the other one connects to the fibula (the little bone on the outer side of the shin).

A strain is a tear in the muscle, and healthcare providers assign a grade based on the severity of the tear. A grade 1 strain (the least severe type) indicates that the muscle is slightly torn, whereas a grade 3 strain (the most severe type) indicates that the muscle is completely torn. The Mets have not publicized the grade of Wright's hamstring strain; however, it is very likely just a grade 1 strain, given that Wright was placed on the 15-day DL and is only expected to miss a few weeks.

What is the purpose of the hamstring?

The hamstring acts to flex the knee and extend the hip, but plays a much bigger role during dynamic activities such as walking and running. When someone is walking or running, his hamstring controls how quickly he extends his knee, while bracing the leg for impact when the foot hits the ground. As soon as the foot makes contact, the hamstring suddenly changes its role; at that point, the hamstring applies force to help extend the hip, thus allowing the other leg to swing through and repeat the process. Given the cyclical nature of running, the hamstring is essential for running safely, especially in sports that require an athlete to change his speed and/or direction quickly.

Is this injury serious?

No, but it can be. Wright has likely suffered a mild/grade 1 strain, and should recover well. Nevertheless, hamstrings are very susceptible to injury given the role that they play in running. Any number of factors (such as muscle weakness, poor flexibility, improper technique, etc.) can lead to poor running mechanics, and they can result in several types of injuries, including a hamstring strain. Soccer fans know Jozy Altidore and Jets fans know Dee Milliner as athletes who suffer from chronic hamstring issues, and see how those injuries can affect those players' performances on the field.

What will the recovery process look like?

As with most injuries, the first phase is to settle down any irritation and inflammation that the injury caused. This process can take up to a week. Some popular ways to treat inflammation include RICE (rest, ice, compress, elevate) and anti-inflammatory medication. Ice can help to relieve pain because it has a numbing effect and reduces blood flow to the affected area, which in turn reduces the inflammation and swelling. Compression and elevating the leg have similar effects by reducing blood flow to the injured area.

Wright received a cortisone injection to help expedite this first phase. Cortisone injections provide the local area around the injection site with corticosteroids that act to reduce inflammation. At the end of this phase, the pain will be minimized and the hamstring will be strong enough to return to normal—and, eventually, sports-related—activities.

The second phase typically lasts between one and two weeks, and focuses on retraining the hamstring to work effectively and efficiently. This requires doing exercises that help to increase the hamstring's flexibility and strength, and also help other muscles that may have become tight and/or weak due to inactivity. Athletes must be careful not to re-injure themselves during this phase, as the recovering muscle is somewhat fragile.

As Wright moves through this phase and gets healthier, he will then start the final phase, which involves baseball-related activities. He will begin with light running or jogging, and progress to sprinting and agility drills to make sure that he is able to run the bases and turn the corners well. Next, he will ease into fielding ground balls and doing pop-up drills at the "hot corner," which require some cutting and twisting motions. Finally, Wright will work his way into the batting cage and start swinging the bat, an activity puts a significant amount of stress on the whole body, including the hamstrings.

In the end, barring a setback, Wright's recovery should take about three to four weeks. Given both GM Sandy Alderson's track record of handling injuries conservatively and how well Campbell is performing in Wright's absence, there is no indication that the Mets will rush the Captain's recovery.

Before he went down with the hamstring injury, Wright was hitting an impressive .333/.371/.424 (130 wRC+) in 35 plate appearances. The Mets hope that, when he does return, Wright can pick up where he left off and continue to be an offense force in their lineup.