A sadly familiar and always unwelcome sight greeted the Phillies during A.J. Burnett's last start - a solemn pitcher leaving the mound with a trainer bowing his head. It was later announced that the hurler was suffering from a sports hernia, but, despite suspicions, Burnett will pitch his next start.
The 37-year-old is averaging a bit over five innings per start, keeping his ERA a hair under 4.00, and leads the league with 14 walks. He has not been the most effective starter in a rotation aching for the return of Cole Hamels. So, how smart of a move is it for Burnett to throw with a hernia inside of him?
"An inguinal hernia is what you think of as a hernia," said Justin Shaginaw (MPT, ATC), an athletic trainer with Aria 3B Orthopaedic Institute. "You have a protrusion on your abdomen where it's an inguinal ring where your - for lack of a better term - your inside bulges out; versus a sports hernia, which can be all kinds of different things. It's usually when an abdominal muscle and the abductor muscle attach onto the pelvic bone."
Surgery is in Burnett's future, but his current condition is one that he - and most others with it - should be able to pitch through.
"It's just about whether it bothers him enough and whether or not he decides to get it fixed," Shaginaw said.
For an older pitcher with injuries in his past, Burnett may find himself in that position. As a pitcher, the slightest alteration to his delivery could shave five miles per hour off his heater.
Scott Rice of the 2013 Mets pitched with a secret hernia until September 6, amounting an ERA of 3.71 in 73 games. Manager Terry Collins was in the loop about it and explained that it wasn't until Rice complained of intensified pain that he was made unavailable.
Collins said Rice had received treatment "each and every day," and initially thought that Rice might be suffering from an unrelated hip strain. But in the end, Rice's season ended early with surgery.
The lefty, now 32, recovered and is part of the Mets bullpen again this year, appearing in four games thus far and giving up four runs over 2.2 innings for a 13.50 ERA.
Rice's example aside, Burnett now has a season ahead of him in which daily responses to the current condition of his hernia will be likely.
"You do whatever you can," Shaginaw said. "You try to do some flexibility and strengthening, treat it with medicine or ice or cortisone injections. It doesn't really worsen, it just gets more symptomatic. You can wait forever to get it fixed. It's just about how painful it is."
For a team that was granted quickly thinning pitching depth by Burnett's arrival, this is an unwelcome, if manageable, development for the Phillies.