The Tigers were dealt a nasty little surprise this week when Miguel Cabrera underwent surgery on his right ankle. The surgery itself wasn't surprising — the Tigers admitted that Cabrera had bone spurs in the ankle during the regular season — but what Dr. Robert Anderson found was. In addition to the bone spurs, Cabrera also had a stress fracture in his navicular bone, which was repaired by inserting screws into Cabrera's right foot.
Had the surgery only involved bone spurs, Cabrera's rehab would have been relatively straightforward. He would have been off his feet for a couple weeks, but would have began stretching and strengthening soon after. His regular offseason training regimen may have been delayed, but that surgery — a relatively minor procedure compared to the core muscle repair he had in 2013 — would not have put any of his 2015 season in jeopardy.
The stress fracture complicates things. Jose Iglesias missed the entire 2014 season due to stress fractures in both of his legs, and fans will probably have the same level of concern over Cabrera's availability in 2015. It would be unwise to compare the two, however. With Cabrera's fracture already surgically repaired, this speeds up his timetable relative to Iglesias. That said, this injury is no picnic.
The navicular bone is situated on the inside of the foot, just below the ankle. It is one of the bones that comprises the "arch" of the foot, and accepts a great deal of pressure whenever a person stands, walks, or puts weight through that foot. A healthy foot and ankle is able to dissipate the pressure with proper muscle activation, allowing the person to move while maintaining a proper foot arch.
Problems can arise in a number of areas. If a person has poor intrinsic* muscle activation, they may overpronate, or allow their foot arch to "collapse." This puts greater pressure on the navicular and surrounding bones, increasing the risk of injury. This increased pressure takes its toll over time, leading to irritation and inflammation in the area. If the inflammation goes untreated and the pressure is continually applied, the bone will eventually start to crack, resulting in a stress fracture.
*Intrinsic muscles = the muscles inside the foot
In Cabrera's case, the ankle injury he suffered earlier in the season likely led to the formation of this stress fracture. With any trauma to the ankle, the muscles in the ankle and foot have to work harder to stabilize the area. The foot will fatigue quicker, and as these muscles fail, more stress is placed on the bones in the foot — namely, the navicular. This can be painful, even before the bone actually fractures. This makes it all the more impressive that Cabrera was able to play out the season, let alone at such a high level.
But this is about 2015, not 2014. Cabrera's season is not in jeopardy, but it's fair to wonder whether he will be 100 percent ready on Opening Day. He will be off his right foot for six to 12 weeks following the surgery to allow the bone to heal. This will be the major determinant in how long Cabrera takes to recover. If he is cleared to bear weight through his foot in six weeks, he may be ready to participate in baseball activities at the start of Spring Training. If his recovery time approaches 12 weeks, his availability for Spring Training and Opening Day may be in doubt.
After the bone has healed, Cabrera will work his way back to bearing his full weight through the right foot, which can take a few weeks. Even walking can be irritating during this time period, and running will almost certainly be out of the question. Planting and pivoting on that right ankle — something that Cabrera has to do with every swing of the bat — will take even longer.
As bad as this injury sounds, it is not as daunting as the core muscle repair he underwent last offseason. Cabrera will be under close watch throughout his recovery, and he will be able to participate in any activities that don't involve putting weight through his right foot. Upper body and core muscle strengthening are all fair game, and once Cabrera has no pain with weightbearing through that right foot, his timetable speeds up considerably.
Will he be ready for Spring Training and Opening Day? That part remains to be seen, but I would not expect this injury to impact him throughout the 2015 season like his core muscle repair did in 2014.