The Detroit Tigers announced that Shane Greene will undergo an MRI on his right elbow today after leaving last night's game early with an injury. Greene was diagnosed with mild ulnar neuritis after experiencing numbness in his right hand along the ring and pinky fingers during last night's start.
Greene said that he had no pain in his hand during last night's game, only numbness. "I'm a little scared but there's no pain," Greene said. "So I'm just going to keep telling myself there's no pain, everything's going to be all right."
Tigers manager Brad Ausmus provided a little more detail during his postgame press conference. "It's a nerve thing," Ausmus said. "Two of his fingers on his throwing hand, the pinky and ring finger, were just getting kind of numb. There was no pain. He told me that when he had surgery that ulnar nerve was moved. It's possible on one of the swings he just aggravated it. We don't think it's anything long term or overly concerning. But we took him out mainly out of precaution. He said he didn't have any pain at all."
The ulnar nerve is situated on the underside of the elbow and runs along the ulna, one of the bones in the forearm. In the elbow, the nerve is very close to the ulnar collateral ligament. It is not uncommon for surgeons to move the nerve during ulnar collateral ligament reconstructive surgery, also known as Tommy John surgery. Because of this, the nerve can become increasingly prone to irritation.
The ulnar nerve is responsible for both motor and sensory function in parts of the forearm, wrist, and hand. It is one of three main nerves that runs into the hand, which explains why Greene was only experiencing numbness in two of his fingers. Greene may have had some difficulty gripping the baseball on the mound, but probably did not equate the two since most pitches are gripped with the other three fingers.
Treatment for ulnar neuritis is similar to that of a tendonitis injury. The first and most important step is to calm down the inflammation in the affected area. Provided Greene's MRI doesn't reveal something more sinister -- it shouldn't, but you never know -- he will spend plenty of time icing his elbow and taking anti-inflammatory medication. If the inflammation persists, team doctors may opt for an injection directly into the inflamed area.
Depending on how long Greene experiences numbness in his forearm and hand, he may need to work on strengthening areas that have become weakened by the lack of nerve innervation. Muscles will atrophy when their nerve supply is cut off, which is essentially what is happening with Greene's injury. Severe cases can even lead to surgery to remove scar tissue surrounding the nerve and/or moving the nerve to a different location in the elbow.
The timetable for Greene's recovery is highly variable, and depends entirely on how long it takes for his ulnar nerve to calm down. He could make his next start or miss a month of action, and neither would be all that surprising with an injury of this nature. Based on everything Greene and Ausmus have described thus far, it seems that his injury should not keep him out of action long.