Kearns underwent surgery in March 2003 to remove loose bodies from his left elbow.[2] He played just 82 games that year after suffering a torn labrum and rotator cuff in his right shoulder following a home plate collision with Atlanta Braves pitcher Ray King.[3]
In April 2004, Kearns was hit by a pitch from Pittsburgh Pirates pitcher Ryan Vogelsong that broke his left forearm.[4] In June, he also required surgery on his right thumb to clear our scar tissue.[5]
On September 23, 2006, playing against the New York Mets at Shea Stadium, Kearns and first baseman Nick Johnson collided while making a sliding attempt to catch a fly ball. Kearns originally remained in the game relatively unhurt, but was removed shortly after play resumed by Manager Frank Robinson. Kearns was replaced by Ryan Church, who played in Kearns' spot for most of the rest of the season. Kearns suffered severe bruising down his left side as well as soreness. Johnson sustained a broken femur and underwent surgery that night to repair his injuries.[7] Johnson missed all of 2007 recuperating from his injuries. Kearns, however, had career highs in several key areas, including 161 games played and 74 RBIs.
On May 12, 2007, in a game at home against the Florida Marlins, Kearns hit a bases-empty inside-the-park home run, the first ever for a Nationals player. The ball bounced off the glove of Florida Marlins player Reggie Abercrombie.[8] Down the stretch, he tallied 4 hits in 11 at bats (with 2 home runs) in a late-season Nats' series sweep over the division leading New York Mets that kept the Mets out of the playoffs.
In 2008, the Nationals placed Kearns on the 15-day disabled list on May 22 because of loose bodies in his right elbow and on August 25 with a stress fracture in his left foot.[9]
Kearns was placed on the disabled list on August 5, 2009, with a right thumb injury. His move to the list was retroactive to August 4.[10] The Nationals called up outfielder Jorge Padilla from the Triple-A Syracuse Chiefs to replace the ailing Kearns.[11] On November 6, the Nationals declined the 2010 contract option on Kearns making him a free agent.[12]
Cleveland Indians
On January 5, 2010, Kearns signed a minor league contract with the Cleveland Indians with an invite to spring training.[13] He was added to the Major League roster on April 3. On July 5, 2010, vs. the Texas Rangers, Kearns was hit by a pitch three times. This set a new all time Indians record and tied the Major League record for most hits by pitch. The last player to do so was Manny Ramirez on the same date in 2008.
New York Yankees
On July 30, 2010, Kearns was traded to the New York Yankees for a player to be named later,[14] later revealed to be Zach McAllister.[15] Kearns was part of the Yankees 2010 postseason roster until the team lost to the Texas Rangers in the 2010 ALCS.
Second stint with Cleveland
On December 20, 2010, Kearns signed a one-year deal with the Cleveland Indians.[16] Kearns was arrested on February 12 in Lexington, Kentucky on a DUI charge.[17][18] He was designated for assignment on August 12, 2011, to make room on the active roster for the return of Shin-Soo Choo from the disabled list. Kearns was released on August 17.[19]
Miami Marlins
Kearns signed a minor league contract with the Miami Marlins on January 25, 2012.[20] He also received an invitation to spring training and would later make the Opening Day roster.
On May 23, 2012, the Marlins placed Kearns on a 15-day Disabled List after he strained his right hamstring. He was reinstated on June 7. In 2012, he hit .245 with 6 doubles, no triples, 4 home runs, 16 RBI, 22 walks, and 2 stolen bases in 147 at bats.[21]
Kearns was re-signed for the 2013 season.[22] He was batting .185 through 19 games before he was placed on the Bereavement List by the Marlins.[23] After seven games, having not returned to the team, he was transferred to the restricted list.[24][25]
As of June 2015, Kearns had yet to announce his official retirement. Following his mother's heart attack, he remained in Lexington to work with his sons' youth league teams and serve as a volunteer coach with Lexington Christian Academy.[26] He also hosts the annual Austin Kearns Celebrity Golf Classic fundraising event in association with former Kentucky Wildcats baseball coach and evangelical Christian missions organizer Keith Madison.[27]