Injury updates: Teixeira, Buchholz, more
June, 17, 2013
Jun 17
8:09
PM ET
By
Stephania Bell | ESPN.com
Every Monday in this space, we'll provide updates on a variety of players to help you make your weekly lineup decisions. We'll specifically try to hit the players who are day-to-day, have just gone on the DL or are ready to return, so that you can better decide whether you can count on them or not.
All projected return timelines should be considered fluid.
Teixeira
Mark Teixeira, 1B, New York Yankees (day-to-day): Ever since Teixeira sustained a partial tear in the tendon sheath on his right wrist during spring training, there was always the concern that even if he were able to return to play, the injury could linger or worsen. I expressed that concern in my preseason injury blog: "Teixeira's wrist may heal with rest, but if it doesn't, the power on the left side of the plate won't be there, and he may not last long, either."
It certainly seems that is the case now. Teixeira was removed from Saturday's game in the fourth inning, not so much because of a specific incident that aggravated the injury, but because of continuing discomfort and weakness. According to ESPN New York, an MRI on Sunday revealed inflammation in the area, but no new tear. Teixeira received a cortisone shot and will sit out for a few days. No move to the disabled list is specifically planned, though it has not been ruled out.
The bigger issue for the Yankees is what they can expect from Teixeira going forward. Manager Joe Girardi's comments from Saturday evening were very telling. "He came to us and said he just feels like there's not a lot of strength there," Girardi said. "I think he just doesn't feel he has the whip that he normally has hitting left-handed." Since the injury is to Teixeira's right wrist, the strain on the injured sheath is greatest when he bats from the left side of the plate, which is also how he hurt himself in the first place. If his strength is impaired and the wrist remains irritated months after sustaining the original injury, not to mention after having nearly two full months off, it's hard to envision it improving significantly now. It's possible the "S" word (surgery) could start to enter the conversation.
YoukilisKevin Youkilis, 3B, Yankees (placed on DL June 14): Well, you can tack on some more time to the 33 days Youkilis has already spent on the disabled list this season because of his back ailment, plus the additional week of intermittent days to rest it. The Yankees placed him on the DL again Friday after the stiffness in his back recurred and did not show evidence of subsiding. This is hardly a surprise, as Youkilis has been dealing with chronic back issues for quite some time; the only unknown was whether he would go weeks or months before it flared. Given that the interval of playing time was so short between DL stints, it must be more of a concern going forward.
AvilaAlex Avila, C, Detroit Tigers (placed on DL June 17): Avila was clearly in a great deal of pain after taking a 93 mph pitch off his left forearm Sunday, and he will now be out for at least two weeks. According to Mlive.com, initial X-rays revealed no fracture, but more tests have been scheduled. Although the results of those tests aren't yet known (or haven't been shared), the team clearly felt Avila needed to be removed from possible contact. As a catcher, that area of his body is certainly at risk defensively, probably more so than a player at another position. No timetable has been released by the team, but it could vary depending on whether there is a true structural injury versus a deep contusion or bruise.
CabreraEverth Cabrera, SS, San Diego Padres (day-to-day): It's not just the outfielders who must contend with hamstring injuries; shortstops have been falling victim to them lately as well. Dodgers shortstop Hanley Ramirez recently returned from the disabled list after missing a month with the injury and is still on controlled playing time. Now Cabrera may be headed there as well. This is not good news for the Padres or for fantasy owners who were counting on him in the stolen base category.
After getting hurt Sunday while trying to steal yet another base, Cabrera has been scheduled for further evaluation of his left hamstring. Although the results have not yet been reported, Cabrera had the sound of someone who knew from prior experience that this was not good. According to the Padres' official website, Cabrera said, "I knew something was wrong right away. I have experience with hamstring problems, and this one is unfortunate." Fantasy owners should be prepared for a DL stint.
HarperBryce Harper, OF, Washington Nationals (placed on DL retroactive to May 27): Last week in this space, I said it would be a little optimistic to expect Harper to come off the disabled list when eligible, especially given that he was traveling to Florida for consultation with Dr. James Andrews. He likely won't be off it this week, either, although he is reportedly making some progress after receiving a cortisone and a PRP injection.
According to the Washington Post, manager Davey Johnson said he expects Harper to test the knee with some on-field activities early in the week, then potentially begin a rehab assignment later in the week. Of course, everything depends on how Harper's knee responds to the uptick in work. If all goes well, it sounds like the Nationals could be eyeing a return in the not-too-distant future, but considering Harper's path has been a little bumpy so far, no timetable can be set in stone.
KempMatt Kemp, OF, Los Angeles Dodgers (placed on DL May 30): The Dodgers finally got Hanley Ramirez back from a substantial hamstring injury, but Kemp, whose injury was relatively minor by all accounts, was not able to return when eligible … and it's not looking as if he'll return this week, either.
Kemp looked as if he was inching closer to rejoining his teammates when he did some pregame running work with them last weekend. He was still experiencing symptoms, however, which led to the Dodgers pushing back more aggressive activity. A rehab assignment date remains fluid, although it could begin late this week if Kemp is showing signs of progress.
There is little doubt that Kemp's major setback to his opposite hamstring after trying to return too soon last year is likely causing some apprehension this time around. And his performance at the plate certainly hasn't been encouraging. Fantasy owners should not plan on having Kemp available this week, and even if next week starts to look like a possibility, it might be worth waiting to see how he performs first.
BraunRyan Braun, OF, Milwaukee Brewers (placed on DL June 10): It finally happened. Braun ended up on the disabled list because of his chronic thumb issues, even though last week the Brewers indicated it might not do much to change the symptoms. Still, resting can't hurt, and Braun had already been held out of multiple games before the decision was made to formally place him there.
It sounds as if the Brewers expect him to resume playing in the presence of the symptoms, even if they remain unresolved when the DL window is up. The only problem there is that even if they don't expect the injury to worsen, there's no guarantee his power at the plate will return, at least on a consistent basis. Braun acknowledged that the thumb was bothering him enough to affect his performance, even after trying to make adjustments to his grip. It sounds as if Braun might return when eligible, but whether he's the Braun fantasy owners have come to expect is anybody's guess.
HillAaron Hill, 2B, Arizona Diamondbacks (placed on DL April 15, could return this week): Could Hill finally rejoin his team this week, even if the fracture that sent him to the DL in April hasn't fully healed? It does appear that this is possible, although manager Kirk Gibson won't commit to a return date, preferring instead to wait and see how Hill performs and how his hand tolerates games. According to Jack Magruder of FOXSportsArizona.com, Gibson said, "When he starts to get comfortable, we'll start talking about a return date."
When it was discovered that Hill had a non-union fracture in his hand, the plan became to try to progress his activity to see how well he could function despite the condition and any associated discomfort. So far, so good. Good enough, in fact, for the Diamondbacks to allow Hill to progress from a simulated game to a rehab assignment with Triple-A Reno. Hill played seven innings Saturday for Reno and will be in line for more innings early this week. It is not clear how many rehab games he will require before he's ready to return to his team, but there finally appears to be hope that it could come soon.
Fantasy owners should keep in mind that he will not be 100 percent recovered from the injury, although he might be able to function at or close to his normal level. There is the possibility the hand could become painful again at any time, and Hill may still require an offseason procedure. For now, however, it just comes down to whether he can do enough to contribute to the team. It sounds like we shall soon see.
UtleyChase Utley, 2B, Philadelphia Phillies (placed on DL May 23, could return this week): Utley has turned a corner in his recovery from a right oblique strain. He has been swinging the bat without issue, including taking live batting practice with his teammates last weekend. Utley originally injured himself swinging a bat, so performing the activity uneventfully on back-to-back days is a good sign. The Daily News reports a rehab assignment could come as early as Tuesday, which means if all goes well, the Phillies could see Utley back in the lineup late this week.
Utley's strain was originally diagnosed as a Grade 1 (mild) type, but the Phillies have been understandably cautious, not wanting him to exacerbate the injury and have it turn into something more severe. If he returns this weekend, it will mark just about a month since the injury or just under the average length of DL stay for an oblique strain. Given that his injury was minor, there is a good chance that it will be completely behind him when he does make his return.
SanchezAnibal Sanchez, SP, Tigers (placed on DL retroactive to June 16): It looked as if a trip to the DL might be the next move by the Tigers after Sanchez was forced to exit early from his Saturday start. Sanchez skipped a start a week earlier because of stiffness in his shoulder which despite having the sounds of something relatively benign, is worrisome given he is a pitcher with a history of shoulder surgery. Sanchez has enjoyed a few healthy seasons recently but in 2007 underwent surgery to address a torn labrum. He missed extended time again because of his shoulder in 2009. Add up the years and the mileage on his throwing shoulder and it's not surprising that it is acting up again. While the severity of this episode is not known -- and it may require nothing more than a brief period of rest -- his history (including Tommy John surgery in 2003) makes us a little more concerned than we would otherwise be.
BuchholzClay Buchholz, SP, Red Sox (day-to-day): Last week we discussed how the AC joint issue from late May and Buchholz's recent neck stiffness could be related. At the time it did not sound as if he were DL-bound, but the last week has not been particularly encouraging. Although he has been able to toss on flat ground, he has not done any downhill throwing and the neck soreness persists. Buchholz is expected to attempt a bullpen session Tuesday but if he cannot complete it or it goes poorly, he could wind up on the DL. As ESPN Boston reported, manager John Farrell was very matter of fact about the Buchholz decision. "The bottom line is ... we're not going to put him out there without making sure he's in a safe place physically," Farrell said. The good news is that the placement could be retroactive to June 9, meaning he could make a start next week if things improve. If he is able to throw Tuesday's bullpen, Buchholz could still be in line for a weekend start so his status is very much up in the air right now.
BeachyBrandon Beachy, SP, Braves (started season on DL, no timetable for return): Beachy was all but penciled into this Tuesday's starting lineup until a poor rehab outing last week prompted further discussion and investigation. Beachy, coming off Tommy John surgery, underwent an MRI Saturday and as the Atlanta Journal-Constitution reports, there was no significant structural damage but there was some inflammation in the area. Naturally the plan is to back Beachy off of throwing to let the inflammation settle; there is no word as to when he will attempt to resume his program. With Diamondbacks pitcher Daniel Hudson reinjuring his elbow eleven months post-Tommy John surgery, it serves as a reminder that no outcome is guaranteed and even minor setbacks need to be taken seriously. Beachy is just about a year removed from his reconstruction and another few weeks – even a couple of months – would be well worth waiting for as opposed to the alternative. While the news is disappointing after such a strong rehab process so far, it does not mean we won't see Beachy this year. We just won't see him for a while.
All projected return timelines should be considered fluid.
Hitters

Teixeira
It certainly seems that is the case now. Teixeira was removed from Saturday's game in the fourth inning, not so much because of a specific incident that aggravated the injury, but because of continuing discomfort and weakness. According to ESPN New York, an MRI on Sunday revealed inflammation in the area, but no new tear. Teixeira received a cortisone shot and will sit out for a few days. No move to the disabled list is specifically planned, though it has not been ruled out.
The bigger issue for the Yankees is what they can expect from Teixeira going forward. Manager Joe Girardi's comments from Saturday evening were very telling. "He came to us and said he just feels like there's not a lot of strength there," Girardi said. "I think he just doesn't feel he has the whip that he normally has hitting left-handed." Since the injury is to Teixeira's right wrist, the strain on the injured sheath is greatest when he bats from the left side of the plate, which is also how he hurt himself in the first place. If his strength is impaired and the wrist remains irritated months after sustaining the original injury, not to mention after having nearly two full months off, it's hard to envision it improving significantly now. It's possible the "S" word (surgery) could start to enter the conversation.

Youkilis

Avila

Cabrera
After getting hurt Sunday while trying to steal yet another base, Cabrera has been scheduled for further evaluation of his left hamstring. Although the results have not yet been reported, Cabrera had the sound of someone who knew from prior experience that this was not good. According to the Padres' official website, Cabrera said, "I knew something was wrong right away. I have experience with hamstring problems, and this one is unfortunate." Fantasy owners should be prepared for a DL stint.

Harper
According to the Washington Post, manager Davey Johnson said he expects Harper to test the knee with some on-field activities early in the week, then potentially begin a rehab assignment later in the week. Of course, everything depends on how Harper's knee responds to the uptick in work. If all goes well, it sounds like the Nationals could be eyeing a return in the not-too-distant future, but considering Harper's path has been a little bumpy so far, no timetable can be set in stone.

Kemp
Kemp looked as if he was inching closer to rejoining his teammates when he did some pregame running work with them last weekend. He was still experiencing symptoms, however, which led to the Dodgers pushing back more aggressive activity. A rehab assignment date remains fluid, although it could begin late this week if Kemp is showing signs of progress.
There is little doubt that Kemp's major setback to his opposite hamstring after trying to return too soon last year is likely causing some apprehension this time around. And his performance at the plate certainly hasn't been encouraging. Fantasy owners should not plan on having Kemp available this week, and even if next week starts to look like a possibility, it might be worth waiting to see how he performs first.

Braun
It sounds as if the Brewers expect him to resume playing in the presence of the symptoms, even if they remain unresolved when the DL window is up. The only problem there is that even if they don't expect the injury to worsen, there's no guarantee his power at the plate will return, at least on a consistent basis. Braun acknowledged that the thumb was bothering him enough to affect his performance, even after trying to make adjustments to his grip. It sounds as if Braun might return when eligible, but whether he's the Braun fantasy owners have come to expect is anybody's guess.

Hill
When it was discovered that Hill had a non-union fracture in his hand, the plan became to try to progress his activity to see how well he could function despite the condition and any associated discomfort. So far, so good. Good enough, in fact, for the Diamondbacks to allow Hill to progress from a simulated game to a rehab assignment with Triple-A Reno. Hill played seven innings Saturday for Reno and will be in line for more innings early this week. It is not clear how many rehab games he will require before he's ready to return to his team, but there finally appears to be hope that it could come soon.
Fantasy owners should keep in mind that he will not be 100 percent recovered from the injury, although he might be able to function at or close to his normal level. There is the possibility the hand could become painful again at any time, and Hill may still require an offseason procedure. For now, however, it just comes down to whether he can do enough to contribute to the team. It sounds like we shall soon see.

Utley
Utley's strain was originally diagnosed as a Grade 1 (mild) type, but the Phillies have been understandably cautious, not wanting him to exacerbate the injury and have it turn into something more severe. If he returns this weekend, it will mark just about a month since the injury or just under the average length of DL stay for an oblique strain. Given that his injury was minor, there is a good chance that it will be completely behind him when he does make his return.
Pitchers

Sanchez

Buchholz

Beachy
Tulowitzki suffers another significant injury
June, 14, 2013
Jun 14
12:45
PM ET
By
Stephania Bell | ESPN.com
Just when it seemed enough time had passed to allow those fantasy owners nervously anticipating a Troy Tulowitzki injury to finally exhale, the Rockies' star shortstop is indeed hurt again. He suffered a broken rib making a diving defensive play Thursday night, and is expected to be out for more than a month.
It's actually Tulo who is the one finding it difficult to breathe. According to the Denver Post, Tulowizki was having difficulty breathing after suffering the injury to his right side in the eighth inning. He was taken to a local hospital, where an MRI revealed a rib fracture. "I'm just really upset. I worked so hard [to get back]," Tulowitzki said in a text message to the Denver Post. "I'm in a lot of pain right now; I'm not sure how long [I'll be out]."
MLB.com is reporting Tulowitzki is expected to miss four to six weeks. There are several factors that make this injury particularly difficult not only for a baseball player, but for a shortstop in particular. The first issue is the bone healing; there must be sufficient evidence that the bone is repairing itself before allowing an athlete to return to high-level baseball activities. That process typically requires three to four weeks, although it can take longer depending on the fracture location, whether it is displaced or not and the individual's general capacity for healing. During the early stages of recovery, unlike many other injuries in which the athlete can at least maintain cardiovascular training to some degree, rib injuries must be kept quiet. All movements are painful -- reaching, twisting, leaning and sometimes even just quiet breathing (no movement at all) -- which makes it impossible to tolerate the increased breathing demands of cardio training. Naturally, there is some deconditioning that occurs as a result.
Even after the rib heals to the point where the athlete can move more freely and resume cardio workouts, there are still the challenges of the sport itself. In baseball, the demands on the ribs are high both on offense and defense, for a shortstop in particular. The torsion through the rib cage that accompanies swinging a bat (even checking a swing) or cross-body defensive throws is exceptionally high. There is also the frequent leaping or diving necessary to make a catch, which stresses the rib cage either by stretching or by contact. A baseball player also needs to potentially absorb collision when running the bases or sliding. All of these factors have to be taken into consideration when evaluating the timeline for Tulowitzki's return, along with restoring his conditioning to one of game readiness. The latter part of the four-to-six-week timetable seems reasonable, but it could certainly take longer. As always, the time frame must be considered fluid.
Perhaps you remember the challenges Red Sox outfielder Jacoby Ellsbury faced when trying to return following rib fractures in 2010. His original injury was in April, and although he attempted to return twice, he played in only 18 games that season before ultimately being shut down. Dodgers pitcher Zack Greinke had a rib fracture entering spring training while with the Royals in 2011 and did not return to the mound until the first week of May. Granted, the positional demands are different -- he was in the AL, so he didn't have to hit -- but the torsion involved in pitching is similarly stressful.
Meanwhile, it seems unfair that Tulowitzki is out again with a lengthy injury. He has been beset by several injuries in recent years, including season-ending surgery in 2012 to repair core muscles and address scar tissue around a nerve in his left groin area. He worked diligently in his rehab following surgery to ensure he would be in good shape to start the 2013 season, and he was. After 58 games, he has a .347 batting average with 16 home runs. More important, he was playing consistently, even though it meant taking planned days off at times in the interest of long-term health management of his left leg. Unfortunately, Tulowitzki is again being forced to the sideline for at least a month, and the first threshold he must cross is simply being able to breathe without pain.
It's actually Tulo who is the one finding it difficult to breathe. According to the Denver Post, Tulowizki was having difficulty breathing after suffering the injury to his right side in the eighth inning. He was taken to a local hospital, where an MRI revealed a rib fracture. "I'm just really upset. I worked so hard [to get back]," Tulowitzki said in a text message to the Denver Post. "I'm in a lot of pain right now; I'm not sure how long [I'll be out]."
MLB.com is reporting Tulowitzki is expected to miss four to six weeks. There are several factors that make this injury particularly difficult not only for a baseball player, but for a shortstop in particular. The first issue is the bone healing; there must be sufficient evidence that the bone is repairing itself before allowing an athlete to return to high-level baseball activities. That process typically requires three to four weeks, although it can take longer depending on the fracture location, whether it is displaced or not and the individual's general capacity for healing. During the early stages of recovery, unlike many other injuries in which the athlete can at least maintain cardiovascular training to some degree, rib injuries must be kept quiet. All movements are painful -- reaching, twisting, leaning and sometimes even just quiet breathing (no movement at all) -- which makes it impossible to tolerate the increased breathing demands of cardio training. Naturally, there is some deconditioning that occurs as a result.
[+]Enlarge
AP Photo/Joe MahoneyBeing a shortstop, Troy Tulowitzki puts an added stress on his body that many players don't have.
AP Photo/Joe MahoneyBeing a shortstop, Troy Tulowitzki puts an added stress on his body that many players don't have.Even after the rib heals to the point where the athlete can move more freely and resume cardio workouts, there are still the challenges of the sport itself. In baseball, the demands on the ribs are high both on offense and defense, for a shortstop in particular. The torsion through the rib cage that accompanies swinging a bat (even checking a swing) or cross-body defensive throws is exceptionally high. There is also the frequent leaping or diving necessary to make a catch, which stresses the rib cage either by stretching or by contact. A baseball player also needs to potentially absorb collision when running the bases or sliding. All of these factors have to be taken into consideration when evaluating the timeline for Tulowitzki's return, along with restoring his conditioning to one of game readiness. The latter part of the four-to-six-week timetable seems reasonable, but it could certainly take longer. As always, the time frame must be considered fluid.
Perhaps you remember the challenges Red Sox outfielder Jacoby Ellsbury faced when trying to return following rib fractures in 2010. His original injury was in April, and although he attempted to return twice, he played in only 18 games that season before ultimately being shut down. Dodgers pitcher Zack Greinke had a rib fracture entering spring training while with the Royals in 2011 and did not return to the mound until the first week of May. Granted, the positional demands are different -- he was in the AL, so he didn't have to hit -- but the torsion involved in pitching is similarly stressful.
Meanwhile, it seems unfair that Tulowitzki is out again with a lengthy injury. He has been beset by several injuries in recent years, including season-ending surgery in 2012 to repair core muscles and address scar tissue around a nerve in his left groin area. He worked diligently in his rehab following surgery to ensure he would be in good shape to start the 2013 season, and he was. After 58 games, he has a .347 batting average with 16 home runs. More important, he was playing consistently, even though it meant taking planned days off at times in the interest of long-term health management of his left leg. Unfortunately, Tulowitzki is again being forced to the sideline for at least a month, and the first threshold he must cross is simply being able to breathe without pain.
Injury updates: Braun, Kemp, Stanton, more
June, 10, 2013
Jun 10
11:18
AM ET
By
Stephania Bell | ESPN.com
Every Monday, in this space, we'll provide updates on a variety of players to help you make your weekly lineup decisions. We'll specifically try to hit the players who are day-to-day, have just gone on the DL or are ready to return, so that you can better decide whether you can count on them or not.
All projected return timelines should be considered fluid.
Hitters
Bryce Harper, OF, Washington Nationals (placed on DL retroactive to May 27): Last week, Harper was officially placed on the DL (backdated to his last appearance); this week he’s hoping he can come off of it. That sounds a little optimistic given that Harper is traveling to Pensacola, Fla., to pay a visit to Dr. James Andrews for a consultation. That appointment was scheduled when Harper’s irritated knee appeared to be making no progress. In recent days, he seems to have turned a corner according to the Washington Times. Harper had been running in the pool but the Times reports he stopped that activity and the discomfort has subsided. Still, Harper will be evaluated by Andrews Monday after which more information should be forthcoming. As of now, it’s worth keeping an eye on his activity this week to see if he is cleared to do more intense workouts. But if running in the pool was bothering him, it’s hard to imagine running on land will be smooth sailing out of the gate.
Matt Kemp, OF (placed on DL May 30), Hanley Ramirez, SS (day-to-day), Carl Crawford, OF (placed on DL June 2), Los Angeles Dodgers: The Dodgers’ collective hamstring woes are the ultimate example of how difficult these injuries are to manage. After missing five weeks following thumb surgery, Ramirez returned for a few days, then missed another month with his hamstring strain. The team wanted to be very careful about bringing him back, especially with Kemp and then Crawford suffering similar, albeit lesser, injuries of their own. This is how I described the Ramirez situation last week: What the Dodgers cannot afford is for Ramirez to return and reinjure himself. Obviously there are no guarantees but the team at least needs to feel comfortable they have seen enough in his rehab outings to suggest his leg is ready for prime time.
Well, Ramirez was back only one day before experiencing tightness in his left hamstring. Although he was out of the starting lineup for several consecutive days, he did make pinch-hit appearances. Ramirez is getting repeat imaging on that leg however, given that it remains bothersome. This was exactly the situation the Dodgers were trying to avoid. Ramirez played in a handful of rehab games exhibiting nothing that would hint at his being less than ready to return. Still, as we often say, until an athlete has returned to his prior level of play for a few weeks without incident following a hamstring injury, it’s difficult to exhale and believe the problem is truly behind him.
And Ramirez is not the only one. When Kemp was first injured roughly 10 days ago, there was some initial thought he might not even require a DL stint, given his hamstring symptoms were so minor. It looked as if 15 days would be more than enough time to recover. Apparently not. The Dodgers’ official website reports Kemp’s right hamstring bothered him enough during pregame workouts Sunday that he does not look to be ready to return. The team originally anticipated having him back Friday; now it’s unclear just when a return could come. Manager Don Mattingly offered this: “We're not where we need to be with him. We do know that he's not 100 percent." Whether Kemp is apprehensive given his recent injury woes and struggles at the plate or whether there is more significance to the injury is unclear.
In the meantime, fellow outfielder Crawford was officially placed on the DL last Monday (retroactive to June 2) with a hamstring injury Mattingly characterized as “fairly significant” after it had originally been described by the team as a cramp. It certainly looks as if his absence will extend beyond the 15-day minimum.
At this point there is no real timetable on ANY of these players. The team has to be hoping that Yasiel Puig, whose brilliant performance since being called up at least provides a temporary distraction from the injuries, remains immune to the hammie bug.
Ryan Braun, OF, Milwaukee Brewers (day-to-day): It has not been a good week for Braun on multiple fronts, including the injury department. Braun has had a thumb ailment which has been giving him intermittent trouble over the last month. On Sunday, he was removed from the game in the third inning and his words hinted at perhaps more extended time off. After the game, Braun told reporters he should have taken steps to address it sooner. "From the very beginning, I should have taken more time off and gotten it right," said Braun. "But I just continued to try to fight through it, play through it. It's at the point where it doesn't feel very good.” No specifics have been revealed as to the nature of Braun’s thumb injury other than “soreness,” making it difficult to ascertain just how much time it could cost him for it to completely heal. Braun has indicated on prior occasions that he has made adjustments to his swing but clearly it hasn’t gone away. The timing may be right for a DL move.
Austin Jackson, OF, Tigers (placed on DL retroactive to May 12, could return soon): Last week it sounded as if Jackson might return but I did caution it could get postponed. The Tigers opted not to send Jackson on a rehab assignment until he progressed further with his running, something he did to the team’s satisfaction last week, according to MLive.com. Now the Tigers are officially sending him out on assignment with a specific plan that will have him increase his activity over several days. While the team is allowing for flexibility in his rehab appearance schedule based on how the hamstring responds, Jackson could potentially return to the big league club by late next week.
Giancarlo Stanton, OF, Miami Marlins (placed on DL April 30, could return Monday): When Stanton went down with a hamstring injury, it immediately looked serious. A June return seemed most plausible. After missing multiple weeks and a seemingly (yet understandably) slow rehab process, suddenly Stanton’s imminent return feels a bit hurried. Stanton only just embarked on a rehab assignment last Tuesday and got off to a slow start at the plate but was able to play on back-to-back days. Because of inclement weather, Stanton lost a couple of game opportunities in the middle of the week. The Palm Beach Post reports Stanton could return Monday, according to manager Mike Redmond. While Monday was floated as a potential target when Stanton entered a rehab assignment, the missed days because of weather seemingly would have delayed his return. According to the Post, Redmond indicated Stanton could return because Casey Kotchman might be unavailable because of sore ribs. Surely the Marlins would not activate Stanton unless they thought he was out of the woods with the hamstring. Or would they? The Dodgers’ recent challenges with players returning from hamstring injuries even on a conservative timetable would be a warning. Stanton may return Monday and he may ultimately return without incident but it seems like a big “if.” Given how serious his injury looked when he originally went down while sprinting to first base, it’s going to take some convincing -- as in a few weeks of no setbacks -- before the specter of potential reinjury fades.
Pablo Sandoval, 3B, San Francisco Giants (day-to-day): Last week, we talked about Sandoval’s vague diagnosis related to his foot and that he was quite literally day-to-day. On Saturday, Sandoval aggravated his foot injury during his first at-bat and did not play Sunday. The natural next question is whether this setback will lead to a turn on the DL. According to the San Jose Mercury News, manager Bruce Bochy said, “The DL is a possibility.” Sandoval, who is in a walking boot, has an injury on the outside of his left foot, according to the Mercury News (although it is still unclear which structure then is compromised). Sandoval is not tiny and between the torsion through his foot when swinging the bat and the pounding it absorbs while running, the demands are fairly high. A more extended absence may be in his future.
Will Middlebrooks, 3B, Boston Red Sox (placed on DL May 24, likely return this week): Middlebrooks expressed optimism from the outset that he would return when eligible, or close to it. After some solid outings at Triple-A Pawtucket, it appears his return is near. According to the Providence Journal, manager John Farrell has made it clear what his role will be when he does rejoin the lineup. "Will's our third baseman," Farrell said. The team has not indicated precisely when Middlebrooks is expected to return but fantasy owners should keep an eye on any potential roster move. His uneventful recovery from this episode of back spasms -- and his performance at the plate during his rehab games -- warrants inserting him in fantasy lineups immediately upon return.
Jedd Gyorko, 2B, San Diego Padres (day-to-day): Gyorko exited Sunday’s game in the middle of the 10th inning with what the team is referring to as soreness in his right groin. He apparently suffered the injury just prior to sliding into second base, according to the San Diego Union-Tribune. Although Gyorko hoped it wasn’t severe, Padres manager Bud Black was less clear. “We’re not sure what it is,” said Black, “a strain, a pull, a cramp. But he had to come out of the game.” Gyorko is likely to undergo further evaluation Monday to determine whether a DL stint will be necessary. Awkward slides or missteps heading into slides have proved to be problematic for several players this year, a reminder that seemingly benign maneuvers can still result in injury. Fantasy owners should prepare for at least a couple of missed days for Gyorko, if not a little longer.
Pitchers
Stephen Strasburg, SP, Washington Nationals (placed on DL retroactive to June 1, expected return June 16): Last week we discussed the nature of Strasburg’s injury and the concern the Nationals likely had about him compromising his shoulder if he played through it. That concern translated to a formal DL-designation for Strasburg later in the week after soreness kept him from attempting a Wednesday bullpen session. The reported non-severe nature of the lat strain also proved to be true as Strasburg was able to complete a throwing session just three days later. If all continues well with his program this week, Strasburg will make his next start on June 16, the first day he is eligible to return.
Clay Buchholz, SP, Boston Red Sox (day-to-day): A couple weeks ago, it was an irritated AC joint after sleeping awkwardly that forced Buchholz to miss a start. After a successful return outing, Buchholz left his subsequent start prematurely due to tightness in his neck. Are the two related? It’s hard to say with any degree of certainty. Certainly the neck and the shoulder are closely integrated in the throwing motion, but these can still be separate issues. Nonetheless, one of the concerns when Buchholz was dealing with the AC soreness was whether he was compensating for the shoulder. In an effort to prevent any significant change in his throwing mechanics, Buchholz was scratched from one start, then delayed for his next start. He seemed to be past the issue with his shoulder, but it’s certainly possible that subtleties from one injury contributed to how he was throwing. The close timing of the two injuries also hints at some relationship, even if a specific cause-and-effect mechanism is difficult to determine. In any event, Buchholz has indicated he will take every measure to ensure he’s fully healthy before attempting a return but for right now it does not appear that will involve a move to the DL.
Alexi Ogando, SP, Texas Rangers (placed on DL retroactive to June 6): Ogando returned from the DL for one start … and then went right back. After missing a month with biceps tendinitis, Ogando is back on the DL with what is simply being termed right shoulder inflammation. The concerns are fairly obvious. Back-to-back moves to the DL for a pitcher with a shoulder injury is never a good sign. More concerning is what it might mean from a structural standpoint. Often a diagnosis of biceps tendinitis (at the shoulder) signals a problem with the labrum, given their interface at the shoulder. An MRI in mid-May when Ogando hit the DL the first time reportedly revealed no structural issues, although the nuances of what is observed on imaging may be subtle. This is not to suggest his season is necessarily threatened but it wouldn’t be surprising if he is sidelined for a bit longer this time to help guard against yet another setback. The bigger question long-term may be how his role is modified, if at all, when he returns.
Daniel Hudson, SP, Arizona Diamondbacks (on DL to start season, no timetable for return): In what may be the sad news of the week when it comes to injuries, Hudson reportedly suffered another tear in his ulnar collateral ligament (UCL), according to the Diamondbacks. Hudson was 11 months post-Tommy John surgery and was in the phase of rehab starts as he prepared to return to the majors. After feeling discomfort in his throwing elbow following his first rehab start Tuesday night, subsequent evaluation revealed the injury. The Diamondbacks have indicated they are exploring all medical options, but Hudson will first consult with Dr. James Andrews. While the initial news sounds dire, it is worth waiting to see the results of his consultation before presuming the worst-case scenario of yet another procedure.
All projected return timelines should be considered fluid.
Hitters
Bryce Harper, OF, Washington Nationals (placed on DL retroactive to May 27): Last week, Harper was officially placed on the DL (backdated to his last appearance); this week he’s hoping he can come off of it. That sounds a little optimistic given that Harper is traveling to Pensacola, Fla., to pay a visit to Dr. James Andrews for a consultation. That appointment was scheduled when Harper’s irritated knee appeared to be making no progress. In recent days, he seems to have turned a corner according to the Washington Times. Harper had been running in the pool but the Times reports he stopped that activity and the discomfort has subsided. Still, Harper will be evaluated by Andrews Monday after which more information should be forthcoming. As of now, it’s worth keeping an eye on his activity this week to see if he is cleared to do more intense workouts. But if running in the pool was bothering him, it’s hard to imagine running on land will be smooth sailing out of the gate.
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Kirby Lee/USA TODAY Sports Matt Kemp's hamstring woes are just part of the Dodgers' many problems.
Kirby Lee/USA TODAY Sports Matt Kemp's hamstring woes are just part of the Dodgers' many problems.Matt Kemp, OF (placed on DL May 30), Hanley Ramirez, SS (day-to-day), Carl Crawford, OF (placed on DL June 2), Los Angeles Dodgers: The Dodgers’ collective hamstring woes are the ultimate example of how difficult these injuries are to manage. After missing five weeks following thumb surgery, Ramirez returned for a few days, then missed another month with his hamstring strain. The team wanted to be very careful about bringing him back, especially with Kemp and then Crawford suffering similar, albeit lesser, injuries of their own. This is how I described the Ramirez situation last week: What the Dodgers cannot afford is for Ramirez to return and reinjure himself. Obviously there are no guarantees but the team at least needs to feel comfortable they have seen enough in his rehab outings to suggest his leg is ready for prime time.
Well, Ramirez was back only one day before experiencing tightness in his left hamstring. Although he was out of the starting lineup for several consecutive days, he did make pinch-hit appearances. Ramirez is getting repeat imaging on that leg however, given that it remains bothersome. This was exactly the situation the Dodgers were trying to avoid. Ramirez played in a handful of rehab games exhibiting nothing that would hint at his being less than ready to return. Still, as we often say, until an athlete has returned to his prior level of play for a few weeks without incident following a hamstring injury, it’s difficult to exhale and believe the problem is truly behind him.
And Ramirez is not the only one. When Kemp was first injured roughly 10 days ago, there was some initial thought he might not even require a DL stint, given his hamstring symptoms were so minor. It looked as if 15 days would be more than enough time to recover. Apparently not. The Dodgers’ official website reports Kemp’s right hamstring bothered him enough during pregame workouts Sunday that he does not look to be ready to return. The team originally anticipated having him back Friday; now it’s unclear just when a return could come. Manager Don Mattingly offered this: “We're not where we need to be with him. We do know that he's not 100 percent." Whether Kemp is apprehensive given his recent injury woes and struggles at the plate or whether there is more significance to the injury is unclear.
In the meantime, fellow outfielder Crawford was officially placed on the DL last Monday (retroactive to June 2) with a hamstring injury Mattingly characterized as “fairly significant” after it had originally been described by the team as a cramp. It certainly looks as if his absence will extend beyond the 15-day minimum.
At this point there is no real timetable on ANY of these players. The team has to be hoping that Yasiel Puig, whose brilliant performance since being called up at least provides a temporary distraction from the injuries, remains immune to the hammie bug.
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Jamie Sabau/Getty Images Ryan Braun's thumb is the short-term concern for fantasy owners. There could be long-term ones on the horizon.
Jamie Sabau/Getty Images Ryan Braun's thumb is the short-term concern for fantasy owners. There could be long-term ones on the horizon.Ryan Braun, OF, Milwaukee Brewers (day-to-day): It has not been a good week for Braun on multiple fronts, including the injury department. Braun has had a thumb ailment which has been giving him intermittent trouble over the last month. On Sunday, he was removed from the game in the third inning and his words hinted at perhaps more extended time off. After the game, Braun told reporters he should have taken steps to address it sooner. "From the very beginning, I should have taken more time off and gotten it right," said Braun. "But I just continued to try to fight through it, play through it. It's at the point where it doesn't feel very good.” No specifics have been revealed as to the nature of Braun’s thumb injury other than “soreness,” making it difficult to ascertain just how much time it could cost him for it to completely heal. Braun has indicated on prior occasions that he has made adjustments to his swing but clearly it hasn’t gone away. The timing may be right for a DL move.
Austin Jackson, OF, Tigers (placed on DL retroactive to May 12, could return soon): Last week it sounded as if Jackson might return but I did caution it could get postponed. The Tigers opted not to send Jackson on a rehab assignment until he progressed further with his running, something he did to the team’s satisfaction last week, according to MLive.com. Now the Tigers are officially sending him out on assignment with a specific plan that will have him increase his activity over several days. While the team is allowing for flexibility in his rehab appearance schedule based on how the hamstring responds, Jackson could potentially return to the big league club by late next week.
Giancarlo Stanton, OF, Miami Marlins (placed on DL April 30, could return Monday): When Stanton went down with a hamstring injury, it immediately looked serious. A June return seemed most plausible. After missing multiple weeks and a seemingly (yet understandably) slow rehab process, suddenly Stanton’s imminent return feels a bit hurried. Stanton only just embarked on a rehab assignment last Tuesday and got off to a slow start at the plate but was able to play on back-to-back days. Because of inclement weather, Stanton lost a couple of game opportunities in the middle of the week. The Palm Beach Post reports Stanton could return Monday, according to manager Mike Redmond. While Monday was floated as a potential target when Stanton entered a rehab assignment, the missed days because of weather seemingly would have delayed his return. According to the Post, Redmond indicated Stanton could return because Casey Kotchman might be unavailable because of sore ribs. Surely the Marlins would not activate Stanton unless they thought he was out of the woods with the hamstring. Or would they? The Dodgers’ recent challenges with players returning from hamstring injuries even on a conservative timetable would be a warning. Stanton may return Monday and he may ultimately return without incident but it seems like a big “if.” Given how serious his injury looked when he originally went down while sprinting to first base, it’s going to take some convincing -- as in a few weeks of no setbacks -- before the specter of potential reinjury fades.
Pablo Sandoval, 3B, San Francisco Giants (day-to-day): Last week, we talked about Sandoval’s vague diagnosis related to his foot and that he was quite literally day-to-day. On Saturday, Sandoval aggravated his foot injury during his first at-bat and did not play Sunday. The natural next question is whether this setback will lead to a turn on the DL. According to the San Jose Mercury News, manager Bruce Bochy said, “The DL is a possibility.” Sandoval, who is in a walking boot, has an injury on the outside of his left foot, according to the Mercury News (although it is still unclear which structure then is compromised). Sandoval is not tiny and between the torsion through his foot when swinging the bat and the pounding it absorbs while running, the demands are fairly high. A more extended absence may be in his future.
Will Middlebrooks, 3B, Boston Red Sox (placed on DL May 24, likely return this week): Middlebrooks expressed optimism from the outset that he would return when eligible, or close to it. After some solid outings at Triple-A Pawtucket, it appears his return is near. According to the Providence Journal, manager John Farrell has made it clear what his role will be when he does rejoin the lineup. "Will's our third baseman," Farrell said. The team has not indicated precisely when Middlebrooks is expected to return but fantasy owners should keep an eye on any potential roster move. His uneventful recovery from this episode of back spasms -- and his performance at the plate during his rehab games -- warrants inserting him in fantasy lineups immediately upon return.
Jedd Gyorko, 2B, San Diego Padres (day-to-day): Gyorko exited Sunday’s game in the middle of the 10th inning with what the team is referring to as soreness in his right groin. He apparently suffered the injury just prior to sliding into second base, according to the San Diego Union-Tribune. Although Gyorko hoped it wasn’t severe, Padres manager Bud Black was less clear. “We’re not sure what it is,” said Black, “a strain, a pull, a cramp. But he had to come out of the game.” Gyorko is likely to undergo further evaluation Monday to determine whether a DL stint will be necessary. Awkward slides or missteps heading into slides have proved to be problematic for several players this year, a reminder that seemingly benign maneuvers can still result in injury. Fantasy owners should prepare for at least a couple of missed days for Gyorko, if not a little longer.
Pitchers
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Scott Cunningham/Getty Images Stephen Strasburg's DL stint may be very short-lived.
Scott Cunningham/Getty Images Stephen Strasburg's DL stint may be very short-lived.Stephen Strasburg, SP, Washington Nationals (placed on DL retroactive to June 1, expected return June 16): Last week we discussed the nature of Strasburg’s injury and the concern the Nationals likely had about him compromising his shoulder if he played through it. That concern translated to a formal DL-designation for Strasburg later in the week after soreness kept him from attempting a Wednesday bullpen session. The reported non-severe nature of the lat strain also proved to be true as Strasburg was able to complete a throwing session just three days later. If all continues well with his program this week, Strasburg will make his next start on June 16, the first day he is eligible to return.
Clay Buchholz, SP, Boston Red Sox (day-to-day): A couple weeks ago, it was an irritated AC joint after sleeping awkwardly that forced Buchholz to miss a start. After a successful return outing, Buchholz left his subsequent start prematurely due to tightness in his neck. Are the two related? It’s hard to say with any degree of certainty. Certainly the neck and the shoulder are closely integrated in the throwing motion, but these can still be separate issues. Nonetheless, one of the concerns when Buchholz was dealing with the AC soreness was whether he was compensating for the shoulder. In an effort to prevent any significant change in his throwing mechanics, Buchholz was scratched from one start, then delayed for his next start. He seemed to be past the issue with his shoulder, but it’s certainly possible that subtleties from one injury contributed to how he was throwing. The close timing of the two injuries also hints at some relationship, even if a specific cause-and-effect mechanism is difficult to determine. In any event, Buchholz has indicated he will take every measure to ensure he’s fully healthy before attempting a return but for right now it does not appear that will involve a move to the DL.
Alexi Ogando, SP, Texas Rangers (placed on DL retroactive to June 6): Ogando returned from the DL for one start … and then went right back. After missing a month with biceps tendinitis, Ogando is back on the DL with what is simply being termed right shoulder inflammation. The concerns are fairly obvious. Back-to-back moves to the DL for a pitcher with a shoulder injury is never a good sign. More concerning is what it might mean from a structural standpoint. Often a diagnosis of biceps tendinitis (at the shoulder) signals a problem with the labrum, given their interface at the shoulder. An MRI in mid-May when Ogando hit the DL the first time reportedly revealed no structural issues, although the nuances of what is observed on imaging may be subtle. This is not to suggest his season is necessarily threatened but it wouldn’t be surprising if he is sidelined for a bit longer this time to help guard against yet another setback. The bigger question long-term may be how his role is modified, if at all, when he returns.
Daniel Hudson, SP, Arizona Diamondbacks (on DL to start season, no timetable for return): In what may be the sad news of the week when it comes to injuries, Hudson reportedly suffered another tear in his ulnar collateral ligament (UCL), according to the Diamondbacks. Hudson was 11 months post-Tommy John surgery and was in the phase of rehab starts as he prepared to return to the majors. After feeling discomfort in his throwing elbow following his first rehab start Tuesday night, subsequent evaluation revealed the injury. The Diamondbacks have indicated they are exploring all medical options, but Hudson will first consult with Dr. James Andrews. While the initial news sounds dire, it is worth waiting to see the results of his consultation before presuming the worst-case scenario of yet another procedure.
Injury report: Strasburg, Harper and more
June, 3, 2013
Jun 3
4:05
PM ET
By
Stephania Bell | ESPN.com
Every Monday, in this space, we'll provide updates on a variety of players to help you make your weekly lineup decisions. We'll specifically try to hit the players who are day-to-day, have just gone on the DL or are ready to return, so that you can better decide whether you can count on them or not.
All projected return timelines should be considered fluid.
Hitters
Harper
Bryce Harper, OF, Washington Nationals (placed on DL retroactive to May 27): Last week, I said not to expect Harper's left knee (originally injured crashing into the outfield wall in Dodger Stadium on May 13) to land him on the DL if he could help it. It couldn't be helped. In fact, Harper acknowledged to reporters that he aggravated his knee with a headfirst slide May 25 and it turns out the persistent swelling and soreness was too much to overcome. On Sunday, Harper described his knee as "still swollen and crappy" yet said he hopes to start running and hitting at some point this week. The bottom line is he won't be given the green light to run if he is still experiencing swelling to the point where he continues to walk with a limp, as he reportedly was Thursday night.
There's no magic antidote for the swelling associated with bursitis; rest is perhaps the key ingredient for getting it under control. The bigger concern would be preventing this from turning into a chronic issue over the remainder of the season. Harper's move to the DL reflects the Nationals' desire to curb the problem now and he's not likely to resurface until his progress moves him out of range of the easy threat of a setback. After all, teammate and fellow outfielder Jayson Werth followed a similar pattern of being placed on the DL following a string of consecutive missed games. At the time, Werth expected to return when eligible but was held back when his hamstring continued to nag at him with certain explosive activities. Now it looks as if Werth will rejoin the team Tuesday, so at least the Nationals anticipate getting a player back as they lose Harper, but it's worth noting his absence will have exceeded a month. If Harper's progress remains slow, expect his timetable to be extended because the Nationals know he isn't wired to play at anything less than 110 percent effort, regardless of how his body actually feels.
Kemp
Matt Kemp, OF, Los Angeles Dodgers (placed on DL May 30): The Dodgers' decision to place Kemp on the DL seems to be more of a proactive effort to keep his injury from worsening than a reactive response to severity. Kemp felt his right hamstring tighten up while chasing down a Mike Trout double on Wednesday and took himself out of the game, perhaps a lesson learned from last year's episode with his left hamstring. Although the injury did not appear serious, the move to the DL forces Kemp to sit out at least 15 days and rest his legs. Last year, Kemp tried to return quickly following his hamstring strain, only to suffer a setback within two days, resulting in another six-week absence. And let's face it, he has not had the best start to his season. Kemp has been struggling at the plate after coming off surgery to repair his labrum, not because the shoulder is bothering him, but he has not rediscovered his swing. While his performance has been below expectations, other power hitters have said it can take months before they feel like their stroke is effortless after undergoing shoulder surgery. The twinge in his hamstring and the forced time off may be just the thing to help Kemp restart his season. No timetable has been issued, but it appears Kemp's leg will not require much beyond the minimal two weeks. Beyond how he looks and feels in running situations, it will be worth paying attention to how Kemp fares at the plate once those rehab games get underway.
Crawford
Carl Crawford, OF, Los Angeles Dodgers (day-to-day): Another outfielder, another hamstring issue. These injuries seem to be running rampant among outfielders throughout the league. Crawford, who has been quiet on the injury front so far this year after missing virtually all of last season following wrist surgery and later Tommy John surgery, left Saturday's game with a left hamstring "cramp," according to the Dodgers' Twitter account. Crawford was held out of the game Sunday. A cramping or tugging is often a precursor to something more sinister; the question is whether a few days of rest is enough to clear the issue or whether more downtime is needed. Crawford did have some issues with the same hamstring in the early part of May and sat out one game as a result. In 2011, Crawford went on the DL for a left hamstring injury and missed a month. Other than that one episode, Crawford has not dealt with significant hamstring problems. Naturally, the Dodgers would like to keep it that way. With Kemp out and Crawford potentially out for several days -- or longer -- the Dodgers have promoted top prospect Yasiel Puig to provide outfield help.
Ramirez
Hanley Ramirez, SS, Los Angeles Dodgers (placed on DL May 4, expected to return this week): Hamstring injuries aren't just for outfielders, as the Dodgers are all too aware. Ramirez, who strained his left hamstring just days after returning from a month-long absence following thumb surgery, suffered a serious enough injury to sideline him another month. As frustrating as this injury has been for Ramirez and everyone else, he finally appears on the brink of return. He has been on a rehab assignment this weekend (with Sunday off) and is expected to play in a game again Monday with a possible activation as early as Tuesday. The key for the Dodgers' comfort level with his return is adequate situational play to stress the hamstring and observe its response. Ideally that would include turning corners running from first to third, which also happens to be how Ramirez suffered the injury in the first place, but that particular test has not presented itself. What the Dodgers cannot afford is for Ramirez to return and re-injure himself. Obviously there are no guarantees but the team at least needs to feel comfortable they have seen enough in his rehab outings to suggest his leg is ready for prime time. It appears this will be the week they get him back, barring a setback, but the specific day he will return is not yet set in stone.
Jackson
Austin Jackson, OF, Detroit Tigers (placed on DL retroactive to May 12, possible return this week): Jackson's strain was not viewed as serious even when the team placed him on the DL, but as hamstrings are wont to do, his recovery time has proceeded slower than expected. Jackson has resumed baseball activities over the past 10 days and ran the bases Saturday, although it is unclear whether he did so at full speed. The expectation is that if all goes well, he will embark on a rehab assignment shortly. Manager Jim Leyland told reporters last week that Jackson would head to Toledo for a short rehab assignment prior to being activated. This gives him the opportunity to test the hamstring in unpredictable, reactionary situations, an important final step before returning to the lineup. If the rehab assignment is uneventful, Jackson could be back with his teammates this week however the Tigers have been clear they do not want to rush him. Should his rehab start get delayed or should they decide they want him to get more games under his belt before returning, he might not make an appearance before next week.
Hill
Aaron Hill, 2B, Arizona Diamondbacks (placed on DL April 15, no definite timetable): When Hill was first diagnosed with a fracture in his left hand, the projected timetable was his absence was four to six weeks, the standard for bone healing. The problem is that the bone hasn't healed. As reported by the Arizona Republic last week, Hill has a nonunion fracture, and the choices at this point are to try to resume baseball activities gradually and see how he is able to tolerate them, or to undergo surgery. Hill is trying the former option and so far has been able to hit from a tee. The Republic notes the next step will be facing live pitching. Hill would need to work his way through a rehab assignment before considering a return, suggesting he is still at least a couple of weeks out. And that's if the hand doesn't become too painful along the way. There's no clear answer here as to when Hill might return but at least there's some encouragement that he has picked up a bat again.
Lawrie
Brett Lawrie, OF, Toronto Blue Jays (placed on DL May 28): When Lawrie was injured this spring, forcing him to open the season on the DL, a source in the Jays' organization expressed concern to me about Lawrie's ability to stay healthy, given how he plays (a la Bryce Harper). Everyone admires the enthusiasm but knows it comes with a bit of risk. Still, there's nothing that could have prevented Lawrie's left ankle from catching the bag and twisting as it did on a recent attempted steal. In fact, it looked violent enough that it actually brought to mind a similar injury suffered by his teammate Jose Reyes, who has now been out over a month and is still recovering. Indications are that Lawrie's sprain was not as serious, but it still will take time to get back to full Brett Lawrie mode. He is currently undergoing rehab in Florida and will miss the full two weeks, possibly more. Fantasy owners should expect he will need some extra time to push the ankle with agility maneuvers, sliding and turning corners. Don't be surprised if it requires an additional week or two.
Pitchers
Strasburg
Stephen Strasburg, SP, Washington Nationals (day-to-day): Strasburg clearly looked uncomfortable Friday night and it didn't take long for the decision-makers to decide to pull him. Originally thought to be an oblique strain, Strasburg is now reported to be dealing with a Grade 1(minor) strained lat (latissimus dorsi) muscle, the large muscle on the back that attaches to the arm and is involved in throwing. Based on how Strasburg was flinching Friday night, rolling his shoulders around in an apparent effort to loosen up, it seemed as if the ailment was not behaving like a typical oblique (the highest oblique muscles attach around the middle of the rib cage and most often players will reach for their side or lean towards one side when that's the issue) and the announcement that it is indeed his lat makes sense. As of now the Nationals say they will be taking it day by day and that Strasburg could test himself throwing a side session Wednesday. This, of course, will happen only if he is pain-free.
It's worth pointing out that Strasburg also appeared to be uncomfortable during an outing in late April. That episode was later reported to be forearm tightness and he did not miss his next start. The Nationals have to be watching him closely for all the body language that would suggest he is less than full capacity, given that Strasburg seems to hold back when it comes to discussing injury. Their worst fear would be not simply an aggravation of a lat strain that could sideline him longer, but a more significant injury to this throwing arm as a result of compensating, especially when he is only recently removed from Tommy John surgery. More information should be available Wednesday after Strasburg's scheduled throwing session.
Johnson
Josh Johnson, SP, Toronto Blue Jays (placed on DL April 26, expected to return Tuesday): There's some good news finally for the Jays, or at least it appears to be. According to the Jays' official website, Johnson, out since late April with a triceps injury, is expected to rejoin his team Tuesday to face the San Francisco Giants. Johnson has made three rehab starts with generally mixed results but most importantly has not had any discomfort in his arm and feels comfortable throwing all his pitches. The Jays could certainly benefit from his presence but as manager John Gibbons said, "We need Josh to be good when he comes back. He's got to stabilize things." The rehab and offseason maintenance programs Johnson has participated in over the last two years seemed to be paying off for him when he looked strong in his spring outings. If this episode can be viewed as just a minor speed bump on the season -- and there's no reason to think Johnson can't stay healthy for the remainder of the year -- then it really could be good news for everyone, including fantasy owners.
Price
David Price, SP, Tampa Bay Rays (placed on DL May 16, no timetable for return): At least we can see some progress in Price's throwing progression, but he still isn't throwing from the mound. Price has increased the distance at which he's playing catch to 105 feet, according to the Tampa Bay Times. He has now been playing catch for about a week with no reported setbacks and at progressive distances. Still, the vigor of throwing increases substantially when a pitcher throws downhill, something Price could start to do within the week. While the Rays continue to refrain from establishing a timetable, it would stand to reason that Price would need rehab outings prior to a return. First things first. Let's see how his arm responds when he ratchets up the effort.
Betancourt
Rafael Betancourt, RP, Colorado Rockies (placed on DL June 1): When the Denver Post reported in May that Betancourt had inflammation around scar tissue in his right groin area, it seemed unlikely that a few days rest would be sufficient. After all, he had been experiencing what he described as tightness and weakness in the area since April. Even the Rockies indicate he's been dealing with this issue for several years, according to the Post. Betancourt never blamed the injury for his performance but his recent struggles would suggest it has to at least be considered a factor. Now he will have no option but to take some time to see if it settles down. When he returns - and it's possible he could miss only the minimum time - perhaps it will be clearer just how much a factor the groin has been.
Street
Huston Street, RP, San Diego Padres (placed on DL retroactive to May 30): Uh-oh. It's deja vu with Street again. Not only is he returning to the DL, a place he has spent time each of the last three seasons, but he is dealing with an injury to the same part of his body that landed him there last August. Street has a strained left calf and last year it cost him 41 days. Padres manager Bud Black and Street told reporters the injury is less severe this time. According to the Padres' official website, Street had a simple assessment: "Same calf, different spot and a different severity level," he said. Perhaps the quick decision to move to the DL will result in less down time. Last year, Street did try to pitch through discomfort but that ultimately turned to pain and a lengthy absence. Street is hopeful he will only need to rest the leg a week or so before resuming activity. Calf injuries are not unlike hamstring strains in that an athlete often begins to feel better until he tests it at full speed. Fortunately for Street, he shouldn't be faced with sprinting that often and perhaps will be able to return after the minimum time.
Injury report: More big names hit the DL
May, 27, 2013
May 27
2:30
PM ET
By
Stephania Bell | ESPN.com
Every Monday in this space, we'll provide updates on a variety of players to help you make your weekly lineup decisions. We'll specifically try to hit the players who are day-to-day, have just gone on the DL or are ready to return, so that you can better decide whether you can count on them or not.
All projected return timelines should be considered fluid.
Hitters
Curtis Granderson, OF, New York Yankees (placed on DL May 25; expected to miss at least a month): When it comes to injuries this season, if the Yankees didn't have bad luck, they wouldn't have any luck at all. Granderson, whose season finally got under way just a few weeks ago, is now out for at least a month with another fracture.Two hit-by-pitches have resulted in fractures for Granderson, the first a broken right radius (forearm bone) just above the wrist, and now a broken left fifth metacarpal (the long bone of the hand, at the base of the fifth (pinkie) finger). The latest incident occurred Friday night when Granderson absorbed the impact of a pitch to his left knuckle in the fifth inning. In an almost eerie forewarning of this event, Granderson spoke to the Yankees' website just weeks ago during his rehab assignment (from the first fracture) about not fearing the inside pitches. "There's going to be pitches inside, I'm going to get hit again, but you got to stay in," Granderson said. In this case, he stayed in until he was forced out, literally, because of injury.
If there's any good news here, it's that it appears this fracture, like the first, will not require surgery. Broken bones typically require four to six weeks to allow sufficient healing to permit return to play; if Granderson's finger shows good early callus formation (bone healing) and he can grip the bat effectively, his timetable should fit right in that timeframe. That said, he might have to encase his fingers, hands and forearms in bubble wrap when he steps to the plate to get through the rest of the season.
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AP Photo/Alex BrandonBryce Harper is becoming known for his "all-out" style of play ... which could lead to missed games.
Shane Victorino, OF, Boston Red Sox (placed on DL retroactive to May 21): Victorino had been battling back spasms in recent weeks yet managed to avoid a DL stint. Not now. This time it's his left hamstring that's giving him fits, and Victorino will be forced to rest until he can run without limitation. Interestingly, Victorino's hamstring started to bother him just days after returning to the lineup following missed time for his back. If these two issues are related, which would not be surprising, this could turn out to be intermittently problematic throughout the season.
Will Middlebrooks, 3B, Red Sox (placed on DL May 24): Perhaps back spasms are contagious in Boston. Middlebrooks left Thursday's game early due to back spasms, something manager John Farrell told reporters might have begun Wednesday night as Middlebrooks came out of the batter's box. The good news is that Middlebrooks said, according to ESPN Boston, that as of Saturday he was already feeling improvement. "I do [think I'll come off the DL when eligible]," he said, adding, "I feel better than yesterday, so if I'm already making steps forward, that's where I want to be." This looks to be a minor episode.
Jayson Werth, OF, Nationals (placed on DL retroactive to May 3): When Werth was first placed on the disabled list, the thought was that he would miss the minimum amount of time. After all, when the decision was made to formally move him, he had already missed eight games and seemed to be faring better. But if there's anything we know about hamstring injuries, it's that they are among the least predictable of all soft-tissue ailments. It is often not until the athlete tests the leg with full-speed sprinting activities that lingering issues make themselves known. In Werth's case, he experienced discomfort when breaking out of the batter's box, according to Amanda Comak of the Washington Times. The persistent discomfort led to an MRI, which manager Davey Johnson told reporters was "alarming." Consequently, Werth's timetable has been extended with a new target date of June 3, according to general manager Mike Rizzo (via the Washington Post). It's worth reiterating, however, that hamstrings remain unpredictable. Let's see what Werth does this week in his workouts before counting on a Monday return.
Chase Utley, 2B, Philadelphia Phillies (placed on DL May 23): Utley's knees haven't really been a topic of discussion this season since they haven't seemed to limit him thus far. Now, however, Utley is dealing with a different type of injury issue: a strained right oblique. The Phillies report it as a Grade 1 or minor strain, and the move to the DL reflects their desire to not allow it to worsen. Phillies GM Ruben Amaro Jr. offered a timetable of 2-4 weeks, which is certainly reasonable, adding, "We do believe and hope that Chase will be ready to play in Philadelphia within 15 days." The average missed time for an oblique strain in a hitter runs right around a month, but the most mild forms have allowed an athlete return after the minimum stay (such as Freddie Freeman earlier this season). Although there is some optimism Utley will be back after the 15 days, there's no reason for the team to rush him, especially this early in the season.
Trevor Plouffe, 3B, Minnesota Twins (placed on 7-day concussion DL May 22; expected to return Wednesday): Plouffe took a knee to the head while sliding last Tuesday and was subsequently placed on the concussion DL. Concussions are the least predictable of all injuries, but based on Plouffe's fairly swift recovery so far, it appears the Twins will get him back the first day he's eligible to return. According to the Minneapolis Star-Tribune, Plouffe passed his neurocognitive (ImPACT) tests Thursday and participated in cardio work Friday, which shows progression. If he is able to perform baseball-related activities early this week without any recurrence of symptoms, it appears he will be cleared to rejoin his team's lineup Wednesday.
Wilkin Ramirez, OF, Twins (placed on 7-day concussion DL May 26): Another collision, another concussion for a Twins player. Unlike the knee to the head Plouffe sustained, Ramirez was concussed making a defensive play in the outfield Saturday when he crashed into teammate Josh Willingham. According to the Minneapolis Star-Tribune, Ramirez was not originally on board with the DL designation, that is until he experienced queasiness during the team's flight home Sunday. Good job by the Twins, who certainly have had experience with complex concussions (think former AL MVP Justin Morneau). Now it will be a matter of waiting to see how Ramirez progresses throughout the next week.
Pitchers
Chris Perez, RP, Cleveland Indians (placed on DL May 27): Perez is sidelined with right shoulder soreness, and he was placed on the disabled list for the first time in his major league career early Monday. He was forced to leave Sunday's game against the Red Sox early because of the shoulder, according to ESPN.com. "It kind of pinched on me and sent a little pain down my arm," Perez said. While any shoulder issue is of concern for a pitcher, this doesn't yet have the sounds of something major. It appears Perez at least needs some down time to let the symptoms settle, and he can then hopefully return to throwing. Hopefully.Clay Buchholz, SP, Red Sox (day-to-day, expected to start at some point this week): Buchholz was scratched from his Monday start after irritating his right acromioclavicular (AC) joint (the point of the shoulder), something he attributes to falling asleep on his side with his arm wrapped around his young daughter. The impression is that this is just a simple matter of delaying his start to account for the soreness, preventing him from compensating and potentially creating another problem. According to ESPNBoston.com, the plan is for Buchhholz to play catch Monday, and he expects to pitch again later this week.
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Jeff Hanisch/USA TODAY SportsJim Henderson is expected to get his closer job back once he returns from his hamstring injury.
Chris Sale, SP, Chicago White Sox (day-to-day): Mild tendinitis in his posterior throwing shoulder was the diagnosis for Sale. While any inflammation in a thrower's shoulder is a cause for some concern, the Sox immediately indicated they expected Sale to return for his next start after being scratched last Wednesday. Those plans were confirmed after Sale played catch in the outfield prior to Saturday's game. Afterward, Sale said, "It felt a lot better than I actually thought it would be. Everything is on track, and I will be ready to go Tuesday." He was scheduled to follow up Saturday's session with a Sunday bullpen, and there has been no word of any setback.
If Sale returns without incident, there will be a big sigh of relief from his fantasy owners. But the specter of concern has been raised once again -- last year, there were some questions about whether he was dealing with an elbow injury in May, followed by a reported dead arm period in July -- which must remain in the back of our minds. The bigger question will be whether or not Sale can get through the remainder of the season without this turning into something more substantial.
David Price, SP, Tampa Bay Rays (placed on DL May 16): Triceps tightness originally put Price on the DL, but nobody on the Rays seemed overly concerned. Manager Joe Maddon said he did not expect Price to miss more than two or three starts. Apparently there's now reason to be at least a little more concerned. Despite Price's assertions that his arm feels "great," he hasn't yet begun to throw. According to the Tampa Bay Times, playing catch hopefully will begin within the next few days, but Price will have to proceed through a throwing progression before returning the rotation, which could take an additional few weeks. So much for him missing only 2-3 starts; now there is no official timetable. Until Price actually starts throwing with effort, it's difficult to gauge whether the slow progress is as a result of the Rays taking a conservative approach with him or because of legitimate concern over the health of Price's arm.
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Dilip Vishwanat/Getty ImagesJaime Garcia finally succumbed to his shoulder injury.
Ryan Madson, RP, Los Angeles Angels (opened the season on DL; no timetable for return): Every time it seems Madson is making progress in his recovery from Tommy John surgery, he seems to have some form of setback, which delays his return. The most recent incident occurred last week, when Madson developed soreness in his arm while throwing. Instead of beginning an anticipated rehab assignment with Triple-A Salt Lake, Madson has been shut down indefinitely. He is now 14 months post-surgery, and while the timetable for return following this procedure has a range of anywhere from nine to 16 months, the multiple setbacks Madson has experienced are discouraging.
Rarely is the road back to competition entirely uneventful, but Madson seems to have been pushed back with various episodes of discomfort a bit more than usual. At this point, the Angels seem to be getting solid production from Ernesto Frieri in the closer role, and it looks as if he will stay there for the foreseeable future. No doubt the Angels would like to see Madson return to the mound this year, but it has already proven to be slow going. For fantasy purposes, it's probably time to move along.
Jered Weaver, SP, Angels (placed on DL April 8; expected to return Wednesday): It's always nicer to see someone returning from the disabled list as opposed to going on it, especially when it's your team's -- real or fantasy -- ace hurler. Weaver has been out for more than a month after sustaining a non-displaced fracture of his radial head as a result of an awkward fall on the mound. His road to recovery has been uneventful, with the latter part primarily focused on building up his arm strength to the point of being able to reclaim his spot in the rotation. The Angels have announced Weaver will return Wednesday to face the Angels' neighboring rival, the Los Angeles Dodgers, and fantasy owners should have no concerns about starting him right out of the gate.
Ryan Vogelsong, SP, Giants (placed on DL May 21; expected to miss eight weeks): Vogelsong had not one break but two in his right (throwing) hand, an injury sustained while hitting last week. He underwent surgery last week which required five pins to stabilize the fractures, according to manager Bruce Bochy, and he will need time for the bone to show evidence of healing before he can resume throwing. He will then need additional time to regain throwing strength. Given the projected timeline, expect Vogelsong to be out until well after the All-Star break.
Every Monday in this space, we'll provide updates on a variety of players to help you make your weekly lineup decisions. We'll specifically try to hit the players who are day-to-day, have just gone on the DL or are ready to return, so that you can better decide whether you can count on them or not.
All projected return timelines should be considered fluid.
Hitters
Jason Heyward, OF, Atlanta Braves (placed on DL April 21, could return this week): Heyward went on the disabled list following an emergency appendectomy, so at least there's comfort in knowing this is not going to be a recurrent problem. Now it's just a matter of when he will return … and when he'll be effective.Heyward has been on a rehab assignment for several days at Triple-A Gwinnett, and other than some soreness that warranted a day off, his stint has been uneventful from a health perspective. It also has been uneventful at the plate, that is until Sunday, when he finally started hitting. The Braves don't have an exact date for his return, but he's expected to rejoin the team at some point this week.
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AP Photo/Seth WenigCurtis Granderson could return to the Yankees as early as Tuesday.
The Yankees would like it if he stays healthy and stays in. There's every indication he will come back and be productive immediately, and that return could happen any day now, potentially as early as Tuesday, when the Yankees open a series at home.
Coco Crisp, OF, Oakland Athletics (placed on DL April 30, could return this week): Crisp strained his left hamstring trying to run out a ground ball in the A's seemingly never-ending Monday night game nearly two weeks ago. Fortunately, the strain appeared mild and Crisp could potentially attempt to run the bases soon, according to the San Francisco Chronicle. Obviously his tolerance of running will help determine his readiness to return -- manager Bob Melvin told reporters Crisp might not need a formal rehab assignment -- but as is always the case with hamstrings, until he runs in games without a setback, it will be impossible to tell just how healthy he is.
Chris Young, OF, A's (placed on DL April 30, could return Wednesday): The A's hope to get another outfielder with a soft tissue injury back soon. Just as Coco Crisp recovers from his hamstring, Young is working to get past a left quad strain that has sidelined him the past couple of weeks. After passing the necessary rehab clearances, Young is expected to get some at-bats in extended spring training games during the early part of the week, according to the A's official website. If all goes well, he could return when eligible on Wednesday.
Neil Walker, 2B, Pittsburgh Pirates (placed on DL retroactive to April 27, expected to return Monday): Two weeks ago in this space, I wrote about how the Pirates hoped to return Walker within days if he could swing the bat effectively. Clearly he could not, and the decision was made to place him on the DL. After beginning a rehab assignment last Thursday, it seems Walker has shown he has moved past the injury, and his return appears imminent.
Michael Cuddyer, OF, Colorado Rockies (placed on DL retroactive to May 9): Cuddyer had already missed three games with what he referred to as inflammation in his neck, related to a disc problem. Now it's clear he will be missing a few more. This is not Cuddyer's first episode of neck pain, but it appears to be the first time it has forced him on the DL. The hope is that the symptoms are limited to his neck and that it won't progress into his shoulder or arm. Rest is the best option for him in the short term, but given the variability of these types of ailments, a definitive timetable is difficult to determine. The soonest he can return is May 24, if his neck cooperates.
Jayson Werth, OF, Washington Nationals (placed on DL retroactive to May 3): This doesn't come as a huge surprise after Werth's hamstring continued to bother him despite missing the past eight games. If there is any good news, it's that it can be backdated to the last time Werth saw the field, making him eligible to return May 18. Whether he will be able to actually run at full speed by the end of this week remains to be seen. The Nationals have also indicated they believe dehydration was a factor in Werth's repeated muscle cramping.
The hope is that all will be under control and back to normal by the end of the week, although fantasy owners might want to wait until next week to insert him into their lineup.
Adrian Gonzalez, 1B, Los Angeles Dodgers (day-to-day): Gonzalez has been dealing with a minor muscular strain in his neck, recently aggravated when he and an umpire crossed paths as he was attempting to field a ground ball. An MRI revealed little of significance and Gonzalez returned to play late last week. However, he promptly aggravated it again, then sat out Sunday's game.
This is what falls under the header of "annoying" injuries, frustrating to the athlete because of the come-and-go pattern and difficult to predict in terms of behavior and severity. It does not look as if Gonzalez is in danger of going on the DL, but fantasy owners will want to check daily lineups until he is playing consistently.
Austin Jackson, OF, Detroit Tigers (placed on DL retroactive to May 12): Another outfielder, another hamstring injury. It seems to be quite the injury trend this week. Also a trend: Teams opting to send players to the disabled list for seemingly minor strains early in the season, not wanting to risk a more severe injury. That makes sense. Teams as a whole seem to be offering their players a couple of days to test the effects of rest, but if there are any lingering warning signs, they waste little time scaling the athlete back (in the form of a DL stint). The hope then is that the player will miss the minimal amount of time, and Jackson's case is no different.
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AP Photo/Winslow TownsonShane Victorino (lying down) collided with the outfield wall Sunday at Fenway Park.
Desmond Jennings, OF, Tampa Bay Rays (day-to-day): Jennings has missed a few games with a minor groin strain, but the Rays seem fairly confident they will have him back Tuesday. Jennings has downplayed the injury since it first cropped up last week, suggesting he could play if necessary. Given that it's May and not September, manager Joe Maddon opted to rest Jennings for several days. The proof that it is not anything to worry about will come when Jennings returns to action for consecutive days without incident.
Pitchers
Zack Greinke, SP, Los Angeles Dodgers (placed on DL April 12, could return Wednesday): When Greinke was injured in the brawl with Carlos Quentin, no one knew what to expect since a clavicle fracture in the non-throwing arm of a pitcher is not exactly your everyday injury. As soon as the Dodgers announced he was undergoing surgery to stabilize the fracture, his prognosis for return actually improved, as it appeared he would not face as much down time from throwing.Turns out that was an accurate assessment. Despite the Dodgers' (understandably) conservative eight-week projection, Greinke appears poised to possibly return this week, which would mark 4 1/2 weeks post-surgery. He has passed the point of having discomfort and pitched in high Class A ball last Friday. His velocity is up where he left off at the time of injury, and he appears from a functional standpoint to be ready to pitch in the majors. The final remaining hurdle is whether the bone has healed to the point where the team is comfortable with him absorbing contact. (The high Class A outing afforded him the opportunity to pitch with a DH in the lineup; when he returns to the Dodgers, he will need to hit, run and potentially absorb contact should there be a collision). Expect those clearing tests to be performed over the next 24 hours and a decision to be forthcoming shortly after. If the team opts to hold Greinke out of a return to the majors Wednesday, he would likely get another rehab start this week and rejoin the team next week.
Brett Anderson, SP, A's (placed on DL April 30, could return Friday): After originally spraining his ankle in mid-April, it looked as if Anderson could avoid a DL stint with some rest. But he got called into service in the A's marathon game a couple of weeks ago and it set him back, forcing the DL stint. With a pitcher so recently removed from Tommy John surgery, it's probably for the best that he allow the ankle to recover sufficiently to not threaten his throwing mechanics and, consequently, the health of his arm. According to the San Francisco Chronicle, Anderson is likely to rejoin the rotation Friday.
Ryan Madson, RP, Los Angeles Angels (opened the season on DL, could return this week): Madson's return following last April's Tommy John surgery has been delayed due to the soreness he experienced this spring. The delays aren't highly unusual, but it does bode for a gradual progression even as he returns to his major league team. Madson has been pitching in extended spring training and will begin a rehab assignment this week. He might not spend much time there, as the team could bring him up to the majors to build further endurance in that setting. As the Los Angeles Times has reported, he will not be the closer immediately upon return, and how the Angels opt to use him will likely depend on what they see from him as he resumes big league action.
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Eric Hartline/US PresswireHe's been out of sight, out of mind, but it shouldn't be forgotten that Johnny Cueto finished 13th among all pitchers on the ESPN Player Rater in 2012.
It's entirely possible the team opts for another rehab start, depending on what they see during his outing this week and how Cueto feels after consecutive starts. Either way, it appears that, barring a setback, his return is not far off.
Andrew Bailey, RP, Boston Red Sox (placed on DL retroactive to April 29, could return within a week): Bailey is eligible to return from the DL on Wednesday, but the club could still opt to send him out on a rehab assignment, pushing back that return. Bailey went on the disabled list with a biceps strain, a bit more worrisome than the one that sidelined teammate John Lackey because of the location of Bailey's symptoms (higher, closer to the shoulder). As noted in this space last week, Bailey has been plagued by a series of injuries, but he started the season strong for the Red Sox. With Joel Hanrahan now out for the remainder of the season, it would seem Bailey has the opportunity to recapture his closer role from Junichi Tazawa, if he can stay healthy. Considering his history, particularly in light of this current ailment, that's a big if. Even if Bailey returns without a rehab assignment, the bigger question will be how long he can go without a potential flare-up.
Chris Perez, RP, Cleveland Indians (day-to-day): As he began to warm up Sunday before entering the game in relief, Perez experienced what the team is calling "stiffness" in his throwing shoulder. Manager Terry Francona opted not to press his luck and rested Perez instead. At this point, it doesn't appear to warrant major concern, but it does warrant you keeping an eye on the situation. Unless he's scratched again this week, consider this just a bump in the road.
Jake Westbrook, SP, St. Louis Cardinals (placed on DL May 12): Westbrook becomes the latest pitcher to hit the disabled list with inflammation in his elbow. According to ESPN's Jim Bowden, Westbrook received a cortisone injection in his elbow. Expect several days of rest with a gradual increase in activity to see if he can resume throwing. Until he reaches that point, it will be difficult to project the length of his absence.
Wei-Yin Chen, SP, Baltimore Orioles (day-to-day): After getting his team off to a good start Sunday, Chen was forced to leave the game early because of a strained oblique. He was scheduled to undergo an MRI Monday, and it would not be surprising if this results in a trip to the DL. The typical absence for a pitcher runs on the order of a month, so if it is serious enough to warrant the trip, plan on not having him available for approximately four weeks.
It isn't as bad as it could have been. At least not yet.
Arizona Diamondbacks closer J.J. Putz is not immediately headed for any operative procedure, and if things go well, he's hopeful surgery won't be necessary. That, however, remains to be seen.
Putz
According to the Arizona Republic, Putz is going to be shut down from throwing because of a sprained ulnar collateral ligament, a strained pronator and irritation of the ulnar nerve, as determined by MRI. The goal in the short term is to calm the elbow discomfort and control inflammation while maintaining his cardiovascular conditioning and shoulder strength to the extent possible. As manager Kirk Gibson said of the plan for Putz over the next two weeks, "He's certainly not going to be picking up a ball."
In 2009, Putz went on the disabled list in conjunction with surgery to remove loose bodies from the elbow. At the time, he received precisely the same diagnosis with regards to the UCL ligament, flexor muscle and ulnar nerve in the elbow. As the Republic noted, doctors compared Putz's most recent MRI with images taken four years ago and did not see significant enough change to warrant surgery at this time. Still, the decision for more aggressive and invasive treatment is often guided by the athlete's symptoms, not the picture alone. While the Diamondbacks hope Putz can return after some forced rest and rehabilitation, if the elbow doesn't respond, they will be forced to reconsider the options.
Putz's MRI findings are certainly not uncommon for a 36-year-old pitcher. But it's precisely because he is 36 -- combined with the fact that this is not his first experience with these symptoms -- that makes this episode more concerning. In fact, Putz was placed on the DL with ulnar neuritis (inflammation of the ulnar nerve, the same nerve currently giving him trouble) in 2008 and missed more than a month. Five years later, irritation of the nerve (manifested as tingling) is one of the symptoms that have flared up, forcing him off the mound.
In approximately two weeks, Putz will be re-evaluated, and a determination will be made whether he can pick up a ball or to continue the conservative route of treatment.
Even if the symptoms have subsided to the point where he can resume throwing, it will be a gradual process requiring additional time (likely weeks, not days) to return to the mound. When Putz experienced similar problems in 2011, he missed almost a month and sounds as if he anticipates a comparable timeframe, according to the Diamondbacks' official website. "It's pretty similar," Putz said. "Hopefully it won't be any [longer] than that."
Putz doesn't seem too concerned about the possibility of undertaking more drastic measures if his symptoms don't improve. At least not yet.
It is never good news when a pitcher says he is headed for shoulder surgery, given the inconsistent results and uncertain outcomes associated with procedures in that area and in that population. So when Philadelphia Phillies ace Roy Halladay announced Wednesday that he will undergo surgery on his right (throwing) shoulder to address a bone spur, fraying in his labrum and a partial rotator cuff tear and said he thinks this is "very good news," it took everyone by surprise. Halladay added it is his understanding that he has a "good chance" of returning this season.
"I have a good chance to come back and pitch this year and hopefully be a lot more effective," Halladay said. "They said that my range of motion will be better, my location will be better and hopefully the velocity will be better."
So which is it? Gloom and doom, or sunshine and roses? The truth, as they say, is somewhere in the middle.
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Thearon W. Henderson/Getty ImagesRoy Halladay (2-4, 8.65 ERA) informed the media Wednesday that he has a bone spur in his right shoulder but still hopes to pitch again this season.
Part of the challenge, however, in evaluating comparables when it comes to pitchers and shoulder pathology is that the injuries themselves can be highly variable. The extent of damage to the soft tissues -- such as labrum, biceps tendon and rotator cuff -- and the precise location can influence recovery. The health of the shoulder joint and the strength of the musculature both directly and indirectly responsible for shoulder function play a role. And just as the anatomical variants are unique to each pitcher, so are the intangibles -- the work ethic, the mental toughness, the belief in one's own recovery -- all of which likely contribute to a return to play in a manner that is impossible to quantify. So yes, it is concerning that Halladay is headed for surgery, but it isn't necessarily a career death sentence.
And what about the upside?
While any surgical procedure on a thrower's shoulder carries inherent risk, it is entirely possible, likely even, that this is the treatment option that could allow Halladay to extend his already impressive career. The findings Halladay described (labral and cuff damage) are not uncommon in veteran throwers who have pitched more than 1,000 innings, much less the 2,700-plus innings he has racked up over his professional career. If indeed the presence of a spur -- a bony growth typically formed in response to repeated stress -- is accelerating the soft tissue damage, taking down the spur should provide some relief to that tissue. Cleaning up the associated soft tissue structures also provides reinforcement to the thrower's shoulder. The strengthening regimen Halladay undertook during the offseason targeted the musculature supporting his shoulder with the goal of preserving his health. Although it couldn't completely prevent the inevitable given the degenerative changes in his shoulder, it may help speed his recovery following this procedure. Consider it "learning" that his shoulder girdle has already acquired and can build upon following surgery.
Combine the recently acquired strength with the overall physical health Halladay has exhibited across his career. Three DL trips were entirely unrelated to his throwing arm. They included a leg fracture as a result of being hit by a ball (random), an appendectomy (not a durability issue) and a groin strain (a minor ailment that resolved quickly). Problems with his throwing arm have landed Halladay on the DL three times in his career. The first episode was tendinitis in 2004, perhaps an early flicker of the more profound problems he is facing currently. Last year's trip to the DL with a lat strain seemed to foreshadow the consequences of wear and tear that Halladay can no longer avoid. Suffice it to say Halladay has put in far more days on the mound than many of his peers and has an outstanding health track record for a pitcher. This bodes well for his ability to recover.
As do those intangibles. Halladay is not speaking like someone who is concerned that his career is in jeopardy. He sounds like someone who is setting a goal of returning this season and who, barring an unexpected discovery during surgery, plans to achieve it. It is not automatic that he will return this year, but based on what Halladay outlined as the planned procedure, it is also not impossible to think he could come back late in the season. We do not typically hear of pitchers returning from shoulder surgery better than before; rather we hope for them to be able to return to close to their prior form. Yet Halladay spoke Wednesday of turning back the clock via surgery. The athlete's mindset is not insignificant when it comes to accomplishing rehab goals, and Halladay certainly has the necessary outlook.
There is little doubt that Halladay's range of motion will be better after surgery, just as he predicted. The unknown until he retakes the mound will be whether his location and velocity will be restored to the point where he can be dominant once again. History tells us that the odds of returning to form following shoulder surgery are not in a pitcher's favor. History also tells us that Halladay has defied the odds thus far in his career. It seems like the greater risk may be in betting against him.
Injury updates: Bailey, Hanrahan, Greinke
May, 7, 2013
May 7
4:19
PM ET
By
Stephania Bell | ESPN.com
A few more updates since posting Monday's injury cheat sheet.
Andrew Bailey, RP, Boston Red Sox (placed on DL May 6): Inflammation in his biceps is the latest ailment for Bailey, who is guaranteed to miss at least two weeks but could miss more, particularly if the area involved is near the shoulder. According to the Boston Herald, Bailey hopes to be held back from throwing for only a couple of days, but if the symptoms were enough to warrant a DL placement, the downtime is likely to be longer. The team hardly wants to bring him back in two weeks just to see him exit again with an exacerbation of the condition or, even worse, further damage.
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Jared Wickerham/Getty ImagesAndrew Bailey has a 0.81 WHIP in 13 appearances this season.
The first order of business for the Red Sox is getting Bailey healthy enough to perform. Whether he can resume the closer role will have to be answered later and may depend on Hanrahan's status. Hanrahan, who just returned last week from a stint on the DL because of a right hamstring strain, had lost his closer role because Bailey was pitching so well. Then, just as he got the job back (following Bailey's injury), he exited Monday's game with forearm tightness.
While the vague diagnosis of a forearm strain, which is what the team is describing Hanrahan's injury as, can be either benign or serious depending on the source of the symptoms, it raises concern. Hanrahan has experienced pain in his throwing elbow and forearm before, even going on the DL to start the 2010 season because of a flexor-pronator strain, but told reporters after leaving Monday's game, "This is the first time it felt like this." Not exactly encouraging words.
Now both Bailey and Hanrahan are down, and the Red Sox will yield the closing spot once again (to whom is not yet clear).
Zack Greinke, SP, Dodgers (placed on DL April 12, expected back in late May/early June): Greinke went on the DL with a fractured collarbone sustained in a hit delivered by an angry Carlos Quentin, who had charged the mound. Greinke underwent surgery within days to repair the bone, and now it's just a matter of pain management. In fact, the surgery to repair Greinke's clavicle was performed with the goal that he would experience less overall downtime. Since he injured his non-throwing side, the main hurdle for Greinke post-surgery was pain. He must be able to complete his throwing motion without provoking the surgically repaired area such that it leads him to compensate.
The goal seems to be working. Greinke began playing catch shortly after surgery and has resumed harder throwing recently. The short interval of downtime post-surgery was key in keeping his throwing arm from losing the buildup work of spring training.
If he continues progressing at his current rate, it's possible that Greinke could return later this month, sooner than the eight weeks originally projected. Given the rash of injuries that have plagued the Dodgers' roster, they would no doubt welcome his presence.
Every Monday in this space, we'll provide updates on a variety of players to help you make your weekly lineup decisions. We'll specifically try to hit the players who are day-to-day, have just gone on the DL or are ready to return, so that you can better decide whether you can count on them or not.
All projected return timelines should be considered fluid.
Hitters
Brian McCann, C, Atlanta Braves (opened season on DL, expected to return May 6): McCann has been on the radar of many fantasy owners looking forward to his season debut. It appears that day has arrived. According to news reports, manager Fredi Gonzalez says McCann will be active and with the team Monday when the Braves open a series in Cincinnati. McCann underwent surgery to repair the labrum in his right (throwing) shoulder in October and has been working his way back since. Although he has been hitting throughout the spring, the slower component of his return was throwing. McCann says he is now making the necessary throws, telling reporters this week, "The way I'm throwing now is basically the way I was throwing before I got hurt." While that is all good news as far as performance expectations, the Braves have indicated that McCann would not return to an everyday role immediately. Fantasy owners should keep tabs on the Braves' daily lineups for the next few weeks to check McCann's status.Hanley Ramirez, SS, Los Angeles Dodgers (placed on DL May 4, timetable uncertain): No sooner did Ramirez rejoin his team than he departed again, this time with a strained left hamstring that required him to be helped off the field. After wasting no time proving his surgically repaired thumb was a nonissue, as evidenced by him going yard in his season debut, Ramirez injured his lower half running the bases Friday night. Difficulty putting weight on it reflected the severity of the injury. Manager Don Mattingly did not shy away from the likelihood Ramirez would miss more than the minimum stay, telling reporters, "It's going to be a while." In fact, Mattingly referenced Dodgers outfielder Matt Kemp's injury of last year. Kemp, who was injured at virtually this same time of year, returned after a minimal DL stint only to reinjure his hamstring two days later. He then went back on the DL for more than a month.
Interestingly, Ramirez had not been sidelined for extended time with a left hamstring strain previously; however, he did have a 2011 DL stint for sciatica and numbness in his left leg associated with a lower back problem. It is not unusual clinically to see hamstring strains on the same side as previous sciatic episodes; whether they are directly or indirectly related -- or completely unrelated -- is often difficult to determine. The bottom line is that Ramirez will not be rushed, but as is always the case with hamstring injuries, until he returns successfully without a flare-up, there will be reason for concern about the potential for recurrence.
Michael Bourn, OF, Cleveland Indians (placed on DL April 15; expected to return late this week): It seems as if the "spike to the hand" is the injury du jour in baseball this season. And the injuries are proving to be a bit more challenging to return from than one might think. (Last week in this space, we discussed Pirates second baseman Neil Walker, who has a similar injury and was placed on the DL after having difficulty swinging a bat.) Bourn sustained a laceration to his right index finger when he dove into first base and his hand met the foot of pitcher Matt Thornton. It required five stitches to close the wound, and the DL move was not a surprise; the time allowed the finger time to heal.
What may come as more of a surprise to many was how difficult the injury can be to hit with. Bourn must close his fingers around the grip, which can be a challenge following a laceration. Bourn was finally able to take live batting practice Friday, and he's expected to begin a rehab assignment Monday. Manager Terry Francona told Jordan Bastian of MLB.com that Bourn likely will need three games before he can rejoin the team. The organization likely want him to get enough at-bats to test how his grip is holding up against live pitching and for him to feel comfortable with his timing.
Angel Pagan, OF, San Francisco Giants (day-to-day): Pagan got an early warning sign that his right hamstring was not feeling quite right Saturday night, and he sat out Sunday's game as a result. The good news for Pagan and the Giants is that it was not as severe an injury as that of Dodgers shortstop Hanley Ramirez or Marlins outfielder Giancarlo Stanton. As the San Francisco Chronicle noted, by coming out of the game shortly after feeling a "twinge" Saturday, the hope is that Pagan did not suffer significant tissue damage. Although he told reporters he hopes to play Monday night, manager Bruce Bochy said, "He's not going to be out there if this thing bothers him at all." Given the relative ease with which these injuries become more serious and the time off becomes more protracted, it would not be surprising if Pagan is held out for at least day or two to allow the hamstring to settle.
Jayson Werth, OF, Washington Nationals (day-to-day): Werth is trying to press through not one but two ailments. He suffered pain and swelling in his left ankle and foot area when he fouled a ball off it Tuesday. Fortunately, X-rays showed no fracture, and he has been able to play, despite some discomfort. His hamstring, however, is another story.
Werth began experiencing cramping in the back of his thigh earlier in the same game he fouled the ball off his foot, making his slightly early exit fortuitous. It appears that wasn't enough, though, to keep the hammy from pestering him some more. It tightened up further on Thursday, and Werth has not played since exiting that game early.
One of the most challenging decisions for a medical staff is how long to hold out an athlete who is experiencing discomfort in the hamstring. While the player may feel nothing at rest or during warmups, it is virtually impossible to simulate the maximum effort of in-game play, which is most likely to aggravate it. The obvious concern is potentially losing an athlete for an extended time to a more serious injury. That said, it's difficult to force the athlete to sit when he can pass all the pregame tests and has no symptom complaints. At this point, there is no indication Werth is headed for the DL, and he might even be able to return to the lineup Tuesday after sitting out the weekend series. This doesn't have a great feel about it, as the lingering concern for fantasy owners will be just how well -- and how long -- his hamstring will hold up.
Pitchers
Roy Halladay, SP, Philadelphia Phillies (DTD): Halladay has admitted to experiencing shoulder discomfort and will be traveling to Los Angeles for a consultation with Dr. Lewis Yocum. According to ESPN's Jayson Stark, Halladay began feeling discomfort in the shoulder the morning after his April 24 start. Halladay said the soreness "just kind of progressed over the last two weeks or so." Now they will try to get to the bottom of what exactly is causing this soreness. When speaking with reporters Sunday, Halladay also indicated this was the first time he had experienced this particular ailment, suggesting it was not the same sensation he had last year when he was diagnosed with a latissimus dorsi strain. The team has not yet confirmed a move to the DL, but it seems inevitable. At age 35, with the accumulated pitching mileage on his throwing shoulder, there was reason to be concerned heading into this season that Halladay's body would start showing signs it was unable to keep up with the physical demands of another baseball year. It is likely he will be shut down from throwing for a period of time; hopefully after his visit to the West Coast, we will learn more.May 6 addendum: The Phillies have officially placed Halladay on the DL, recalling left-hander Joe Savery from Triple-A Lehigh Valley to take his place on the roster.
As I noted April 5, Dylan Bundy was shut down from throwing for precautionary reasons after experiencing stiffness in his right (throwing) elbow. Now Bundy has been shut down for six more weeks, and the undertone of concern is evident within the organization.
Bundy tried to resume a throwing program after the forced rest in early April, but even throwing from a short distance on flat ground was enough to resurrect his symptoms. He was seen earlier this week for a second opinion by Dr. James Andrews, who administered a platelet-rich-plasma injection and recommended the six-week hiatus.
So what are we to make of this latest setback?
It's hard to draw any definitive conclusions other than the obvious one: Pain, stiffness or tightness in a thrower's elbow combined with a lack of velocity is enough to provoke legitimate concern. It's worth remembering that the initial MRI on Bundy's elbow revealed no significant structural damage. That said, the MRI isn't always perfect; some issues do not manifest themselves on imaging. Many pitchers will experience intermittent episodes of something abnormal in the throwing elbow or forearm area yet will go on to recover and return to throwing without incident.
It's also worth noting when evaluating the phrase "no significant structural damage" that the presence of tissue changes is more common than not in pitchers as a result of the wear and tear they subject their arm to by performing their craft. Recent studies have shown up to two-thirds of professional pitchers may have demonstrable changes in the ulnar collateral ligament on imaging yet have no symptoms whatsoever. Translation: Many throwers are out there on a daily basis, doing their job, with elbows that are not altogether "healthy." It is only when the picture and the symptoms combine to tell a common story that medicine has something definitive to address.
Furthermore, while the PRP injection may be of help to Bundy, it is also possible that his symptoms will persist. The jury is still out on the sum total of the effects of PRP, but it is seen by many as a treatment option with virtually no downside since it involves using the patient's own blood components -- and nothing synthetic -- as a means of trying to facilitate healing. There is much more to be learned about what the optimal treatment parameters and ultimate benefits of PRP injections are.
In the meantime, the Orioles have to hope that the combination of PRP and extended rest will allow Bundy's elbow to hit the reset button on the start of the season. After the rest period, the team will attempt to move him through a throwing progression, which will continue until he either returns to the mound or the symptoms recur. If Bundy's elbow continues to be problematic, the next course of action will be determined at that time. Until then, a concerned Orioles organization will hold out hope that this episode will be in the rearview mirror soon enough.
Bundy tried to resume a throwing program after the forced rest in early April, but even throwing from a short distance on flat ground was enough to resurrect his symptoms. He was seen earlier this week for a second opinion by Dr. James Andrews, who administered a platelet-rich-plasma injection and recommended the six-week hiatus.
So what are we to make of this latest setback?
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AP Photos/Tony Farlow/Four Seam ImagesDylan Bundy checked in at No. 3 in Keith Law's Top 100 prospect rankings prior to the 2013 season.
It's also worth noting when evaluating the phrase "no significant structural damage" that the presence of tissue changes is more common than not in pitchers as a result of the wear and tear they subject their arm to by performing their craft. Recent studies have shown up to two-thirds of professional pitchers may have demonstrable changes in the ulnar collateral ligament on imaging yet have no symptoms whatsoever. Translation: Many throwers are out there on a daily basis, doing their job, with elbows that are not altogether "healthy." It is only when the picture and the symptoms combine to tell a common story that medicine has something definitive to address.
Furthermore, while the PRP injection may be of help to Bundy, it is also possible that his symptoms will persist. The jury is still out on the sum total of the effects of PRP, but it is seen by many as a treatment option with virtually no downside since it involves using the patient's own blood components -- and nothing synthetic -- as a means of trying to facilitate healing. There is much more to be learned about what the optimal treatment parameters and ultimate benefits of PRP injections are.
In the meantime, the Orioles have to hope that the combination of PRP and extended rest will allow Bundy's elbow to hit the reset button on the start of the season. After the rest period, the team will attempt to move him through a throwing progression, which will continue until he either returns to the mound or the symptoms recur. If Bundy's elbow continues to be problematic, the next course of action will be determined at that time. Until then, a concerned Orioles organization will hold out hope that this episode will be in the rearview mirror soon enough.
The most recognizable name on the Miami Marlins roster will no longer be visible in the starting lineup for at least a few weeks. Giancarlo Stanton, the power-hitting outfielder who looks like he would be equally comfortable on a football field, will not be on any field in the near future as he rests his ailing right hamstring.
Stanton has been diagnosed with a Grade 2 (moderate) strain, an injury he suffered in the 10th inning of Monday night's game against the Mets as he tried to beat out a grounder. As Stanton crossed first base, he displayed the universal "I just pulled my hamstring" sign when he abruptly shortened his stride and reached instinctively for the back of his thigh. Stanton then fell forward to the ground, pounding his fist in clear frustration. He was able to get up and amble off the field gingerly, but it was obvious to anyone watching this was more than a mild cramp.
The Marlins' prompt move to transfer Stanton to the DL confirmed the seriousness of the injury; there would be no wait-and-see period for Stanton, as is usually the case when a mild strain is suspected and the team is hoping for a quick return. After undergoing an MRI on Tuesday, Stanton's hamstring injury was officially designated as a Grade 2.
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Brad Mills/USA TODAY SportsGiancarlo Stanton will have to wait even longer now to turn around his slow start.
Initial treatment is directed at minimizing pain and swelling while protecting and preserving pain-free range of motion. As the athlete regains normal range of motion and the ability to walk without a limp, strength exercises can be progressed. The activity eventually progresses to running, ultimately incorporating sprinting and sharp deceleration along with directional movements and peaking with a return to baseball activity. There is no magic way of knowing with absolute certainty when an individual is ready to return to play. That decision is made based on functional pain-free performance of gradually increasing intensity. Then, fingers are crossed in the hopes that the body withstands the demands of actual competition.
As for Stanton, he did struggle with a right hamstring issue late in the 2011 season, but it was never enough to send him to the DL. He missed a handful of games at the time but was able to recover during the offseason. In 2012, he underwent surgery to remove loose bodies from his right knee, which led to him missing a month in the second half of the season, but the hamstring itself was not reported to be a problem. Earlier this month, Stanton had a bruised shoulder, which seemed to be affecting him at the plate and ultimately sidelined him for six games. Finally, it seemed things were looking up. He hit his first home run of the season Saturday, followed by a second and a third on Sunday. Now this. His discouragement was evident when he told reporters after Monday's game, "If we could just erase all of April, that would be lovely."
April can't be erased, but if Stanton is able to recover well and return strong, it may be able to be overlooked, at least by fantasy owners. The hope is that his age (23) and physical conditioning will aid in his recovery and that the injury will not result in excessive scarring, which could make re-injury more likely. He will not be rushed, precisely to avoid aggravating the injury, meaning everyone -- Stanton included -- will need to be patient.
At this point, it appears likely to be June before we see the familiar name of Stanton back in the Marlins lineup.
Every Monday in this space, we'll provide updates on a variety of players to help you make your weekly lineup decisions. We'll specifically try to hit the players who are day-to-day, have just gone on the DL or are ready to return so that you can better decide whether you can count on them or not.
All projected return timelines should be considered fluid.
Hitters
Troy Tulowitzki, SS, Colorado Rockies (DTD): The good news is that Tulowitzki's latest ailment does not appear to be serious; the better news is that his surgically repaired groin is doing just fine. The hot start to Tulowitzki's season has likely helped put to rest any lingering concerns about the injury that ended his 2012 campaign prematurely. Unfortunately, Sunday's game brought a different scare. Tulowitzki strained his left shoulder on an awkward slide in the third inning, forcing him out of the game. According to the Denver Post, the injury is being described as a strained rotator cuff. It appears he will only be sidelined for a couple of days to allow any inflammation and soreness to subside, and there are no plans to place him on the DL at this time.Ryan Zimmerman, 3B, Washington Nationals (placed on DL 4/20, could return Friday): Zimmerman was placed on the DL with a strained left hamstring. While the injury was not considered serious, there are never any guarantees when it comes to these ailments. Zimmerman described it perfectly to the Washington Times: "Usually you can tell the difference between something that's bad and something that's not that bad, but with hamstrings you never know." What Zimmerman and the Nationals do know is that he has progressed well during his down time, performing running and hitting activities over the weekend. According to the Times, Zimmerman will play in rehab games Tuesday and Wednesday. If those outings are uneventful, he will rejoin the Nationals on Friday, when he is eligible to return. As is always the case with hamstrings, the only true measure of recovery is return to play without incident, but Zimmerman may be able to put that to the test soon.
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AP Photo/Wilfredo LeeHanley Ramirez has been out since injuring his thumb in the World Baseball Classic championship game March 19.
Mark Ellis, 2B, Los Angeles Dodgers (DTD): Ellis pulled up while running to first base Friday and it was determined later that he had strained his right quadriceps muscle. According to the Dodgers' official site, Ellis worried initially that it might be something more serious, but as he was able to jog on it, he recognized that it was not severe. He has already been able to swing a bat and throw the ball without any discomfort and is hopeful he can avoid a trip to the DL. Of course, the big issue with a quad strain is straight-ahead running, something Ellis has not yet tested at full speed. It appears he will be given some additional recovery time of a few days but if he remains relatively symptom-free and can increase his activity, he could potentially return by the end of the week.
Kevin Youkilis, 3B, New York Yankees (DTD): Last week, we said concern over Youkilis experiencing tightness in his lower back would be justified given his history. At the time, however, manager Joe Girardi downplayed it, saying he expected Youkilis back within a couple days. Well, those two days turned into a week and after a return on Saturday when he went 0-for-3, Youkilis was again experiencing stiffness the following day. He is scheduled for an MRI Monday. Concern is officially warranted. ESPN New York's Andrew Marchand notes how this could affect a timeline for Youkilis should he need a trip to the DL. Girardi acknowledged Sunday that all backs "can be tricky" and this situation with Youkilis reminds us that it is often the case with chronic low back pain, where "management" becomes the goal, as opposed to "cure." Right now the Yankees are in wait-and-see mode with their third baseman, but it appears the team will err on the side of caution. With Alex Rodriguez out until at least the All-Star break, it would be a significant blow to lose Youkilis for multiple weeks at a time.
Shane Victorino, OF, Boston Red Sox (DTD): The tricky back is in play with Victorino as well. What looked to originally be a one- to two-day affair has now extended past a week thanks to a flare-up, and may require a longer recovery. Victorino left the game early on April 20 with back spasms and after returning to action on April 22, was forced to leave the April 24 game early when the symptoms recurred. According to the Boston Globe, Victorino's improvement has only been "slight" in recent days, and with the team heading to the harsh turf of Toronto this week, his absence could be extended. It is not clear whether this will translate to a DL stint, but that does not seem to be ruled out. At the very least, it looks as if Victorino will rest a few more days before being tested in a game outing.
Neil Walker, 2B, Pittsburgh Pirates (DTD): Those nasty spikes. Walker sustained a deep cut near the knuckle of his right index finger Friday while attempting to break up a double play, and he was forced out of the game. He received six stitches in what Walker described as "the deepest cut I've ever had for stitches," according to MLB.com. He was incredibly fortunate to escape without any damage to extensor tendons in the hand, which lie very close to the injury site. The team did not place Walker on the DL, in the hopes that he could return late this week. While he may not have the stitches out, if he can bend the finger enough to swing the bat effectively and throw accurately, he will return to the lineup. Walker is expected to test those skills Monday, and if all goes well, expect him to be back in the mix later this week.
Michael Saunders, OF, Seattle Mariners (placed on DL 4/11, could return Monday): Saunders has been recovering from a right AC sprain suffered when his shoulder encountered the outfield wall a few weeks ago. After returning to batting practice little more than a week post-injury, Saunders was able to gradually increase his throwing in subsequent days. He began a rehab assignment over the weekend, and the hope is that he will be activated Monday. As long as Saunders has shown he can make the necessary throws and bat effectively, there is no reason for lingering concerns regarding this injury. But it would probably be for the best if that right shoulder and the outfield wall can keep their distance for a bit.
Erick Aybar, SS, Los Angeles Angels (placed on DL 4/13, could return by midweek): Aybar was sent to the DL with a bruised left heel which was causing him trouble swinging the bat from the right side of the plate. He has since returned to running and hitting, all without incident thus far. Aybar has seen action in extended spring training games, but the Angels have opted to give him some more at-bats before returning him to the team. He will play in a Triple-A game Monday, but it's not yet clear whether this will be his final hurdle. The heel issue appears to be largely behind him; at least the extended rehab time allows him to test it in multiple situations. Aybar's return to the lineup is expected shortly, perhaps within the next couple days.
Pitchers
Justin Verlander, SP, Detroit Tigers (DTD): The Detroit News reports Verlander said he developed "a little bit of a blister" on his right thumb near his fingernail, which was enough to bring him out of last Thursday's game after seven innings. Verlander shrugged off the notion that it would compromise his next start. Despite the thumb, Verlander had a decent outing, and there is no real indication for concern, particularly given that this is something he has contended with in the past. Blisters or other forms of skin breakdown can certainly threaten a pitcher's status, depending on the severity and location. This does not appear to be one of those times.[+] Enlarge

Kim Klement/USA TODAY SportsR.A. Dickey (4.50 ERA, 1.31 WHIP) currently rates just 112th among all pitchers on the 2013 ESPN Player Rater.
Brett Anderson, SP, Oakland Athletics (DTD): Anderson sprained his right ankle on April 19, forcing him to leave a start after just one inning of work. It initially appeared as if it would be a non-issue since Anderson made his subsequent start. It was a rough outing, however, and he only lasted four innings. On Sunday, the team announced Anderson's Monday start would be skipped because of the ankle which, according to the San Francisco Chronicle, was aggravated during Wednesday's appearance. Although Anderson has indicated the ankle feels much better and he hopes to only miss the one start (his next outing would come Saturday this week), even subtle issues on a pitcher's landing leg can be enough to throw off his mechanics. With Anderson so recently removed from Tommy John surgery, there is no reason to press through an issue which should otherwise resolve quickly and risk greater consequences.
Josh Johnson, SP, Toronto Blue Jays (DTD): Sometimes players just know. After being scratched from his last start Friday due to triceps tightness and given his injury history, many were concerned as to what an MRI might show. Not Johnson. Shi Davidi of Sportsnet reported Johnson expected the MRI to come back clear. Turns out he was right. According to John Lott of the National Post, Johnson's MRI showed no ligament damage, only inflammation, and he is expected to resume his throwing program soon. While that program will likely be increased based on tolerance, it is too early to definitively say whether he will miss his next start, although it seems likely. Most importantly, on the scale of major injuries this does not appear to be a significant worry for Johnson.
Every Monday, in this space, we'll provide updates on a variety of players to help you make your weekly lineup decisions. We'll specifically try to hit the players who are day-to-day, have just gone on the DL or are ready to return, so that you can better decide whether you can count on them or not.
All projected return timelines should be considered fluid.
Hitters
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Victor Decolongon/Getty ImagesFantasy owners will have to keep a close eye on Albert Pujols' foot in the upcoming days.
Ryan Zimmerman, 3B, Washington Nationals (placed on DL April 20): Zimmerman had been experiencing cramping in his left hamstring for several days before being forced out of last Wednesday's game early. He did not play Friday or Saturday, instead undergoing an MRI, which led to placement on the DL. While it sounds as if the strain is not serious, it was hampering him not only with his running but also while hitting. Manager Davey Johnson noted Zimmerman was not comfortable landing on his left leg when hitting. One has to wonder if some of his recent throwing inconsistencies can also be attributed, at least in part, to discomfort in his left leg. According to Amanda Comak of the Washington Times, the Nationals are hopeful that Zimmerman will only miss the minimum time, but hamstrings can be finicky. The key for the Nationals is preventing this from turning into a bigger injury, undoubtedly part of the rationale for a DL placement.
Dan Uggla, 2B, Atlanta Braves (DTD): Sometimes being a veteran means understanding when to take yourself out of a game proactively. It appears Uggla did just that on Saturday when he felt something in his left calf while trying to run out a ground ball. According to the Atlanta Journal-Constitution, Uggla let manager Fredi Gonzalez know he was having discomfort in the calf and was concerned it could get worse if he stayed in the game. Uggla then sat out Sunday's game also but was hopeful he could return Monday. Calf strains tend to be increasingly prevalent as athletes move into their thirties (Lance Berkman, Derek Jeter, Albert Pujols) and early rest may be the best medicine in trying to minimize downtime.
Asdrubal Cabrera, SS, Cleveland Indians (DTD): Slipping on the dugout steps is not how an athlete wants to incur an injury. Unfortunately that's precisely how Cabrera ended up with a contusion of his left wrist, and it's lucky it wasn't worse. X-rays taken of his wrist were negative, but as the Cleveland Plain-Dealer reported, it started to bother Cabrera during Saturday's game, so he came out early. Falls on an outstretched hand can often result in a fracture of the forearm or wrist bones but it appears Cabrera escaped both. He sat out Sunday's game and could sit longer if the wrist is still painful so fantasy owners should monitor his status daily.
Kevin Youkilis, 3B, New York Yankees (DTD): When Youkilis left Saturday's game early because of tightness in his lower back, those familiar with his history may have been a little nervous. That concern would be justified because Youkilis has a fairly extensive history of low back problems including an episode, which required a trip to the DL in 2011. This flare-up appears to be of the minor variety with manager Joe Girardi telling reporters he thinks Youkilis will be available Monday night.
Shane Victorino, OF, Boston Red Sox (DTD): Victorino also left Saturday's game early due to tightness in his lower back. He sat out Sunday's doubleheader but is expected to return to the lineup Monday. Early Sunday, manager John Farrell had considered using Victorino in the second game, suggesting he was making rapid improvements. Ultimately he was given all of Sunday off but it appears he will be back to face the Oakland Athletics.
Freddie Freeman, 1B, Atlanta Braves (placed on DL April 7, activated April 22): It looks as if the decision to rest Freeman early -- despite his displeasure -- has paid off. ESPN's Jim Bowden reported Monday that manager Frank Wren indicated Freeman has been activated and is ready to play against the Colorado Rockies on Monday night. Freeman had been sidelined with a right oblique strain, but it was always considered minor; the Braves were trying to ensure that it remained that way. After a couple of uneventful rehab games, Freeman has been deemed ready to return.
Michael Saunders, OF, Seattle Mariners (placed on DL April 11, could return late in week): A crash into the outfield wall resulted in a sprained right shoulder for Saunders. Although the team did not issue a timetable initially, it looked as if it could sideline him for an extended time. There are some encouraging signs that Saunders is progressing nicely however, most notably that he took batting practice last Friday. According to Geoff Baker of the Seattle Times, Saunders hopes to return when eligible (April 26) but will need to test throwing with his injured shoulder first. One of the most difficult things to do after an injury such as this is raise the arm completely overhead. Throwing with power will perhaps present more of a challenge than hitting so fantasy owners should monitor his activity closely throughout the week.
Pitchers
Jhoulys Chacin, SP, Colorado Rockies (placed on DL retroactive to April 20): Chacin was off to a solid start but has been sidelined with a lower back strain that forced him out of Friday's game early. According to the Rockies' official website, Chacin is scheduled to undergo an MRI on Monday. As for now there is no timetable for his return in place. The Rockies have recalled right-hander Rob Scahill from Triple-A Colorado Springs to take his place.[+] Enlarge

David Banks/USA TODAY SportsKyuji Fujikawa could be back this week to boost the Cubs' bullpen.
Brett Myers, SP, Cleveland Indians (placed on DL April 21): Myers has been fighting some tendinitis in his throwing elbow, but the picture has recently become more complex. The Indians announced via Twitter that Myers was placed on the DL Sunday with tendinitis and a mild UCL sprain. The report also indicated Myers would be shut down for two weeks and would not throw until symptom free. While the suggestion that the UCL sprain is minor is encouraging, it ultimately comes down to function. The fact that Myers experienced a drop in velocity is worrisome, but he also indicated he was not having any pain while pitching. At the very least, fantasy owners should expect him to miss four to six weeks (shutdown time followed by throwing progression), although the timeline ultimately will be dictated by how his elbow responds.
Ted Lilly, SP, Los Angeles Dodgers (opened season on DL, expected return April 24): Lilly underwent a labral repair of his left (throwing) shoulder last September and was slowed in the spring by the flu. He felt he was ready to pitch in the majors when Zack Greinke went down with a clavicle fracture, but the Dodgers preferred to keep him on a rehab assignment, moving Chris Capuano to the starting rotation instead. As it turns out, Capuano was moved to the DL with a calf strain last week and Lilly was able to get some extra innings under his belt. According to Dylan Hernandez of the Los Angeles Times, Lilly has confirmed he will start Wednesday against the New York Mets. Given the Dodgers' starter woes, a healthy -- and effective -- Lilly is badly needed.
Chad Billingsley, SP, Los Angeles Dodgers (placed on DL retroactive to April 16, could be out for the season): Did we mention the Dodgers are having some woes with their starting rotation? It looked initially as if Billingsley had survived the scare with his throwing elbow that cropped up last season. He underwent PRP injections in the fall, rested his right elbow, then resumed a progressive throwing program. The Dodgers waited during the offseason, expecting perhaps a bump in the road to recovery as often happens with partial UCL tears, but nothing went wrong with the elbow ... until now.
Billingsley managed well all through the spring but had a delayed start to the 2013 season due to a bruised index finger sustained while he was attempting a bunt. He eventually joined the rotation April 10 but it wouldn't last long. After two starts, Billingsley experienced some renewed elbow pain and now finds himself back on the DL. The bigger concern is that this may signal the beginning of the end of his season. If in fact the UCL tear has progressed to the point where Billingsley cannot function well enough to throw, he will be headed for Tommy John surgery. Given the recovery time from reconstructive elbow surgery, Billingsley stands a chance of losing time into next season if he does not address it quickly. No one wants to send an athlete to surgery when it isn't warranted and there will undoubtedly be careful evaluation of all sides of the equation, but the writing seems to be on the wall. Don't count on seeing Billingsley back in the lineup anytime soon, if at all.
Shaun Marcum, SP, New York Mets (placed on DL April 1, could return late this week): Marcum has been sidelined since the start of the month with what the team called "nerve inflammation" in his neck. After receiving injections early to help with pain and inflammation, Marcum has been on a slow and steady rehab course. There have been no reports of any setbacks thus far, an encouraging sign. According to ESPN New York's Kieran Darcy, Marcum will throw 70-75 pitches in a rehab outing Monday and, if all goes well, could return to face the Philadelphia Phillies on Saturday. This is all positive news for Marcum and the Mets, but it is worth noting that these types of ailments lend themselves to recurrence.
Brett Anderson, SP, Oakland Athletics (DTD): Anderson has been contending with a sprained right ankle, which resulted in a shortened appearance Friday and a complete day of rest Saturday. Susan Slusser of the San Francisco Chronicle reports that Anderson threw a bullpen Sunday, which went well, and he appears "likely" to make his Wednesday start. The biggest concern with an ankle sprain on the landing leg of a pitcher is that it not throw off his mechanics and risk injury to his throwing arm. The A's must like what they see if they're considering a prompt return.
Broken foot to cost d'Arnaud two months
April, 19, 2013
Apr 19
2:07
PM ET
By
Stephania Bell | ESPN.com
Mets general manager Sandy Alderson announced that catching prospect Travis d'Arnaud has a non-displaced fracture of the first metatarsal (the long bone of the forefoot which connects the midfoot to the big toe) in his left foot and is being further evaluated by team doctors in New York City Friday. According to ESPN New York, D'Arnaud sustained the injury while behind the plate during a Wednesday game and is currently in a walking boot.
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Chris Trotman/Getty ImagesTravis d'Arnaud has twice been traded for Cy Young award winners, first going to Toronto as part of the Roy Halladay trade, then to the Mets in the package for R.A. Dickey.
If the All-Star Break was a target date for bringing d'Arnaud to the majors, it is certainly no longer automatic.
