Prognosis of stars opening 2010 on DL
April, 7, 2010
By Stephania Bell | ESPN.com
It may have seemed as if all the stars were on the field on Opening Day, but many marquee players were relegated to the disabled list entering the 2010 season. Some may be just a few days from making their season debuts. Others, well, we're just hoping that we get to see them play this year.
Because fantasy owners always want to know when their injured star is expected to return, we've decided to highlight some of the key members of the group of 80-plus players starting their season at less than full health. In some cases there's reason to be very optimistic, but, as always, there are many more cases where there's cause for some level of concern.
Brandon Webb, SP, Arizona Diamondbacks (15-day DL, April 4): Webb has been a topic of injury conversation since last season. The hope coming into 2010 was that surgery, despite no significant findings, would help Webb move past his previous right shoulder problems. So far, that has not been the case. Although things initially looked promising, Webb has run into repeated setbacks that have postponed his return indefinitely.
Chirs Morrison/US PresswireBrandon Webb continues to have setbacks in his return from a shoulder injury.
The latest bit of discouraging news is that Webb received a cortisone shot in his surgical shoulder one week ago and was ordered to rest for a few days before resuming throwing. Webb's description of the shoulder is one not so much of pain, but rather a general sense of not feeling right. According to ESPN news reports, Webb said, "It doesn't feel great, but it doesn't hurt bad. I still feel like I can't let it go. I still feel like I'm not ready to get on the mound yet."
Hmmmm. A year plus one surgery later, and Webb is experiencing similar symptoms. It's impossible to thoroughly evaluate the situation from a distance, but it almost sounds as if there's more to this puzzle than the shoulder itself. Webb has made no progress in more than a month, and it is hard to be optimistic about his return, no matter when it occurs, at this point in time.
Cliff Lee, SP, Seattle Mariners (15-day DL, April 4): Lee is making some headway as he recovers from the abdominal strain that forced him to start the season on the DL. He is expected to throw a bullpen session Friday.
Lee also has made headlines in that he has been undergoing PRP (platelet-rich plasma) injections, along with all the other typical elements of rehabilitation, in an effort to aid his recovery from this injury.
It should be noted that the average missed time for these types of abdominal injuries hovers around 30 days for a thrower, and Lee is on pace for that time frame. He still needs to increase his pitch counts once he gets on the mound and appear in some rehab outings (at least two, perhaps more). The ultimate test of whether true healing has occurred doesn't happen until a pitcher throws at competitive velocity, so until he has been in that setting, the team -- and Lee's fantasy owners -- will not really be able to exhale.
Keep in mind that this is Lee's third significant abdominal injury. The hope, particularly with the addition of PRP, is that not only will the injury heal a little more quickly, but (and more importantly) it will heal more completely. To that end, one can assume the team will not rush him back. Reinjury could result in another four to six weeks of downtime. If all goes well, look for him to return in the latter half of April.
Ted Lilly, SP, Chicago Cubs (15-day DL, March 26): After undergoing a "cleanup" procedure on his left shoulder in early November, Lilly is expected to make his season debut in the third week of April. So far, his rehab course has been uneventful, which is a good sign. At 34 years old, you have to expect the presence of some wear and tear in a pitcher's shoulder. Although the goal is to avoid surgery whenever possible, in some instances it can add years to a pitcher's career. The fact that Lilly is doing so well provides much encouragement heading into the season. The disabled-list stint allows him to continue to build his throwing endurance in minor league games until everyone, including Lilly, is confident that he is indeed ready to return.
Joe Blanton, SP, Philadelphia Phillies (15-day DL, April 1): Blanton had never been on the disabled list in six major league seasons heading into this campaign. But all good things must come to an end. Blanton is being forced to start the 2010 season on the DL with a left oblique strain. The Phillies have maintained that Blanton's strain is on the mild side, but the initial projections have him missing anywhere from three to six weeks, standard for an oblique injury. According to ESPN news reports, team physician Michael Ciccotti said that if all goes well for Blanton, "we're looking at the earliest at the third week of April."
Again, the goal is to have the athlete avoid a second trip to the DL for the same injury, so it makes sense to keep Blanton out a little longer this time if it means better insurance for the long haul. The average DL stint for a pitcher with a true oblique strain is approximately 30 days, so an uneventful rehab could mean Blanton will return in late April.
Daisuke Matsuzaka, SP, Boston Red Sox (15-day DL, April 3): Matsuzaka started the season on the disabled list as a result of neck and back problems that have bothered him this spring. Currently, he is making progress with a pitching program in which he's expected to make at least three rehab starts, with his first one scheduled for Saturday. The biggest question is whether these issues are really behind Matsuzaka. He did work more closely with the team on his offseason conditioning and reportedly showed up to spring training in better shape, but there were still setbacks. The Red Sox are not sounding particularly worried at this point, and the injuries themselves do not seem serious. Last year, however, Matsuzaka was nagged by various ailments that kept him from being fully effective. The hope is that this will not be a repeat performance.
Erik Bedard, SP, Seattle Mariners (15-day DL, retroactive to March 26): In our preseason draft kit, we indicated that Bedard's offseason surgery to repair the labrum in his throwing shoulder would mean a delayed start to the season. Bedard, who has been playing long toss, is expected to throw a bullpen session of roughly 30 pitches Wednesday, according to Geoff Baker of The Seattle Times. Bullpen sessions evolve into rehab assignments, and Bedard will have to build up his endurance and velocity in his throwing arm. Assuming no setbacks, Bedard still appears on track to return around June.
AP Photo/Charlie NeibergallErik Bedard has lots of talent, but this year, his DL time is already built in.
Baker makes an interesting point regarding some of the mechanical adjustments the Mariners are working on with Bedard. Specifically, they are trying to adjust the turn in his delivery to minimize stress on his throwing shoulder without revamping his throw and making his pitches easier to read. It will be interesting to see whether the downtime has allowed Bedard's body some additional recovery. He has been plagued by soft tissue injuries in recent years and has not been the model of physical endurance. A shortened season after a lengthy time off may serve him well. He's not out of the woods yet, though; he has many hurdles to cross before he becomes a consideration in the Mariners' rotation.
Edinson Volquez, Cincinnati Reds (15-day DL, April 4): Volquez is another pitching ace who underwent Tommy John surgery last year on his throwing (right) elbow, but he did not go under the knife until August, making his return this season a question mark at this point in time. Although we've heard that the Reds hope to have him after the All-Star break, there's still no indication whether that means July or September, and there's no way to predict with any certainty. Typical recovery takes about a year, give or take a month or two (or longer) depending on whether any setbacks arise during the rehab process. Beyond that, it often takes a pitcher time in games to truly return to form, and he often doesn't put up typical numbers until the following year.
Currently, Volquez is throwing limited pitches at controlled speed off a mound and is doing all the right things so far. The biggest hurdles are yet to come, however, so it remains to be seen just what he can accomplish as far as returning this year.
Scott Kazmir, SP, Los Angeles Angels: (15-day DL, retroactive to March 31) Just when it seemed as if Kazmir might blow by a couple of minor spring training injuries to start the season on time ... he didn't. Not that there appears to be much to worry about. ESPNLosAngeles reports that, according to manager Mike Scioscia, "There's no setback with Kaz. It's just a matter of time and him getting stretched out to pitch a little deeper into a game."
Kazmir came into spring training with a hamstring strain which slowed him a bit. Later in the spring he developed some shoulder fatigue. Neither was believed to be serious, but it did delay the build-up of his throwing. As of now Kazmir is expected to make a rehab start Friday and is then expected to rejoin his team when they face the New York Yankees on the road April 13. Kazmir, with the help of pitching coach Mike Butcher (with whom he worked when both were with the Tampa Bay Rays), has made some adjustments that he believes will make him a bigger threat on the mound this year. He also focused on extensive offseason strengthening. Once Kazmir's season gets underway, he might restore his fantasy value if he can just stay healthy.
Relief pitchersBrad Lidge, RP, Philadelphia Phillies (15-day DL, retroactive to March 26): Lidge is coming off not one but two surgeries this offseason. First, he underwent elbow surgery in November to repair a torn flexor tendon and remove a loose body in his throwing (right) elbow. In January, he had surgery on the medial meniscus in his right knee. Lidge indicated that pain in the knee throughout the 2009 season led to changes in his throwing mechanics, which ultimately contributed to his elbow injury. The good news this spring is that Lidge has made steady progress with his rehab and had not experienced any pain ... until recently.
Lidge has had some elbow soreness, which is not unusual for him as he builds up his arm strength, but there were concerns that it might have been related to his recent procedure. Not so, said team physician Michael Ciccotti. According to The Philadelphia Inquirer, Ciccotti emphasized that the recent cortisone shot to help calm inflammation in Lidge's elbow was delivered to the lateral or outer portion of his elbow. Lidge has no discomfort on the medial side (where the repaired flexor tendon is located along with the ulnar collateral or Tommy John ligament), and his elbow is stable.
Lidge threw 25 pitches in a Sunday bullpen session and had "no pain, no issues," according to Phillies general manager Ruben Amaro. If all goes according to plan, Lidge should return in April. Whether it's in the next week when he's eligible to come off the DL or, more likely, a little later in the month, Lidge should be in good health and figures to have a strong season. Remember, the last time he entered the season on the disabled list (2008 after right knee surgery), Lidge managed to put together 41 saves and a 1.95 ERA before the year was through.
Huston Street, RP, Colorado Rockies (15-day DL, retroactive to March 26): Street began experiencing shoulder stiffness in the middle of March. Although any sign of a shoulder issue is a worry when it comes to a pitcher, the good news is that Street had no significant findings on an MRI. Despite a few setbacks in his throwing progression thus far, Street was reassured by none other than Dr. James Andrews this week that his shoulder indeed looked just fine. The plan is for Street to resume throwing in the next week, but beyond that there is no firm timetable in place. It would figure to be about a month or so before Street could be ready for competition, as he will have to return to throwing from a mound and ultimately log some innings in the minors first.
AP Photo/Ed AndrieskiA sore shoulder will keep Huston Street out of action until sometime next month.
At this point there is plenty of reason to be optimistic, but bear in mind that occasionally lingering problems evolve from trivial beginnings. Diamondbacks ace Brandon Webb is just the most recent example of a similar pattern ... and he's still not back. The Rockies have to have their fingers crossed that Street's issue is indeed of the simple variety, and if that's the case, look for him to be available for competition in mid-to-late May.
Kerry Wood, RP, Cleveland Indians (15-day DL, retroactive to March 26): Wood suffered a moderate strain to a muscle in his back (latissimus dorsi) in spring training, and the team's medical staff indicated that he would be out a minimum of six weeks. Although Wood said he hoped to be back sooner, there is really no reason to expect that. Even if the injury is not terribly serious, the message from the Indians appears to be that they will not rush him back.
Nor should they. Wood's injury history is well documented, and although everyone is thankful that the injury is not to one of the rotator cuff muscles or within the shoulder joint itself, the latissimus plays a significant role in controlling the throwing arm. A strain or weakness in one area can lead to compensations in another, something Wood cannot afford. Allowing him to recover fully before resuming the work of throwing makes perfect sense. Given what the team has projected, do not expect to see him in the closer role before mid-May. In the meantime, Chris Perez will handle the job.
Joey Devine, RP, Oakland Athletics (15-day DL, retroactive to March 26): Devine had a less-than-divine 2009 when a bout of elbow pain in the spring later deteriorated into a need for Tommy John surgery. The silver lining in his dark cloud was that surgery was early enough (April) to allow him to be available for most of the 2010 season. Devine has had a very strong rehab progression back from surgery. Other than some minor tendinitis, which is not unexpected with this particular recovery, Devine's road to return has been smooth.
Now come the big tests. Devine's first bullpen session is scheduled for Wednesday, and this is a big transition, as it involves throwing from a mound. After the bullpen sessions come the simulated batting practices and eventually real innings. If all continues well, Devine could rejoin the roster in late April. It's worth bearing in mind that pitchers generally require some time before they truly return to competitive form, but so far things are lining up in Devine's favor this year.
HittersIan Kinsler, 2B, Texas Rangers (15-day DL, retroactive to March 26): Kinsler is battling a right high-ankle sprain, an injury that can be notoriously tricky when it comes to return to full activity. Whether he comes off the DL when eligible on April 10 is still very iffy. Kinsler was able to take some swings with the bat early this week but still has not been cleared to run or perform any lateral movements.
Athletes often begin to feel better in their recovery from this injury and think they are closer to return than they really are. When they are subjected to increasingly difficult movement challenges, they often find that the ankle is still a little weak and uncomfortable. The worst-case scenario would be to return too soon only to have a second, more protracted visit to the DL. So while Kinsler told the Fort Worth Star-Telegram on Monday that he hopes to begin a rehab assignment this weekend, his body may not be quite up to that task.
Lance Berkman, 1B, Houston Astros (15-day DL, retroactive to March 26): Persistent swelling in Berkman's left knee after a contusion suffered during spring training led to an arthroscopic procedure in mid-March. Unfortunately, he has had some lingering issues with swelling in the knee, resulting in multiple drainages to extract the fluid. On Monday, Berkman had it drained for the fifth time and also received a cortisone injection to help control the inflammation. The next day, Berkman told the Houston Chronicle that the swelling seemed to be staying down a bit, an improvement from the earlier drainages. Although he's taken batting practice, he is still a ways removed from returning to play. He will have to demonstrate that he can increase his activity without causing another flare-up. At this point, he appears to be at least a week or two from rejoining the team.
Jose Reyes, SS, New York Mets (15-day DL, retroactive to March 26): It looks as if the speedy shortstop will rejoin the team Saturday, the first day he is eligible to do so. Reyes, whose hamstring surgery and thyroid issues have been well documented here, has been looking strong since returning from New York. And for those questioning whether he had his speed back, he did net two stolen bases in an extended spring training game Monday.
Jim McIsaac/Getty ImagesAfter a lost 2009 season, Jose Reyes could be back as early as this weekend.
The bigger concern going forward will be whether Reyes can maintain his health across the season. There is no doubt that he is in great physical shape and is eager to prove that he is back in full capacity. There is some doubt, however, that his hamstrings will cooperate with the demanding grind of baseball. For fantasy owners, this is a risk-reward relationship here. Let's hope the reward wins in the end.
Carlos Beltran, OF, New York Mets (15-day DL, retroactive to March 26): Beltran has been working his way back from January surgery to address cartilage damage in his right knee, the same one that caused him to miss the majority of the 2009 season. Beltran has said that his knee is finally pain-free and he is making big improvements in strength and control.
The big tests will come with the pounding, something he has not tried until now. Beltran is scheduled to begin running Saturday, and according to reports in the New York Post, Mets general manager Omar Minaya says Beltran will need another four to eight weeks beyond that before he could rejoin the team.
It seems that the earliest Beltran could return would be mid-May; however, it would not be surprising if he does not return before early June. The hope is that a careful, steady rehab will help ensure that once he does come back, he can stay healthy for the remainder of the season. That's still a question mark, given that his knees are not quite what they once were, although likely much improved over last year. As he increases his baseball-related activities, we should get better insight as to how healthy Beltran truly looks. This is definitely a situation to watch.
Alex Gordon, 3B, Kansas City Royals (15-day DL, retroactive to March 26): For a youngster with huge potential, Gordon has not been able to reach his targets yet because of injury. Last year he dealt with a torn labrum in his hip that required surgery and missed a big chunk of the season. After an offseason of intense work with the Royals' strength and conditioning team, Gordon seemed poised to jump start 2010.
And then there was the headfirst slide on March 6 while stealing second base that resulted in a broken thumb. There's a reason managers cringe at the headfirst slide; while they seem to be a little faster, there is an increased risk of broken fingers and thumbs or cleated hands. Luckily Gordon's thumb, is nearly healed. The DL move for Opening Day was to allow Gordon some more playing time in the minors to ensure that he is fully ready to return to competition. If all goes well expect to see him back with the team by late April, probably sliding feet-first.
Freddy Sanchez, 2B, San Francisco Giants (15-day DL, retroactive to March 26): Sanchez's season with the Giants ended early last year when he was shut down in September thanks to a meniscus tear in his left knee. He ended up undergoing surgery for his knee shortly thereafter but somewhat surprisingly later underwent surgery on his left shoulder. In December, Sanchez had a procedure to address the labrum and the AC joint in his nonthrowing shoulder, but the lengthy rehab meant that he would miss Opening Day. Giants manager Bruce Bochy said that Sanchez, who remains at the team's spring training camp in Arizona, is still three to four weeks away from a minor league assignment, according to the San Jose Mercury News. For fantasy owners, this translates to a projected return of somewhere in mid-to-late May. Hopefully the wait will have been worth it, as Sanchez should exceed his performance from late last year now that his injury issues have been addressed.
If you have any other injury questions, feel to drop a note in my mailbox and I may answer it in my next blog entry.