Stephania Bell: Alex Cobb

As the injury news pours in this season, we'll take a quick-hit look at the fantasy-relevant players who are battling health issues. We'll be splitting them up into players we're keeping a watchful eye on -- those who have suffered injuries recently but have not been placed on the disabled list -- as well as those who have been placed on the DL.

To the DL
Beltre


Adrian Beltre, 3B, Texas Rangers (left quadriceps): The Rangers placed Beltre on the disabled list Sunday (retroactive to April 9), making April 25 the first day he would be eligible to return (Rangers are off on April 24). The move doesn’t come as a huge surprise given the Rangers had made it known they were leaning that direction.

While the injury was classified as a Grade 1 or mild strain, the bigger picture -- as in the timing of this injury relative to the scope of the entire season -- undoubtedly factors into the team’s decision. According to ESPNDallas.com, general manager Jon Daniels acknowledged as much. "That's probably the smarter thing, to err on the side of caution," Daniels said. "The last thing we want is to be without him for an extended period of time." The hope is that Beltre will be able to return when eligible.

Extended absence is a reasonable concern with a player who has a history of soft tissue injuries, particularly on that left side. While Beltre has managed his prior injuries well enough with a few days' rest to avoid the DL, the increasing number, frequency and, well, age elevate the level of concern.

Beltre has primarily experienced hamstring strains in his past, but this quad issue first appeared during spring training. The opposing dynamic of the quadriceps and hamstrings along with increased presence of scar tissue and an overall decrease in tissue flexibility pose a risk.

During spring training, manager Ron Washington had already hinted at increased DH days for Beltre, especially during day games following night games. Not only is that likely to be in place, it wouldn’t be surprising if there were increased days off for strategic rest as the season progresses. For a player who’s averaged 149 games a season over the last four years (playing 154 or more for three of those years), sitting and watching is not his style. That may be something Beltre will have to adjust to, however, to preserve his health for the long haul.
Zimmerman


Ryan Zimmerman, 3B, Washington Nationals (right thumb): Another dive to a base, another thumb injury. When Zimmerman made the unsuccessful attempt to dive back to second base Saturday, the blood on his hand indicated something was wrong. It turned out to be a fracture in his thumb that will require four to six weeks to heal. Bone is one of the more predictable tissue types when it comes to repair, so the timetable issued by the team appears reasonable, presuming a clean break and no unusual setbacks. General manager Mike Rizzo said Zimmerman will consult with a hand specialist Monday as a precaution.

While his loss is a blow for the Nationals, there may be a silver lining. Zimmerman was already struggling with discomfort in his right shoulder, the source of an errant throw just one week prior to this injury. An MRI revealed only inflammation, but the chronic nature of Zimmerman’s shoulder issues had the team giving him practice time at first base. Now that he is sidelined by the thumb injury, his shoulder will get some well-timed rest.
Cobb


Alex Cobb, SP, Tampa Bay Rays (left oblique): Cobb sure looked good in his Saturday start, but apparently, by the end of his outing, he didn’t feel so great. According to the Tampa Tribune, Cobb felt something pull in his side early in the game but was able to continue. An MRI taken later revealed a strained left oblique, and Cobb was placed on the DL Sunday.

Cobb’s injury is typical of the type of oblique injury pitchers suffer, that is to the side opposite their throwing arm. The average DL stay for pitchers suffering an oblique injury is just over a month. Timetables can vary obviously depending on the precise location and degree of injury as well as the individual’s rate of healing, but a month’s absence is a reasonable expectation. Cobb’s return date is not likely to be any sooner, but it could roll into five or six weeks before his next major league start.

Adequate down time to ensure the injury heals properly is critical for anyone, but especially a pitcher. Continued attempts to push through an oblique injury lead to compensations by other, often weaker muscle groups, which then can lead to other problems (read: arm). Depending on the time required for the oblique injury to resolve, the amount of throwing a pitcher will need to return his arm strength to normal can vary. It will be important to monitor how Cobb responds once he is allowed to resume throwing, particularly downhill.
Anderson


Brett Anderson, SP, Colorado Rockies (left index finger): Anderson had some bad luck on Saturday. There are enough ways for a pitcher to get injured; during an at-bat is not the usual one. Unfortunately for Anderson, what was initially thought to be a contusion (or deep bruise) turned out to be a break of his index finger on his throwing hand. He is now expected to miss the next four to six weeks as the bone heals. The challenge for him initially will be overcoming any stiffness in the finger and restoring his normal grip after having the digit immobilized.
Every week 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.

All projected return timelines should be considered fluid.

Hitters

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Hanley Ramirez
AP Photo/Joe RaymondHanley Ramirez injured his throwing shoulder at Wrigley Field on Sunday.

Hanley Ramirez, SS, Los Angeles Dodgers (day-to-day): Playing hard can come with associated risks, as we have seen throughout this season. We also have seen Dodgers starters succumb to an unusual number of injuries. Ramirez fell into both of those classes Sunday night when he injured his right shoulder crashing into the stands while tracking a foul ball. According to the Los Angeles Times, there was initial concern that his injury was serious. The good news is that, as of Monday, Ramirez already reported feeling improvement. According to MLB.com, his pain had decreased and manager Don Mattingly indicated his range of motion also had improved. If his function improves dramatically in the first 48 hours, Ramirez might not need more than a few days of rest. Fantasy owners should plan on a handful of days off at the minimum, but it appears he could avoid another trip to the DL -- it would be his third of the year -- if he continues to progress.

Howie Kendrick, OF, Los Angeles Angels (day-to-day): Collisions in the outfield are always scary, and the one between Kendrick and teammate Collin Cowgill in the fifth inning of Monday night's game was no different. Kendrick's leg hit Cowgill's body, and he was clearly in pain when he hit the ground, ultimately requiring assistance to get off the field. The Angels later reported that the injury is a hyperextended knee (when the knee moves backward beyond its normal range, placing strain on the structures on the back side of the knee) and that Kendrick is day-to-day. Depending on the amount of swelling and the severity of any soft tissue injury, Kendrick could be out just a few days or could require a DL trip. More should be known in the next several days as the team sees how Kendrick's knee responds.

David Wright, 3B, New York Mets (placed on disabled list Aug. 3): According to Adam Rubin of ESPN New York, Wright was diagnosed as having a moderate hamstring strain (otherwise known as a Grade 2 strain) and is expected to miss three to five weeks. Wright left Friday's game early, and a subsequent MRI confirmed the extent of the injury. Apparently, the "cramping" he had experienced earlier in the week signaled something bigger, and now the Mets can expect to be without their star for the better part of a month or more. A one-month absence for a moderate strain would be consistent with what other star players have experienced this year (Hanley Ramirez, Giancarlo Stanton), so fantasy owners shouldn't hold their breath for a dramatically earlier return.

Derek Jeter, New York Yankees (placed on DL Aug. 5): Jeter cannot seem to get any groove going this year. Now that his surgically repaired ankle (and subsequent stress fracture) has finally healed, his muscles are not cooperating. His first appearance in a major league game resulted in quadriceps soreness, which forced him back to the DL just as quickly as he had left it. In Jeter-like fashion, he homered out of the gate in his return to the majors, but, within the week, he was dealing with another soft tissue injury. Jeter was diagnosed as having a right calf strain, and the team returned him to the DL on Monday. With only five major league games under his belt in 2013, Jeter described the season as a "nightmare," according to ESPN New York.

On a more positive note, Jeter also said, "It won't be three weeks," a reference to the amount of time he missed in 2011 with a similar injury. His quick definitive declaration suggests he is not experiencing as much soreness this time around, but you can bet, considering the type of season it has been for Jeter, the Yankees will exercise caution. Even if Jeter feels substantially improved, the team will put him through all the testing paces before returning him to action, just as they did with the quad. At 39 years old, with a rough start to the season and with this injury occurring in the same leg as the recent ankle fracture, the team will ensure he's as close to full health as possible before he plays. It appears he could be available by the last week-plus of August, but, until he strings together a couple of consecutive weeks of plate appearance, there's reason to be cautious.

Desmond Jennings, Tampa Bay Rays (placed on DL Aug. 5): Jennings injured the middle finger on his left (non-throwing) hand on a slide into second base on Saturday. Originally thought to be a sprain when initial X-rays were negative, further tests Monday revealed a small fracture, according to the Tampa Bay Times, hence the placement on the DL. The team has not issued a timetable for Jennings' return, and, although simple fractures can take approximately six weeks to heal, a return to activity can happen significantly earlier. The key is good early healing and functionally being able to grip and swing a bat without threatening the bone. All that's certain at this point is that Jennings won't be in the lineup for at least two weeks.

Carlos Gonzalez, Colorado Rockies (day-to-day): Speaking of middle finger injuries, Gonzalez was already day-to-day with an injury to the third finger of his right hand, which has bothered him intermittently in the past month. By Sunday, it seemed he was inching closer to the DL stint he had been trying to avoid. Just a week ago, this was my assessment:

"While it sounds as if the team does not believe a DL stint will completely resolve the problem, it also sounds as if this is not likely to go away anytime soon, no matter what path they choose. The risk of aggravation exists with every swing of the bat. It's unclear how much time he will miss in the near future, as the Rockies are calling him day-to-day. The likelihood is that, regardless of whether he goes on the DL, he will again string together series of games where he performs well, but a setback could be lurking around the corner."

The challenge for Gonzalez is that, no matter what adjustments he tries to make, the finger continues to limit him. "I don't want to go on the DL," Gonzalez told The Denver Post. "But I can't swing. I am just a slap hitter; that's all I can do right now."

As of Tuesday morning, the Rockies had not made the move to place Gonzalez on the DL, and it's unclear whether they will opt (for now) to continue with the current plan, essentially resting him as needed, or move him to the DL. Gonzalez has remained fairly productive, despite the finger issue, when he has been in the lineup. The problem for fantasy owners is that the interruptions seem to be coming a little more frequently over the past couple of weeks. Unfortunately, that pattern is not likely to change in the course of the remaining season -- unless there's a two-week break with a DL move, of course -- so get used to checking the daily lineups.

Miguel Cabrera, 3B, Detroit Tigers (returned to lineup Monday, had been day-to-day): After missing three games because of his strained abdominal muscle, Cabrera made a pinch-hit appearance in the 12th inning of Sunday night's game. Although he didn't run, he apparently showed enough to return to the Tigers' lineup Monday. It's not clear whether he's entirely past the injury, however, and fantasy owners should monitor his performance (and status) closely this week. If he aggravates the injury, he could be pulled again to rest.

Pitchers

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Ryan Vogelsong
AP Photo/The Canadian Press, Frank GunnRyan Vogelsong is all set to return to the Giants' rotation Friday.

Ryan Vogelsong, SP, San Francisco Giants (placed on DL May 21): According to the San Francisco Chronicle, Vogelsong will be activated from the DL and start for the Giants on Friday. His return will be a welcome sight after a May injury in which he was hit by a pitch and suffered not one but two breaks in his hand. He required surgery to stabilize the fractures (and a subsequent procedure to remove pins), followed by a lengthy rehab process. Apparently, the rehab has gone well, as Vogelsong has looked sharp in rehab starts thus far. In fact, part of the length to return is the process of rebuilding his arm strength and overall throwing endurance, but his control has been strong. This all bodes well for a strong return for Vogelsong.

Alex Cobb, SP, Rays (placed on DL June 15): Cobb has made two rehab starts now, and the most important news is that he has not experienced a recurrence of concussion-related symptoms. Cobb told The Tampa Tribune, "The vertigo was nonexistent all night." He went on to say that he did not experience any headache, either, something he was concerned could happen. This ability to get through the next level of performance without a return of symptoms is critical in allowing Cobb to not only continue but to progress to the next level (increased innings, increased intensity of competition).

Also important is that he is getting more comfortable on the mound. After taking a line drive to the head in June, it's understandable that he'd need to acclimate to being back on the mound and facing hitters after an extended layoff. The combination of these two things suggests he is getting closer to rejoining the Rays. The plan was for Cobb to make two rehab starts (not counting a start that was shortened by a blister on his finger), and he is scheduled to make another this Thursday. If he continues to pitch well, is more comfortable on the mound and, most importantly, does not experience any recurrence of symptoms, his subsequent start could be alongside his major league teammates.

Yovani Gallardo, SP, Milwaukee Brewers (placed on DL July 31): Gallardo was placed on the DL with a hamstring injury suffered when he delivered a pitch in the fifth inning a week ago. It was Gallardo's left hamstring, the one on his landing leg that is stretched while controlling his body as he moves from ball release to follow-through. Before he can return to pitching, the leg needs to be strong enough to support him in a single-leg stance as he increases the load through that side. It also needs to be flexible enough to be placed under stretch while controlling his delivery.

One week into his DL stint, Gallardo seems to be making some progress. He has been long tossing to keep his arm loose while rehabbing the leg. The next test will be resuming throwing from a mound, which could happen later this week.

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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Ryan Howard
Brad Penner/USA TODAY Sports Ryan Howard lands on the DL while hitting .266 with 11 homers and 43 RBIs.

Ryan Howard, 1B, Philadelphia Phillies (placed on DL July 6): Howard’s move to the DL couldn’t have come as a complete surprise. He had been in and out of the starting lineup recently with soreness in the knee, but now he will be out for an extended period. Speaking to reporters Monday, Phillies general manager Ruben Amaro Jr. stated Howard has a meniscus tear and will undergo surgery to address the issue. The Phillies are hopeful they can have Howard back in the lineup within six to eight weeks, not an unreasonable expectation if the operation and subsequent rehab process go smoothly. Although Howard had been dealing with soreness since May, he told the Philadelphia Inquirer the pain and stiffness had recently increased to the point where he could not play through it. This procedure should allow Howard to move forward from the injury and return to play this season. But it is yet another injury to the left leg, which has been responsible for most of Howard’s DL time during his professional career, including his Achilles rupture in 2011.

Aramis Ramirez, 3B, Milwaukee Brewers (placed on DL July 8): Day-to-day could really describe the entire season for Ramirez, given that his left knee has not been 100 percent healthy since he initially injured it this spring. On Saturday, Ramirez made a diving catch after which he came up limping, exiting the game shortly thereafter. On Monday, he was placed on the disabled list as Ryan Braun was activated.

The bigger question is whether Ramirez can really be expected to be at full health at any point this season. Based on how the knee has responded so far and with the potential for aggravation any time he slides or dives, the answer would appear to be no. In the absence of being healthy though, can he be effective? The Brewers have to hope the answer to that question is yes, but it may be on only an intermittent basis.

Ryan Braun, OF, Milwaukee Brewers (activated from DL July 8): Braun’s thumb injury has been discussed multiple times in this space and the uncertainty of how it will behave across the rest of the season remains. However, he made enough progress in terms of gripping and swinging the bat that he was activated Monday in time for the evening matchup against the Cincinnati Reds. He swaps roster spots with teammate Aramis Ramirez. While he's back in action, Braun would still benefit from a few days off during the All-Star break. This might offer fantasy owners a good glimpse of whether the layoff has helped Braun’s symptoms to the point where he can be productive at the plate.

Carlos Gonzalez, Colorado Rockies (day-to-day): If it’s not one thing, it’s another. Literally. Gonzalez left the game early after straining his upper back Thursday; now it’s a finger which caused him to exit early on Sunday. Gonzalez reportedly took an awkward swing and injured the middle finger on his right hand. According to Troy Renck of the Denver Post, X-rays were negative and Gonzalez remains day-to-day with a sprain. It will all come down to whether he can effectively grip and control the bat. Literally.

Yadier Molina, C, St. Louis Cardinals (day-to-day): Molina and the Cardinals were relieved to learn that his right knee does not have any structural damage, according to the MRI he underwent this weekend. Molina’s knee had been sore for a month but he told reporters he was sent for further tests after it hurt him to run Friday. "Everything came back negative and that's a relief," Molina said Sunday. He hopes to be back Tuesday after the Cardinals’ off day Monday. It’s hard to imagine a couple days will make this disappear, particularly if it has been bothering him for a month. After all, it’s not as if his position isn’t stressful on his knees without adding in the demands of running the bases. With former catcher Mike Matheny at the helm, it’s a safe bet the Cardinals will be mindful of Molina’s workload this week if his knee continues to nag at him.

Matt Kemp, OF, Los Angeles Dodgers (day-to-day): The good news is the Dodgers expect Kemp back in the lineup soon, possibly as early as Monday. The bad news is that he’s making an appearance in this blog. Again. And his left shoulder is the culprit. Again. The good news is that this time the injury is not in the glenohumeral joint, the location of his offseason labral surgery and where the arm bone or humerus interfaces with the socket. This pain was located in the AC (acromioclavicular) joint, where the collarbone and the shoulder blade meet at the point of the shoulder. Kemp received an injection to help alleviate the pain, but the key to his return will be whether he has any (as in even a hint of) discomfort in that shoulder when he attempts to swing. After all of his struggles to regain his form and along with it his power following surgery, he is going to be closely monitored to ensure he’s not compensating and altering his swing. Again. In any case, it looks as if he escaped a serious issue and should return in short order; now the Dodgers have to hope this is a one-time incident and not another problem that will resurface as the season progresses.

(After this was initially posted, the Dodgers placed Kemp on the disabled list again.)

Neil Walker, 2B, Pittsburgh Pirates (day-to-day): Walker left Saturday’s game with soreness in his right side and is expected to undergo an MRI this week (although he did not have one on Monday). There are hints of an oblique ailment, but the imaging test should help confirm the location and the severity of the injury. While Walker did not seem to think his injury was serious initially, it’s often not until the athlete tests the area later with activity that the limitations become apparent. He is not in Monday’s lineup and will likely be out several days at the very least.

Shane Victorino, OF, Boston Red Sox (day-to-day): Victorino’s back has been giving him fits throughout the season, but he left Saturday’s game early because of tightness in his left hamstring. It’s unclear whether the two are related, but manager John Farrell seemed to think so. Victorino did not play Sunday and it is not immediately clear how much time the Red Sox anticipate he will miss. Given his history not only with his back and his hip this year, but with a prior DL stint in May specifically attributed to his left hamstring, caution is warranted.

Lance Berkman, DH, Texas Rangers (placed on DL July 7): The Rangers placed Berkman on the DL not because of his ever-troublesome knees, but because of a low back or hip ailment. The knees are still likely to blame, though. According to ESPNDallas.com, Berkman tweaked his right knee on an awkward step a week ago, missed a few games, then developed this issue while running to first. Rangers manager Ron Washington seems a bit surprised that the knees are an issue. "When we signed him, we thought everything was going to be fine with the knees," Washington said. Really? This is a 37-year-old player with chronic knee issues which, while he’s managed to undergo various procedures and return to play, are not the same joints as when he was in his 20s. These potential flares have to be expected. And then there’s always the possibility that the pain travels up the chain toward the hip and back, as appears to have been the case this time. Berkman will return and may even do quite well, but the risk is not going away.

Yasmani Grandal, C, San Diego Padres (placed on 60-day DL July 7): Catchers and plays at the plate are always risky and the Padres are the latest to experience the effects. After he injured both his ACL and MCL in a collision at home plate Saturday, the prospects of Grandal returning this year seem grim. The Padres’ immediate placement of Grandal on the 60-day DL further outlines the severity of the injury. After the game, Grandal was on crutches and Padres manager Bud Black indicated the outlook was not good. An MRI is scheduled for Monday after which more information should be forthcoming. If he has a complete ACL tear, which requires reconstructive surgery, then Grandal’s season will indeed be over.

Jedd Gyorko, 2B, San Diego Padres (placed on DL June 10): Last week in this space we discussed Gyorko’s setback during a rehab game, which delayed his return to the team. Although he indicated the setback was minor, it seemed only logical the team would require another rehab outing before allowing him to play in major league games. That appears to be the plan, although a definitive timetable has not been offered. Manager Bud Black told reporters Gyorko could renew a rehab assignment toward the middle of this week. Given the way things have unfolded, no matter how strong Gyorko feels, it would not come as a surprise if he is held out of a return to the majors until after the All-Star break.

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Troy Tulowitzki
Chris Humphreys/USA TODAY Sports Troy Tulowitzki's injury likely will also keep him out of next week's All-Star Game.

Troy Tulowitzki, SS, Colorado Rockies (placed on DL June 13): Last week we said Tulowitzki could get clearance to advance his activities and he has done precisely that. On Thursday he took batting practice for the first time since fracturing his rib. It obviously did not set him back since he returned for more on Friday. The swings are a good test of how aggressive he can be while still healing from the injury as long as he is giving it full effort, something that’s often hard to simulate in practice. As Tulowitzki told the Denver Post, “I have to have my game swing. I can’t baby it.” Even though his injury was to the rib itself, the muscles which attach to the ribs (such as intercostals and obliques) contract violently with rotation. If the bone were still sensitive, he would no doubt feel the discomfort and be limited in terms of how vigorously he could swing. Only he knows whether he is truly testing it full bore.

According to the Post, Tulowitzki is expected to wear protective padding over the injured rib area on his right side when he returns, something that could help protect him in the event of direct contact. Contact was how Tulowitzki originally sustained the injury when he met the ground hard while making a diving defensive play. Even if bone is showing evidence of good healing, it continues to remodel itself for some time beyond the projected four to six weeks following a break. Another direct insult to the area could result in a setback in the form of reinjury, hence the layer of padding for extra insurance. Padding would not minimize the force of the muscular contraction which happens underneath it, however, meaning Tulowitzki needs to be able to throw (especially hard, cross-body throws) and swing without hesitation or discomfort -- including checking a full-throttle swing -- in order to prove he is ready to return.

He’s not quite there and he knows it. Tulowitzki told the Post on Sunday he is not completely symptom-free with his hard swings and knows he needs to be tested in a variety of game situations before returning to the lineup. A rehab assignment is slated to begin Monday and the next step will be completely dependent upon how the assignment goes. It’s important to remember he has not yet reached the four-week mark since suffering the injury; a return after the All-Star break would put him at five weeks out, a seemingly safer target. Tulowitzki has made it clear he will not play in the All-Star Game (to which he has been selected as a starter) if he does not play for his team first. It may come down to the weekend before we have the answer.

Pitchers

Dan Haren, SP, Washington Nationals (returning to action July 8): Haren is returning from the shoulder ailment that sent him to the DL in late June. It was only ever described as shoulder stiffness and Haren never seemed too concerned. If anything, he and the Nationals were more focused on his overall struggles and the hope is that the break may have helped him in this department. Haren threw bullpens and navigated a simulated game without incident but never went on -- nor did he or the team feel the need for -- a rehab assignment. He gets the start Monday night at Citizens Bank Park against the Phillies.

Wei-Yin Chen, SP, Baltimore Orioles (placed on DL May 13 , expected to return this week): Oblique injuries are becoming relatively commonplace amongst pitchers and while they can still vary in terms of severity, the standard return of just over a month remains fairly consistent. And, just as important, when pitchers recover fully from an oblique injury prior to returning to the mound, there seems to be a low rate of injury recurrence. That bodes well for Chen and the Orioles as he is set to return this week after being out since mid-May.

Alex Cobb, SP, Tampa Bay Rays (placed on DL June 15): It was terrifying when it happened, a line drive to the head which resulted in a concussion and sent Cobb to the hospital. Fortunately, he has made impressive strides since that time, including a return to a throwing progression. Initially following the injury there was no discussion about baseball but that quickly changed as Cobb progressed. As of early July he was playing catch and increasing his cardiovascular workouts. Last Friday he threw his first bullpen since the injury and he repeated the effort Monday, increasing the number of pitches. According to the Tampa Tribune, Cobb hopes to return to the Rays’ rotation late July or early August. No matter where your team allegiances lie, everyone has to feel good about Cobb’s recovery.

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