Stephania Bell: Bartolo Colon



It's mailbag time again! We're mixing it up a little more this week to include some of the questions that have come in via Twitter that deserve more than a limited number of characters in response. Thanks to everyone who has been contributing to the dialogue. Great thoughts as usual.

Dan Kukla (Carlsbad, N.M.): You mentioned in your injury blog that setbacks with back injuries, like the one Hanley Ramirez is dealing with, are not uncommon. Is this the type of injury that could linger all season or is he likely to be free of it sometime after the All-Star break? Really what I'm getting at is should we invest or avoid when it comes to Ramirez and his current injury?

Ramirez has been in the news this week, but not because of his back. With the attention focused on his benching by interim manager Jack McKeon and his interaction with his teammates, it's hard to know whether Ramirez is still contending with any discomfort in his lower back. His first outings after coming off the disabled list did little to indicate that his troubles at the plate were behind him. Now he has been moved in the lineup, and at least on Tuesday, his performance improved. Ramirez has not indicated how his back is feeling, but he also didn't say anything about it in the month preceding the episode that led to his disabled list stint. The risk for recurrence will not go away this season, but it does lessen the longer Ramirez is able to play without incident. Given his struggles, the turmoil and his injury, it would be wise to spend cautiously if you are thinking about making a move for Ramirez.



[+] EnlargeStephen Strasburg
Mitchell Layton/Getty ImagesStephen Strasburg could return by season's end, but given his circumstances, fantasy owners shouldn't count on it.
@ping33: 20 team H@H, currently in 1st, starting to think playoffs: Strasburg, worth stashing on 1 of 2 DL slots?

Here's Stephen Strasburg's current activity: In early June, he was throwing from a mound several times a week, averaging 30-40 fastballs per bullpen session, according to the Nationals' website. Changeups were recently added into the mix. Although this is encouraging, he needs to expand his pitching repertoire gradually to include his full complement of breaking balls (thrown later because of the increased stress on the arm); then there is the long road back to facing live hitters and ultimately rehab assignments. There is also the matter of building up to maximum effort when throwing. Each advancement in the pitcher's progression is predicated on success established at the previous stage.



Despite the optimism with his progress, it is important to remember that although the rehab progression after this surgery has general guidelines, it remains a fluid process, adapting at every stage based on how the athlete responds. For instance, when Strasburg was early in his rehab, there were rumblings that he could pitch in late 2011. Then in mid-April, The Washington Post's Adam Kilgore pointed out that at that precise moment, Strasburg was a week behind where Jordan Zimmermann had been in his post-Tommy John program. More importantly, as Kilgore noted, that comparison is actually irrelevant because every pitcher will return at the pace dictated by his individual healing process. As Nationals head athletic trainer Lee Kuntz aptly said, "No one is in a rush."



No one except fantasy owners, that is. The Nationals organization, however, understands the larger value of Strasburg and won't risk his long-term value for a few potentially meaningless games late in the season. Even if the games are meaningful, if Strasburg is not ready, he will not pitch. It's possible that if he's ready, he could return to get some major league-competitive innings, but that is not likely to be determined until that time draws much closer. For a fantasy owner who may well need the DL for other players more likely to provide significant contributions late in the season, those spots are probably better reserved for them. If you happen to have a wide-open DL (although it seems rather impossible, given all the injuries this year), it might not hurt to place Strasburg there, but be prepared to let go.

@gameofinches: When do you expect Harden to start pitching for the Oakland A's?

Rich Harden's return to the Oakland Athletics' rotation is rapidly approaching. Although no definitive date has been given for his return, Harden made his first rehab start for the Triple-A Sacramento River Cats on Monday and had a great outing. He threw three innings and struck out six batters, a performance so encouraging that it would not be surprising to see him moved along quickly. Of course, the concern is whether his strained latissimus dorsi muscle will be ready to handle the stamina of being used regularly. Given Harden's health history, the concern is understandable. It's undoubtedly a risk-versus-reward scenario, and the A's, who are dealing with a multitude of injuries in their pitching ranks, may be ready to take the gamble very soon.

Quick hits


• Pitcher Jake Peavy (right groin) has been activated from the DL and is returning to the Chicago White Sox's rotation. He is expected to start Wednesday against the Chicago Cubs.

New York Yankees shortstop and face of the franchise Derek Jeter has been doing some activity at the team's complex in Florida. In addition to his rehab activities, Jeter participated in some long toss. Although the news prompted manager Joe Girardi to say, "He's going in the right direction," the team's website noted that Girardi expects Jeter to participate in at least one rehab game before returning to the team. It's worth repeating that the biggest test after a calf strain is running, especially pushing off when beginning a sprint. No doubt the team will want to see those movements in game-related action before it puts Jeter back in the lineup. ... Meanwhile, pitcher Bartolo Colon, nursing a left hamstring strain, has begun long-toss throwing. This is a positive step, but he is not a lock to return automatically at the end of 15 days.

• After being pushed back several times, pitcher Josh Johnson finally threw his first bullpen session on Friday, and according to the Miami Herald, he felt good afterward. The team continues to be optimistic that Johnson will return when eligible from his 60-day DL designation (July 16, after the All-Star break). It's still early, however, and Johnson has to face live hitters and some minor league outings before he'll be cleared.



Once again following the weekend games, there are some comings and goings in baseball. Some players are coming back from injury while others are departing (in one case potentially for the remainder of the season) due to injury. This week, it appears a few players who have been out for extended time are about to resurface. Wandy Rodriguez returns Monday for the Houston Astros to face the Atlanta Braves after spending some time on the DL with elbow inflammation. The team seems to think he's ready. But will he and the others returning from injury last?



Coming

Hanley Ramirez, SS, Florida Marlins: The Marlins sound optimistic that their ailing shortstop could rejoin the lineup Tuesday night when the team faces the Phillies. Ramirez, currently on the DL for the first time in his career, has been dealing with back pain and sciatica. Even though we did not learn of Ramirez's pain until he was removed from a game in late May, it turned out the back had been bothering him for several weeks prior, which may explain his offensive struggles.

Ramirez did not resume baseball activities until late last week and then engaged in a rehab assignment Friday and Saturday. The plan was for him to work out with the Marlins on Monday (originally Sunday also but that was changed), according to the Palm Beach Post, after which he was expected to be activated Tuesday (his first day eligible). This presumes no setbacks, which, in the case of low back and associated leg pain, unfortunately is not uncommon. While it's encouraging that Ramirez has apparently made enough progress to return after the minimum DL stay, it's not evidence that he's completely out of the woods. Bear in mind that it was just over a week ago when he was forced to cut a workout session short because of pain. The good news is that his swing has reportedly improved which suggests his back is indeed feeling better. Ramirez told the Miami Herald, "My back is better now and I'm going to be able to compete out there." Now the Marlins and Ramirez's fantasy owners will have to hope it stays that way.



[+] EnlargePablo Sandoval
Jeanine Leech/Icon SMIPablo Sandoval was hitting .313 with five homers when he landed on the disabled list.
Pablo Sandoval, 3B, San Francisco Giants: This might also read Pablo Sandoval, 1B, since he is expected to see some playing time at that position as well while Brandon Belt remains on the DL with a fractured wrist. He will not, however, be playing catcher anytime soon. Mostly the Giants hope Sandoval is playing hitter. Period. They have missed his bat in the lineup and with the loss of second baseman Freddy Sanchez (see below in the "Going" section) they need Sandoval to deliver some offense even more urgently.

Sandoval has been recovering from surgery to remove a fractured portion of the hamate bone in his right wrist. The big concern was whether he could effectively hit from the left side of the plate, the more challenging side following this injury given the pressure the bat puts on the surgical site. Even as Sandoval was hitting the ball out of the park on his rehab assignment, he was forced to take subsequent days off because of persistent soreness in his wrist, which is not unusual during the first few weeks of hitting following this procedure. Apparently, everyone is feeling confident that Sandoval is ready to contribute immediately and he is expected to be in the lineup Tuesday when the Giants face the Arizona Diamondbacks.



Ryan Zimmerman, 3B, Washington Nationals: Adam Kilgore of the Washington Post reports via Twitter that the Nationals will activate Zimmerman on Tuesday, presumably in time for the contest against the St. Louis Cardinals. The move would not be unexpected as there were hints late last week that Zimmerman was likely to return soon.

Credit the Nationals for taking the time to ensure Zimmerman's full recovery from surgery to repair an abdominal tear before bringing him back to the majors. According to the Washington Post, manager Jim Riggleman was clear that he wanted to take no chances. "We don't want to push it," Riggleman said. "I really want him to be 100 percent. I don't want any setbacks." The good news is the success rate following this type of procedure is very high. The key is making sure the athlete can perform every aspect of his position without hesitation and without any sensation of pulling or tightness in the surgical area. When Zimmerman first returned to baseball activities, he acknowledged soreness with hard throwing. As his strength and endurance have improved along with the extension of innings he has seen in the minors, it has become less of an issue. Additionally, as the Washington Post reported in early June, Zimmerman has taken advantage of the rehab window to work on his throwing mechanics. There is every reason to think Zimmerman will be able to be effective immediately.

Matt Holliday, OF, St. Louis Cardinals: It's about as confident a statement as one can hope for from an athlete looking to return from the DL. Holliday told the St. Louis Post-Dispatch, "I have full confidence I'll be ready to play Thursday." Thursday will be the first day Holliday, who has been out with a strained left quadriceps, is eligible to be activated. He has tested his quadriceps in the best way possible, explosive directional running. According to the Dispatch, Holliday performed sprints from home to first base, then first to second. Most quadriceps strains in baseball happen during the first few steps out of the batter's box as the athlete attempts to explode towards first. And while it might seem strange that a muscle strain forced Holliday to the DL when an appendectomy didn't, it reflects the difficulty in returning an injured muscle, particularly one so critical for athletic performance, to full power. There is always a little something extra that the body delivers in a game situation so until an athlete has returned and stayed healthy for several weeks following an injury such as this, it's difficult to be confident that it's completely behind him. But when an athlete sounds as confident as Holliday does in his recovery, it should be taken as a very good sign.

Going

Freddy Sanchez, 2B, San Francisco Giants: Sanchez dislocated his right (throwing) shoulder in Friday night's opener against the Cincinnati Reds while diving to make a play. Not only is he on the DL, Sanchez may be done for the season. Giants head athletic trainer Dave Groeschner indicated that Sanchez suffered damage to both the labrum (cartilage ring which enhances stability of the shoulder) and the capsule (fibrous tissue that envelops the shoulder joint). In other words, after this event, Sanchez's shoulder is undoubtedly less stable. It is likely that he will ultimately require a surgical procedure, but the question is when that would take place.

According to AP reports, Sanchez will consult with the Arizona surgeon who previously operated on his left shoulder. The San Jose Mercury News reports Sanchez will undergo a course of rehabilitation to see if he can return to play and postpone any surgery, at least until the offseason. One of the most challenging issues for anyone who has suffered a traumatic dislocation with extensive damage to the joint is regaining adequate mobility in the arm to make it functional while overcoming the apprehension that it will dislocate again. A one-time dislocation in the absence of severe joint trauma can often do well with rehab alone. The more damage to the joint, however, the less stability (on what is already a relatively loose joint) and even minor subsequent subluxations (where the shoulder slips but does not completely dislocate) can be pain-inducing and cause the athlete to automatically guard the shoulder against movement. In other words, it can be very difficult to return to free and easy play. This will be the challenge for Sanchez who, as an infielder, has to dive without hesitation and throw hard regularly to make defensive plays.



Even if Sanchez does have some success with the rehab course, it would likely be multiple weeks before he could attempt to play. He will need to keep the shoulder immobilized in a sling initially, then gradually resume range of motion and strengthening before returning to any baseball activities. Given that a decision as to whether he could return or not might take some time to play out, fantasy owners would be wise to make alternate plans.

[+] EnlargeBartolo Colon
AP Photo/Paul J. BereswillBartolo Colon was throwing a two-hit shutout when he injured his hamstring covering first base.
Bartolo Colon, P, New York Yankees: Look at it this way. At the start of the season, who would have thought Colon would get this far? When it came to discovering the fountain of youth, pitching was one thing. Attempting to run to cover first base proved to be quite another. Colon strained his left hamstring on just such a move, which reminded us that he is indeed 38 years old and, well, shall we say, less than the model of fitness. The Yankees have placed him on the DL and according to ESPN New York, Colon indicated (through an interpreter) that he does not think the injury is serious and he expects to return at the end of the 15 days. Given the way he's pitched so far this year, the Yankees would love to get him back that quickly, but it's his landing leg that's injured. That left leg has to support Colon's body weight and slow down the momentum of his upper half following ball release, which is not a small task. Stay tuned.

Mike Napoli, C, Texas Rangers: Napoli is going to be missed by his teammates and fantasy owners alike, but everyone is hoping he won't have to be missed for long. He is being placed on the DL with a left oblique strain; however so there is no telling at this point just how long his absence might be. There is some encouraging news, though, that Napoli may have jumped on this injury early before it became more severe. According to the Fort Worth Star-Telegram, Napoli first felt discomfort Friday that worsened during Sunday's game. Napoli seemed to recognize the potential for a more severe injury, telling the Star-Telegram he was concerned about continuing to play and aggravating the condition. "I didn't want to do that and miss eight weeks instead of two weeks," Napoli said. Given that statement it sounds as if Napoli may have avoided the type of injury which results in a four-week (or more) absence but naturally it remains to be seen how long before he can ease back into baseball activity.

Aaron Harang, P, San Diego Padres: The foot issue Harang has been trying to work through for the last couple weeks has proven to be painful enough to force him out of service for a while. The Padres have placed him on the DL due to persistent pain in his right foot which has been present since early June. The team website reported negative findings on X-ray and MRI, and said Harang is not sure how he injured it. Nonetheless, the pain in the top of his foot is sharp enough to be bothersome. Harang said of the pain, "It kind of sends a quick shock through my foot." Harang's last start came June 9, so he should be eligible to come off the DL by late June, presuming the foot pain has resolved.

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