Stephania Bell: Cliff Lee
April, 23, 2012
This weekend provided plenty of injury news worth discussing:
Santos has sore shoulder
On Friday, I noted that with five closers out due to injury, they could form an entire division. That division just expanded in size. As of Saturday, a sixth closer had been added to the DL but the hope is that it will be a short-term visit. Sergio Santos of the Toronto Blue Jays becomes the first of the group to go on the DL because of a shoulder issue.
AP Photo/Chris YoungSergio Santos is the latest closer to hit the DL.
According to the Blue Jays' website, Santos felt some tightness in his shoulder while pitching in Friday night's game. Although he was able to pitch through it and pick up the save, Santos felt worse when he woke up Saturday. Santos said he could feel "something wasn't quite right" during his outing Friday but when he woke up Saturday with the shoulder bothering him he decided to tell the team. "I came in and let the staff know," Santos said. "Their thought was let's get this over with and not have it drag on, so let's shut it down now and hope that we can catch it early."
Santos is an interesting case because he has only been pitching for a few years, as he converted from shortstop to pitcher while with the White Sox organization in 2009. While his shoulder should have less wear and tear than the shoulder of a lifetime pitcher, Santos has not had the benefit of developmental adaptations to throwing.
The Blue Jays are referring to his condition as shoulder inflammation, which sounds non-specific and not particularly serious. For the time being there is no specific timetable for Santos, but he will be evaluated further by Dr. Lewis Yocum on Monday. Francisco Cordero will serve as the closer while Santos is out.
Another abdominal injury for Lee
There were consequences after Cliff Lee's impressive, scoreless, 10-inning outing against the San Francisco Giants on Wednesday that he even tried to lobby to extend into the 11th. The Philadelphia Phillies' loss that night may have been the insult; however, Lee's subsequent oblique strain made it even worse. Lee was placed on the DL on Saturday with a left oblique strain, an injury with which he has become somewhat familiar. Lee has dealt with various abdominal injuries over the years, even starting his 2010 season on the DL for that reason. That injury was termed a lower abdominal strain and Lee, then with the Seattle Mariners, received a platelet-rich-plasma (PRP) injection to support the recovery process. Lee was able to rejoin the team in late April (about five weeks after the injury occurred) and held up the remainder of the year.
AP Photo/Marcio Jose SanchezCliff Lee is no stranger to abdominal injuries, but it's even more bittersweet since it comes after he threw 10 shutout innings.
This February, Lee skipped a bullpen session after experiencing some abdominal soreness. Although he made it out to be no big deal at the time, Lee acknowledged to the Philadelphia Inquirer that his history was a factor in taking a day off. "In the past I've had ab strains and it was a little sore," Lee said, "so I decided to skip my bullpen, which is a minor deal and just basically play it safe at this point." That rest seemed to pay off as Lee was able to resume his normal throwing schedule later that week and, until Wednesday night, had been fine. The Inquirer reported Lee hurt himself in the 10th inning but he and Phillies general manager Ruben Amaro Jr. denied the lengthy outing played a role, citing higher pitch count outings in the past with no complications. (It's debatable whether throwing the same number of pitches in fewer innings results in the same physical demand as the 10 innings Lee delivered Wednesday night.)
Amaro also said this injury in the rib cage area is higher in the abdomen than Lee's prior injuries. Regardless of exactly where the injury is in the abdomen, the average oblique strain costs a pitcher 34.5 DL days as noted in a 20-year retrospective study of professional baseball players published this year in the American Journal of Sports Medicine. Given Lee's history of prior abdominal injuries, his age and the ease with which these injuries are aggravated, caution is certainly warranted. Although the team has indicated it does not expect Lee to miss more than a few starts, his return ultimately will be dictated by how quickly he heals and how soon he can return to throwing without any discomfort. The data on multiple pitchers over time -- which includes Lee's prior appearances on the DL with abdominal injuries -- speaks for itself, though. While an early return would be welcome, with the way Lee has been pitching, the Phillies undoubtedly would rather have him available for the bulk of the season than risk a chronic injury. He should not be counted on until late May.
D-backs' Hudson lands on DL
Daniel Hudson is joining Arizona Diamondbacks teammate Chris Young on the DL, also with a shoulder problem, albeit not the result of a crash into a wall. Hudson has been diagnosed with a shoulder impingement, really a fancy term for "pinching." A number of structures can become impinged in the shoulder of an overhead athlete, and the pain typically results from inflammation developing in and around the area. The narrow space at the top of the shoulder where several soft tissue structures pass underneath the bony projection of the shoulder blade (acromion) becomes even smaller during overhead motion. Thickening of the soft tissues and the presence of inflammation can further decrease the available space, creating even less room. Any friction or pinching (impingement) can create pain. The initial goals are aimed at decreasing the pain and inflammation by eliminating the painful motion (shutting down the thrower). Treatment can include anti-inflammatory medication along with physical therapy directed at pain relief along with exercises targeted at reinforcing proper muscular balance around the shoulder. Sometimes cortisone injections are indicated.
Mark J. Rebilas/US PresswireDaniel Hudson is just the latest addition to the Diamondbacks' DL.
Hudson underwent an MRI which did not reveal any specific structural damage, according to manager Kirk Gibson. The goal is to prevent this from becoming a bigger issue for Hudson by not having him press through a painful shoulder. At this point it is too soon to know if he will require more time than the minimum 15 days.
Odd injury for Dempster
Here's one you don't see every day. A pitcher has been placed on the DL because of a quadriceps injury. Ryan Dempster strained his right quad (the large muscle on the front of the thigh) while throwing a bullpen and is still experiencing soreness. Dempster is not a complete stranger to unusual injuries. Remember back in 2009 when he inadvertently broke his right big toe while climbing over the dugout railing? This latest injury doesn't fall quite in that category, but it is atypical for a pitcher, where we're more accustomed to seeing injuries of the shoulder, elbow or oblique variety.
According to the Chicago Cubs' website, Dempster's DL stint was backdated to April 18, and he is expected to miss only two starts. In other words, the good news is this strain is considered mild, and Dempster is expected to return when eligible in early May.
Beltre's hamstring again
Last July, Adrian Beltre had a left hamstring injury that cost him 37 games, but according to ESPNDallas.com, he says this one isn't as severe. "I don't think it's quite as bad as last year," Beltre said. "It didn't grab me that much. I don't think it's that bad. Hopefully, that's the case."
Beltre, who left Saturday's game early with the injury, is scheduled for an MRI on Monday. Regardless of how significant the actual injury is, the concern it raises going forward is legitimate, given the 33-year-old Beltre's history.
May, 5, 2010
Another week, another slew of injuries. This week, though, in addition to adding names to the injury roster, we learned that several players are going to be spending some additional time on the disabled list. Never music to a fantasy owner's ears but it's always better to be prepared.
Joe Mauer, C, Minnesota Twins (day-to-day): Mauer has been dealing with a deep bruise in his left heel since Friday night when a sharp lunge to first base left him in pain. It sounded dire by Sunday when manager Ron Gardenhire described Mauer's condition as "week-to-week" instead of day-to-day. Gardenhire also made it clear the Twins would not be rushing Mauer back, telling the Minneapolis Star-Tribune, this injury is "something you don't screw around with."
Gary A. Vasquez/US PresswireJoe Mauer may miss a few more games, but he probably isn't "week-to-week" as Twins manager Ron Gardenhire mentioned earlier.
It now sounds like it's not as bad as it could have been. According to the Twins' website, an MRI confirmed a soft tissue injury (as in, there is no fracture) and the healing will be assessed on a daily basis. Mauer is reportedly feeling better and is running in a pool to maintain conditioning while eliminating impact that could aggravate the situation. It appears that the Twins have avoided a move to the DL for Mauer ... at least so far.
Rafael Furcal, SS, Los Angeles Dodgers (15-day DL, retroactive to April 28): Furcal has been pestered by a hamstring injury for the last week. On Tuesday, the Dodgers determined that more time was needed and the decision was made to place Furcal on the DL. The issue now is how concerned fantasy owners should be. Does the DL just buy Furcal another week of healing time or is this injury enough to keep him out significantly longer?
Before panic sets in, it appears that the answer is the former. Furcal has been progressing well with his hamstring injury but is not quite ready to resume full speed activity. As a shortstop, he needs to make explosive defensive movements. As a leadoff hitter, he is likely to be exposed to more sprinting situations. Consequently, Furcal is at far greater risk of a setback if he returns at less than full strength. Since it's May and not September, there is no reason for the Dodgers to take that chance. The move to the DL appears to have been largely precautionary. Expect Furcal to return when eligible, barring, of course, a setback.
Manny Ramirez, OF, Los Angeles Dodgers (15-day DL, April 23): Speaking of Dodgers placed on the DL for precautionary reasons, Ramirez began a rehab assignment Tuesday and the news is so far, so good. Ramirez, who suffered a Grade I calf strain, has been running without incident for several days. He is eligible to return May 9 and appears on track to meet that target.
Jacoby Ellsbury, OF, Boston Red Sox (15-day DL, retroactive to April 12): Ellsbury continues to recover from the pain that comes with having four broken ribs.
Tom Szczerbowski/US PresswireJacoby Ellsbury would like to be comfortable swinging the bat before he returns from four broken ribs.
From last week's injury blog: Although it can take four to six weeks for a rib fracture to heal, from the standpoint of activity this is a symptom-based condition meaning whatever he can tolerate, he can do. The fact that four bones were broken, however, tells us that it will take longer to tolerate just about everything.
That statement still holds true. The Boston Globe reported that when pressed for a timetable earlier in the week, Ellsbury declined to provide one, reminding everyone that he does indeed have broken bones "and they need to heal." It may feel like forever to fantasy owners, but it's only been three weeks, very reasonable when you consider his injury.
Ellsbury did take a positive step Tuesday when, according to the Red Sox's website, he took batting practice before the team's game against the Los Angeles Angels. Let's see how Ellsbury feels the day after this new activity before we get too excited. And keep in mind, he likely will require a rehab assignment to get his body back in the groove of playing both offense and defense. He may very well be more than just a few days away from returning. The road back may continue to feel slow, but at least we are seeing some tangible progress.
Jimmy Rollins, SS, Philadelphia Phillies (15-day DL, April 13): A week ago, we pointed out that Rollins had not done any explosive movement that would really test his calf; now we know why. According to the Phillies' website, Rollins still feels discomfort in his right calf when he has to move to his left while fielding ground balls. This makes perfect sense from an injury standpoint. As he makes that initial lateral movement to make a play on a ground ball traveling to his left, he is forced to push his full body weight through that calf muscle. While it might not be bothersome in straight-ahead running, making a quick directional movement from a stationary position requires significantly more power. The discomfort Rollins feels is his calf's way of telling him that it's not healed.
Consequently, the Phillies have expanded the time frame for his return from four weeks to six. This is hardly shocking; we have said from the outset that these injuries are unpredictable and easily aggravated. The Phillies don't want him to come back only to be forced out again. The idea is to have him back for the remainder of the season. Fantasy owners should set their sights on the latter part of May.
Kerry Wood, RP, Cleveland Indians (15-day DL, retroactive to March 26): Last week we said that Wood was scheduled to begin a rehab assignment soon. He did. We also said that when pitchers face live hitters, the adrenaline goes up and the body can react. It's also a time for pitchers to work on their velocity and location. Wood had a chance to get some work in and found out what he still needed to work on before rejoining his team.
Wood may have given up six runs in less than an inning in a rehab outing, but on the positive side, he reported feeling good afterward. Wood told the Akron Beacon Journal, "that's the most important thing for me." Certainly given his injury history that couldn't be more true. Wood may require another couple rehab appearances before he retakes the closer role with the Indians but his return date appears close.
Brian Roberts, 2B, Baltimore Orioles (15-day DL, April 10): The quote heard 'round the fantasy world: "It could be three weeks, it could be three months" was Roberts' assessment of his situation, according to the Orioles' website. For fantasy owners wondering whether they should still hold out any hope, it's worth noting that Roberts was quick to add that he did not really think it would be three months.
J. Meric/Getty ImagesBrian Roberts' seemingly uncertain return frustrates many owners.
Nonetheless, we have outlined here in past weeks that Roberts' back condition has the potential not only to linger, but to continue to be problematic across the season. Disc problems are notoriously difficult and this is behaving no differently. Roberts is still very limited in his activity as the team brings him along slowly. Because there are many hurdles to overcome, it is hard to establish a clear timeline. That brings frustration for players and fantasy owners. At this point, it's anyone's guess, including Roberts', as to when he'll be able to return.
Curtis Granderson, OF, New York Yankees (15-day DL, May 2): When Granderson pulled up sharply while rounding the bases Saturday and hobbled toward third base. it was obvious he had pulled something, it just wasn't clear exactly what it was. We have learned that he suffered a Grade II groin strain, and according to ESPN's Buster Olney, Granderson is expected to miss a month.
This is not dissimilar to the Grade II muscle strain that the Phillies' Rollins is dealing with, other than the exact location of the injury. Grade II, also called a moderate strain, represents the widest range of injury somewhere between a minor strain with no visible tissue damage (Grade I) and a complete muscle tear (Grade III). As we have seen with Rollins, it takes time for the tissue to heal, and the most challenging aspect of recovery is regaining explosiveness and speed, a critical component of Granderson's game. Fantasy owners should hope for four weeks, be prepared for six and know that his timetable could still fall outside of those parameters depending how his rehab goes.
Jorge Posada, C, New York Yankees (day-to-day): Posada's calf strain is being called mild following an MRI this week. According to the New York Daily News, Posada is not expected back before Friday. Let's face it, at age 38, these types of injuries are more apt to occur. The most fortunate thing for the Yankees is that the strain was not more serious, like Rollins' was. It looks like this will not land Posada on the DL, but if it doesn't progress as expected, he won't be an automatic start for the weekend series, even if it is the Red Sox. Fantasy owners need to be sure to check pregame lineups.
Etc.Cliff Lee, SP, Seattle Mariners: If there were any lingering doubts as to how Lee would fare coming off the DL following his abdominal strain, he seems to have put those to rest. Lee pitched seven scoreless innings in his first start of the season while dishing up eight strikeouts.
Mike Cameron, OF, Boston Red Sox: Cameron seems to be progressing nicely with an abdominal strain that initially appeared as if it might require surgery. In fact, he could be headed for a rehab assignment within a week.
Erik Bedard, SP, Seattle Mariners: Bedard continues to move forward in his throwing progression, slightly ahead of schedule as he recovers from shoulder surgery. After a bullpen session Friday, Bedard was projected to move up to a simulated game this week. According to manager Don Wakamatsu, Bedard has adjusted his mechanics to place less stress on his throwing shoulder. The key will be whether he can maintain these mechanics as he begins to face hitters. The best case has him returning the end of May, but don't be surprised if it stretches a bit longer.
Mariano Rivera, RP, New York Yankees: Rivera shrugged off the stiffness in his left side as no big deal, much as one would expect. Pain on the opposite side of the trunk from the throwing arm always raises the specter of an oblique issue, but Rivera's confidence is convincing. So is the fact he threw a bullpen session before Tuesday's game. This does not appear to be something that will limit him beyond a few days.
Huston Street, RP, Colorado Rockies: As a pitcher returns in his throwing progression, one big hurdle comes when he moves from throwing on flat ground to throwing off a mound. Street overcame that hurdle Tuesday when he threw a bullpen session and experienced no discomfort in his shoulder afterward, according to the Examiner. The plan is for Street to throw in an extended spring training game next followed by a rehab assignment. If all goes well, he should be back with the team within a few weeks.
Jeff Weaver, SP, Los Angeles Dodgers: Weaver has been doing well in his simulated games and is expected to be activated Friday. Apparently the back issue he was dealing with was minor as these things go and he has recovered quickly, as expected.
From my mailbagCameron (Atlanta): Are any injuries really freak injuries? I mean, I realize that if a player slips on water in his kitchen and falls on his wrist and breaks it, then that is a freak injury. But, you often hear that somebody pulled their hamstring in a "freak injury." I would have to argue that it is never really a freak injury. I think these types of injuries happen for various reasons, especially in a non-contact sport such as baseball. For example, someone is carrying around extra weight and didn't put in the work in the offseason, they didn't warm up and stretch properly, they have tight quads or hamstrings that cause one or the other to overcompensate that eventually leads to a pull or strain. Or one part of the body has been severely overworked and leads to another part of the body being vulnerable. If any of those situations happen, then technically the injury could have been prevented if the athlete worked harder and took better care of their body. What say you?
Stephania Bell: What a great question! This is one of those philosophical questions where I'm not sure we really ever have a definitive answer. As you point out, the true "accident" such as slipping on the wet floor, or stepping in a lawn divot that is hidden from view, even a car accident in which there is no fault on the part of the injured party ... these could all be described as freak injuries.
At the same time, there are certainly "unusual" (as in uncommon) injuries that occur in sports that may be more likely to happen, as you point out, because of inadequate warm-up, less than ideal fitness or some other contributing factor. In medicine, we always feel that individuals with better fitness tend to recover better and faster from injury. In some cases, the more skilled individual may even be able to avoid an injury that would have felled the average person. To that end, we spend a lot of time encouraging proper fitness and, when possible, tailoring that fitness to the individual's activity. Someone who lifts repeatedly at work needs to be "fit" for that job, just as a baseball pitcher needs to tailor his exercise program to support his occupation.
Great food for thought, though. And if it encourages anyone to spend a little extra time on core strengthening or flexibility to help prevent injury, then we've accomplished something!
If you have any injury questions you want answered in the blog, drop a note in my mailbag, or stop by my Tuesday chats.
April, 29, 2010
Wow! It's hard to believe that May is almost here. Seems like we were just ringing in the New Year and trying to figure out whether to refer to it as "Two Thousand Ten" in the pattern of years past or "Twenty-Ten" like the hip kids we want to be. I don't know about everyone else, but I'm struggling to get used to the sound of either one.
Here's what else is hard to get used to: We're only in the fourth week of the season and the disabled list is deep enough to field a new baseball division. Fantasy owners are well aware of this fact as they try to scour the waiver wire to complete their rosters. I'm struggling to find someone whose team has not been affected by injury.
In this merry-go-round of lineup adjustments, it's important to consider who might be on the verge of returning and who might need a little extra time in the rehab department. There's no time to waste, so we bring you the quick hits version of the injury blog.
Here are 10 players whose injury status may impact your lineup in the next week, or at least your waiver wire activity.
Cliff Lee, SP, Seattle Mariners (15-day DL, April 4): The best part about Lee's rehab is that it has been relatively uneventful. Once he was able to move past the pain of his abdominal strain, Lee has progressed steadily. From his bullpen sessions to his simulated games to his recent rehab start, Lee has looked solid. He is scheduled to make his 2010 (that's Twenty-Ten) season debut Friday, beating the projected first-week-of-May return by a day. And he doesn't even have to worry about that five-game suspension he received during spring training; that's been dropped. Given his consistent recovery, fantasy owners should feel comfortable plugging him in right away.
Otto Greule Jr/Getty ImagesCliff Lee's regular-season debut with the Mariners will be slightly earlier than expected, and he appears to be in good health leading up to it.
Jacoby Ellsbury, OF, Boston Red Sox (15-day DL, retroactive to April 12): Initially it appeared that Ellsbury had escaped major injury when he collided with teammate Adrian Beltre's knee in mid-April. Apparently, that was not at all the case. Despite negative X-ray results immediately after the injury, a later CT scan (which was undertaken when Ellsbury failed to show any significant progress) revealed four hairline fractures. While the CT results really don't do much to alter Ellsbury's treatment, they sure do validate his pain!
Although it can take four to six weeks for a rib fracture to heal, from the standpoint of activity, this is a symptom-based condition, meaning whatever he can tolerate, he can do. The fact that four bones were broken, however, tells us that it will take longer to tolerate just about everything. Ellsbury hit off a tee Tuesday, but that's a far cry from the speed and torque required for a true swing. As manager Terry Francona stated on the Red Sox's website, "We're just trying to increase the intensity every day." Don't be surprised if it takes Ellsbury another couple weeks to get his groove back.
Kerry Wood, RP, Cleveland Indians (15-day DL, retroactive to March 26): Get ready to move over, Chris Perez, Wood is knocking on the door. Wood, who missed the start of the season because of a strained latissimus dorsi muscle suffered during spring training, is nearing a return. Wood had a bullpen session Tuesday, is scheduled for another Friday, and according to the Indians' website will then have a simulated game followed by a brief rehab assignment. That would bring Wood back to the team within two weeks, assuming all goes well, which is right around what we projected three weeks ago. The Indians have indicated that Wood will assume the closer role upon rejoining the team.
It's worth remembering that when pitchers face live hitters, the environment changes. A little adrenaline translates to a little more effort on the delivery and the body sometimes reacts. Maybe the command is a bit off, maybe there's a little more post-throwing soreness than usual, any of which could potentially influence the timetable. That said, the Indians appear to have kept Wood on track (remember when their medical staff said this would keep him out for a minimum of six weeks?). Expect to see his season debut around mid-May.
Brian Roberts, 2B, Baltimore Orioles (15-day DL, April 10): If you were wondering whether you should continue to hang on to your second base fill-in knowing that Roberts has already exceeded the 15-day minimum requirement of the DL assignment, the answer is a definitive yes. However, the news for Roberts just got a little worse. As if his herniated disc-related symptoms weren't enough, the Orioles reported on their website that Roberts was scheduled to undergo an endoscopy Thursday after recently experiencing stomach pain along with flu-like symptoms.
Although he was cleared for light exercise recently, he was not anywhere near ready to perform baseball activities. This latest setback certainly won't expedite things. Let's hope for Roberts' sake that there is nothing more serious going on. In the meantime, fantasy owners need to plan on an indefinite substitution in their middle infield.
Jimmy Rollins, SS, Philadelphia Phillies (15-day DL, April 13): By now everyone knows that Rollins suffered a calf strain before the Phillies' home opener this month. The question is, how long will that calf strain keep him sidelined? The strain appeared serious enough from the outset to suggest that he would need more than the 15 day minimum to recover. Our initial projection here of approximately four weeks still appears to be reasonable.
Although Rollins is doing some light running and taking batting practice, he certainly has not done any explosive movement that would really test the calf. He will continue to be progressed gradually, and according to the Philadelphia Daily News, the Phillies will refrain from announcing a specific timetable. This is a wise move as these injuries are very unpredictable and easily aggravated. Once he is able to run full speed, we should have a better clue as to when he might be nearing a return.
Manny Ramirez, OF, Los Angeles Dodgers (15-day DL, April 23): Hey, while we're talking calf strains, we might as well include Manny. Not to worry. His injury is not as serious as the one Rollins suffered. Ramirez has a Grade I calf strain, meaning the injury is minor enough that there is no significant tissue damage visible on MRI. Inflammation in the area still indicates a problem and it is certainly a condition that can easily worsen. In other words, pushing through it could result in more extensive injury to the muscle, which would translate into more missed time. There's no need to chance that outcome this early in the season, so Ramirez is proactively resting. The good news is that fantasy owners can expect Ramirez to return when eligible.
Kirby Lee/US PresswireManny Ramirez's stint on the disabled list apparently will be a short one.
Brad Lidge, RP, Philadelphia Phillies (15-day DL, March 26): Return alert! It looks as if Lidge will be back in the Phillies' bullpen this weekend after another successful rehab outing Tuesday. Lidge believes he is ready to return on all fronts. He has no pain, his command is solid and his elbow and knee issues appear to be behind him. According to the Philadelphia Inquirer, Lidge is expected to rejoin the team Friday when it hosts the New York Mets.
Jorge De La Rosa, SP, Colorado Rockies (15-day DL, April 28): The Denver Post reported that De La Rosa was placed on the DL with a torn flexor band but will not need surgery. De La Rosa injured the middle finger of his throwing (left) hand during his last outing and initially it was thought to be just a bone bruise. An MRI revealed the extent of the damage. It sounds as if De La Rosa tore a pulley in his finger, one of the ligamentous bands that help to anchor the flexor tendon (a tendon, which as the name implies, helps to flex the finger, obviously a critical function for grip and control). The pulleys are essential to proper function of the hand. It appears that De La Rosa's hand will be rested in an effort to let the tissue heal; if he were to try to press through, this he could end up being a season-ending injury that would require surgery. Stepping away now is a better option, but expect it to take on the order of many weeks, as in more than a month, for him to return.
Nelson Cruz, OF, Texas Rangers (15-day DL, April 27): As soon as his hamstring "cramp" turned into something that forced an early exit from Monday's game, it seemed as if Cruz was headed for the DL. Indeed, that was the decision. There was no need to turn this into a significant season-long injury, as the hamstring issue was just not going away. The hope will be that with forced rest, Cruz will be able to return when eligible.
Ian Kinsler, 2B, Texas Rangers (15-day DL, retroactive to March 26): When your projection as to how healthy you'll be upon return is less than ideal, as Kinsler's was, fantasy owners have to be a little nervous. Kinsler told the Fort Worth Star-Telegram, "When I return to play, I don't think I'll be 100 percent. But I want to get on the field." To be fair, that comment was made a week ago, but the questions about just how well his ankle will support him remain.
Mark Goldman/Icon SMI Ian Kinsler is set to return Friday, but how long before he makes another trip to the DL?
Kinsler suffered a right high ankle sprain in early March and these injuries are always more difficult to recover from than anticipated. Kinsler did steal a base in his last rehab outing, which is encouraging, and he is expected to be activated Friday. Fantasy owners should temper expectations as it may take him a while to return to form. It will also be worth keeping an eye on how his ankle responds to the stress of daily play.
From my mailbagArthur (Long Beach, N.Y.): I am in a 10-team mixed league with one DL and four bench spots. I am comfortably in first place (thank you, Mr. Halladay), but sense imminent danger based on a shallow bench. I am carrying both Carlos Beltran and Brandon Webb on my roster. Based on projected value and severity of injury, which player would you recommend keeping? I recognize this is partially based on my roster mix, but if you were drafting today, which player would you choose? Thanks for the fantastic columns.
Stephania Bell: Arthur, thanks so much for writing. Let's get right to the point: You are in that location they call somewhere between a rock and a hard place. While I'm still holding out hope that Beltran is able to return this season, there has been some speculation that he won't. Beltran traveled to Colorado last week to visit his surgeon and was not cleared to run. According to the New York Daily News, he was fitted with a custom brace for his ailing right knee while in Colorado, which in and of itself is not a bad thing and may help his progression. I thought all along that a May return would be premature in light of both the nature of Beltran's injury and the date of his surgery. We have to remember that even post-surgery, he does not have a "perfect" knee and his best chance of being successful is returning in a slow, deliberate manner. No one is saying with any certainty when he will return because this is a day-to-day evaluation, but June appears to be the soonest possible target.
Webb, on the other hand, is still playing catch with no clear-cut targeted return date. It's worth noting that there is no clear explanation as to why he's had so many setbacks, which is most problematic for me. Before we can even begin to consider a return time, we have to see Webb successfully throw off a mound. His prognosis is more questionable in my mind, simply for the fact his problem is ill-defined.
I'd stick with Beltran and then cross my fingers.
If you have any other injury questions you want answered in the blog, drop a note in my mailbag, or stop by my Tuesday chats.
April, 15, 2010
The term "15-day DL" can be so misleading. Sure, we know once a player has been placed on this disabled list we won't see him in the lineup for at least 15 days. But it really gives us no idea as to the true severity of the injury. Some injuries simply require time beyond the allotted 15 days for sufficient healing. For many athletes, returning to play requires restoration of strength, conditioning and timing in addition to recovery from the injury itself, so that can translate to extended time.
To further complicate matters, the date the decision is made to place an athlete on the DL may not be the day the countdown clock starts ticking. A team can make a DL designation retroactive to the day following the last game in which the player appeared. Sometimes this happens when an injury that initially seemed would limit a player for just a few days turns out to be a little more problematic. It may also be used when a team wants to give a player who is progressing well a little extra time before returning to competition. In other words, a move to the DL does not necessarily indicate that an athlete's injury is worrisome.
How to make sense of it all then? Except for obvious injuries (such as broken bones or knee ligament tears) that immediately force a player to the DL, there are often clues that emerge before a team decides to place an athlete on that list. There are also hints throughout the course of an athlete's rehab that signal whether he will require additional time beyond those 15 days before returning to the lineup. We look for those clues and share them with you right here, week in and week out. After all, your fantasy roster is only as good as the guys who are actually playing.
We start this week by looking at the injuries that have befallen middle infielders around the league and ask the question, "Just how concerned should you be?"
Jimmy Rollins, SS, Philadelphia Phillies (15-day DL, April 13): When he pulled up with calf pain during pregame sprints in the outfield Monday, Rollins had to be thinking to himself, "I was out there warming up just so this type of thing WOULDN'T happen ..."
Kim Klement/US PresswireExpect Jimmy Rollins to miss about four weeks with a calf injury.
But, alas, it did. Rollins strained his right calf muscle and subsequently underwent an MRI on Tuesday which, according to the Philadelphia Inquirer, confirmed the severity of the injury. He has been placed on the 15-day DL, but the Phillies are acknowledging up front that they expect this injury may require more time, indicating that Rollins is likely to be sidelined for two to four weeks.
Rollins is sporting a protective boot that controls ankle movement and allows the calf to rest. Since rest is a critical element of recovery, it would not be surprising to see this injury keep Rollins out closer to the four-week end of the timetable.
The calf muscle is necessary for any hitter to push off when running, particularly when driving out of the batter's box or when getting a jump on a steal. The explosive defensive maneuvers Rollins has to make at his position also place high demand on the calf. Once the initial inflammatory phase has passed, many athletes feel as if they are ready to return to competition, only to discover that explosive movements still lack power or cause discomfort. The risk at that point is that it is easy to overdo those movements and suffer a setback, turning a few weeks of recovery into potentially months. Fantasy owners and Phillies fans will need to be patient with Rollins' return in the hopes that once he's back, the injury is truly behind him.
Brian Roberts, 2B, Baltimore Orioles (15-day DL, April 10): There was concern this spring that Roberts' ailing back might prevent him from being able to start the season. That turned out to not be the case.
Less than a week into the season, Roberts suffered a different injury, an abdominal strain. He hurt himself while stealing second against the Toronto Blue Jays on Friday, and he also managed to aggravate his lower back in the process. As a result, Roberts received an epidural injection Monday, according to The Baltimore Sun, his second this year to help calm symptoms associated with the herniated disk in his back. Roberts has been advised to rest for several days to allow the symptoms to calm down. He will then gradually be reintroduced to exercise with an eventual progression toward baseball activities.
Manager Dave Trembley has already warned that Roberts is expected to be out longer than the 15 days, not surprising given the nature of his injuries. The bigger concern is just how reliable Roberts' health will be once he does return. Disk problems are notoriously chronic in nature and Roberts has really not been 100 percent healthy this year. He entered spring training with back pain and, despite making significant improvements as Opening Day neared, he clearly was not completely out of the woods. His will likely be a tenuous situation and even when he does return, fantasy owners should keep a backup stashed on their bench.
Aaron Hill, 2B, Toronto Blue Jays (15-day DL, retroactive to April 6): Hill was placed on the DL because of a strained right hamstring, but according to ESPN reports, Hill indicated that if it were a different point in the season he "could" play. While acknowledging that his hamstring was tender enough to keep him from going at full speed, Hill, who ran the bases Monday before game time, did not seem overly concerned about his injury. At this point, it appears Hill will come off the DL when eligible next week.
Jeff Griffith/US PresswireAaron Hill's attempt to match his 36 homers from 2009 has taken a short break.
There's every reason for the team to err on the side of caution with this one. A mild hamstring strain can certainly benefit from a little extra rest. Aggravating it by pushing too fast can just as easily turn a mild ailment into a season-compromising injury. The good news for Hill owners is that the conservative approach taken by the team here may pay off down the road.
Mark Ellis, 2B, Oakland A's: Another second baseman, another hamstring injury. Ellis was hurt Sunday trying to beat out a grounder in the eighth inning. Soreness in his left hamstring kept him out of Monday's game.
On the plus side, Ellis himself said he expected to be out for only "a couple of days." According to Susan Slusser of the San Francisco Chronicle, Ellis reports that the hamstring is feeling better and he could return to the lineup Thursday. On the minus side, Ellis had some hamstring issues during the spring as well, so fantasy owners should be mindful that this may not be the last of it.
Jayson Werth, OF, Philadelphia Phillies: There were a couple of minor injuries this week that struck outfielders (more listed below). Werth injured his left hip running out of the batter's box in the fourth inning on Monday. According to the Philadelphia Inquirer, Werth said his removal from the game was precautionary. He added that he expected to miss only a few days, calling the injury "no big deal."
So far Werth's assessment appears accurate in that he is expected back in the regular lineup Thursday following a pinch hitting appearance Wednesday. The Phillies are hoping that one player to the DL this week is enough.
Chris Young, SP, San Diego Padres (15-day DL, retroactive to 4/7): Before fantasy owners start griping that this is the injury-prone Chris Young from years past, take a deep breath and remember that not all DL stints are created equal.
Christian Petersen/Getty ImagesChris Young is back on the disabled list, but don't be alarmed by the move.
Remember, Young is coming off offseason surgery to debride the labrum in his throwing shoulder. He had an uneventful rehab and steady return to throwing, and had a successful first outing in the Padres' home opener. After that game, Young felt some discomfort and was sensible enough to recognize that he did not need to push it now. As he pointed out, these mini-setbacks typically happen during spring training but his just happened a little further into his throwing progression.
Caution in the early season could well be the difference in keeping Young on the mound more than off it this year. He expects to be ready to take his turn in the rotation when eligible.
Brian Fuentes, RP, Los Angeles Angels (15-day DL, retroactive to 4/6): This is one of those situations where the date is important. Although the move was announced Wednesday, it has been made retroactive to eight days prior. Fuentes, who has been placed on the DL because of a back strain, is eligible to return next week. The Angels can't be especially concerned about Fuentes' injury given the retroactive date but likely feel he will benefit from a few more days off. Fernando Rodney is the closer in the interim but it sounds as if the team does not anticipate that lasting long.
Mike Gonzalez, RP, Baltimore Orioles (15-day DL, retroactive to 4/10): Gonzalez has had a rough start to 2010; the Orioles decided Wednesday to place him on the DL. After an up-and-down spring training Gonzalez struggled early in the season, picking up a pair of blown saves. Now we learn that he has a shoulder strain. While the seriousness of his current injury is unclear, it's worth noting that Gonzalez dealt with issues in his back this spring that seemed to impact his velocity. The hope is that he has not suffered an injury as a result of some compensatory adjustments. His status is worth watching.
• Boston Red Sox outfielder Jacoby Ellsbury dodged a bullet -- but not teammate Adrian Beltre's knee -- Sunday. The collision was enough to take Ellsbury's breath away and he ended up with a rib contusion but fortunately no fractures. Lingering soreness has caused him to miss a few days but he should be able to avoid a trip to the DL.
• Colorado Rockies outfielder Carlos Gonzalez is another player dealing with "tightness" in his hamstring, leaving Sunday's game early after feeling the discomfort in his left hamstring. He has not played in the two games since. According to The Denver Post, Gonzalez was available only for emergency situations, as he could still not run the bases effectively. While so far it appears that he will avoid the DL, there are no guarantees as to when he may return to the starting lineup.
• The Seattle Mariners' Cliff Lee is hoping he will debut for his new team in early May. Lee has thrown a couple of bullpen sessions where he has looked strong and been pain-free. The next goal is a simulated game late this week. He will still need to build up his arm endurance, but so far, so good.
• Los Angeles Angels pitcher Scott Kazmir, who started the season on the DL with a mild hamstring strain, is expected to start Thursday against the New York Yankees. Nothing like jumping in feetfirst.
From my mailbag
Luke (Monroe, Conn.): Hi Stephania, I'm trying to decide if Lance Berkman is just dead weight, even on my DL. I am in a 10-team mixed league with 2 DL slots, and right now I am carrying Berkman and Erik Bedard on my DL with Ted Lilly occupying a bench spot even though he is on the DL. My staff is good enough that I can get by with Lilly on the bench for a few weeks, but the more I read about Berkman, the more it seems to me like he is not going to be nearly the player he has been for his career, and maybe not even the player he was last year. ... What kind of player to you project Berkman to be this year, assuming he comes back fully healthy and has no complications? In other words, best case scenario? If he's anything less than a 25-HR, 100-RBI guy, I doubt he's worth my bench spot since I don't have anywhere to play him full time.
Mark Cunningham/Getty ImagesLance Berkman's return is still up in the air, as are his stats when he returns.
Stephania Bell: You are certainly right about there being a lot of questions about Berkman, given the start to his season. This week there were some encouraging signs in that he has made some progress with his activity. After having persistent issues with fluid in his left knee following March arthroscopic surgery (which required having his knee drained multiple times), Berkman was able to begin some light running Monday. The key to him returning next week will be whether the swelling stays down as he continues to increase his activity. And that's a big if ...
Your question is a tough one because I'm not convinced his return will be completely smooth. While there may not be any obvious outward signs of trouble once he is able to get back in the lineup, he could be in a situation where the team opts to rest him more frequently to protect the knee. He may also have less power at the plate initially if his leg strength is not 100 percent. He may be well enough to play but it still may take him time to perform like the Lance Berkman you drafted. I'm not convinced he'll reach the targets you've set for him, so you may want to re-evaluate your bench spots.
If you have any other injury questions you want answered in the blog, drop a note in my mailbag, or stop by my Tuesday chats.
April, 7, 2010
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.
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