Stephania Bell: David DeJesus

Some say it's the year of the pitcher. I say it's the year of the thumb.

We seem to have a trending injury every year. While a review of recent injury patterns does not support the notion that there are any statistically significant differences from one year to the next, it always feels like there is some "hot" injury in any given season. This season is no different and the hot spot is the thumb.

AP Photo/Kathy WillensDavid DeJesus injured his left thumb crashing into the Yankee Stadium wall trying to track down an eventual Derek Jeter inside-the-park homer.
Sure, there have been the usual array of injuries involving the ulnar collateral ligament (Minnesota Twins closer Joe Nathan), the abdominal oblique (Milwaukee Brewers ace Yovani Gallardo) and the hit-by-a-pitch broken hand (Colorado Rockies power hitter Tory Tulowitzki). There have also been a couple of injuries that are so unusual, you might not see them again in five, 10 or 15 years (Joel Zumaya's fractured olecranon and Jake Peavy's detached lat tendon).

But there has also been an odd cluster of thumb injuries. Not only are there a number of high-profile players who have dealt with some sort of thumb injury (Jason Heyward, Aramis Ramirez, Chase Utley, Victor Martinez, Shin-Soo Choo, to name a handful) but the frequency seems to be on the rise. Whether it's the result of a headfirst slide (Utley, Heyward), an awkward bend to the glove hand (Choo) or a foul tip (Martinez), the injury is typically serious and results in missed time. The amount of time varies depending on the severity of the injury and whether surgery is required, but in many cases it translates to a DL stint.

So while we celebrate the fifth no-hitter of the year (congratulations, Matt Garza), I still say the thumb outranks the pitcher in 2010, especially when it comes to this blog. Just ask the Kansas City Royals' David DeJesus, who will watch the rest of the season from the sideline thanks to the outfield wall that sabotaged his thumb.

Let's not let the thumbs steal all the injury thunder though. There are plenty of alternate ailing body parts to go around this week and we start with those in the lower half.

Magglio Ordonez
Tony Ding/Icon SMIMagglio Ordonez's fantasy usefulness screeched to a halt as he limped off the field Saturday.
Magglio Ordonez, OF, Detroit Tigers: The headfirst slide has been a topic of much discussion because of the injured thumbs that have resulted this year. But there's no guarantee that the foot-first slide is injury-proof. Ordonez found that out Saturday when a traditional slide led to a broken right ankle. He is expected to miss up to eight weeks (and potentially the remainder of the season) while the injury heals. But was the slide itself to blame?

Ordonez, who was already dealing with a sore ankle and was limited to DH duties, was thrown out at the plate while attempting the slide. According to Mark Snyder of the Detroit Free Press, Ordonez's ankle appeared to give way as he was sliding. It's possible that the pre-existing weakness made Ordonez less able to control his ankle on what would normally be an automatic maneuver. Now, it seems, he will be spending the next month and then some working on his ankle strength and stability once the bone heals. Ultimately, he should recover fully from this, but fantasy owners should plan on doing without Ordonez for the remainder of their season.

Carlos Guillen, 2B, Detroit Tigers: When it rains, it pours. Just ask Jim Leyland. After losing Ordonez to the aforementioned ankle fracture last Saturday, the Tigers saw Guillen exit later that day with a right calf strain.

The good news is that Guillen's injury does not appear to be serious and he is expected to return at the end of his 15-day DL stint. In fact, Guillen is likely to resume baseball activities within a week, according to the Detroit Free Press, and assuming no setback, should be ready to return when eligible. Guillen has experienced some issues with his calf since mid-June resulting in intermittent days off to rest it. Given that this was not his first episode and knowing how disabling a significant calf strain can be (Philadelphia Phillies shortstop Jimmy Rollins has endured two DL stints this year because of it), the Tigers are fortunate -- for once -- in that this should not cost Guillen excessive time.

Ben Sheets, SP, Oakland Athletics: Remember when everyone was buzzing about Sheets' January throwing sessions for scouts when he was looking for a team after his flexor tendon repair? And remember when the A's picked him up at the exorbitant price tag of $10 million for one year?

Ben Sheets
Jason O. Watson/US PresswireBen Sheets had stayed relatively healthy until recently, although he's just 4-9 with a 4.53 ERA this season.
Here's an excerpt from our fantasy draft kit where we talked about thoughts on Sheets from an injury perspective heading into 2010:

The concern is not so much in the recovery of this particular injury. Overuse of the flexor-pronator (the muscle group on the front side of the forearm that controls downward wrist motion and some forearm rotation) is not uncommon in pitchers and failure (or partial failure) of the tendon (which anchors that muscle group to the bone at the inner aspect of the elbow) is not unusual. ... The issue is whether the flexor tendon tear is an isolated injury or whether there is other structural damage present which, even if insignificant now, could manifest itself in the future. Where is a crystal ball when you need one?

Sheets had plenty of time to recover from this particular surgery in advance of the 2010 season. Unfortunately, there is no true way of knowing how long his health will hold up.

It seems as if some of those preseason concerns are indeed manifesting themselves. Sheets, on the DL and out indefinitely, has had recurrent problems with swelling in his throwing elbow, which suggests that there are bigger issues lurking beneath the surface. The San Francisco Chronicle reports that Sheets is scheduled to visit his orthopedic surgeon, Dr. Keith Meister, on Tuesday and the team will wait until that visit is complete to discuss his condition. Given that Sheets already indicated that the problem could be season-ending, there is not a lot of reason to be optimistic.

More definitive details regarding Sheets' diagnosis should be forthcoming shortly but it's safe to say that recurrent swelling and discomfort in a pitcher's throwing elbow is never good. Fantasy owners should begin making alternate plans if they haven't already.

And dare we say it ...

Colorado Rockies shortstop Troy Tulowitzki is expected back in the lineup Tuesday. Last week we said all signs were positive as Tulowitzki headed to a rehab assignment. Indeed they were. Tulowitzki has shown manager Jim Tracy enough to warrant rejoining the team. Fantasy owners should bear in mind that he is just shy of six weeks since the injury, pretty much close to his original timetable. There may be a delay between Tulowtizki returning to the lineup and Tulowitzki returning to hitting over .300.

Jacoby Ellsbury
Elsa/Getty ImagesJacoby Ellsbury has not played since May 24.
Boston Red Sox outfielder Jacoby Ellsbury started a rehab assignment, a significant step in his comeback efforts from multiple rib fractures. Ellsbury played DH on Monday with the Red Sox's rookie league team, going 1-for-3. Clearly he still has a way to go before returning to the majors, but getting back to facing opposing pitchers was an important target. The Boston Globe reports that Ellsbury could be moved to Triple-A Pawtucket this week if all continues to go well, perhaps as early as Wednesday. While the Red Sox, for obvious reasons, are reluctant to offer a specific timetable for Ellsbury, his rehab calendar suggests that he will rejoin the team within the next 2-3 weeks. Given his much more gradual progression back this time, fantasy owners can have more confidence in his return.

New York Yankees lefty Andy Pettitte is feeling good in his recovery from a left groin strain. Pettitte told the New York Daily News that he is "not having any problems at all." Of course he is quick to add that he hasn't done much other than play catch in the outfield. There are still a number of hurdles to cross before Pettitte can consider rejoining the rotation and the team will be cautious for reasons outlined in a previous blog, meaning the original timetable of 4-5 weeks may yet hold. Nonetheless, the fact that Pettitte is not having any pain is a positive sign.

Dan Haren, the new addition to the Los Angeles Angels' pitching staff, suffered a bruised right forearm when he absorbed the brunt of a comeback line drive Monday. Haren will be evaluated Tuesday to ensure that this is indeed just a soft tissue injury to his throwing arm. Obviously any sort of bone injury would translate to significantly more missed time. Not what the Angels want to see happen the day after they make a trade.

From my mailbag:

Adam (Los Angeles): Maybe a paragraph on Andruw McCutchen would be nice.

Stephania Bell: Thanks, Adam, for writing. Hopefully you were able to sneak McCutchen into your fantasy lineup for this week! But for those who may still be wondering about the nature of his injury ...

McCutchen suffered an injury to his AC (acromioclavicular) joint when he made a diving catch in the outfield. The AC joint is where the acromion (tip of the shoulder) meets the clavicle (collarbone) and is easily sprained (meaning the ligaments that support the joint are injured) by a fall onto the point of the shoulder. An injury here makes overhead movement difficult, but general soreness around the shoulder could potentially limit most baseball activities, including batting. Because McCutchen made his return to the Pittsburgh Pirates' lineup Sunday, it confirms the original projection of a mild injury and unless he happens to dive and land on it exactly the same way, he should be fine going forward.

Opening week injury notes

April, 1, 2008

Play ball! These words were heard around the country as most teams officially opened their seasons this week. And so it is time for me to resume my regular season of injury blogging. We talked about key injury concerns during the offseason, and I shared some of my observations from training camps in Florida and Arizona, but now that the real deal is here, it is time to monitor how those preseason injuries are progressing (or not), and who is being added to the injury list each week.

We start this season off by welcoming a long absent player back from injury. Of course, because this is the injury blog, we also have to add to the injury list the players who have already gone down early in Week 1.

Welcome back!

Nick Johnson
Drew Hallowell/Getty ImagesNick Johnson is looking good after missing all of 2007 with a broken leg.
Nick Johnson has returned to the lineup in grand style. The Washington Nationals first baseman missed the entire 2007 season after suffering a broken right femur (thigh) in September 2006 as a result of a violent collision with right fielder Austin Kearns. It takes a lot of force to break a femur, and that's what happens when two adults moving at high speed in opposite directions crash into each other. Johnson had a titanium rod and screws placed into the femur to stabilize it, but persistent pain in his hip and knee resulted in subsequent surgery to remove the hardware. After first relearning how to walk, then run, Johnson had to reteach his leg some of the basics of baseball. One of the most challenging skills? Sliding. Imagine leading with that leg, knowing it will come into contact with something -- whether that something is a base or a body -- and overcoming the anxiety of that leg enduring the impact.

Well, Johnson came back with a vengeance, delivering an RBI double in the first inning Sunday and demonstrating confidence in his leg on a slide into second, which occurred without a second thought. It is wonderful to see someone who has been through so much and who has worked so hard to get back to the game be able to succeed. Forget the fact that Johnson's performance helped secure a Nationals victory on Sunday night to open their brand new park, as well as earn another victory Monday. His success was already evident by the fact that he earned the starting position, somewhat ironically, over Dmitri Young, the 2007 National League comeback player of the year. With two great outings to start the season, Johnson is making the Nationals very excited to see what is yet to come from him and his teammates in 2008.

New Injury Worries

Cleveland Indians catcher Victor Martinez folded while trying to run to second when a pitch got away from Chicago White Sox catcher A.J. Pierzynski on Monday. An athlete's instinctive reaction to acute discomfort is to pull back immediately on the speed and grab the leg, a sure sign of a strained or pulled muscle. According to an ESPN report, Martinez, who has what the team is calling tightness in his left hamstring, will undergo an MRI to determine the extent of the injury. He is considered day-to-day for the time being. Last year, Martinez strained his left quadriceps on Opening Day and subsequently missed six games. The Indians have to hope this is not the beginning of a trend.

Carlos Zambrano
Tom Fluegge/US PresswireCarlos Zambrano, left, leads the Cubs with eight wins and is second on the team with a 3.01 ERA.
Chicago Cubs pitcher Carlos Zambrano managed to pitch 6 2/3 innings in Monday's opener but complained of discomfort in his forearm. That was enough for the medical staff. Zambrano exited the mound, perhaps a proactive move to prevent it from becoming a significant problem. According to the Cubs' official Web site, Zambrano was experiencing forearm cramps and is not expected to miss his next start. For his part, Zambrano says he needs to "drink water." Can't hurt.

Kansas City Royals outfielder David DeJesus left Monday's game with a sprained left ankle. Apparently, the ankle had been bothering him all week and was aggravated during the game when he chased down a ball. The Kansas City Star is reporting that X-rays on DeJesus' ankle were negative and that the pain he experienced Monday is not as severe as when he originally injured it March 24. The challenge with sprained ankles is avoiding re-injury while trying to recover, and this is an example of the type of minor aggravation that can set you back. Fortunately, this does not sound serious for DeJesus and should not result in an extended absence.

Washington Nationals pitcher Chad Cordero did not make his anticipated entrance at closing time on Sunday night, leading everyone to wonder what the problem might be. As it turns out, Cordero told The Washington Post that he felt a "sharp pain" that shot down his arm while playing catch before the game. Cordero received a cortisone shot, and the team is calling the injury tendinitis. He is not scheduled to throw before Wednesday at the earliest, and his next attempt at activity should give a better clue as to how serious the shoulder condition is. Sharp pain with throwing is always more of a concern than stiffness or tightness, but until Cordero tests the arm again, there is not much to go on.

Sticking with the Nationals, outfielder Elijah Dukes left Sunday's game with a strained right hamstring, the same hamstring he originally injured in mid-March, and was placed on the 15-day disabled list immediately after the contest. Hamstring injuries can easily become chronic and nagging, so this serves as a tiny red flag for Dukes that he will need to rest this ailment sufficiently and not return too soon. Otherwise, it has the potential to simmer just beneath the surface and crop up intermittently throughout the season.

That's it for the early week injury blog. Be sure to check back later in the week as we take a closer look at the players who started the season on the disabled list and what we can expect from them. As always, we will update any new injuries as well. Good luck to all of you playing fantasy baseball and remember, no matter what happens this week, it's a long season. I'll be with you the whole way.