Stephania Bell: Jaime Garcia



Every Monday in this space, we'll provide updates on a variety of players to help you make your weekly lineup decisions. We'll specifically try to hit the players who are day-to-day, have just gone on the DL or are ready to return, so that you can better decide whether you can count on them or not.

All projected return timelines should be considered fluid.

Hitters

Curtis Granderson, OF, New York Yankees (placed on DL May 25; expected to miss at least a month): When it comes to injuries this season, if the Yankees didn't have bad luck, they wouldn't have any luck at all. Granderson, whose season finally got under way just a few weeks ago, is now out for at least a month with another fracture.

Two hit-by-pitches have resulted in fractures for Granderson, the first a broken right radius (forearm bone) just above the wrist, and now a broken left fifth metacarpal (the long bone of the hand, at the base of the fifth (pinkie) finger). The latest incident occurred Friday night when Granderson absorbed the impact of a pitch to his left knuckle in the fifth inning. In an almost eerie forewarning of this event, Granderson spoke to the Yankees' website just weeks ago during his rehab assignment (from the first fracture) about not fearing the inside pitches. "There's going to be pitches inside, I'm going to get hit again, but you got to stay in," Granderson said. In this case, he stayed in until he was forced out, literally, because of injury.

If there's any good news here, it's that it appears this fracture, like the first, will not require surgery. Broken bones typically require four to six weeks to allow sufficient healing to permit return to play; if Granderson's finger shows good early callus formation (bone healing) and he can grip the bat effectively, his timetable should fit right in that timeframe. That said, he might have to encase his fingers, hands and forearms in bubble wrap when he steps to the plate to get through the rest of the season.

[+] EnlargeBryce Harper
AP Photo/Alex BrandonBryce Harper is becoming known for his "all-out" style of play ... which could lead to missed games.
Bryce Harper, OF, Washington Nationals (day-to-day): Add bursitis to the list of Harper's aches and pains resulting from crashing into walls, but don't expect it to land him on the disabled list if he can help it. Harper's knee bothered him enough to warrant an MRI, which came back clean, according to manager Davey Johnson. The Washington Post reports Harper will be sidelined for several days, although he may be utilized as a DH against Baltimore later in the week. One thing is certain, though: Harper has no intention of changing anything about the hard-nosed way he plays baseball. These intermittent minor injuries have threatened his status for a couple of games here and could be an ongoing challenge for Harper and his fantasy owners.

Shane Victorino, OF, Boston Red Sox (placed on DL retroactive to May 21): Victorino had been battling back spasms in recent weeks yet managed to avoid a DL stint. Not now. This time it's his left hamstring that's giving him fits, and Victorino will be forced to rest until he can run without limitation. Interestingly, Victorino's hamstring started to bother him just days after returning to the lineup following missed time for his back. If these two issues are related, which would not be surprising, this could turn out to be intermittently problematic throughout the season.

Will Middlebrooks, 3B, Red Sox (placed on DL May 24): Perhaps back spasms are contagious in Boston. Middlebrooks left Thursday's game early due to back spasms, something manager John Farrell told reporters might have begun Wednesday night as Middlebrooks came out of the batter's box. The good news is that Middlebrooks said, according to ESPN Boston, that as of Saturday he was already feeling improvement. "I do [think I'll come off the DL when eligible]," he said, adding, "I feel better than yesterday, so if I'm already making steps forward, that's where I want to be." This looks to be a minor episode.

Jayson Werth, OF, Nationals (placed on DL retroactive to May 3): When Werth was first placed on the disabled list, the thought was that he would miss the minimum amount of time. After all, when the decision was made to formally move him, he had already missed eight games and seemed to be faring better. But if there's anything we know about hamstring injuries, it's that they are among the least predictable of all soft-tissue ailments. It is often not until the athlete tests the leg with full-speed sprinting activities that lingering issues make themselves known. In Werth's case, he experienced discomfort when breaking out of the batter's box, according to Amanda Comak of the Washington Times. The persistent discomfort led to an MRI, which manager Davey Johnson told reporters was "alarming." Consequently, Werth's timetable has been extended with a new target date of June 3, according to general manager Mike Rizzo (via the Washington Post). It's worth reiterating, however, that hamstrings remain unpredictable. Let's see what Werth does this week in his workouts before counting on a Monday return.

Chase Utley, 2B, Philadelphia Phillies (placed on DL May 23): Utley's knees haven't really been a topic of discussion this season since they haven't seemed to limit him thus far. Now, however, Utley is dealing with a different type of injury issue: a strained right oblique. The Phillies report it as a Grade 1 or minor strain, and the move to the DL reflects their desire to not allow it to worsen. Phillies GM Ruben Amaro Jr. offered a timetable of 2-4 weeks, which is certainly reasonable, adding, "We do believe and hope that Chase will be ready to play in Philadelphia within 15 days." The average missed time for an oblique strain in a hitter runs right around a month, but the most mild forms have allowed an athlete return after the minimum stay (such as Freddie Freeman earlier this season). Although there is some optimism Utley will be back after the 15 days, there's no reason for the team to rush him, especially this early in the season.

Trevor Plouffe, 3B, Minnesota Twins (placed on 7-day concussion DL May 22; expected to return Wednesday): Plouffe took a knee to the head while sliding last Tuesday and was subsequently placed on the concussion DL. Concussions are the least predictable of all injuries, but based on Plouffe's fairly swift recovery so far, it appears the Twins will get him back the first day he's eligible to return. According to the Minneapolis Star-Tribune, Plouffe passed his neurocognitive (ImPACT) tests Thursday and participated in cardio work Friday, which shows progression. If he is able to perform baseball-related activities early this week without any recurrence of symptoms, it appears he will be cleared to rejoin his team's lineup Wednesday.

Wilkin Ramirez, OF, Twins (placed on 7-day concussion DL May 26): Another collision, another concussion for a Twins player. Unlike the knee to the head Plouffe sustained, Ramirez was concussed making a defensive play in the outfield Saturday when he crashed into teammate Josh Willingham. According to the Minneapolis Star-Tribune, Ramirez was not originally on board with the DL designation, that is until he experienced queasiness during the team's flight home Sunday. Good job by the Twins, who certainly have had experience with complex concussions (think former AL MVP Justin Morneau). Now it will be a matter of waiting to see how Ramirez progresses throughout the next week.

Pitchers

Chris Perez, RP, Cleveland Indians (placed on DL May 27): Perez is sidelined with right shoulder soreness, and he was placed on the disabled list for the first time in his major league career early Monday. He was forced to leave Sunday's game against the Red Sox early because of the shoulder, according to ESPN.com. "It kind of pinched on me and sent a little pain down my arm," Perez said. While any shoulder issue is of concern for a pitcher, this doesn't yet have the sounds of something major. It appears Perez at least needs some down time to let the symptoms settle, and he can then hopefully return to throwing. Hopefully.

Clay Buchholz, SP, Red Sox (day-to-day, expected to start at some point this week): Buchholz was scratched from his Monday start after irritating his right acromioclavicular (AC) joint (the point of the shoulder), something he attributes to falling asleep on his side with his arm wrapped around his young daughter. The impression is that this is just a simple matter of delaying his start to account for the soreness, preventing him from compensating and potentially creating another problem. According to ESPNBoston.com, the plan is for Buchhholz to play catch Monday, and he expects to pitch again later this week.

[+] EnlargeJim Henderson
Jeff Hanisch/USA TODAY SportsJim Henderson is expected to get his closer job back once he returns from his hamstring injury.
Jim Henderson, RP, Milwaukee Brewers (placed on DL May 25): Henderson left Friday night's game in the ninth inning after straining his right hamstring while trying to field a ground ball. After visiting with the team doctor Saturday, the decision was made to place Henderson on the disabled list, which would allow him some additional time off to recover. It sounds like it will be a closer-by-committee situation in Milwaukee until Henderson is ready to return, whether that's in two weeks or slightly longer.

Chris Sale, SP, Chicago White Sox (day-to-day): Mild tendinitis in his posterior throwing shoulder was the diagnosis for Sale. While any inflammation in a thrower's shoulder is a cause for some concern, the Sox immediately indicated they expected Sale to return for his next start after being scratched last Wednesday. Those plans were confirmed after Sale played catch in the outfield prior to Saturday's game. Afterward, Sale said, "It felt a lot better than I actually thought it would be. Everything is on track, and I will be ready to go Tuesday." He was scheduled to follow up Saturday's session with a Sunday bullpen, and there has been no word of any setback.

If Sale returns without incident, there will be a big sigh of relief from his fantasy owners. But the specter of concern has been raised once again -- last year, there were some questions about whether he was dealing with an elbow injury in May, followed by a reported dead arm period in July -- which must remain in the back of our minds. The bigger question will be whether or not Sale can get through the remainder of the season without this turning into something more substantial.

David Price, SP, Tampa Bay Rays (placed on DL May 16): Triceps tightness originally put Price on the DL, but nobody on the Rays seemed overly concerned. Manager Joe Maddon said he did not expect Price to miss more than two or three starts. Apparently there's now reason to be at least a little more concerned. Despite Price's assertions that his arm feels "great," he hasn't yet begun to throw. According to the Tampa Bay Times, playing catch hopefully will begin within the next few days, but Price will have to proceed through a throwing progression before returning the rotation, which could take an additional few weeks. So much for him missing only 2-3 starts; now there is no official timetable. Until Price actually starts throwing with effort, it's difficult to gauge whether the slow progress is as a result of the Rays taking a conservative approach with him or because of legitimate concern over the health of Price's arm.

[+] EnlargeJaime Garcia
Dilip Vishwanat/Getty ImagesJaime Garcia finally succumbed to his shoulder injury.
Jaime Garcia, SP, St. Louis Cardinals (placed on DL May 18; done for the season): Garcia tried to get through his shoulder injury without resorting to surgery, and he was successful in doing so for a few starts. His shoulder, like those of so many other pitchers before him, exhibited the wear and tear associated with overhead throwing in the form of labral damage. Eventually that damage made it impossible to throw. After consulting with Dr. James Andrews, Garcia is headed for surgery. It appears his operation will be performed by team physician Dr. George Paletta. The recovery typically requires about six months, meaning if all goes well, Garcia should be ready to return when the season gets under way in 2014.

Ryan Madson, RP, Los Angeles Angels (opened the season on DL; no timetable for return): Every time it seems Madson is making progress in his recovery from Tommy John surgery, he seems to have some form of setback, which delays his return. The most recent incident occurred last week, when Madson developed soreness in his arm while throwing. Instead of beginning an anticipated rehab assignment with Triple-A Salt Lake, Madson has been shut down indefinitely. He is now 14 months post-surgery, and while the timetable for return following this procedure has a range of anywhere from nine to 16 months, the multiple setbacks Madson has experienced are discouraging.

Rarely is the road back to competition entirely uneventful, but Madson seems to have been pushed back with various episodes of discomfort a bit more than usual. At this point, the Angels seem to be getting solid production from Ernesto Frieri in the closer role, and it looks as if he will stay there for the foreseeable future. No doubt the Angels would like to see Madson return to the mound this year, but it has already proven to be slow going. For fantasy purposes, it's probably time to move along.

Jered Weaver, SP, Angels (placed on DL April 8; expected to return Wednesday): It's always nicer to see someone returning from the disabled list as opposed to going on it, especially when it's your team's -- real or fantasy -- ace hurler. Weaver has been out for more than a month after sustaining a non-displaced fracture of his radial head as a result of an awkward fall on the mound. His road to recovery has been uneventful, with the latter part primarily focused on building up his arm strength to the point of being able to reclaim his spot in the rotation. The Angels have announced Weaver will return Wednesday to face the Angels' neighboring rival, the Los Angeles Dodgers, and fantasy owners should have no concerns about starting him right out of the gate.

Ryan Vogelsong, SP, Giants (placed on DL May 21; expected to miss eight weeks): Vogelsong had not one break but two in his right (throwing) hand, an injury sustained while hitting last week. He underwent surgery last week which required five pins to stabilize the fractures, according to manager Bruce Bochy, and he will need time for the bone to show evidence of healing before he can resume throwing. He will then need additional time to regain throwing strength. Given the projected timeline, expect Vogelsong to be out until well after the All-Star break.

Pitchers on the mend

March, 29, 2013
3/29/13
5:19
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Given the number of pitchers who are entering 2013 coming off injuries to their throwing arms, we decided to craft a quick status update list on some of the more intriguing names as the season gets underway. Given that some of these players still have a ways to go in their recovery, consider the timeline fluid and subject to change. For the purposes of ascertaining where these players stand coming out of spring training however, this is our guide.

With elbow surgery becoming virtually commonplace in pitchers, we almost take for granted that they will return to their prior level of performance. But the complexity of the surgery and the variables which can impact recovery affect each athlete differently and should not be overlooked. For more detail on the process of ulnar collateral ligament reconstruction, commonly referred to as Tommy John (TJ) surgery, please see below.

Starting Pitchers

[+] EnlargeCC Sabathia
William Perlman/THE STAR-LEDGER/US PresswireCC Sabathia's 200 innings last season were the fewest he's thrown since the 2006 season, which is also the last time he's had as few as 28 starts.
CC Sabathia, LHP, New York Yankees: Surgery to address bone spur, Oct. 25, 2012. Sabathia reluctantly went on the DL last year with swelling in his elbow, then underwent offseason surgery to address the source of the problem; his return this spring has been just how he prefers it -- uneventful -- and he is expected to be ready Opening Day; while he is racking up the years and the pitching miles, his overall durability remains impressive.

Brandon Beachy, RHP, Atlanta Braves: TJ surgery, June 21, 2012. Has thrown several bullpens this spring without incident; will continue on throwing progression with targeted return in June/July.

Chad Billingsley, RHP, Los Angeles Dodgers: elbow inflammation and sprained UCL in 2012. Underwent PRP injections in fall and threw eight bullpens in offseason without incident, saying his elbow felt "normal" entering the spring; this spring he has sustained a groin ailment and a bruised index finger; Billingsley is still hopeful to start the season on time or close to it, but the recent history of a partial UCL tear warrants caution.

Jaime Garcia, LHP, St. Louis Cardinals: rotator cuff tear (small), no surgery, injured June 2012. Garcia opted for rehab over surgery and so far it seems to be working out for him; his shoulder has not given him any trouble this spring and he is expected to be ready to start the season as a part of the Cards rotation. The concern is whether his shoulder will hold up to a full season of pitching demands.

Daniel Hudson, RHP, Arizona Diamondbacks: TJ surgery, July 9, 2012. Has been making steady progress and threw his first bullpen the last week of March; targeting a return around the All-Star Break.

C.J. Wilson, LHP, Los Angeles Angels: surgery to address bone spur, Oct. 23, 2012. Has had no issues with the elbow this spring, although his performance has not been up to par; the latter should improve and his overall durability record should be an encouraging sign going forward.

Colby Lewis, RHP, Texas Rangers: flexor tendon repair, July 27, 2012. Progress has been steady and, after throwing bullpen sessions this spring, he is hoping to progress to live batting practice in early April; so far he remains on track for a late May/early June return. If he continues to progress this well, there could be a nice second half of the season in store.

Michael Pineda, RHP, New York Yankees: labral repair, May 1, 2012. Began throwing from a mound in February and added some breaking pitches in March; he won't be ready to return until around the middle of the season but he seems to be committed to the rehab and to being in better shape in general (reportedly having dropped about 20 pounds by this spring); it remains to be seen whether he can rediscover his dominant style but he's young enough that there's a reason to believe he can.

Ted Lilly, LHP, Los Angeles Dodgers: labral repair, Sep. 21, 2012. Lilly has been remarkably durable but all good things must come to an end; his shoulder issues required surgery and at age 37 it's hard to know just how he'll bounce back; his spring outings have been limited by flu complications and he'll likely start the season on the DL with a chance to continue to progress his arm; hard to count on when his status appears uncertain.

Scott Baker, RHP, Chicago Cubs: TJ surgery April 17, 2012. Made spring debut in mid-March but inflammation afterward resulted in a shutdown for at least a month; will have to gradually resume throwing and continue to build strength. No firm timetable but could miss first couple months of season.

John Danks, LHP, Chicago White Sox: shoulder surgery Aug. 6, 2012. The surgery was for debridement of biceps tendon and rotator cuff and to repair a small capsular tear. Danks threw bullpens and live batting practice sessions this spring without incident but, as is often the case, struggled in game outings, particularly with velocity. Will open the season on the DL and it's unclear just how long he'll stay there.

John Lackey, RHP, Boston Red Sox: TJ surgery Nov. 1, 2011. If there's an upside to tearing your ulnar collateral ligament late in the year it's that you benefit from the season schedule to gain extra recovery time; Lackey is now almost 17 months post-surgery so recovery is not an issue, but he'll still need to regain the feel of competitive throwing; results may be inconsistent initially but he should be able to get through a full season.

Cory Luebke, LHP, San Diego Padres: TJ surgery and flexor tendon repair, May 23, 2012. Experienced some pain in his reconstructed elbow this spring, forcing a temporary shutdown. This is not unusual but it reinforces the notion that these recoveries cannot be rushed; his timetable suggests a return around midseason but that could always fluctuate, as could his performance in the early stages.

Relief Pitchers

[+] EnlargeFrank Francisco
Jason Szenes/Getty ImagesFrank Francisco has to contend with both his recovery, and with a challenge to his role as closer from teammate Bobby Parnell.
Frank Francisco, RHP, New York Mets: surgery to address bone spur in right elbow, Dec. 18, 2012. Began throwing from a mound in March and has only recently begun throwing to live hitters; still with some soreness and is likely to open season on DL; could be ready by late April/early May.

Casey Janssen, RHP, Toronto Blue Jays: AC joint surgery Nov. 16, 2012. Progressed slowly this spring but has recently gained ground and appears ready for Opening Day; his overall workload has been light so will need to see how he responds in season, but the Jays have help if he needs an occasional day off.

Ryan Madson, RHP, Los Angeles Angels: TJ surgery, April 2012. Experienced some soreness this spring and had to be scaled back; will open the season on the DL but may not stay there long. Now that the arm is feeling better, he still needs to build some endurance and currently looks on track to return at some point in April.

Sergio Santos, RHP, Toronto Blue Jays: labral debridement surgery, July 24, 2012. Expected to be ready for Opening Day. Other than some minor triceps soreness this spring, has had a smooth progression back to the mound; Janssen is expected to function as the Jays' closer but Santos could get opportunities if Janssen is initially unable to tolerate a full workload.

Joakim Soria, RHP, Texas Rangers: TJ surgery April 2, 2012. This is Soria's second TJ surgery, making the road to recovery less certain, but so far the process has been smooth. He began throwing long toss in early October and from a mound in February, added breaking pitches in March and appears headed for a late May/early June return.

Tommy John Surgery: An updated primer


Ulnar Collateral Ligament (UCL) Reconstruction was originally performed by Dr. Frank Jobe in 1974 and is now known by the name of Jobe's first subject, pitcher Tommy John. It has become such a part of the baseball vernacular that it's a common topic of discussion amongst even casual fans. That doesn't mean there isn't more to learn about optimizing the surgical techniques or the rehab process to help ensure success or, more importantly, how to ultimately prevent or even reduce the incidence of these injuries.

The basics: The UCL is not a simple ligament. It is comprised of three bands which blend together to reinforce the medial (inner) elbow joint and runs from the medial epicondyle of the humerus (a bony prominence on the arm bone) to the medial forearm bone (ulna). Not all tears are created equal. In fact, it is rarely the case where the ligament is completely blown out. A partial tear in a critical location however can make it virtually impossible to throw because of pain, loss of control, or both. This is one of the reasons an MRI does not tell the entire picture; clinical examination will substantiate any instability in the elbow and the athlete needs to have symptoms of a magnitude sufficient to warrant surgery. This is not a procedure one enters into lightly given the intensive recovery time. One of the reasons a trial of conservative therapy is typically the first option when there is a suspected UCL tear (beyond the obvious scenario where the athlete's injury was mild and he recovers enough to return to play), is to validate for all involved the need for surgical repair.

The procedure: Typically a tendon is harvested from the forearm (most common) to serve as the replacement ligament. The tendon of choice (palmaris longus) is not present in everyone (hence the reason removing it will not hinder the athlete's function) in which case the option becomes a hamstring tendon. The surgeon drills holes in the bone (tunnels) where the new "ligament" will be implanted. In a fancy method of looping the ligament through the tunnels and tying it together, along with repairing the remaining components of the original ligament for reinforcement, the reconstruction is performed. One tricky element involves the location of the ulnar nerve in the forearm. This nerve runs adjacent to the ligament and supplies the fourth and fifth fingers in the hand. In other words, if the nerve becomes compromised, the athlete could lose feeling and muscular function in that area. (Ulnar neuritis, inflammation of the nerve, is not an uncommon ailment amongst pitchers simply due to the stress on the nerve from pitching.) Surgeons take great care to protect the nerve during surgery and in some cases will actually transpose (move the location of) the nerve to another spot on the forearm. Even when care is taken, complications related to the nerve are a risk factor with this surgery.

[+] EnlargeFrank Jobe
Nancy R. Schiff/Hulton Archive/Getty ImagesDr. Frank Jobe, pioneer of "Tommy John" surgery.
The rehab: As is the case following any new surgical procedure, the post-surgical rehab was very cautious initially. Return timetables approximated 16 months. Over time as more athletes have undergone the procedure and more is known about the healing process, that timetable has shortened to a range of nine to 12 months. The rehab schedule remains fluid as any number of factors can influence the time to return to activity, including whether the athlete is a thrower or non-thrower. Early rehab focuses on regaining elbow motion along with strengthening exercises for body parts away from the elbow and cardiovascular conditioning. Strengthening around the elbow is eventually introduced along with upper extremity coordination activities to retrain the "feel" of the arm in space. One of the biggest benefits of the rehab process is the time away from throwing. Pitchers rarely take such extended down time unless forced to do so because of injury. The rehabilitation following UCL reconstruction allows time to address shoulder imbalances, core muscle weakness, leg strength and any other areas that require attention while throwing is off limits. At approximately four months the athlete can resume light tossing and ultimately moves to a progressive throwing program. The throwing program is modified based on how the athlete responds to each outing and it is not uncommon for the progression to fluctuate at various points in the process. Even after an athlete returns to competitive throwing, it often takes time to reestablish command and consistency. So while a return to competition may occur within a year or less, a return to form can certainly take another six to eight months.

The unknowns: It is unclear just how much an athlete should throw in his first season returning from this procedure. Look no further than the case of Stephen Strasburg in 2012 to find arguments on either side of the Nationals' decision to shut him down early. The fact is there is no definitive research at present to outline a specific number of pitches to target or other such criteria for the first year post-surgery. There is some consensus amongst the medical community that the reconstructed ligament is stronger in the second year following the procedure.

Return to prior level of function, especially at the professional level, is remarkably high. Life expectancy of the reconstructed ligament, however, is unknown and may depend on a number of factors including severity of the injury and whether any of the athlete's original ligament remained intact. In recent years there has been an increase in athletes undergoing a second UCL reconstruction but the numbers are still small making meaningful analysis challenging. Based on preliminary research, it appears the success rate (defined as return to prior level of function) following a second procedure is significantly lower. It also appears that pitchers returning to a relief role fare better than those attempting to return as starters.

The prospect of facing Tommy John surgery is not viewed as career-threatening as it once was but it is still a daunting process. Although many athletes return to their prior level of function, it is not an easy path. Non-pitchers can return at a slightly faster rate, although outfielders may require additional time to make the biggest throws (outfield to home without a cutoff). For pitchers, even after they return to action, there is a high degree of variability as to when they actually return to form. As many similarities as there are among surgical techniques and rehabilitation programs, there are just as many individual variables which make each athlete's recovery unique. Prior injury history, overall tissue health, specific biomechanical demands of the athlete, follow-through with rehab and the surgical procedure itself can all impact the pace and the degree of recovery. In the end, outcomes are largely favorable but nothing should be taken for granted.

Pre-Opening Day injury update

March, 29, 2013
3/29/13
11:38
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With the regular season just about to start, here's a list of notable injury situations and their timetable for a return. Fantasy owners can and should adjust their lineups or draft strategies accordingly.

Notes:

1. All projections reflect expectations as of March 29 and should be considered fluid after that date.

2. Opening Day ready = Expected to be "active" on Opening Day, not necessarily in lineup on Opening Day. For pitchers, first game depends on where slotted in rotation.

Hitters

[+] EnlargeWright
AP Photo/Charlie RiedelDavid Wright was playing well at the WBC before getting hurt, but he appears to be on track for Opening Day.
David Wright, 3B, New York Mets (Opening Day ready): Wright strained an intercostal (rib cage) muscle during the World Baseball Classic, but rest and rehab seem to have done the trick. Potential for setback in the first few weeks exists, but this guy rarely misses time.

Brett Lawrie, 3B, Toronto Blue Jays (due back April): Intercostal strain will sideline him into the first week or two of the season, but a cautious return should help prevent a setback. Bigger concern is tendency to play with reckless abandon. Fun to watch, but may increase risk.

Pablo Sandoval, 3B, San Francisco Giants (Opening Day ready): An irritated ulnar nerve forced Panda to rest for several days in March, but he claims he's ready to return. I admire his enthusiasm but can't say definitively that this is behind him.

Chase Headley, 3B, San Diego Padres (due back late April): Left thumb fracture will delay Headley's regular-season debut by about a month. The good news is that it shouldn't hinder him after he returns.

Curtis Granderson, OF, New York Yankees (due back mid-May): No surgery needed for Granderson's small fracture. No reason to worry about his ability to produce once he returns to the lineup.

Hanley Ramirez, SS/3B, Los Angeles Dodgers (due back mid- to late-May): Ramirez will miss a couple months of playing time following surgery to repair his torn thumb ligament. The concern is that his performance at the plate could suffer a bit longer.

David Freese, 3B, St. Louis Cardinals (due back April): His back injury doesn't appear serious, but the Cardinals want Freese to see more at-bats before his regular-season debut. Recurrence is possible, but the minor nature of this episode keeps the worry factor low.

[+] EnlargeDavid Ortiz
Jim Rogash/Getty ImagesIt's still uncertain when David Ortiz will be ready for this season.
David Ortiz, DH, Boston Red Sox (no timetable): Ortiz continues to have trouble with his Achilles, despite trying to address it in the offseason. Although he's now swinging the bat, it's hard to imagine him being fully healthy for any long stretches.

Derek Jeter, SS, New York Yankees (due back April): Jeter's post-surgery soreness is not unusual. In fact, it will likely take a few months for his ankle to feel normal again. He may return in April but he may not really return until June.

Mark Teixeira, 1B, New York Yankees (due back May/June): A partially torn tendon sheath is what Jose Bautista had ... and then he had surgery. Teixeira's wrist may heal with rest, but if it doesn't, the power on the left side of the plate won't be there and he may not last long, either.

Corey Hart, 1B/OF, Milwaukee Brewers (due back May): The key to Hart's post-surgical knee staying healthy is not returning too soon. The team has been good about controlling his activity thus far, so don't expect them to rush him now. Late May is the most likely scenario.




Brian McCann, C, Atlanta Braves (due back April/May): He's recently returned to hitting, but restrictions on McCann's post-labral repaired throwing shoulder remain in place. Once he returns, it may take a bit to ramp up, but look for a strong second half.

Alex Rodriguez, 3B, New York Yankees (due back around All-Star Break): If he's rehabbing as diligently as he says, Rodriguez should be poised for an uneventful return. The hip may be healthy, but he's still an aging player with mounting injury concerns.

Starting Pitchers


For a more thorough progress report of pitchers returning from injury or surgery, see this blog entry.

[+] EnlargeZack Greinke
AP Photo/Damian DovarganesZack Greinke has caused much concern this spring with his elbow issues and overall poor numbers.
Zack Greinke, Los Angeles Dodgers (Opening Day ready): Right elbow inflammation in the spring should scare a team that spent $147 million and fantasy owners alike. Greinke says the elbow feels OK, but his performance is shaky. It's not exactly confidence-inspiring.

Jaime Garcia, St. Louis Cardinals (Opening Day ready): He opted for rehab instead of surgery for a small (left) rotator cuff tear and has been fine through a handful of spring outings. Starting season strong, but will he last?

Roy Halladay, Philadelphia Phillies (Opening Day ready): Halladay insists there's no injury, but his performance this spring is a concern. Last year he said there was no injury, either. Then he went on the DL and missed nearly two months. This could be the start of the talented veteran's decline.

C.J. Wilson, Los Angeles Angels (Opening Day ready): Underwent arthroscopic surgery in October to address a bone spur and has had no issues with the elbow this spring. Consider this: He's had only two DL stints in his big league career. Aging but durable. Low level of concern.

Phil Hughes, New York Yankees (due back early April): A bulging disc in his back derailed Hughes' spring. He has bounced back quickly, but let's face it, injuries are always going to be a concern with Hughes.

Matt Garza, Chicago Cubs (due back May): Ended last season with stress fracture in right elbow, started this spring with strained lat. Sum total of injuries raises concern.

Shaun Marcum, New York Mets (Opening Day uncertain): Elbow issues last year, now shoulder and neck this spring. Don't like where this is headed. Even if he avoids the DL now, it may only be a matter of time.



Brandon Beachy, Atlanta Braves (due back June/July): On track post-Tommy John surgery. No major concerns, just temper expectations to the typical ups and downs of the first year back.

Relief Pitchers

Jason Motte, St. Louis Cardinals (no timetable, expected to start season on DL): Diagnosed with a "small" tear in his flexor tendon, Motte is reportedly feeling better. He will have to prove he can throw without pain before returning, then hope the injury doesn't worsen across the season.

Ryan Madson, Los Angeles Angels (due back April): After Tommy John surgery last April, Madson is closing in on a return. But the normal inconsistencies that a pitcher first displays after this operation -- and a guy named Ernesto Frieri -- suggest Madson isn't a lock to close.

Casey Janssen, Toronto Blue Jays (Opening Day ready): After November surgery on his AC joint, a slow spring initially threatened Janssen's Opening Day status. He's recently turned a corner but there's still a bit of concern about how an uptick in work (think: frequency) will affect him.



Stephania Bell joins the Fantasy Focus podcast to discuss injury situations surrounding Freddie Freeman, a number of Philadelphia Phillies, Jered Weaver, Pablo Sandoval, Jaime Garcia and Joe Mauer.

Click here to listen to the podcast.

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