Stephania Bell: Joey Votto

Will they or won't they? Whenever the due date approaches for a player to potentially return from the DL, the natural ensuing question is "Will Player X return on time?" The follow-up, if the answer is yes, is, "What can be expected in terms of performance?" The follow-up if the answer is no is, "So when WILL Player X return?"

There are no guarantees in life but that won't keep us from taking a stab at answering the above questions for a few players of note.

Jayson Werth, OF, Washington Nationals: Werth has been sidelined since May 6, when he fractured his left wrist while attempting a sliding catch. Originally projected to be out for three months, it appears Werth will hit the target almost exactly on the money. Late last week, manager Davey Johnson hinted that Werth could return Tuesday night when the Nationals begin a homestand against the Philadelphia Phillies, Werth's former club. Johnson also told the Washington Times that Werth would not be activated until he felt ready. "I'm concerned that he feels mentally that he can go out there and not get hurt running around the outfield and having four at-bats," Johnson said.

It appears Werth does not yet feel ready, but he is close. Werth is back at Nationals Park on Tuesday and taking batting practice, as Adam Kilgore of The Washington Post reported, which indicates he could be activated at any time. While Werth's performance at the plate during his rehab at-bats has been less than spectacular, it is likely more an issue of regaining his timing than anything. Werth was hitting balls out of the park during batting practice before going out on assignment, an indication he could hit the ball hard without any discomfort. His play on back-to-back days suggests no unexpected pain, although he will encounter soreness as his activity increases, which may require intermittent rest. Adjusting to live pitching after being away from the game, especially due to injury, also takes some time. Regaining confidence is as important an element as any for a hitter and Johnson is understandably allowing his player to make a determination as to when that has occurred.

Expect Werth to rejoin his team in the lineup later this week.

David Ortiz, DH, Boston Red Sox: Initially when Ortiz pulled up lame while running the bases in mid-July, the Red Sox hinted at a short absence. That absence is going to extend beyond the 15-day minimum, as Ortiz continues to experience soreness in his right heel. Ortiz is eligible to return Wednesday, but persistent symptoms mean that activation will not happen imminently. So when will he return? According to ESPN Boston, Ortiz summed it up this way: "I can't say right now exactly when I'll be ready to play, let's see how the process goes."

To be fair, that's about as honest as it gets. Clearly in a player of his age and size, with this not being his first episode of pain in the Achilles or heel area, there is concern about pushing too aggressively and ending up with a more significant injury. Symptoms sound the alarm, which drives the activity level when it comes to Achilles injuries, so as long as there is pain, the activity will be limited. The fact that he was having pain when swinging the bat as recently as Saturday and that his primary exercise is currently in the pool hints at a delay of more than a few days.

Evan Longoria, 3B, Tampa Bay Rays: He has been on a rehab assignment with Triple-A Durham since last Thursday but only as a DH. And that's the role he will retain, even when he returns to the majors, at least initially.

While manager Joe Maddon sounds encouraged by Longoria's ability to get through a handful of games without incident, it is worth pointing out that he is functioning in a limited capacity. Before beginning his rehab assignment, Longoria told reporters his left hamstring was not 100 percent, that he still felt it doing defensive drills and that he was about as "ready as [he's] going to be" offensively. According to the Tampa Bay Times, the hope is that he will get enough at-bats to be comfortable potentially rejoining the Rays' lineup and then over time, work his way back defensively.

The bottom line is that what is not being said is no one seems to be targeting a full recovery, at least not right now. In fact, Longoria noted he was told he couldn't make the injury worse by playing. While that statement is puzzling, since there is always potential to strain the muscle belly of the hamstring itself, if indeed Longoria tore a portion of the tendinous attachment, that tissue often does not heal on its own and sometimes warrants a minor procedure to remove the frayed piece. While the team has not offered any specifics on the exact location of Longoria's injury, this concept would fit with the program that is in place. Longoria's ability to return would be dictated by his ability to function in the presence of discomfort, something he seems to be able to largely avoid at present by staying away from defensive drills.

If the Rays get his bat back into the lineup, they may be willing to work with whatever they can get from Longoria given the limitations of his recovery. This is one case where a return to play does not look like the same thing as a return to full health.

Joey Votto, 1B, Cincinnati Reds: When Votto underwent surgery to address a torn left meniscus in mid-July, he was projected to miss three to four weeks. Halfway through that timetable, it's not yet clear whether he will meet that projection or not. The good news early was that he was quickly able to walk normally, without pain. But as is typical following even a relatively minor arthroscopic procedure, when it comes to resuming more aggressive activities, the process slows down.

Votto recently told the Cincinnati Enquirer that while he was running and doing agility drills, it was "not at 100 percent." He hasn't yet resumed hitting. He'll need to progress through all the straight-line activities, add corners and turns, and show he can react with quick, lateral movements and slides into base which, it's worth noting, is how he hurt his knee in the first place. That's a tall order for one week, perhaps even for two, which is why Votto is no doubt reluctant to offer up a return date. The unknown is how his knee will respond to each new rehab challenge. If any swelling or soreness occurs, the program is adjusted accordingly.

It's in Votto's -- and, of course, the Reds' -- best interest to wait until he is clearly ready to return before placing him back in the lineup. If he were to come back early, he would run the risk not only of stirring up inflammation in the joint but potentially straining one of the muscles around the knee. A forced second round on the DL could ultimately cost more time than postponing his return to play on the front end.

Hard-hitting Cincinnati Reds first baseman Joey Votto was dealt his own blow Monday when he found out he would need to miss three to four weeks to address a torn meniscus in his left knee. Votto originally injured his knee on June 29 while sliding into third base, but he remained in that game. (The flexed and rotated position of his knee underneath his body as his foot contacts the bag is a vulnerable position for the meniscus, which is often injured via a twisting mechanism.) Reds team physician Dr. Timothy Kremchek appeared on ESPN's Baseball Tonight on Monday and said, Votto "didn't feel right" the day after the injury. Votto took the first two days of July off to rest the knee and then returned to play, trying to push through the injury gamely despite lingering discomfort.

Joey Votto
Jim McIsaac/Getty ImagesJoey Votto leads the majors in on-base percentage and is second in OPS.
The effects made themselves increasingly apparent however, as Votto struggled at the plate (14 HRs and 27 RBIs before the injury, 0 HR and 2 RBIs since) and appeared slow at times in transitional movements, like trying to get back to first base quickly after leading off. After aggravating the knee again via a twisting maneuver in recent days, Votto felt the need to address the problem now.

"It is in my best interest and in the best interest of the team to do it now, so that I can be healthy during the last two months of the pennant race," Votto said in a statement. As Kremchek noted, "It got to the point where he couldn't perform the way he felt he needed to to help the team. He decided it was the right thing to do to fix this now and get him ready for August, September and a playoff run."

So can he really return within the projected three to four weeks? Kremchek, who will be performing Votto's surgery Tuesday, said the time frame is definitely "reasonable," adding that Votto is in "tremendous shape," which can only help in his recovery. The rehab is straightforward focusing on resolution of swelling and restoring normal motion, walking without a limp and progressively increasing strengthening. The critical element is restoring adequate muscle strength before returning to play so that the knee is not at risk for other injury, not to mention being able to deliver the proper power while swinging the bat. If all goes without a hitch, expect Votto to rejoin the team within a month.

I just like to start with some good news. Any good news. Trust me, some weeks -- like this one -- it's slim pickings. Nonetheless, I feel responsible to fantasy owners to keep the glass half-full, and so I scoured amidst all the downers of guys headed to the DL (including a record number of repeat customers!) and I managed to find a bit of encouraging news this week.

Jose Reyes could make his return from the DL on Friday. I always recommend the cautiously optimistic approach when it comes to returning from a muscle strain or an "-itis" (as in something inflammatory). In fact, Reyes hasn't had the opportunity to test the leg in a game situation because Tuesday's planned extended spring training game was rained out. So much for the glass being half-full. There is another game scheduled for Wednesday when the Mets hopefully will be able to put Reyes to the test. Until he proves he can run without difficulty, Friday's target remains in the category of wishful thinking.

But let's face it, we want to get to the information about who's hurt. Here's who we're talking about this week in the world of baseball injuries. ...

Josh Hamilton
Aaron M. Sprecher/Icon SMIJosh Hamilton is making his second trip to the disabled list this year, and this could be a lot longer.
Josh Hamilton, OF, Rangers: Hamilton underwent an MRI on Monday in an attempt to clarify the cause of his persistent groin pain, which has been with him since his most recent collision with an outfield wall at Rangers Ballpark. On Tuesday, he met with Dr. John Preskitt, who performed a sports hernia repair on Ian Kinsler last season. According to the Fort Worth Star-Telegram, Rangers general manager Jon Daniels indicated that Hamilton's visit with Preskitt was to help rule out a hernia.

If this all sounds confusing, it is. Arriving at a diagnosis of a sports hernia is really a process of ruling out other diagnoses. Here's what we know so far.

1. First and foremost for fantasy owners, Hamilton is on the DL for the second time this season. That means you have to make alternate plans for at least another two weeks. I would recommend that you make plans for another couple of months. Continue reading.

2. Hamilton's injury started out as a groin strain and was later called an abdominal strain, according to the team's official Web site. This is the case with many of the injuries that are eventually diagnosed as sports hernias. Pain begins near the groin, then moves closer to the lower abdominal wall. With all of these muscles converging to attach at the pelvis, the pain patterns can be similar.

3. It is not a hernia. A true (abdominal) hernia represents a protrusion (herniation) of abdominal contents through a weak spot in the soft tissue around it. The hernia can often be palpable (the examining physician can feel it) and can generally be seen on imaging (via ultrasound or MRI). Since many of the symptoms can be similar, it is important to rule out a true hernia. Many sports hernias do not show any visible findings on MRI. If Hamilton had a hernia, he would be having surgery while I'm writing this column.

4. Hamilton has indicated that he faces the most difficulty when trying to run. The hallmark of a sports hernia is an athlete's inability to run. It can be a frustrating diagnosis in this regard because, depending on the degree of injury, the athlete can actually feel quite good ... until he tries to run. Because of the muscles involved and their attachment near the pelvis, the power required to run places a demand on the area that cannot be met. The athlete typically complains of pain and weakness when attempting to run. According to the Dallas Morning News, Hamilton said "I'm hurt and sore and can't run," estimating his running since the groin injury at 50 percent of normal.

The evidence here would suggest that Hamilton is, indeed, dealing with a sports hernia, which is, in essence, what the team is saying. According to the Ranger's official Web site, assistant general manager Thad Levine "likened the injury to a sports hernia" and hopes Hamilton can avoid surgery after a period of rest and anti-inflammatory medication. Hamilton will be re-evaluated at that point and, if he has not improved, likely will face sports hernia surgery that would require six to eight weeks of recovery. Although Hamilton's mechanism of injury is somewhat atypical (these injuries often seem to come on out of nowhere, with no particular incident as the cause), his symptom pattern has many features that fit the bill.

For those wondering why surgery isn't done right away, this rest period is a step in ultimately arriving at the conclusion that surgery is necessary. Since sports hernia diagnosis is often one of exclusion -- figuring out everything that the injury "isn't" -- the decision to proceed with surgery is easier if conservative measures have failed. Fantasy owners can hope for the best, but should prepare for the worst, in the event that Hamilton is headed under the knife.

Evan Longoria, 3B, Rays: Longoria was serving as the DH for the past couple days as a result of elbow soreness; now there's something of potentially bigger concern. Longoria left Tuesday's game with a left hamstring strain after running out a ground ball, and we know how these injuries can go (read: linger).

He is expected to undergo an MRI on Wednesday to determine the extent of damage, but there are a few notes of encouragement. Longoria's description of what he did NOT experience suggests that the strain is on the minor end. Longoria told the team's official Web site Tuesday after the game, "I didn't feel a pop, I didn't feel a pull, I was able to walk and ride the bike and everything." Longoria added that he considers himself day-to-day. Rays manager Joe Maddon indicated that he will act with caution, so don't be surprised if Longoria is given a couple days to rest, even if the MRI turns up nothing significant.

Edinson Volquez
AP Photo/Jeff RobersonEdinson Volquez lasted just one inning in Monday's start before returning to the disabled list.
Edinson Volquez, P, Reds: Volquez may hold the record for shortest return from a DL stint before exiting a game only to be returned to the DL. Not a record he or his fantasy owners really want. And it's not as though he wasn't recovered from the first problem (back spasms) and aggravated the injury. Sadly, this is something altogether different.

Volquez lasted all of a single inning in his return Monday night before being forced out with what he described as "tingling from my elbow down to my fingers," according to the Dayton Daily News. Volquez went on to say that he had "never had this happen ... never had pain in my arm." Specifically, Volquez experienced the sensation in his ring and pinky (fourth and fifth) fingers in his right (throwing) hand. The location tells us that his ulnar nerve was talking to him, and clearly it was not happy.

According to the Cincinnati Enquirer, Volquez has been placed on the DL with tendinitis in his elbow. In that scenario, inflammation in the soft tissue around his pitching elbow could result in increased pressure on the ulnar nerve (which passes just behind the bony part of the inside of the elbow, coming very near to the surface, making it an easy target for injury). The pressure would then result in irritation of the nerve, which shows up as numbness and tingling in the fourth and fifth fingers in the hand. The ulnar nerve is often problematic for pitchers because of its location and its vulnerability when there are problems at the elbow. If the joint is hypermobile, if spurs are present, if there is any ligamentous injury (yes, ulnar collateral or Tommy John ligament) or even in the presence of swelling alone, the ulnar nerve can be affected.

The hope for Volquez is that this truly is a minor condition and not the beginnings of a major problem with his throwing elbow. The plan is for him to rest for at least a week (no throwing at all) and then be re-evaluated. Stay tuned.

Joey Votto, 1B, Reds: A week ago it appeared promising that the team had been able to identify the source of Votto's frustrating intermittent dizziness. He was reportedly dealing with an ear infection and had been placed on anti-inflammatory medication. The problem, however, was that every time Votto got on a plane, the symptoms were exacerbated the next day.

On Saturday, Votto was placed on the DL with what the team is calling "stress-related issues." It's fairly safe to assume that the stress Votto is experiencing is from the on-again, off-again nature of this dizziness. I can tell you that patients who experience chronic dizziness describe it as an extremely debilitating and frustrating condition. We've all experienced feeling dizzy or light-headed at some point, and I have yet to find anyone who thinks it pleasant. Now imagine trying to do your job and performing at the same level to which you and your co-workers are accustomed, with the world spinning around you. It's just not possible.

This trip to the DL is a good move for Votto until he can truly get his symptoms under control. Let's hope that the 15-day period is all he needs.

Asdrubal Cabrera, 2B, Indians: Cabrera left Tuesday's game against the Twins in the first inning with a shoulder injury. He was clearly in pain when he left the field after taking the brunt of Twins shortstop Brendan Harris' weight on his left shoulder as he slid into second base.

The Cleveland Plain-Dealer is reporting that Cabrera suffered a dislocated left shoulder that was "put back into place." X-rays taken at Hennepin County Medical Center were reportedly inconclusive and Cabrera is scheduled to undergo an MRI Wednesday. The description makes it sound as if Cabrera actually subluxed his shoulder (in which it slips slightly off the joint but quickly pops back in) because a true dislocation is often difficult to reduce (put back), unless the athlete has a very unstable shoulder with a history of repeat dislocations. As far as I can tell, this is not the case with Cabrera.

Cabrera also told the Plain-Dealer that he did not think he would need to go on the DL, another sign that he may not have suffered that severe of an injury. It's worth noting though that players often feel far worse the next day once there is post-injury pain and inflammation. There's still a chance, either with or without a complete dislocation, that Cabrera could have suffered enough soft tissue damage to require a minimum two-week absence. Let's see how Cabrera feels over the next few days. That will probably go a lot further in determining just how long it will be before he's back in the lineup.

On the Mend

Alex Gordon has to be pleased with the results of his latest visit with his surgeon. According to the Royals' official Web site, Gordon, who is recovering from surgery to address a torn labrum, got "glowing reports" on his trip to Colorado. His latest activity includes limited tee swings and very light, easy ground balls, so he is still a ways from truly testing his hip (hard swings, fielding bunts, throwing across his body and, ultimately, sliding). Although Gordon was originally given a timetable of 10 weeks (which would mean a return in late June), I have suspected all along that a return after the All-Star break would make the most sense. It seems that Gordon's progress has him on track for that so far.

• Rays ace Scott Kazmir is recovering from his quad strain while simultaneously addressing mechanical faults he attributes to last year's elbow injury. There is no official timetable for his return, but according to the St. Petersburg Times, Kazmir is throwing in the bullpen and hoping to avoid a minor league assignment. It's possible he could be back within another two weeks. Between the quadriceps recovery and the adjustments Kazmir is making, the hope is that his performance will improve when he rejoins the rotation.

Brandon Webb continues to work his way back gradually from the shoulder problem that has kept him out since Opening Day. According to the Arizona Republic, he's throwing on flat ground (with another session planned for Wednesday) and will hopefully progress to a bullpen session Saturday. Don't get too excited; the Diamondbacks haven't brought him along this slowly only to speed him up now. Due to all the missed time, Webb likely will be brought along through every step in the standard return to throwing progression, including several minor league starts to build up endurance. The most encouraging words are from Webb himself, "It took a while to get there, but I feel like we're moving forward." I would not expect much before the All-Star break, but assuming he continues well, it would be a good time to think about picking him up.

Xavier Nady
G Fiume/Getty ImagesXavier Nady likely isn't done for the year, but he isn't coming back in the near future, either.
• In the not so smooth recovery department, Yankees players have endured a couple of setbacks. Outfielder Xavier Nady, who suffered an injury to his previously reconstructed ulnar collateral ligament in April, threw for the first time on Monday and it apparently did not go so well. According to the Newark Star-Ledger, Nady experienced discomfort in his elbow when attempting throws from 50 to 60 feet. Although manager Joe Girardi indicated he would play Nady even if he wasn't at full strength, it's a recipe for disaster if the player and the manager are uncertain whether every throw will result in pain. Nady did throw Tuesday and, according to, only felt minor discomfort this time. When he's throwing consistently without any discomfort, then we can really be encouraged. Until then, everyone should temper expectations.

• Meanwhile, Nady's teammate Jose Molina is having a repeat MRI on his injured left quadriceps after being pulled from an extended spring training game Monday. Those results are expected to guide the next steps. Even without the results, just the fact that he had to be pulled because the muscle became painful tells you what you need to know. He will not be ready to return anytime soon.

• On the other coast, Angels pitcher Kelvim Escobar faced challenges of his own as he recovers from surgery last year to repair a torn labrum. After being ahead of schedule throughout his rehab, he had a setback near the start of the season that has delayed his return. Escobar's shoulder is recovering and he is throwing without pain, but his latest rehab start Monday revealed that he does not have full control of his delivery. The Los Angeles Times reports that, as a result, Escobar has stopped throwing the slider for now. From a rehab perspective, how his shoulder feels is the most important thing. The fact that he is not experiencing pain is critical. A slider is one of the more physically demanding pitches, so it makes sense that it would take longer to get it back. Look for Escobar to rejoin the rotation within the week, perhaps Saturday, but without his slider.

• And finally ... expect John Smoltz back in mid-June. No one will commit to it, but he looks good. Get ready, he's going to be great.

Hamilton back soon, caution with Delgado, Votto

May, 20, 2009

Didn't we start this column last week by celebrating Josh Hamilton's comeback from a strained rib-cage muscle? He came back all right, playing just as hard, including running into walls. Now the center fielder is sitting out Tuesday with another crash-into-the-wall-induced injury; this time it's a strained right groin. No word yet as to how long the team expects him to be sidelined, although this does not appear to be as big a deal as the previous injury which forced him onto the DL. In fact, on the Rangers' official Web site, Hamilton indicated that he felt better Tuesday and hoped he could return to the lineup Wednesday. That might be a little ambitious, but it does sound as though he could return this week.

Last week we also celebrated the return of Angels ace John Lackey. Well, he only lasted two pitches in his first start Saturday. When I first heard that news I wondered what devastating injury could have befallen him so quickly in his season debut. I later found out he had been ejected after hitting a batter (after first throwing behind him) and was relieved, as Lackey fantasy owners everywhere must have been, that his early exit was not injury-related. Incidentally, he did return to pitch Monday and notched his first victory of the season. He did not pitch deep into the game, but assuming his elbow continues to feel good, it will just be a matter of increasing his endurance.

The Angels also saw the return of Ervin Santana last week who, despite being a bit rusty, survived his first outing. Santana's ability to deliver his breaking pitches, most noticeably his slider, inspired confidence that his elbow is feeling good. When Kelvim Escobar rejoins the team -- which appears to be targeted for early June if all goes well in his rehab starts -- the Angels can really feel as if they're overcoming the big injury hurdle.

Chris Carpenter
Mark J. Rebilas/US PresswireChris Carpenter hadn't allowed an earned run in 10 innings in his first two starts of the season.
And there is more good news about an ace returning. Cardinals ace Chris Carpenter is expected to return today after missing time with an oblique strain. Carpenter's oblique was not injured, as one might expect, during pitching, but rather during batting. We see pitchers with oblique injuries and hitters with oblique injuries, but a pitcher succumbing to an oblique injury while hitting is rare. Carpenter's season had been off to an impressive start after he missed nearly two full years with various throwing-arm issues including Tommy John ligament reconstruction and nerve decompression surgery. Since this most recent injury was not to his throwing arm and he was able to maintain his physical conditioning, the hope is that he will be able to pick up his performance right where he left off. Fantasy owners who remained faithful to Carpenter over the past six weeks should be well-rewarded.

Here are the other walking wounded we're talking about in the world of baseball this week ...

Carlos Delgado, 1B, Mets: Delgado tried to play through the hip injury that has been bothering him since April. But after sitting out 10 straight days and trying all forms of conservative treatment -- a cortisone injection, therapeutic mobilization to the hip (which the New York Post accurately described as his leg being "pulled to create space in the hip") and rest -- all to no avail, the surgical option became imminent.

The Post reported that Delgado underwent surgery Tuesday to address a mechanical impingement, a labral tear and a bone spur. The Mets say they expect to have him back within about 10 weeks, a timetable similar to that given to Yankees third baseman Alex Rodriguez this preseason and Royals third baseman Alex Gordon in April.

However, although his timetable is similar to those two, there are a couple of differences in Delgado's situation. Beyond the fact that his name is not Alex, his fielding demands are somewhat different, since he plays first base, not third. Additionally, Delgado's injury -- unlike those of Rodriguez and Gordon -- is to his lead hip when he swings the bat since he bats left-handed. How does that impact his return? It doesn't necessarily alter the time frame, but it does shift some of the emphasis of his rehab.

It is also worth noting that despite the fact this injury is dated to late April when Delgado hurt his hip sliding into third, this hip has bothered him in the past. Last year Delgado missed time with "impingement" in the same hip. Although a longer-term injury can sometimes translate into more damage within the joint, based on the post-surgical rehab time frame issued by the Mets, this does not appear to be the case. In fact, one could potentially make the case that if indeed Delgado's hip has been a limiting factor, even intermittently, over the past two years, he might be able to improve his overall performance once he's fully recovered.

Carlos Delgado
Ezra Shaw/Getty ImagesThe hips are key to generating power for a slugger like Delgado.
A word of caution to fantasy owners. Take a look at some of Rodriguez's struggles since he has returned. He has hit some beautiful home runs, but his limited ability to connect the bat with the ball consistently exposes his lack of a true spring training. ESPN's Jayson Stark wrote this week in his Rumblings and Grumblings column that a scout recently made this observation about A-Rod's defensive play: "His defense has been terrible. He doesn't look like he could move off a dime. He's a dead-stand-up stationary third baseman right now." Presumably some of this is a reflection of Rodriguez still working his way back into the demands of the position post-surgery. In order to effectively play first base when he returns, Delgado will need to have the mobility in his hip to stretch off the bag and the strength to maintain his position. The fact that he has seen playing time early in the season should help his return to hitting, but he is 36 years old, soon to be 37. Returning to sliding along with regaining his defensive play might take longer still. Ten weeks would bring Delgado back in late July, but fantasy owners should not be shocked if that timetable is extended a bit. Stay tuned for updates.

Joey Votto, 1B, Reds: Votto's dizziness remains unexplained, and until there is some resolution, he won't be back on the field, much to the dismay of the Reds and fantasy owners alike. The trouble with dizziness is that there are hundreds of possible causes. Some of those potential causes are easier to eliminate than others, and no doubt the medical specialists evaluating Votto now are working their way through multiple tests and algorithms. According to the Reds' official Web site, Votto will continue to undergo further testing over the next few days, at which point the team will be "more prepared to discuss the cause of [his] dizziness."

Votto is in San Diego undergoing tests at the Scripps Clinic. After removing himself from Saturday's game against the Padres because of dizziness, Votto stayed in San Diego for evaluation. He has been experiencing dizziness intermittently since mid-May, shortly after a bout with the flu, which may or may not be related. It is impossible to prognosticate Votto's condition here without knowing the root cause, but it is worth mentioning that in many instances dizziness is very treatable, once the source is identified. Stay tuned.

On the mend

Red Sox first baseman Kevin Youkilis is scheduled to rejoin the team Wednesday. He has been absent from the lineup for two weeks with an oblique strain. Remember, just last Tuesday Youkilis was expected to play but aggravated the injury during batting practice and was instead forced onto the DL for some additional rest. In other words, he's been almost healthy for about a week. He should be able to jump right back in.

Jorge Posada, who has been out with a Grade 2 hamstring strain, is making strides. According to the Yankees' official Web site, Posada rates himself as 85 percent improved, despite the fact that he's still experiencing some tightness. The challenge with muscle strains is that there is no way to be absolutely certain that complete tissue healing has occurred. Although Posada has improved, he will still have to face a rehab assignment before rejoining the team. Fantasy owners should plan on at least another 10 days to two weeks.

Speaking of rehabbing Yankees, pitcher Chien-Ming Wang has looked impressive in his rehab starts. He has even indicated that he feels his balance is better since doing the strengthening work. Wang threw a bullpen session Tuesday and according to The (Newark, N.J.) Star-Ledger, Wang feels he's ready to return. The Yankees staff watched the session to evaluate Wang's command. The Yankees have not yet said out loud that they're ready to have him back, and they might opt to have him make another rehab start, but it looks as if his return is coming sooner rather than later.

Daisuke Matsuzaka, on the DL since April 15 with a right shoulder strain, could pitch for the Red Sox as soon as Friday. He certainly looks ready, striking out nine in his most recent rehab start. According to the team's official Web site, the decision has not been confirmed, but all signs point to that happening very soon.

An Associated Press report confirms that Angels outfielder Vladimir Guerrero is expected to begin a rehab assignment this week. Keep in mind that his rehab at this stage will only involve hitting and he could return to the team, perhaps as soon as Memorial Day, as a designated hitter. There is still no indication when he will be able to begin throwing.

And finally, the Dodgers' official Web site is reporting that pitcher Hideki Kuroda, who has been battling a lingering left oblique injury, passed the test of a three-inning simulated game this week and could start a rehab assignment Friday. If that progresses well, he could rejoin the team within the next ten days to two weeks.