Stephania Bell: Jorge Posada

With the season approaching 60 days old, it seemed like a good time to take a look at a few key players relegated to the 60-day DL, either before or since Opening Day. Many fantasy owners are re-evaluating their rosters, wondering whether it's time to fish or cut bait. Naturally there's still uncertainty involved, but there has also been some activity to report, although it tends to be in such small increments that it goes unnoticed.

In many cases, it will depend on just how deep a roster you have, or how badly that roster has been bitten by the injury bug. If your team has been lucky enough to avoid serious injury, you may want to hang on to one of these guys in the hopes that he can give you a spark late in the season. If you need help NOW, then it's time to consider purging your DL sheet to make room for an up-and-comer.

Either way, here are the rumblings floating around regarding four noteworthy fantasy players along with my two cents as to how optimistic teams should be about their returns.

Brandon Webb
Mark J. Rebilas/US PresswireAfter pitching just four innings last season, Brandon Webb is no lock to appear for the Diamondbacks this year.
Brandon Webb, SP, Arizona Diamondbacks (60-day DL, April 4): Ever since Webb suffered a setback post-operatively, there has been little reason for optimism. He has not been able to progress successfully to throwing off a mound, the key hurdle for Webb, since his original injury in April 2009.

In the latest effort to get Webb on a trajectory that would return him to the playing field, he recently spent time in Birmingham, Ala., with physical therapist Kevin Wilk, according to the Diamondbacks' website. Wilk, who works closely with Dr. James Andrews, is known for working with high-level athletes, and throwers in particular. Webb also has a history with Wilk, having spent some time with him last year. Plus, the Diamondbacks' head athletic trainer, Ken Crenshaw, is highly regarded among many medical personnel who treat baseball players. This type of collaboration between practitioners is not unusual -- and is, in fact, praiseworthy -- especially when a team is faced with a challenging case.

During the biomechanical evaluative process in Birmingham, Webb reportedly received confirmation of what he had suspected regarding his arm angle; he has been throwing with a much higher arm angle than he had pre-surgery. Sometimes after an injury or surgery, the involved limb loses some of its proprioceptive ability or understanding of where it is in space. No matter how complete the range of motion or how strong the body part, regaining this sense of body awareness is critical to peak performance. The question ultimately is how significant of a factor this is in Webb's overall progression, but given the impact on how the body delivers the ball, Webb has to make the adjustment. So Webb will return to Arizona no doubt with a few tweaks to his rehab program and some attention to his mechanics in the hope that he will be able to regain his form.

It's still impossible to predict just what sort of timetable this sets up for Webb at this point in the season but fantasy owners can assume that the word "soon" is not in the picture.

Erik Bedard, SP, Seattle Mariners (60-day DL, retroactive to March 26): In news that's not necessarily news to longtime Bedard followers, Bedard suffered a setback during his rehab from shoulder surgery. To be fair, Bedard had been making terrific progress and was, in fact, ahead of schedule following his labral repair up until mid-May when he began feeling discomfort in his shoulder. That said, in the inaugural blog of the season, Bedard's long-standing history of soft tissue injuries was noted, making getting excited in April about a possible June return seem a little premature.

Bedard did travel with the team to Anaheim this weekend and threw a side session Friday. It went well enough that he was throwing again Monday (long toss, according to the Tacoma News-Tribune). If all continues uneventfully, Bedard will next progress to throwing bullpens. Prior to his setback, Bedard had thrown several bullpens and a simulated game. It was after his April simulated game that he began feeling discomfort and was transferred to the 60-day DL. Given the marks he still has to meet and the endurance he needs to build in his pitching arm, it's tough to imagine a pre-All-Star break return for Bedard.

Brian Roberts
Cliff Welch/Icon SMI A variety of ailments has limited Brian Roberts to just 14 at-bats this season.
Brian Roberts, 2B, Baltimore Orioles (60-day DL, April 10): Roberts must have walked under a ladder, stepped on cracks or double-crossed a black cat. Something has to explain the horrible string of bad luck he has dealt with since, truth be told, before the season started.

Roberts' back was problematic during spring training, but then it appeared he was out of the woods ... for a few days. Then on an awkward slide he suffered an abdominal strain and aggravated the back injury. Since then we have detailed his slow progress and setbacks (stomach pain that led to an endoscopy, and most recently a bout of pneumonia) on multiple occasions.

This week I am thrilled to report some positive news for Roberts! After just being cleared last week to resume baseball activities post-pneumonia, Roberts, working out at the team's complex in Florida, was able to take live batting practice and field ground balls from second according to the Orioles' website. Manager Dave Trembley went so far as to say "It's a good sign." Wow. That's going out on a limb.

Given the time Roberts has had, it's not surprising that no one -- from Roberts to Trembley -- wants to read too much into a good workout. Roberts is eligible to come off the DL on June 9, but as the Orioles' site indicates, the team anticipates that he will need some more time. After all, he has been away from the game for two months already, has been hospitalized, received spinal epidural injections and without a doubt has lost significant conditioning. If there's anything that's going to help protect his back from another major episode, it's strong core muscles and physical endurance. In fact, it would not be surprising if his return does not come until closer to the All-Star break. Every day will be a test so there are no guarantees at this stage. But at least we're talking about what Roberts is doing, instead of what he's not.

Carlos Beltran, OF, New York Mets: (60-day DL, retroactive to March 26): Beltran has been ever so slowly working his way back from January knee surgery to address cartilage damage in his knee.

We have maintained all along that the big tests for Beltran would come when he began running, and so far he has passed the preliminaries. He recently acknowledged that he has been able to run without pain, something he had not been able to do for months. But he is moving slowly, perhaps more slowly than even Beltran anticipated, although it is not without good reason. David Lennon of Newsday recently reported that Beltran acknowledged that he was given the choice of undergoing microfracture surgery in January -- which would certainly have pre-empted any chance at playing in 2010 -- or undergoing a less complex procedure to smooth the cartilage surface and give him an opportunity to return. He chose the latter but it underscores the point we've been making since before the season started; his knee is not pristine and thus must be treated carefully.

So far, Beltran has done light running but as of late last week, as the Newark Star-Ledger reported, he had not yet been cleared for baseball activities. General manager Omar Minaya reiterated what he had said a month ago: Beltran will need approximately four to six weeks after he is cleared for such activities before he will be able to return to the team.

Fantasy owners should automatically assume that this will take him beyond the All-Star break, but we will look for hints that he is actually increasing his activity and making progress toward a return.

In brief:

Grady Sizemore, OF, Cleveland Indians: He will undergo arthroscopic surgery on his knee. After consulting with several specialists, the plan is for Sizemore to undergo a scope, at which point it will be determined how extensive a procedure is ultimately required. The minimum time he is expected to miss is six weeks, but as we have seen before (like Carlos Beltran above), these situations can be tough to predict. If Sizemore does end up having microfracture surgery, his season will be over.

Kendry Morales
Kirby Lee/Image of Sport/US PresswireIt's possible that Kendry Morales won't play another game this season after his freak injury Saturday.
Kendry Morales, 1B, Los Angeles Angels: Morales, who went from ecstasy to agony in the blink of an eye when he broke his ankle during celebration for a walk-off grand slam Saturday, still has not been able to undergo surgery. According to the Associated Press, Morales' injured ankle remains too swollen for doctors to operate. The Los Angeles Times reported that the Angels' medical staff has suggested the possibility of a return for Morales this season, but the rehab clock has yet to begin ticking because of the delay.

Once the fracture has healed, Morales will need to regain his range of motion and strength, which is often more difficult than the healing of the bone itself when it comes to the ankle. Progressive weight bearing and increasingly demanding drills precede a return to baseball activities and then rehab games will follow. Depending on the precise location of the break, whether it is a clean fracture or whether there are multiple fragments, and the associated surgical procedure, the timetable can be quite variable, but this is more than a 15-day DL stint, with the descriptor more likely to be "months" than "weeks." Stay tuned.

Jorge Posada, C, New York Yankees: He may yet prove all of us medical folks wrong. (We actually don't mind when that happens in the positive direction because it means someone is doing better than expected!) Posada appears to indeed be ahead of schedule in a return from a hairline fracture he suffered in his right foot as a result of a foul tip. The Newark Star-Ledger reports that he ran on the field Monday, and manager Joe Girardi says there's not much more he needs to do, other than prove that he still feels fine the day afterward. Posada may avoid a rehab assignment so he could return to the team within days, not weeks. While running is certainly impressive, there are different stresses on the foot associated with playing the position of catcher so the team may want to see him catch a few innings behind the plate before clearing him. Nonetheless, Posada owners want to keep an eye on him as he is eligible to come off the DL late this week.

Andre Ethier, OF, Los Angeles Dodgers: And why not end on a high note? Ethier was back in the lineup Monday, coming off the DL as soon as eligible despite a still-healing finger fracture. As noted in last week's blog, it's a credit to some creative thinking on the part of the Dodgers' medical staff (and their collaboration with the Lakers' medical staff) that the timetable for Ethier's absence was shortened by as much as a month. Don't be too concerned by his lack of productivity the first night back. The fact he has barely missed a beat swinging the bat since his injury occurred will undoubtedly help him return to form sooner rather than later. He will wear the splint for the foreseeable future as the finger continues to heal.

Welcome back! Here's to being back from an extended stay away from the team, settling into the regular routine and finishing out the season on an upswing. No, the salutation is not self-directed, although I did manage to tear myself away from the beaches of Cabo San Lucas in Mexico to get back to the business of discussing injuries. This welcome is directed to Los Angeles Dodgers shortstop Rafael Furcal, who rejoined the lineup Tuesday in Chicago after missing time with a hamstring strain.

After originally looking as if he'd be back when eligible May 14, there was enough concern about some lingering symptoms to postpone the return date until now. It wasn't exactly Furcal's most notable performance (0-for-4 and a couple of errors), but he got through the game just fine. As reported by Tony Jackson of, Furcal said after the game, "I am very disappointed with the way I played. The best thing is that I'm healthy and I didn't feel anything." Very true. Rust can be overcome quicker than reinjury. The biggest test, however, will come during the next couple of weeks as we see just how Furcal and his hamstring tolerate the grind of daily play.

Also returning from injury were Boston Red Sox outfielder Mike Cameron, returning from an abdominal strain, and Minnesota Twins shortstop J.J. Hardy, coming off a bone bruise in his left wrist. Cameron is going to be eased back into play, according to The Boston Globe. He will not be used daily, at least not initially, plus he will spend some time playing left field. The 37-year-old Cameron, whose superb fitness may be a reason he's even been able to return from this injury, may yet require surgery down the line. Hardy's return Tuesday was abbreviated because the Yankees-Twins game was suspended in the fifth inning by rain. That said, Hardy's first at-bat was a double to deep right, so it looks as if his wrist is not a limiting factor.

Earlier it appeared that we would be welcoming back another star in this week's blog, Philadelphia Phillies shortstop Jimmy Rollins, but he was back on the DL before we ever got the chance. On that unfortunate note, we turn to some of the key injuries in the world of baseball this week ...

Jimmy Rollins
Miles Kennedy/Getty ImagesJimmy Rollins hit a homer in his brief stint off the disabled list earlier this month.
Jimmy Rollins, SS, Philadelphia Phillies (15-day DL, May 22): Rollins' situation exemplifies the challenge for a medical staff when dealing with an athlete returning to play following a significant muscle strain. No matter how many sprints, drills or running workouts an athlete goes through to test the injured part, there is no guarantee that he is out of the woods when he returns to play. It is impossible to simulate every game situation and perhaps even more challenging to simulate the environment -- such as the intensity, the adrenaline of playing in a major league game -- and those things can factor into how the body responds. The Phillies brought Rollins along at a conservative pace, even holding him back at times as a measure of precaution. Sometimes even the best-laid plans don't unfold as anticipated.

In Rollins' case, his right calf gave him a signal that it was not going to fully cooperate with his agenda. Rollins returned to the lineup on May 17 after missing 30 games with the original injury. Just four days later, the calf bothered him while he ran to first on a single. He was forced to leave the game early and returned to the DL the next day. No fooling around here.

As Phillies general manager Ruben Amaro told The Philadelphia Inquirer, "It might not take [the entire 15-day DL stint], but we can't afford to put ourselves in a position where it gets reinjured and turns into something serious." Hmmm. It looks as though the first part (reinjury) already happened, but the hope is that this does not represent a serious setback. The fortunate aspect is that this strain is reportedly not as severe as the initial injury. The team is referring to it as a Grade I, or mild, strain (the original injury was a Grade II, or moderate, strain) and the team hopes he will not require much, if any, additional time off.

Fantasy owners are understandably frustrated (just think how Rollins feels!), but this is not time to panic.

Andre Ethier, Los Angeles Dodgers (15-day DL, retroactive to May 15):
What a difference a day -- or a splint -- makes! Ethier, who landed on the DL after suffering a fracture in his right pinkie finger while taking batting practice, could have missed up to six weeks with the injury. As it turns out, thanks to the aid of a particular splint, Ethier may be able to return when eligible on Sunday.

The emphasis is on the word "may," however, as Ethier will have to show that he can perform without limitation and that the fracture is indeed healing before he can definitively play. But so far, things are looking good. If he performs well in a simulated game Saturday, he could be activated Sunday.

Andre Ethier
Harry How/Getty ImagesAndre Ethier could be back from the disabled list as soon as he's eligible.
The fracture that Ethier suffered was bit odd, or at least the mechanism of injury was unique. Ethier sustained an avulsion fracture -- when a small chip of bone is avulsed or pulled away where the tendon attaches to the bone -- at the tip of his fifth finger. Typically this type of injury, also called mallet finger, results from hyperflexion (exaggerated bending) of the digit, most often when the finger gets jammed by a ball or by contact with another athlete. In Ethier's case, it occurred while batting, when a slight slip of his pinkie finger caused it to get jammed between the bat and his hand.

As the medical staff discussed what route to take for treatment, the Dodgers' director of medical services, Stan Conte (himself a physical therapist and athletic trainer), made a call to colleague Gary Vitti, longtime athletic trainer for the Los Angeles Lakers. Anyone who has followed the Lakers lately knows they have had their share of finger issues, as is common in basketball. Conte said that Vitti recommended use of the "Pro-Ferred" splint, a splint that uniquely maintains the joint of the tip of the finger in extension (keeps it straight) to allow it to heal while allowing the joint just below some ability to flex or bend. This ability to flex the proximal or near part of the finger is what allows Ethier to be able to handle a bat.

Conte said that the use of the splint, along with some modifications of padding at the knob of the bat to make for easier grip, have enabled Ethier to already begin taking batting practice. While Conte stresses that the Dodgers are not yet sure whether Ethier will be ready to return when eligible, he does acknowledge that they are very pleased with the progress he has been able to make. Ethier would continue to wear the splint even if he does return because the tissue will still be healing.

From a medical standpoint, the more normal motion that can be encouraged while still protecting the injured area, the better the outcome typically is. We often see hitters who struggle when returning from wrist and hand injuries, particularly as they work to regain their motion and strength even if the injury has technically healed. In this scenario, it's quite possible that many of those challenges could be avoided as a result of Ethier's being able to continue to swing the bat relatively uninterrupted.

A little interleague cooperation could prove to go a long way to make fantasy owners really, really happy here. Stay tuned.

Grady Sizemore, OF, Cleveland Indians (15-day DL, May 19): An awkward landing while diving back to first base sent Sizemore to the DL, aggravating a knee injury first sustained near the end of spring training. Sizemore's next step will not be known until he gathers several opinions on his injured knee. The team has termed Sizemore's injury a bone bruise, but based on the locales of the specialists he's reported to be visiting -- Vail, Colo., and New York -- it raises the specter of cartilage damage. Vail is home to Dr. Richard Steadman, a pioneer of microfracture surgery (he performed January surgery on the New York Mets' Carlos Beltran), and there are surgeons in New York with similar expertise in cartilage defects.

The question that every fantasy owner wants answered is whether Sizemore will require surgery. Although the bone bruise likely will have him sidelined for multiple weeks, surgery could keep him out even longer, perhaps even threatening his return this season. Until the team releases more information, a timetable remains speculative, but at the very least, fantasy owners should make alternate plans for the next month.

Josh Beckett, SP, Boston Red Sox (15-day DL, May 19): Beckett and back problems are nothing new. In fact, he has dealt with lower back and upper back issues at different points in recent years. It seems that this year will be no different.

Beckett began having back spasms in early May after taking batting practice, and he missed a scheduled start. Days later, while pitching in rainy conditions, Beckett left his start early with tightness in his back. A DL move was natural and precautionary in trying to prevent this from being a lingering and lengthy situation. Although Beckett is eligible to return on June 3, there is certainly no guarantee that he will. So far he has thrown a few side sessions, and next up comes the bullpen. The Red Sox will want to see how he tolerates the progression to the mound before deciding on a return date.

Jorge Posada, C, New York Yankees (15-day DL, May 20): Posada has been placed on the DL with a hairline fracture in his right foot, the result of absorbing a foul tip off that foot in mid-May. Posada was hoping for just a bone bruise, but imaging tests showed the crack.

Initial projections from the team after the fracture was revealed had Posada out for three to four weeks, but he has taken a bit of a defiant position against that notion. According to the Newark Star-Ledger, Posada believes he will return earlier. "They can say whatever they're going to say. I'll be here before that," Posada said. It's worth noting that he followed up by saying he had never had a problem with his feet before, pointing out that "You've got to be able to put your weight on and all that stuff. You've got to be able to transfer your weight from one side or the other." Right. And he was immobilized in a walking boot when he made the remarks.

Given his position as a catcher where he is in a crouch, placing significant load through his feet while intermittently, explosively moving to full stance, the demands on the foot are high. Not only is he not likely to be back before three weeks, he'd be lucky to be back by then.

A hairline fracture can show evidence of healing more quickly than a complete fracture, but beyond the bone repairing itself, the foot needs to be able to tolerate loading, pivoting and twisting, without causing any symptoms before an athlete is able to return to baseball activities. Then, of course, he has to get back up to the level of playing in games. Until Posada is cleared for impact activities, it's probably too soon to even think of a return date. Fantasy owners should be planning on being without his services for the better part of a month.

Brad Penny, SP, St. Louis Cardinals: (15-day DL, May 22): Penny escaped with a relatively mild injury but was still relegated to a DL stint just to be safe. Penny, who was diagnosed with a strained lat (short for latissimus dorsi, one of the broad muscles of the back), left his Friday start early because of discomfort. Despite delivering a grand slam, Penny was not feeling good and came out of the game as a result.

According to the St. Louis Post-Dispatch, the decision to move Penny to the DL was easy for the Cardinals when considering the big picture. General manager John Mozeliak said, "It just makes sense to DL him, rather than put him out there for the next start and he makes a pitch and goes backward. It's a precaution." The team does not expect him to miss time beyond the minimum DL requirement.

Justin Duchscherer
Tony Medina/SMIJustin Duchscherer currently has a 2-1 record with a 2.89 ERA in five starts this season.
Justin Duchscherer, SP, Oakland Athletics (15-day DL, May 16): After working so hard to get back this season, Duchscherer has to be disappointed in the cards he's been dealt so far this year. He knew that keeping his lead hip healthy was the key to keeping his lower back pain-free and avoiding overload on his throwing arm, which was surgically repaired in 2008. In fact, he told me that very thing in spring training after making his first start of the year coming off pain-alleviating sacroiliac joint (where the low back joins the pelvis) injections. That's why he dedicated extra time to stretching his hips and keeping them loose.

But his anatomy is just not cooperating. Duchscherer, who already endured surgery on his right hip, is now being plagued by similar symptoms on the left side. His prior experience with the right hip is no doubt what led him to tell the San Francisco Chronicle that he anticipates needing surgery on the left hip. That statement came just after Duchscherer returned to the DL in mid-May because of continued hip discomfort one mere day after coming off it.

For the time being, Duchscherer is trying the conservative route to see whether he can delay surgery until the season ends. The Chronicle reports that he has undergone a Synvisc injection, a joint lubricant that may alleviate some of his current symptoms.

Fantasy owners who were holding out hope should probably look elsewhere, however. Synvisc was not ultimately able to stave off surgery when Duchscherer's right hip was bothering him; it's hard to be overly optimistic that this will turn out differently.

Other names to watch

Huston Street, RP, Colorado Rockies (15-day DL retroactive to March 26): Street began experiencing shoulder stiffness in mid-March. After steady progress, Street was throwing in a rehab assignment mid-May and was feeling good. So good, in fact, that he told the Rockies' official website, "I'm close -- dangerously close. I'm close enough to start getting my hopes up, and that's something I'm trying to keep together." Then, as if foreshadowing what was to come, Street added, "I got real excited last time [in spring training], and we had the setback. That set us back six more weeks."

Uh-oh. It happened again. Street suffered a setback just when it appeared he was on the verge of returning. It's important to distinguish, however, that this setback was not to his shoulder; instead, Street suffered a groin injury. Fortunately, it appears that the injury was not as serious as first thought, and Street's return may not be extensively delayed. In fact, Street threw a bullpen session Tuesday, which suggests he could be back in a rehab assignment in the not-too-distant future. Fantasy owners should keep an eye on early June if all continues well.

Brett Anderson, SP, Oakland Athletics (15-day DL, April 27): Anderson has been out since late April with a flexor tendon strain in his throwing (left) forearm. ESPN's Buster Olney originally reported that Anderson was expected to miss a month, and it appears that time frame could be right on the money.

Anderson has been progressing well since his injury and threw three innings in a rehab start in Sacramento on Monday. Although it seems like a relatively short rehab stint, the A's must be pleased with what they have seen so far, because Anderson is expected to rejoin the team Wednesday according to Contra Costa Times reporter Joe Stiglich. The plan is for Anderson to throw off the mound and, if there are no setbacks, pitch Saturday. Despite the short rehab assignment, Anderson has been throwing his repertoire of pitches without incident during flat ground sessions since mid-May, according to the San Francisco Chronicle. Although this is certainly a strong sign, the demands of throwing off the mound are always greater. It will be interesting to see how deep he goes into his first game out after the layoff.

And yes, there are always more injuries than there is room to discuss here. We might even hit on some of them in tomorrow's Fantasy Focus podcast. Next week, we will take a look at some of those "forgotten" players nearing the end of their terms on the 60-day DL. Will they be ready? Check back and see what we're hearing.

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.

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.
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."

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
Tom Szczerbowski/US PresswireJacoby Ellsbury would like to be comfortable swinging the bat before he returns from four broken ribs.
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.

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
J. Meric/Getty ImagesBrian Roberts' seemingly uncertain return frustrates many owners.
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.

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.


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 mailbag

Cameron (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.

Ankiel looking to avoid the disabled list

May, 5, 2009

Spring is a time for fresh starts and the Angels have to hope that their time for starting anew has arrived. Instead of subtracting from their starting rotation, the Angels look to be adding a couple of aces back into the mix quite soon. The Los Angeles Times reports that Ervin Santana and John Lackey could both rejoin the team next week after starting the season on the DL with injuries to their throwing arms. Although no firm commitment to a date has been made, if both pitchers tolerate a couple of minor league starts well, and can work their pitch count up toward the 80s without fading, that would be a signal that they could handle a major league start. Both pitchers have some risk attached to them based on their injuries -- Santana with a sprained ulnar collateral ligament and Lackey with a forearm strain -- but both have also been progressing very smoothly through their rehab programs, which has to have the Angels (and fantasy owners everywhere) smiling.

On that note, here's who we're talking about this week in the world of baseball injuries ...

Rick Ankiel, OF, Cardinals: It was a scary moment for the Cardinals when Ankiel hit the outfield wall Monday night, with the left side of his face and neck absorbing most of the impact. Ankiel had to be removed from the field with his neck immobilized and on a spine board. The St. Louis Post-Dispatch reported that Ankiel was taken to Missouri Baptist Hospital for X-rays and a CT scan to rule out any structural injury (spinal or skull fracture, in particular). Despite checking out "neurologically intact" at the hospital according to the Post-Dispatch, Ankiel was kept overnight for observation, which is never a bad move in the case of head injury to insure that the patient's status does not decline over time. This is one of those occasions when it is important to mention just how critical the on-field response of the medical staff is in terms of both managing the injury at hand in an efficient manner and ensuring that no further damage to the patient is incurred during transport. Well done Cardinals.

As of Tuesday morning the Cardinals received some good news when Ankiel was officially released from the hospital. Originally the injury was described as having all the signs of whiplash, which we usually associate with motor vehicle accidents, but which can occur with any rapid movement of the head and neck through space. The resultant trauma is primarily to the soft tissues (muscles, tendons and ligaments) and although not as dramatic as a fracture (broken bone) in the spine, can be equally debilitating in terms of pain, weakness and other associated symptoms. Early reports from the Cardinals Tuesday indicate that everything is "positive" for Ankiel, and he even returned to the ballpark for Tuesday night's game. Ankiel will not play Tuesday and it is unclear at this point just how soon he will return to the lineup. Fantasy owners should keep an eye on his status as it could vary greatly depending upon how much pain and swelling Ankiel is experiencing.

[+] EnlargeCarlos Zambrano
Ron Vesely/MLB Photos/Getty ImagesZambrano has already started to rehab his hamstring injury.
Carlos Zambrano, P, Cubs: Zambrano has been placed on the DL due to a left hamstring strain suffered while trying to run out a bunt. He is certainly not the first pitcher to get hurt while running, but Zambrano's injury and the need to place him on the DL reflect the role of the hamstring in a pitcher's delivery. Since he is a right-handed pitcher, his injured hamstring is on his landing leg. That leg must support his body weight coming over the top while the knee is extended, placing significant load on the hamstring. During follow-through, this position is actually where many pitchers injure their hamstring.

The good news is that the Chicago Tribune is reporting that the Cubs believe Zambrano will be able to return from the DL when eligible. Although manager Lou Piniella revealed that Zambrano has a Grade 2 (moderate) strain which can require significant healing time, he also told the Tribune that his tear is "in the belly of the muscle." Because of the strong blood supply to the muscle belly, it tends to heal faster than a tear in the more fibrous, tendinous attachment of the muscle. As long as Zambrano does not force his activity too soon, there is reason to be encouraged here.

Jorge Posada, C, Yankees: Posada has been placed on the DL as a result of a Grade 2 right-sided hamstring injury according to the New York Daily News. Posada missed a couple starts earlier this year due to a strained left hamstring sustained while stretching. On Monday night, after waiting around due to a lengthy rain delay (which is never kind to muscles, especially in cold weather), Posada felt his hamstring "grab" during a slide according to the Yankees' official Web site. After he underwent further tests Tuesday, the decision was made to place Posada on the DL in an effort to allow the muscle to heal properly. It is worth keeping in mind that these Grade 2 (moderate) injuries are highly variable in their healing time; Posada is 37, not 27, so healing is a little slower; and this is not his first hamstring injury. Expect Posada's return to take longer than the 15 days.

Cole Hamels, P, Phillies: If it's not one thing, it's another. Literally. Hamels began the season with inflammation in his throwing elbow and although it did not keep him down long, he got off to a rocky start. Only four weeks into the season Hamels suffered another injury, this time to the lower extremity, spraining his left ankle as he tried to field a bunt Tuesday against the Nationals.

Although the injury does not appear too serious, Hamels' start for this week was pushed back and, as recently as Saturday, general manager Ruben Amaro left open the possibility of a trip to the DL. For those wondering why Hamels can't just tough it out, it probably has more to do with the functional impact of a sprain on a pitcher's ankle than a toughness issue. A pitcher has to be in a single-leg stance -- on each leg -- through the larger part of his windup, delivery and follow-through. Which joint has to bear a majority of the load through that lower limb? The ankle naturally. Since Hamels is a lefty, his left ankle has to control his balance through the windup while he is rotating his body position. Additionally, as he delivers the ball, the majority of his weight transfers to his right leg, but his left foot drags briefly on the ground behind him, which also serves to help with balance and control.

In fact, Amaro told the Philadelphia Inquirer that it was during this foot drag that Hamels continued to feel some soreness in his ankle while throwing a bullpen Saturday. Nonetheless, Hamels is making progress overall. Barring any setbacks, he is expected to throw another bullpen Tuesday and then rejoin the rotation Friday.

On the Mend

Rangers outfielder and inspirational story Josh Hamilton is improving from the bruised rib cage that forced him onto the DL last week. The Fort Worth Star-Telegram reported that Hamilton was able to play catch Monday, and while throwing was a nonissue, reaching to make a catch caused some soreness in the healing area. Hamilton described his status as about 85 percent recovered, but was clear that he did not want to return too soon if there was any risk of reinjury. He could swing a bat Wednesday, and if that goes well, his overall activity may be further increased. This is a soft tissue injury and as such, it really comes down to how the player feels during activity that dictates return to play. So far he appears on track to return when eligible next Monday, but fantasy owners should keep an eye out for updates on his activity as this will be a day-to-day assessment.

[+] EnlargeBrian McCann
George Gojkovich/Getty ImagesNot being able to see might explain McCann's .195 batting average.
Braves catcher Brian McCann is expected to come off the DL and rejoin his team Friday in Philadelphia according to the Atlanta Journal-Constitution. He has been plagued by dryness and blurred vision in his left eye and has been searching for a solution. The good news is that there appears to be one. The Journal-Constitution reports that McCann will be wearing prescription sports glasses for the first time in his career. Whether this is a temporary fix or a permanent one remains to be seen, but McCann, who underwent Lasik surgery following the 2007 season, will use the glasses for now. He has been consulting with specialists since his symptoms began and when new contacts didn't solve the problem, prescription glasses were the next choice. Obviously clear vision is critical to performance behind the plate, not to mention at the plate when swinging the bat. It looks as if he will be able to avoid surgery, at least temporarily, and should be able to pick up where he left off. The plan is for him to get a couple of minor league games in, playing in one as catcher, before he rejoins his team Friday.

Phillies closer Brad Lidge had a good outing on Saturday in his first performance in a week. Lidge, who had been sidelined for a few days with inflammation in his right knee, was able to throw a scoreless ninth inning without pain. In fact, he told the Philadelphia Inquirer that he had "some real solid mechanics," a welcome relief after his knee-related struggles of just a few days ago. If he can maintain his mechanics and manage his knee well, he should be able to handle the brunt of the workload across the season.

Red Sox ace Daisuke Matsuzaka is expected to make his first of at least three minor league starts Tuesday according to general manager Theo Epstein, who gave the update while speaking to NESN. The good news here is that Matsuzaka really has had no pain in the shoulder and it is just a matter of building up his pitching endurance.

And finally ...

Some folks have had Orioles catcher Matt Wieters stashed away on their fantasy bench hoping for a call-up sometime this season. Those who have been following him know that he suffered a hamstring injury while running to first in mid-April. The good news is that his hamstring strain was considered mild and it did not keep him down long. He has already proved that he can run the bases and play behind the plate, so it is just a matter of when the Orioles decide that they need him in the mix. The injury will not be the decision-maker here as it appears to be behind him.

A-Rod, Smoltz to the DL

April, 30, 2008

Well, well, well. It's spring, and all that's old is new again. The names that we've seen go on the disabled list in the past few days are not, for the most part, unfamiliar. Nor are the injuries unfamiliar. John Smoltz's shoulder is showing the effects of his years (and maybe causing him to consider transitioning to another role?); Alex Rodriguez's quad was not quite ready for prime time; and Nationals reliever Chad Cordero did not get enough relief from his first disabled-list stint.

Alex Rodriguez, 3B, New York Yankees: Rodriguez initially strained his right quadriceps muscle, the large muscle on the front of the thigh, on April 20 in Baltimore. He missed three games afterward but the timing was coincident with the birth of his second child, so the reason he was out of the lineup was unclear. Rodriguez returned for the four-game weekend series against Cleveland, and somewhat surprisingly returned to his regular position at third base, instead of starting as a designated hitter as was originally projected. ESPN reported that, Monday night, Rodriguez felt a "pull" in his quad again while running the bases, resulting in his being sent for an MRI Tuesday. The MRI revealed a Grade 2 (moderate) strain and the Yankees immediately decided to place Rodriguez on the 15-day disabled list. The challenge with a Grade 2 muscle strain is that the time to heal is highly variable depending upon how much actual tissue damage there is. Grade 3 indicates a complete rupture, which would clearly be more serious, and Grade 1 is minor, usually micro-trauma only, leaving Grade 2 to represent everything in between. Grade 2 injuries can run the gamut from two weeks to three months to heal. Rodriguez told the New York Times that he had a similar injury in high school that lingered for two months, so this may not be a 15 days and done scenario. The key for these injuries is allowing the athlete enough time for the muscle to heal before returning him to the lineup. In hindsight this seems obvious given that Rodriguez is now exiting for the second time after aggravating his initial injury. Even teammate Derek Jeter sat out six games before attempting to return from his quadriceps strain. And although no two muscle strains are created equal, especially when comparing two different athletes, the message is still clear: Athletes should not be pressing to play when they are still having symptoms, and when they do, the risk of reinjury, or perhaps more correctly, the risk of exacerbating the injury increases.

[+] EnlargeTroy Tulowitzki
Daniel R. Harris/Icon SMIHow will the young Tulo bounce back from a major injury?
Troy Tulowitzki, SS, Colorado Rockies: In keeping with the theme of infielders and quadriceps strains, Tulowitzki left Tuesday night's game in the first inning with what was initially called a strained left quadriceps muscle. Tulowitzki, who was replacing Jeff Baker in the lineup, is having an MRI Wednesday, and the Rocky Mountain News is reporting that Tulowitzki actually injured his groin. The Rockies' Web site reports that head athletic trainer Keith Dugger said Tulowitzki was in "a lot of pain and discomfort and a lot of spasm" after the injury. Tulowitzki is expected to be placed on the 15-day disabled list, but it is unclear at this point, given the uncertainty as to the true nature and severity of his injury, how much time he will miss. Meanwhile, Jeff Baker is being evaluated for what appears to be another circulation-related issue. Baker broke a blood vessel in the middle finger of his right hand during pregame warm-ups and will undergo further diagnostic tests back in Denver, according to the Rockies' Web site.

Jorge Posada, C, New York Yankees: Posada, who has been challenged with shoulder problems since the start of the season, has now been placed on the 15-day disabled list for the first time in his career while the team tries to sort out exactly what is going on with him. Posada complained of dead-arm-type symptoms, meaning his arm felt like it was lacking the strength to throw effectively, but did not report feeling pain in the shoulder. An MRI revealed a tear in the subscapularis muscle, one of the four muscles of the rotator cuff, according to the New York Times. After resting the arm, Posada returned but did not last. He has had his shoulder examined by the one and only Dr. James Andrews, who operated on Posada's labrum in the past but did not recommend surgery at this juncture. Posada will be making the rounds to get opinions from several more specialists over the next few days. At this point it appears that rest may be the primary need for Posada in terms of getting his shoulder healthy, along with a gradual strengthening and rehab progression designed to bring him along slowly. As a thrower, and it is fair to label Posada a thrower given the frequency with which he throws 60 feet, six inches, Posada no doubt has some wear and tear in his shoulder. In the absence of a major finding, it is most likely that Posada continues to follow a conservative treatment approach, even if it is for an extended period, which gives him the best shot of returning this season. We will stay tuned to plans for one of the signature leaders in the Yankees' clubhouse as they develop.

John Smoltz, P, Atlanta Braves: Smoltz, despite being off to an excellent start, cannot shake the symptoms in his throwing shoulder and has been placed on the 15-day disabled list effective Monday. Smoltz paid a visit to Dr. James Andrews and received an injection for a severely inflamed biceps tendon and rotator cuff inflammation per an ESPN report. Andrews has recommended that Smoltz continue a plan of rest and rehabilitation until his shoulder is pain-free, which means his timeline to return is uncertain. Smoltz has been dealing with some variant symptoms in his shoulder (tightness in the back of the shoulder as well as the upper trapezius) since spring training. Recent MRI and CT scans confirmed the latest findings, and after Smoltz's struggles in his most recent outing, it became clear that he needed to pull back. Smoltz even acknowledged in an interview with the Atlanta Journal-Constitution that he could make a return to the bullpen when he comes back from this injury. Smoltz is intelligent and experienced and seems to recognize that his age in baseball years, reflected in his current injury, combined with the injuries in the Braves' bullpen mean that Smoltz could return as a closer. Smoltz's shoulder will never be pristine again given the abuse it has taken after years and years of pitching, but that is not to say he will not be back and be effective. I believe he will return to be effective, and the likelihood of his lasting the remainder of the season may even increase if he switches roles.

[+] EnlargeChad Cordero
AP Photo/Nick WassYou have to wonder if Cordero will stay healthy this year.
Chad Cordero, P, Washington Nationals: After failing to make an appearance in the season opener because of problems with his shoulder, Cordero was placed on the disabled list with tendinitis. When he returned, his velocity was not quite up to snuff, and Cordero was troubled by some clicking noises in his shoulder. The concerns led to his paying a visit to Dr. James Andrews, who encouraged Cordero to continue on his strengthening program while continuing to serve as a relief pitcher. In what is just the latest setback in a difficult start to the season, Cordero strained the shoulder Tuesday (it is being called a strained lat, according to an Associated Press report). Cordero said that it hurt "really, really bad," not encouraging words by any means. The Nationals have indicated that Cordero probably was compensating for some of the weakness around his shoulder and consequently strained one of the larger back muscles that supports the throwing arm. In any case, given Cordero's challenges so far this season, it is probably best for fantasy owners to watch from a distance until he shows that he is truly beyond his arm issues.

In brief

Chipper Jones, 3B, Atlanta Braves: Despite the fact that he strained his quadriceps muscle in early April and subsequently aggravated it two more times, Jones most recently sat out two games because of his back, not his leg. Jones has been experiencing back spasms, not altogether surprising given how hard he's been swinging the bat lately, but he was able to get into the Tuesday lineup. This appears to have been nothing more than a minor setback, but it serves as a reminder that Jones may have his share of strains and sprains that can threaten his presence in the lineup at any point.

The Yankees and Braves dominated this edition of the injury blog; these two teams have been seeing more than their fair share of injuries. Check back later in the week for updates on other injuries and see if the Yankees and Braves can maintain without losing yet another player to the disabled list. Good luck to all your fantasy teams and stop by my injury chat on Friday!

Victorino on the DL, Bedard's hip acts up

April, 15, 2008

Is it just me or did anyone else notice that David Ortiz suddenly got a hit once his jersey was extricated from the bowels of the new Yankee Stadium? I have been keeping a close eye on him, not only because I have him on two of my fantasy teams, but also because some have been wondering whether his offseason knee surgery is to blame for his slow start. All along, I have maintained that based on Ortiz's comments and his performance in the spring, his knee is not to blame. Now that Ortiz has a hit, just hours after his buried jersey was removed, and one day after he sat out the final game of the series between the Yankees and the Red Sox, it appears that Ortiz has taken steps to right his ship. Coincidence? Hmmm. I'm not so sure.

On that note, we move on to the actual injuries of the week.

[+] EnlargeShane Victorino
Rich Kane/US PresswireShane Victorino is one guy you definitely want to have good and healthy wheels.
Shane Victorino, CF, Philadelphia Phillies: Victorino was removed from Saturday's game with a strained right calf muscle, injured during the fifth inning when he ran home from third to score on a wild pitch. Victorino was immediately placed on the disabled list, raising the level of concern over his injury. The Phillies did not waste any time because Victorino actually missed about one month after the All-Star break with a similar strain last year. The team reported Monday, according to the Philadelphia Inquirer, that an MRI revealed the strain to be in a different area of Victorino's calf than last year, giving them some hope that he could make an earlier return. Despite the fact that the injury is in a different location, it is troublesome that he has had another strain in the same muscle, especially so early in the season. The calf muscle is necessary for explosive push-off, especially during acceleration, something an outfielder has to do constantly to get a jump on a fly ball. It is also necessary for baserunning, particularly in steal (sprint) situations, as evidenced by the way Victorino most recently injured his calf. On the positive side, addressing this latest setback seriously by resting Victorino may be just the thing that keeps it from being a lingering problem this season. Look for him to return to action as soon as the disabled list stint is up, but keep in mind that this could crop up again in the future.

Tom Glavine, SP, Atlanta Braves: At 42 years young, with no prior experience on the disabled list, Glavine is a marvel. On Sunday, however, Glavine had the shortest outing of his 22-year career when he felt his hamstring on his landing leg "grab," according to the Atlanta Journal-Constitution. Glavine later said that he knew right away it didn't feel right. All pitchers rely on the hamstring in their landing leg to help stabilize their trunk during deceleration and follow-through, so Glavine will need to be pain-free before he returns to the mound. For his part, Glavine expects to play catch today and maybe throw a bullpen session Wednesday. If all goes well, he may make his next start (scheduled Friday), or delay it by only a day. Glavine made it clear to the Atlanta Journal-Constitution however that he will not push to start simply to maintain his streak of avoiding the disabled list. He may be stubborn, but you don't succeed in this league as long as he has without being smart. He will do what is best for the long-term interest of both him and the team. Of note, the Braves' Mike Hampton, currently on the disabled list with a pectoral strain that kept him from making his first major start since 2005, may throw a bullpen session this week. The Braves would love to get him back into the rotation soon.

[+] EnlargeErik Bedard
J. Meric/Getty ImagesMore hip problems have sidelined Bedard.
Erik Bedard, SP, Seattle Mariners: Bedard continues to be bothered by what the Mariners are calling "inflammation" in his left hip, according to the Seattle Times. Bedard was scratched from a scheduled start two Sundays ago, then managed to pitch two days later, but had a somewhat shaky outing and threw 107 pitches. Bedard was again scratched this past Sunday as a result of his hip acting up. As a left-handed pitcher, not only must Bedard put full weight through his left hip during the windup, he must also rotate his body on his hip as he moves through his delivery. Any soreness or irritation in the joint will prevent him from throwing with his normal mechanics and would likely render him far less effective. The concern here has to be defining what the source of this hip inflammation truly is. There have been conflicting reports out of Seattle. According to the Seattle Post-Intelligencer, the team says that Bedard initially aggravated the hip during some pregame workouts, but according to the Seattle Mariners' official Web site, Bedard said that he woke up with pain in his hip Saturday. Clearly it stuck around until Sunday, preventing his start. Additionally, Bedard reported having some similar pain in 2001, but indicated that the pain then was far worse than it is this time around.

Bedard is not scheduled to head to the disabled list, at least not yet, but he did not play catch Monday as originally planned. There is a chance that he will do so Tuesday, but any return to light throwing will determine the subsequent timetable. We will keep an eye on this situation.

In brief

Jose Reyes, SS, New York Mets: Reyes sat out several games at the end of the week with a strained left hamstring. These hamstring strains seem to be making their way around the league, but they are of particular concern when they affect the players who make their living based on speed. Reyes has said he expects to play Tuesday so this does not appear to be a serious strain. Let's hope there are no setbacks.

Dontrelle Willis, SP, Detroit Tigers: Willis hyperextended his right (landing) knee Friday when he slipped on a wet mound. Frankly, he was lucky to walk off the mound. The way Willis' weight came down hard over a hyperextended knee could have resulted in a major ligament injury, but luckily, that was not the case. Hyperextension stresses the posterior structures of the knee in that it places an unnatural stretch on them and there can be some pain and inflammation as a result, even in the absence of major structural damage. Willis was placed on the 15-day disabled list to allow the knee some rest, but the rest may be beneficial for Willis in more ways than one. Clearly he has been struggling with his delivery, as he was Friday night before the injury, and the downtime may help him to reset and come back stronger.

Jorge Posada, C, New York Yankees: Posada is still recovering from a strained shoulder, something Posada referred to himself as "dead arm," and although he has been available as a designated hitter, he is still not able to make the throws necessary to resume his position. If you watched the game Sunday night, Posada had to move behind the plate when backup catcher Jose Molina strained his hamstring. He was instructed not to try to throw out runners for fear of aggravating his recovering arm, and the Red Sox caught on. There is still no official date for his return so plan on another week of him in the DH role.

Adrian Beltre, 3B; Mike Morse, RF; J.J. Putz, RP, Seattle Mariners: Beltre developed a sore hamstring after baserunning Saturday. He was able to return Monday, indicating that this is not a serious injury, but nonetheless, it is worth being aware of as this is the type of thing that can easily recur. Morse injured his left shoulder while diving for a ball in the outfield (actually, when landing from the dive) and is now on the disabled list. It is being called a shoulder dislocation but Morse's quote in the Tacoma News-Tribune ("It popped out and popped back in.") makes it sound more like a subluxation, where the shoulder slips slightly out of joint, but does not remain out. The important distinction is that a subluxation episode often results in less trauma to the soft tissues around the joint, making a return after a 15-day disabled list stint more reasonable. Putz is still on the disabled list with costochondritis, but he did throw for six minutes before Sunday's game. It looks as if he is on track to return in late April.

Matt Garza, SP, Tampa Bay Rays: Garza, currently out with radial nerve inflammation which affects the muscles in his forearm and in turn affects his grip, has been able to play catch for a couple of days now. The next step could be a side session, followed by a rehab start. The St. Petersburg Times reports that the Rays are now optimistic that Garza could return on the early end of his projected timetable, meaning in approximately two weeks. With ace Scott Kazmir looking at a late-April or early-May return from elbow inflammation that cropped up during spring training, the Rays have to be feeling sunny about the outlook for their starting rotation.

Placido Polanco, 2B; Carlos Guillen, 1B, Detroit Tigers: Polanco sat out Sunday's game because of back stiffness. This was the second time this season that he has missed a game because of his back. It sounds as if it is a minor issue -- minor that is, unless he misses much more time. Polanco owners should keep an eye on this. Guillen strained his right hamstring in the ninth inning of Friday's game and did not play Saturday as a result, saying that the hamstring felt "tight and sore." Guillen was able to return Monday night, however, and drove in some runs. So far this looks to be a minor incident, but keep doing your stretching, Carlos.

Nomar Garciaparra and Andy LaRoche, 3B, Los Angeles Dodgers: Garciaparra, who was hit by a pitch during spring training that resulted in a small fracture, has been out of commission since mid-March as a result. Garciaparra has been playing some Triple-A ball, and according to manager Joe Torre on the Dodgers' official Web site, he could return as early as the end of this week. The most important thing for the Dodgers is that he return healthy since they do not exactly have backups in place if he reinjures himself. LaRoche, injured in the same game as Garciaparra with a torn ulnar collateral ligament in his thumb, underwent surgery and has been gradually rehabbing the hand ever since. LaRoche actually made some throws across the infield this week and the Dodgers' official Web site reports that LaRoche felt "better than expected." It is normal for him to still be experiencing some soreness in the thumb, but LaRoche is hopeful that he will be able to begin some minor league play this weekend. His original timetable had him missing approximately eight weeks, which would mean a return date near the end of the first week in May. So far, his progress is consistent with that timeline, assuming he does not have any setbacks as he increases the use of his thumb.

That's it for today's update. There are plenty of players we're keeping our eye on for a targeted return in the not too distant future. For more on those players, and of course, for any new developments, check back throughout the week as we will update them right here. And be sure to stop by my chat on Friday mornings at 11 a.m. ET as we talk about all things injury. Never a shortage of topics there! Good luck with your fantasy week, and may all your players stay healthy.

Posada, K-Rod and Jeter headline injuries

April, 12, 2008

Wow! The hits just keep on coming. And I'm not talking about offensive power, at least not on any of my fantasy teams. I'm talking about the hits teams are taking, real and fantasy, as a result of injury early in the season. Is there any team that has not succumbed to the injury bug yet this year? Not as far as I can tell. Some seem to be particularly unlucky, but maybe teams like the Angels and the Rays are just getting all of their injuries out of the way early. No doubt that's what they are hoping is the case. I'm just the messenger. Let's take a closer look.

[+] EnlargeJorge Posado
Elsa/Getty ImagesPosada at least can hit right now.
Jorge Posada, C, New York Yankees: "Dead arm" sounds like a scary condition. But don't let it scare you. I actually wrote about this in our fantasy draft kit and described it as a condition that most often affects pitchers, which is still true. Certainly a catcher is throwing the ball fairly frequently during the course of a game and is subject to suffering from this ailment as well. Posada, who himself said on the Yankees' official Web site that he felt as if his arm was "dead," indicated that he has suffered from this condition in the past, including earlier this year in spring training. The issue is one of fatigue, and the complaint most often, as was the case with Posada, is an inability to throw because the arm feels weak, not painful. Recovery is fairly quick, and usually simply requires a few days of rest. An MRI was reassuring in that it reportedly showed no structural damage, and Posada already has returned to the lineup as a designated hitter. The Yankees likely will give Posada some more time before he resumes throwing, primarily to ensure that this does not turn into something more serious.

Mike Lowell, 3B, Boston Red Sox: Lowell is now a member of the disabled list thanks to a sprained left thumb sustained Wednesday while fielding a ball. The injury is to his non-throwing hand, but nonetheless, he needs to be able to get his hand into his glove, and needs to grip a bat effectively, both of which would be limited by pain and swelling. Lowell admitted that the thumb felt worse the day after the injury than he initially thought it would, and the team placed him in a thumb splint to help rest the joint and the soft tissue around it. The time frame for Lowell ranges from two to four weeks, and the variability in an athlete's response to swelling and functionality after a hand injury makes it difficult to be more precise. Keep in mind that it is not just the ability to return to play, but the ability to be productive that usually takes a bit longer with these cases.

Matt Garza, SP, Tampa Bay Rays: The Rays are hoping ace Scott Kazmir is on the mend in short order because they just placed another teammate on the disabled list. Garza left Tuesday night's game with what the team is referring to as "radial nerve irritation." Garza reportedly told the team that he was experiencing numbness in his right hand and had trouble gripping the ball. The radial nerve travels through the back of the upper arm and across the top of the forearm toward the hand. Overstretching of the nerve, or tightness of the muscles through which it passes, can cause irritation, and in Garza's case, there may have been some of both. Garza has had discomfort of this type before but, as he told the St. Petersburg Times, he always has been able to pitch through it. Many pitchers are tight in their forearm musculature, especially because it is well-developed. Interestingly, during Tuesday night's outing, Garza fielded a ground ball hit back his way, and in the process fell forward such that his right wrist got folded up underneath him. It just so happens that this is exactly the position that could place an excessive stretch on the radial nerve. Although we can't say for certain, Garza did exit the game shortly thereafter, complaining of discomfort and demonstrating a lack of ball control. A combination of tight musculature, and a quick abnormal stretch, could very easily provoke symptoms similar to what Garza described. The team has indicated that Garza will not be allowed to throw for several days in order to let the inflammation settle, and then he will be re-evaluated in two weeks. Since Garza has had similar symptoms in the past, the Rays no doubt want to be sure that this does not become severe and chronic. Translation: Extra rest if he requires it. Assuming no setbacks in his rehabilitation, Garza likely will return in late April or early May.

Justin Duchscherer, SP, Oakland Athletics: First Harden (out on the disabled list with what is now being called a subscapularis strain), then Duchscherer. The Athletics must be wondering what they need to do to catch a health break for their starting rotation. Duchscherer felt a pull in his right biceps during Friday night's game, a particularly unfortunate circumstance because he had been pitching well. An MRI confirmed the presence of inflammation at the biceps, which surprised Duchscherer because he had described the pain as "mild," according to the Athletics' official Web site. The A's, however have learned to take no chances where their starters are concerned, and decided to rest Duchscherer a bit longer by placing him on the disabled list. The biceps is especially important in the pitcher's anatomy because it attaches to the labrum. A pitcher's torn labrum most often requires surgery, and that would spell an end to a season. Resting him and quieting the biceps now may go a long way toward preserving his throwing arm, so the move is completely reasonable. The good news? Duchscherer has already thrown from 80 feet without experiencing pain and will be eligible to return April 20, assuming he continues to progress well.

[+] EnlargeFrancisco Rodriguez
Jeff Gross/Getty ImagesK-Rod has been KO'd by some weak ankles.
Francisco Rodriguez, RP, Los Angeles Angels: As if the Angels needed another injury in the pitching department. The latest Halo to suffer a setback is K-Rod, he of the not one, but two, bad ankles. Rodriguez had trouble with his left ankle last year after contending with a crumbly pitcher's mound. Apparently, according to a report in the Los Angeles Times, the ankle continued to bother him during the winter, although the Angels insist he had no trouble with it during spring training. Saturday, however, Rodriguez twisted the right ankle coming down the dugout steps, and it continued to bother him Monday. An MRI revealed no major soft tissue injury (ligament or tendon) which provided a bit of a silver lining, but nonetheless, with his ankles as sore as they were, the Angels wanted Rodriguez to rest for a few days.

The concern here is that the ankles, which each provide a full weight bearing base of support for Rodriguez at different points in his pitching motion, must be strong for him to pitch effectively. As manager Mike Scioscia told the Los Angeles Times, "We don't want to put him at any undue risk." The concern becomes that Rodriguez could injure himself further, and in a worst case scenario could injure his throwing arm if either ankle gives out on him while pitching. The hope at this point is that after a few days rest, Rodriguez will be able to throw a bullpen, or perhaps even make a game appearance this weekend. It is of concern, however, that the left ankle has some lingering symptoms from last season, and fantasy owners should consider that this may be the type of thing to crop up again during the season.

Rafael Soriano, RP, Atlanta Braves: Soriano experienced some elbow soreness after pitching last weekend, and the Braves wasted no time moving him to the disabled list. One of the reasons the decision was made to impose a period of forced rest on Soriano is that he had similar symptoms during spring training. Soriano's symptoms are actually above the elbow, near where the triceps muscle (large muscle on the back of the arm) attaches. The team is calling Soriano's condition elbow tendinitis according to the Atlanta Journal-Constitution, and it sounds as if this muscle group could be the culprit. Soriano has had his share of elbow woes, having undergone Tommy John (ulnar collateral ligament reconstruction) surgery and missing most of 2004 and all of 2005 as a result. The good news here is that Soriano's discomfort does not appear to be located near the area of reconstruction, and tendinitis issues are much likelier to resolve than ligament sprains or joint problems at the elbow. It sounds as though the Braves are taking a cautious approach with their closer, which will no doubt benefit him and the team in the long run. Soriano will be out until at least April 22, but the hope is that this will not be a season-long problem.

In brief

Dontrelle Willis, SP, Detroit Tigers: Willis, who had a walk-filled first outing to start the season, was hoping to right the ship Friday. That was not to be. Despite the best efforts of the Chicago grounds crew, rain in the area may have contributed to a slippery mound. Willis started by walking leadoff batter Carlos Quentin, then slipped on the mound while facing the second batter, Orlando Cabrera. Willis' front leg stretched out in front of him as he transferred his weight during ball release, forcing his right knee into hyperextension. Willis reached for the back of his leg in obvious discomfort. Although Willis remained in the game through Cabrera's at-bat (another walk), he clearly appeared to be struggling as he faced the next batter, Jim Thome. Willis was removed from the game, and we will now wait to see what the future holds for him.

Derek Jeter, SS, New York Yankees: Jeter has not played this week since straining his quadriceps muscle. There is still a chance that he could make an appearance this weekend, but according to the Hartford Courant, manager Joe Girardi says that is "doubtful," meaning Jeter could sit out until next week. Despite the enticement of the Yankees-Red Sox rivalry, it is important that Jeter's minor strain does not become major, and the team will exercise patience.

Jimmy Rollins, SS, Philadelphia Phillies: All good things must come to an end. And so it goes with Rollins' streak of 230 consecutive games played. Rollins sprained his ankle on Tuesday night when making a directional change to get back to second base. Rollins has been out of the starting lineup for three straight games, but it does not appear that this injury will send him to the disabled list. According to Rollins in a quote on the Phillies' official Web site, the ankle bothers him when going "left to right," and that is a big part of his defensive game. Don't be surprised if he makes an appearance this weekend, but check the lineups daily, as the team could decide to hold him out until Tuesday if cutting remains a problem.

Francisco Liriano and Kevin Slowey, SP, Minnesota Twins: Finally, there is some good news to report: The return of Liriano has arrived! The Minnesota Star Tribune is reporting that Liriano will start Sunday for the Twins in place of the injured Kevin Slowey, who is being placed on the disabled list with soreness in his biceps. Liriano, who will make his major league return after undergoing Tommy John surgery in 2006, has struggled somewhat in the minors. It is normal for pitchers to take some time to regain their velocity and command after this procedure, so his struggles are not a concern from a health perspective. And just wait until he gets more time under his belt. By July, Liriano's numbers should be on the upswing. Meanwhile, Slowey, who left his first start with pain in his biceps, is improving, although he is still experiencing some lingering soreness. This downtime will give Slowey an opportunity to recover fully, and it helps make room for Liriano.

I know. I know. It appears never-ending. Where there are sports, there are bound to be injuries. And so it will go throughout the season. Keep checking back, and we'll keep updating you. Right here at On Fantasy Insider (ESPNews, 11 a.m. EST). On Fantasy Focus (ESPN Radio, 9 p.m. EST). And wherever else those injury nuggets crop up. Have a good weekend, and may your fantasy teams go injury-free!