Stephania Bell: Lance Berkman
Every Monday, in this space, we'll provide updates on a variety of players to help you make your weekly lineup decisions. We'll specifically try to hit the players who are day-to-day, have just gone on the DL or are ready to return, so that you can better decide whether you can count on them or not.
All projected return timelines should be considered fluid.
Brad Penner/USA TODAY Sports Ryan Howard lands on the DL while hitting .266 with 11 homers and 43 RBIs.
Ryan Howard, 1B, Philadelphia Phillies (placed on DL July 6): Howard’s move to the DL couldn’t have come as a complete surprise. He had been in and out of the starting lineup recently with soreness in the knee, but now he will be out for an extended period. Speaking to reporters Monday, Phillies general manager Ruben Amaro Jr. stated Howard has a meniscus tear and will undergo surgery to address the issue. The Phillies are hopeful they can have Howard back in the lineup within six to eight weeks, not an unreasonable expectation if the operation and subsequent rehab process go smoothly. Although Howard had been dealing with soreness since May, he told the Philadelphia Inquirer the pain and stiffness had recently increased to the point where he could not play through it. This procedure should allow Howard to move forward from the injury and return to play this season. But it is yet another injury to the left leg, which has been responsible for most of Howard’s DL time during his professional career, including his Achilles rupture in 2011.
Aramis Ramirez, 3B, Milwaukee Brewers (placed on DL July 8): Day-to-day could really describe the entire season for Ramirez, given that his left knee has not been 100 percent healthy since he initially injured it this spring. On Saturday, Ramirez made a diving catch after which he came up limping, exiting the game shortly thereafter. On Monday, he was placed on the disabled list as Ryan Braun was activated.
The bigger question is whether Ramirez can really be expected to be at full health at any point this season. Based on how the knee has responded so far and with the potential for aggravation any time he slides or dives, the answer would appear to be no. In the absence of being healthy though, can he be effective? The Brewers have to hope the answer to that question is yes, but it may be on only an intermittent basis.
Ryan Braun, OF, Milwaukee Brewers (activated from DL July 8): Braun’s thumb injury has been discussed multiple times in this space and the uncertainty of how it will behave across the rest of the season remains. However, he made enough progress in terms of gripping and swinging the bat that he was activated Monday in time for the evening matchup against the Cincinnati Reds. He swaps roster spots with teammate Aramis Ramirez. While he's back in action, Braun would still benefit from a few days off during the All-Star break. This might offer fantasy owners a good glimpse of whether the layoff has helped Braun’s symptoms to the point where he can be productive at the plate.
Carlos Gonzalez, Colorado Rockies (day-to-day): If it’s not one thing, it’s another. Literally. Gonzalez left the game early after straining his upper back Thursday; now it’s a finger which caused him to exit early on Sunday. Gonzalez reportedly took an awkward swing and injured the middle finger on his right hand. According to Troy Renck of the Denver Post, X-rays were negative and Gonzalez remains day-to-day with a sprain. It will all come down to whether he can effectively grip and control the bat. Literally.
Yadier Molina, C, St. Louis Cardinals (day-to-day): Molina and the Cardinals were relieved to learn that his right knee does not have any structural damage, according to the MRI he underwent this weekend. Molina’s knee had been sore for a month but he told reporters he was sent for further tests after it hurt him to run Friday. "Everything came back negative and that's a relief," Molina said Sunday. He hopes to be back Tuesday after the Cardinals’ off day Monday. It’s hard to imagine a couple days will make this disappear, particularly if it has been bothering him for a month. After all, it’s not as if his position isn’t stressful on his knees without adding in the demands of running the bases. With former catcher Mike Matheny at the helm, it’s a safe bet the Cardinals will be mindful of Molina’s workload this week if his knee continues to nag at him.
Matt Kemp, OF, Los Angeles Dodgers (day-to-day): The good news is the Dodgers expect Kemp back in the lineup soon, possibly as early as Monday. The bad news is that he’s making an appearance in this blog. Again. And his left shoulder is the culprit. Again. The good news is that this time the injury is not in the glenohumeral joint, the location of his offseason labral surgery and where the arm bone or humerus interfaces with the socket. This pain was located in the AC (acromioclavicular) joint, where the collarbone and the shoulder blade meet at the point of the shoulder. Kemp received an injection to help alleviate the pain, but the key to his return will be whether he has any (as in even a hint of) discomfort in that shoulder when he attempts to swing. After all of his struggles to regain his form and along with it his power following surgery, he is going to be closely monitored to ensure he’s not compensating and altering his swing. Again. In any case, it looks as if he escaped a serious issue and should return in short order; now the Dodgers have to hope this is a one-time incident and not another problem that will resurface as the season progresses.
(After this was initially posted, the Dodgers placed Kemp on the disabled list again.)
Neil Walker, 2B, Pittsburgh Pirates (day-to-day): Walker left Saturday’s game with soreness in his right side and is expected to undergo an MRI this week (although he did not have one on Monday). There are hints of an oblique ailment, but the imaging test should help confirm the location and the severity of the injury. While Walker did not seem to think his injury was serious initially, it’s often not until the athlete tests the area later with activity that the limitations become apparent. He is not in Monday’s lineup and will likely be out several days at the very least.
Shane Victorino, OF, Boston Red Sox (day-to-day): Victorino’s back has been giving him fits throughout the season, but he left Saturday’s game early because of tightness in his left hamstring. It’s unclear whether the two are related, but manager John Farrell seemed to think so. Victorino did not play Sunday and it is not immediately clear how much time the Red Sox anticipate he will miss. Given his history not only with his back and his hip this year, but with a prior DL stint in May specifically attributed to his left hamstring, caution is warranted.
Lance Berkman, DH, Texas Rangers (placed on DL July 7): The Rangers placed Berkman on the DL not because of his ever-troublesome knees, but because of a low back or hip ailment. The knees are still likely to blame, though. According to ESPNDallas.com, Berkman tweaked his right knee on an awkward step a week ago, missed a few games, then developed this issue while running to first. Rangers manager Ron Washington seems a bit surprised that the knees are an issue. "When we signed him, we thought everything was going to be fine with the knees," Washington said. Really? This is a 37-year-old player with chronic knee issues which, while he’s managed to undergo various procedures and return to play, are not the same joints as when he was in his 20s. These potential flares have to be expected. And then there’s always the possibility that the pain travels up the chain toward the hip and back, as appears to have been the case this time. Berkman will return and may even do quite well, but the risk is not going away.
Yasmani Grandal, C, San Diego Padres (placed on 60-day DL July 7): Catchers and plays at the plate are always risky and the Padres are the latest to experience the effects. After he injured both his ACL and MCL in a collision at home plate Saturday, the prospects of Grandal returning this year seem grim. The Padres’ immediate placement of Grandal on the 60-day DL further outlines the severity of the injury. After the game, Grandal was on crutches and Padres manager Bud Black indicated the outlook was not good. An MRI is scheduled for Monday after which more information should be forthcoming. If he has a complete ACL tear, which requires reconstructive surgery, then Grandal’s season will indeed be over.
Jedd Gyorko, 2B, San Diego Padres (placed on DL June 10): Last week in this space we discussed Gyorko’s setback during a rehab game, which delayed his return to the team. Although he indicated the setback was minor, it seemed only logical the team would require another rehab outing before allowing him to play in major league games. That appears to be the plan, although a definitive timetable has not been offered. Manager Bud Black told reporters Gyorko could renew a rehab assignment toward the middle of this week. Given the way things have unfolded, no matter how strong Gyorko feels, it would not come as a surprise if he is held out of a return to the majors until after the All-Star break.
Chris Humphreys/USA TODAY Sports Troy Tulowitzki's injury likely will also keep him out of next week's All-Star Game.
Troy Tulowitzki, SS, Colorado Rockies (placed on DL June 13): Last week we said Tulowitzki could get clearance to advance his activities and he has done precisely that. On Thursday he took batting practice for the first time since fracturing his rib. It obviously did not set him back since he returned for more on Friday. The swings are a good test of how aggressive he can be while still healing from the injury as long as he is giving it full effort, something that’s often hard to simulate in practice. As Tulowitzki told the Denver Post, “I have to have my game swing. I can’t baby it.” Even though his injury was to the rib itself, the muscles which attach to the ribs (such as intercostals and obliques) contract violently with rotation. If the bone were still sensitive, he would no doubt feel the discomfort and be limited in terms of how vigorously he could swing. Only he knows whether he is truly testing it full bore.
According to the Post, Tulowitzki is expected to wear protective padding over the injured rib area on his right side when he returns, something that could help protect him in the event of direct contact. Contact was how Tulowitzki originally sustained the injury when he met the ground hard while making a diving defensive play. Even if bone is showing evidence of good healing, it continues to remodel itself for some time beyond the projected four to six weeks following a break. Another direct insult to the area could result in a setback in the form of reinjury, hence the layer of padding for extra insurance. Padding would not minimize the force of the muscular contraction which happens underneath it, however, meaning Tulowitzki needs to be able to throw (especially hard, cross-body throws) and swing without hesitation or discomfort -- including checking a full-throttle swing -- in order to prove he is ready to return.
He’s not quite there and he knows it. Tulowitzki told the Post on Sunday he is not completely symptom-free with his hard swings and knows he needs to be tested in a variety of game situations before returning to the lineup. A rehab assignment is slated to begin Monday and the next step will be completely dependent upon how the assignment goes. It’s important to remember he has not yet reached the four-week mark since suffering the injury; a return after the All-Star break would put him at five weeks out, a seemingly safer target. Tulowitzki has made it clear he will not play in the All-Star Game (to which he has been selected as a starter) if he does not play for his team first. It may come down to the weekend before we have the answer.
Dan Haren, SP, Washington Nationals (returning to action July 8): Haren is returning from the shoulder ailment that sent him to the DL in late June. It was only ever described as shoulder stiffness and Haren never seemed too concerned. If anything, he and the Nationals were more focused on his overall struggles and the hope is that the break may have helped him in this department. Haren threw bullpens and navigated a simulated game without incident but never went on -- nor did he or the team feel the need for -- a rehab assignment. He gets the start Monday night at Citizens Bank Park against the Phillies.
Wei-Yin Chen, SP, Baltimore Orioles (placed on DL May 13 , expected to return this week): Oblique injuries are becoming relatively commonplace amongst pitchers and while they can still vary in terms of severity, the standard return of just over a month remains fairly consistent. And, just as important, when pitchers recover fully from an oblique injury prior to returning to the mound, there seems to be a low rate of injury recurrence. That bodes well for Chen and the Orioles as he is set to return this week after being out since mid-May.
Alex Cobb, SP, Tampa Bay Rays (placed on DL June 15): It was terrifying when it happened, a line drive to the head which resulted in a concussion and sent Cobb to the hospital. Fortunately, he has made impressive strides since that time, including a return to a throwing progression. Initially following the injury there was no discussion about baseball but that quickly changed as Cobb progressed. As of early July he was playing catch and increasing his cardiovascular workouts. Last Friday he threw his first bullpen since the injury and he repeated the effort Monday, increasing the number of pitches. According to the Tampa Tribune, Cobb hopes to return to the Rays’ rotation late July or early August. No matter where your team allegiances lie, everyone has to feel good about Cobb’s recovery.
• Now that Lance Berkman is back with the St. Louis Cardinals, the hope is that he'll be back on the playing field in the not-too-distant future. Berkman is recovering from meniscus surgery (remember when the worry was that he might have retorn his ACL?) and was originally projected to return in 8-10 weeks.
He recently told the St. Louis Post-Dispatch that his knee was "over the surgery," suggesting he merely needed to get in baseball shape. Getting the conditioning back is truly part of getting past the surgery, but to be fair, Berkman has undergone multiple procedures on his knees over the years and has a pretty good idea of what it takes. He sounds optimistic about a return shortly after the All-Star break. It may turn out to be a little slower going for his knee once he gets back into action, but it certainly appears the Cardinals will have him available in mid-July.
Kemp, who will not participate in the All-Star Game despite being voted in by the fans, has been cleared to begin a rehab assignment Tuesday. According to the Los Angeles Times, Kemp will travel to Kansas City to participate in the Home Run Derby. If all goes well in rehab games, he could return to major league play on July 13, when the Dodgers begin a home series against the San Diego Padres. One thing is certain: the Dodgers will have Kemp participate in more rehab games this time around. When Kemp suffered his initial hamstring injury, he passed every test with flying colors and played in two rehab games without incident. His first major league game after that initial injury also went without incident. In his second game, however, Kemp experienced the dreaded tightening in the back of his left thigh; his frustration was apparent as he broke a bat over his leg before exiting the dugout.
Even Kemp acknowledged at the time of reinjury that he would likely be headed back to the DL (he was) and that it would perhaps take longer to get healthy (it has). An MRI showed another strain higher up in the hamstring and swelling in the previously injured area, according to Dodgers head athletic trainer and physical therapist Sue Falsone. Despite passing all field tests, nothing reproduces the unanticipated demands on the hamstring quite like playing in a game. Situational running, whether trying to leg out a ground ball or making a defensive play, is impossible to reproduce in drills or practice. The hope is that with a few extra days of game play, Kemp will have an opportunity to increasingly challenge his hamstring, preferably without a setback. This would then help increase Kemp's confidence in his leg, something that can become problematic once there is a second injury. Athletes can become reluctant to press or challenge their leg for fear of suffering yet another setback.
• Meanwhile one of Kemp's teammates, second baseman Mark Ellis, could also be on the verge of return. Ellis underwent an emergency fasciotomy in the middle of May to release pressure and swelling inside the left leg after taking a blow just below the knee. After a fasciotomy, the initial priority is allowing the wound to heal, then increasing range of motion, particularly through the ankle. A gradual return to activity is permitted as the healing allows. Ellis has been on a rehab assignment and is expected to play seven innings in his final rehab game Tuesday, alongside Kemp, according to the Dodgers' website. Ellis could then be activated and join the Dodgers on Thursday.
• Baby steps are still steps. Boston Red Sox outfielders Carl Crawford and Jacoby Ellsbury seemed to be in a state of suspended animation for the last two months when it came to the question of when they might return. The only real news was that they were progressing through rehab. Now however, they are making significant strides toward returning.
Crawford, who started the season on the DL following wrist surgery, then sustained a partial tear of the ulnar collateral ligament in his throwing elbow, has been on a rehab assignment in Florida. He appeared in five games, initially as DH, then progressing to the field, a key test for his elbow. So far, so good. Apparently the medical staff feels the same way Crawford does, moving his rehab assignment to Double-A Portland, according to ESPNBoston.
Ellsbury may not be too far behind. Out since April after suffering a shoulder subluxation, he began his rehab assignment in Florida on Saturday. Ellsbury also began his stint serving as the DH, but has now progressed to seeing some outfield play. Given that his injury is to his glove side, playing defense is an important measure of his recovery. There's no guarantee that all situations can be accounted for during a rehab assignment, but the idea is to account for as many of those possibilities and see how the shoulder responds. One good sign is that his bat seems to be responding; Ellsbury hit a home run Monday. He remains in Florida for now.
Given the time clock of 20 days for position players on a rehab assignment, both Ellsbury and Crawford should be able to join their team shortly after the All-Star break, barring any late setbacks.
• Drew Storen's timetable has remained fairly consistent since he came out of surgery to remove bone chips from his right elbow. His progress has been steady and he has not experienced any pain in the elbow. Storen's challenge has been taking it one day at a time and not overdoing it during his recovery. His bullpen sessions have gone well; next up is a short rehab assignment. According to The Washington Post, Storen expects to return to the Washington Nationals for the first game following the All-Star break. Given his smooth progression thus far, and the increased extension Storen has in his elbow post-surgery, there is reason to be optimistic about how the second half of the season will shape up for him.
Players whose timetables are unknownEvan Longoria: The Tampa Bay Rays third baseman has been out since April with a partial tear in his hamstring. After making it to a rehab assignment in June, Longoria experienced discomfort in the thigh in only his second outing, causing him to exit the game before the injury worsened. Understandably, it has been a cautious road back. Longoria has only just been cleared to resume baseball activities. Depending how he tolerates resuming hitting, ensuing running and field drills will determine when he will make his next attempt at a rehab assignment. Longoria still looks to be several weeks from a return.
Chris Carpenter: Despite taking some positive steps in his return to throwing, the St. Louis Cardinals' ace continued to experience episodes of weakness in his throwing shoulder. That led to consultation with a vascular surgeon in Dallas, and a diagnosis of thoracic outlet syndrome, a condition not uncommon in pitchers, in which nerves and/or arteries between the neck and shoulder can be compromised, resulting in symptoms into the arm.
In Carpenter's case, there is no immediate surgery planned, suggesting the source of the symptoms is more neurogenic (nerve-related) than vascular (circulatory). "If I can pitch, that's what I'm going to do," Carpenter told the St. Louis Post-Dispatch. "If I can't, then we come up with another plan." The outcome is still tenuous at best and will continue to be a day-to-day assessment based on how Carpenter feels. Surgery may still be an option, just not one Carpenter is intending to pursue right now.
Update (5:38 p.m.): Carpenter is now scheduled to undergo surgery later this month, and will miss the rest of the season. According to Cardinals general manager John Mozeliak, recovery time is three to six months, so the team hopes to have him ready for spring training next year.
It seemed as if St. Louis Cardinals first baseman Lance Berkman was about to be added to the growing list of baseball players whose seasons have been cut short by ACL tears. Not so fast ... maybe. Cardinals general manager John Mozeliak announced Monday that the results of Berkman's MRI revealed a torn meniscus, not an ACL tear as originally feared. In an interesting follow-up, Jenifer Langosch, who covers the Cardinals for MLB.com, tweeted the following: "While no evidence of ACL tear came on MRI, it hasn't been ruled out. 'I'm not as optimistic' as team, Berkman said." In other words, it sounds as if the picture is not totally clear. He is expected to get a second opinion this week. At the very least, a meniscal injury would require surgery and subsequent rehabilitation that could sideline Berkman for the better part of two months.
The complexity of the injury could make a big difference in terms of Berkman's future. According to the St. Louis Post-Dispatch, even Berkman seemed to question what the future would hold if the injury turned out to be serious. "If I've re-torn my ACL or something like that, I'd certainly get it fixed but you don't know how psychologically you're going to come back from something like that," Berkman said. "I'm not talking from the standpoint of being scared of hurting it again. I'm talking about doing everything it takes to come back and play again at an elite level." We have seen an aging baseball star return from a second ACL procedure (Atlanta Braves third baseman Chipper Jones did so in 2011) but it is not an easy task, particularly if there is no guaranteed job at the finish line. Until the evaluation process is complete, the next steps for Berkman are on hold.
Last week we talked about the incredible run of bad luck the Washington Nationals have been confronted with recently in terms of injuries. Just when it seemed as if they could not possibly be presented with any more bad news, ace pitcher Stephen Strasburg was forced to leave Sunday's game against the Baltimore Orioles in the fifth inning ... because of his biceps? At least that's how manager Davey Johnson described the situation.
As for Strasburg, he seemed to downplay the incident when speaking with reporters after the game, relating it to arm fatigue and suggesting it is just a byproduct of returning from his 2010 elbow procedure. "It's all part of coming back from Tommy John [surgery]," Strasburg said. "It's something I have to be smart about."
On the other hand, it's worth remembering that Strasburg had shoulder inflammation that sent him to the DL just weeks before he tore his ulnar collateral ligament. The data of pitchers returning from Tommy John surgery suggests there might be a relationship between the elbow procedure and subsequent shoulder issues leading to DL placements (read: Josh Johnson). Is it possible Strasburg could be headed that direction?
It's certainly feasible that any major league pitcher could be beset by shoulder problems at some point in his career; in fact, it is almost expected that given their profession, most pitchers will sustain some form of elbow or shoulder injury. But in Strasburg's case, there has already been a DL placement related to the shoulder, which makes any shoulder-like symptoms now a bit more worrisome. If, in fact, Strasburg has any existing damage to a structure that does not heal independently, such as the labrum, there is an increased likelihood that it will present a recurring problem at some point in time. Davey Johnson said Strasburg's issue was with his biceps, but the specific location within the biceps becomes relevant. If it is the portion of the biceps tendon that attaches to the labrum, it becomes more significant than if it is general soreness or tightness in the muscle belly itself.
There are a number of questions raised by the incident, most of which are not likely to be answered directly. Before we can become either dismissive or obsessive about Strasburg's latest incident, however, it is worth watching to see how he responds. The Nationals have indicated they do not expect him to miss his next start. Amanda Comak of the Washington Times reported via Twitter on Monday that Strasburg was participating in the pitchers' flying disc match (hmmm). In the meantime, expect him to return to his structured routine. If questions remain as to whether the Nationals will adhere to the innings limit originally set for Strasburg at the start of the season, they seem to be diminishing with every yellow flag.
Other injuriesTexas Rangers pitcher Neftali Feliz has been placed on the DL with right elbow inflammation. There was some concern about his health this spring when he was experiencing shoulder stiffness. After backing off his work for a few days he resumed throwing and was able to start the season on time. His performance, however, has been up and down this year as he has transitioned from a closer role to the rotation. It's unclear when the elbow began to bother him but he is being forced to rest it now. An MRI revealed only inflammation, according to ESPNDallas.com, but the pitcher will be shut down from throwing for a month to protect the elbow. Feliz will then resume a progressive throwing program. A more precise timetable is impossible to project until Feliz picks up a ball again and then, naturally, it will be dependent on no further recurrence of symptoms.
Dan Hayes of the North County Times is reporting San Diego Padres pitcher Cory Luebke will undergo Tommy John surgery Wednesday. Luebke had been evaluating his options, including an attempted rehabilitation period, but appeared recently to be leaning toward surgery. It can't be overemphasized that a pitcher needs to be afforded the time and the latitude to carefully evaluate his options before embarking on such an intensive procedure and lengthy recovery process. Once he is fully committed to the idea that surgery is indeed the best option, the road becomes more about going forward than looking back at the what-ifs, a necessary step in a successful return. Luebke should be expected to return at some point in 2013.
Los Angeles Angels outfielder Vernon Wells was expected to be placed on the DL after suffering a thumb injury Sunday while stealing second base. After an MRI Monday, it became clear he would miss more than 15 days. Wells announced via Twitter that he would be undergoing surgery Tuesday to repair a torn ligament in his thumb. Expect him to be out a minimum of two months.
Boston Red Sox outfielder Cody Ross has been diagnosed with a fracture of the navicular bone in his left foot. The team has not indicated yet what the plans are for treatment or how long Ross is expected to be sidelined, but plan for at least a couple of months (six weeks for the bone to hopefully heal followed by rehab games).
Did you know ...
... there are so many top closers sidelined indefinitely right now they could comprise an entire division? Yep, it's true. Three are out for the season (Ryan Madson, Tommy John surgery; Brian Wilson and Joakim Soria, both on their second Tommy John surgeries) and two are out for an extended period (Drew Storen, post-bone chip removal from elbow, no firm timetable for his return; and Kyle Farnsworth, elbow strain, out at least a month). That's a total of five, or one-sixth of the league's closers, now out of commission. All we can do is hope this closer injury rate doesn't continue.
Yankees outfielder Brett Gardner has already been placed on the disabled list because of a bruised right elbow. The Yankees made the move Wednesday after an MRI showed a bone bruise and a strained forearm muscle. The involved muscle (extensor) affects grip and extension, and although Gardner is a lefty, the injury could compromise his grip of the bat and his ability to achieve full extension on his swing. According to ESPNNewYork.com, Gardner suffered the injury when he landed awkwardly, bending his wrist under him, while making a sliding catch in Tuesday's game. Gardner reportedly had difficulty swinging the bat Wednesday, hence the decision to rest him. It's unclear at this point whether 15 days will be sufficient for Gardner to fully recover.
The key for Berkman is getting the calf fully healthy to avoid dealing with a chronic issue throughout the season. After all, he is three years older now, and these injuries can be particularly tricky for 30-somethings. Just ask Derek Jeter and Jimmy Rollins.
Upton is up
How about some good news for a change? As in, someone who is actually coming back to the lineup instead of leaving it. That someone would be B.J. Upton, who has rejoined his Rays teammates and is expected to return to the lineup Friday. Upton was injured this spring when he collided with teammate Desmond Jennings and (understandably) had some lingering back soreness as a result. The extra downtime proved helpful, and after several uneventful minor league outings, Upton is ready to upgrade. There's no reason to think he will have any particular issues going forward, based on what we've heard about his progress thus far.
If you were up late watching the Pittsburgh Pirates and Atlanta Braves battle for 19 innings, chances are you were disappointed either as a fan or a fantasy owner ... or both. There has been plenty of chatter over the questionable call at home plate which ultimately decided the outcome of the game. But for our purposes there has also been plenty of chatter about the big injury of the game, much of it coming my way via Twitter.
Here's a sampling of your questions about Braves catcher Brian McCann, who exited in the 10th inning with what the team later called a left oblique strain (McCann was expected to be placed on the 15-day DL Wednesday.):
@myown4nw: Any word on how long McCann will be injured?
@SloshballGM: What's the recovery time for non-pitcher oblique strain? When can we expect McCann back?
@Bwill02: Do you expect the minimum stay for McCann or worse? Our trade deadline is Friday
While moderate oblique strains commonly sideline hitters and pitchers for at least a month, less severe strains often allow players, even those with big, powerful swings, to return within a few weeks. It all depends on the severity of the injury -- something the team has not yet declared -- and how long it takes for McCann to function without pain. Knowing that they will need him in the lineup come September, though, it's hard to imagine him being rushed back and risking a setback during routine play. As manager Fredi Gonzalez told the Atlanta Journal-Constitution, "Hopefully it is not a bad oblique. There are different grades of it and hopefully we can get him back in 15-20 days." At this point it appears McCann is likely to exceed the minimum 15-day stay simply based on the pattern of recovery for these injuries, even the minor variety, but as to when he will realistically return, an optimistic projection would hover around three weeks, presuming no setbacks.
• St. Louis Cardinals outfielder Lance Berkman was expected to undergo an MRI on his ailing right shoulder Wednesday, according to the team's website. It's too soon to speculate what the imaging test and evaluation by the medical staff might lead to, but given that this has lingered since Sunday, affecting his ability to swing the bat, expect Berkman to potentially be out of the lineup for a few days minimum.
• Toronto Blue Jays heavy hitter Jose Bautista gave everyone a scare when he absorbed a pitch on the left side of his batting helmet Tuesday. Bautista went to the ground immediately but was able to walk off on his own, escorted by the medical staff. After the game, Bautista told reporters, "My head doesn't hurt, I'm not dizzy. I feel perfectly fine." He says he expects to be in Wednesday's lineup but fantasy owners may want to check in advance of game time.
The term "15-day DL" can be so misleading. Sure, we know once a player has been placed on this disabled list we won't see him in the lineup for at least 15 days. But it really gives us no idea as to the true severity of the injury. Some injuries simply require time beyond the allotted 15 days for sufficient healing. For many athletes, returning to play requires restoration of strength, conditioning and timing in addition to recovery from the injury itself, so that can translate to extended time.
To further complicate matters, the date the decision is made to place an athlete on the DL may not be the day the countdown clock starts ticking. A team can make a DL designation retroactive to the day following the last game in which the player appeared. Sometimes this happens when an injury that initially seemed would limit a player for just a few days turns out to be a little more problematic. It may also be used when a team wants to give a player who is progressing well a little extra time before returning to competition. In other words, a move to the DL does not necessarily indicate that an athlete's injury is worrisome.
How to make sense of it all then? Except for obvious injuries (such as broken bones or knee ligament tears) that immediately force a player to the DL, there are often clues that emerge before a team decides to place an athlete on that list. There are also hints throughout the course of an athlete's rehab that signal whether he will require additional time beyond those 15 days before returning to the lineup. We look for those clues and share them with you right here, week in and week out. After all, your fantasy roster is only as good as the guys who are actually playing.
We start this week by looking at the injuries that have befallen middle infielders around the league and ask the question, "Just how concerned should you be?"
But, alas, it did. Rollins strained his right calf muscle and subsequently underwent an MRI on Tuesday which, according to the Philadelphia Inquirer, confirmed the severity of the injury. He has been placed on the 15-day DL, but the Phillies are acknowledging up front that they expect this injury may require more time, indicating that Rollins is likely to be sidelined for two to four weeks.
Rollins is sporting a protective boot that controls ankle movement and allows the calf to rest. Since rest is a critical element of recovery, it would not be surprising to see this injury keep Rollins out closer to the four-week end of the timetable.
The calf muscle is necessary for any hitter to push off when running, particularly when driving out of the batter's box or when getting a jump on a steal. The explosive defensive maneuvers Rollins has to make at his position also place high demand on the calf. Once the initial inflammatory phase has passed, many athletes feel as if they are ready to return to competition, only to discover that explosive movements still lack power or cause discomfort. The risk at that point is that it is easy to overdo those movements and suffer a setback, turning a few weeks of recovery into potentially months. Fantasy owners and Phillies fans will need to be patient with Rollins' return in the hopes that once he's back, the injury is truly behind him.
Brian Roberts, 2B, Baltimore Orioles (15-day DL, April 10): There was concern this spring that Roberts' ailing back might prevent him from being able to start the season. That turned out to not be the case.
Less than a week into the season, Roberts suffered a different injury, an abdominal strain. He hurt himself while stealing second against the Toronto Blue Jays on Friday, and he also managed to aggravate his lower back in the process. As a result, Roberts received an epidural injection Monday, according to The Baltimore Sun, his second this year to help calm symptoms associated with the herniated disk in his back. Roberts has been advised to rest for several days to allow the symptoms to calm down. He will then gradually be reintroduced to exercise with an eventual progression toward baseball activities.
Manager Dave Trembley has already warned that Roberts is expected to be out longer than the 15 days, not surprising given the nature of his injuries. The bigger concern is just how reliable Roberts' health will be once he does return. Disk problems are notoriously chronic in nature and Roberts has really not been 100 percent healthy this year. He entered spring training with back pain and, despite making significant improvements as Opening Day neared, he clearly was not completely out of the woods. His will likely be a tenuous situation and even when he does return, fantasy owners should keep a backup stashed on their bench.
There's every reason for the team to err on the side of caution with this one. A mild hamstring strain can certainly benefit from a little extra rest. Aggravating it by pushing too fast can just as easily turn a mild ailment into a season-compromising injury. The good news for Hill owners is that the conservative approach taken by the team here may pay off down the road.
Mark Ellis, 2B, Oakland A's: Another second baseman, another hamstring injury. Ellis was hurt Sunday trying to beat out a grounder in the eighth inning. Soreness in his left hamstring kept him out of Monday's game.
On the plus side, Ellis himself said he expected to be out for only "a couple of days." According to Susan Slusser of the San Francisco Chronicle, Ellis reports that the hamstring is feeling better and he could return to the lineup Thursday. On the minus side, Ellis had some hamstring issues during the spring as well, so fantasy owners should be mindful that this may not be the last of it.
Jayson Werth, OF, Philadelphia Phillies: There were a couple of minor injuries this week that struck outfielders (more listed below). Werth injured his left hip running out of the batter's box in the fourth inning on Monday. According to the Philadelphia Inquirer, Werth said his removal from the game was precautionary. He added that he expected to miss only a few days, calling the injury "no big deal."
So far Werth's assessment appears accurate in that he is expected back in the regular lineup Thursday following a pinch hitting appearance Wednesday. The Phillies are hoping that one player to the DL this week is enough.
Remember, Young is coming off offseason surgery to debride the labrum in his throwing shoulder. He had an uneventful rehab and steady return to throwing, and had a successful first outing in the Padres' home opener. After that game, Young felt some discomfort and was sensible enough to recognize that he did not need to push it now. As he pointed out, these mini-setbacks typically happen during spring training but his just happened a little further into his throwing progression.
Caution in the early season could well be the difference in keeping Young on the mound more than off it this year. He expects to be ready to take his turn in the rotation when eligible.
Brian Fuentes, RP, Los Angeles Angels (15-day DL, retroactive to 4/6): This is one of those situations where the date is important. Although the move was announced Wednesday, it has been made retroactive to eight days prior. Fuentes, who has been placed on the DL because of a back strain, is eligible to return next week. The Angels can't be especially concerned about Fuentes' injury given the retroactive date but likely feel he will benefit from a few more days off. Fernando Rodney is the closer in the interim but it sounds as if the team does not anticipate that lasting long.
Mike Gonzalez, RP, Baltimore Orioles (15-day DL, retroactive to 4/10): Gonzalez has had a rough start to 2010; the Orioles decided Wednesday to place him on the DL. After an up-and-down spring training Gonzalez struggled early in the season, picking up a pair of blown saves. Now we learn that he has a shoulder strain. While the seriousness of his current injury is unclear, it's worth noting that Gonzalez dealt with issues in his back this spring that seemed to impact his velocity. The hope is that he has not suffered an injury as a result of some compensatory adjustments. His status is worth watching.
• Boston Red Sox outfielder Jacoby Ellsbury dodged a bullet -- but not teammate Adrian Beltre's knee -- Sunday. The collision was enough to take Ellsbury's breath away and he ended up with a rib contusion but fortunately no fractures. Lingering soreness has caused him to miss a few days but he should be able to avoid a trip to the DL.
• Colorado Rockies outfielder Carlos Gonzalez is another player dealing with "tightness" in his hamstring, leaving Sunday's game early after feeling the discomfort in his left hamstring. He has not played in the two games since. According to The Denver Post, Gonzalez was available only for emergency situations, as he could still not run the bases effectively. While so far it appears that he will avoid the DL, there are no guarantees as to when he may return to the starting lineup.
• The Seattle Mariners' Cliff Lee is hoping he will debut for his new team in early May. Lee has thrown a couple of bullpen sessions where he has looked strong and been pain-free. The next goal is a simulated game late this week. He will still need to build up his arm endurance, but so far, so good.
• Los Angeles Angels pitcher Scott Kazmir, who started the season on the DL with a mild hamstring strain, is expected to start Thursday against the New York Yankees. Nothing like jumping in feetfirst.
From my mailbag
Stephania Bell: You are certainly right about there being a lot of questions about Berkman, given the start to his season. This week there were some encouraging signs in that he has made some progress with his activity. After having persistent issues with fluid in his left knee following March arthroscopic surgery (which required having his knee drained multiple times), Berkman was able to begin some light running Monday. The key to him returning next week will be whether the swelling stays down as he continues to increase his activity. And that's a big if ...
Your question is a tough one because I'm not convinced his return will be completely smooth. While there may not be any obvious outward signs of trouble once he is able to get back in the lineup, he could be in a situation where the team opts to rest him more frequently to protect the knee. He may also have less power at the plate initially if his leg strength is not 100 percent. He may be well enough to play but it still may take him time to perform like the Lance Berkman you drafted. I'm not convinced he'll reach the targets you've set for him, so you may want to re-evaluate your bench spots.
If you have any other injury questions you want answered in the blog, drop a note in my mailbag, or stop by my Tuesday chats.
It may have seemed as if all the stars were on the field on Opening Day, but many marquee players were relegated to the disabled list entering the 2010 season. Some may be just a few days from making their season debuts. Others, well, we're just hoping that we get to see them play this year.
Because fantasy owners always want to know when their injured star is expected to return, we've decided to highlight some of the key members of the group of 80-plus players starting their season at less than full health. In some cases there's reason to be very optimistic, but, as always, there are many more cases where there's cause for some level of concern.
The latest bit of discouraging news is that Webb received a cortisone shot in his surgical shoulder one week ago and was ordered to rest for a few days before resuming throwing. Webb's description of the shoulder is one not so much of pain, but rather a general sense of not feeling right. According to ESPN news reports, Webb said, "It doesn't feel great, but it doesn't hurt bad. I still feel like I can't let it go. I still feel like I'm not ready to get on the mound yet."
Hmmmm. A year plus one surgery later, and Webb is experiencing similar symptoms. It's impossible to thoroughly evaluate the situation from a distance, but it almost sounds as if there's more to this puzzle than the shoulder itself. Webb has made no progress in more than a month, and it is hard to be optimistic about his return, no matter when it occurs, at this point in time.
Cliff Lee, SP, Seattle Mariners (15-day DL, April 4): Lee is making some headway as he recovers from the abdominal strain that forced him to start the season on the DL. He is expected to throw a bullpen session Friday.
Lee also has made headlines in that he has been undergoing PRP (platelet-rich plasma) injections, along with all the other typical elements of rehabilitation, in an effort to aid his recovery from this injury.
It should be noted that the average missed time for these types of abdominal injuries hovers around 30 days for a thrower, and Lee is on pace for that time frame. He still needs to increase his pitch counts once he gets on the mound and appear in some rehab outings (at least two, perhaps more). The ultimate test of whether true healing has occurred doesn't happen until a pitcher throws at competitive velocity, so until he has been in that setting, the team -- and Lee's fantasy owners -- will not really be able to exhale.
Keep in mind that this is Lee's third significant abdominal injury. The hope, particularly with the addition of PRP, is that not only will the injury heal a little more quickly, but (and more importantly) it will heal more completely. To that end, one can assume the team will not rush him back. Reinjury could result in another four to six weeks of downtime. If all goes well, look for him to return in the latter half of April.
Ted Lilly, SP, Chicago Cubs (15-day DL, March 26): After undergoing a "cleanup" procedure on his left shoulder in early November, Lilly is expected to make his season debut in the third week of April. So far, his rehab course has been uneventful, which is a good sign. At 34 years old, you have to expect the presence of some wear and tear in a pitcher's shoulder. Although the goal is to avoid surgery whenever possible, in some instances it can add years to a pitcher's career. The fact that Lilly is doing so well provides much encouragement heading into the season. The disabled-list stint allows him to continue to build his throwing endurance in minor league games until everyone, including Lilly, is confident that he is indeed ready to return.
Joe Blanton, SP, Philadelphia Phillies (15-day DL, April 1): Blanton had never been on the disabled list in six major league seasons heading into this campaign. But all good things must come to an end. Blanton is being forced to start the 2010 season on the DL with a left oblique strain. The Phillies have maintained that Blanton's strain is on the mild side, but the initial projections have him missing anywhere from three to six weeks, standard for an oblique injury. According to ESPN news reports, team physician Michael Ciccotti said that if all goes well for Blanton, "we're looking at the earliest at the third week of April."
Again, the goal is to have the athlete avoid a second trip to the DL for the same injury, so it makes sense to keep Blanton out a little longer this time if it means better insurance for the long haul. The average DL stint for a pitcher with a true oblique strain is approximately 30 days, so an uneventful rehab could mean Blanton will return in late April.
Daisuke Matsuzaka, SP, Boston Red Sox (15-day DL, April 3): Matsuzaka started the season on the disabled list as a result of neck and back problems that have bothered him this spring. Currently, he is making progress with a pitching program in which he's expected to make at least three rehab starts, with his first one scheduled for Saturday. The biggest question is whether these issues are really behind Matsuzaka. He did work more closely with the team on his offseason conditioning and reportedly showed up to spring training in better shape, but there were still setbacks. The Red Sox are not sounding particularly worried at this point, and the injuries themselves do not seem serious. Last year, however, Matsuzaka was nagged by various ailments that kept him from being fully effective. The hope is that this will not be a repeat performance.
Baker makes an interesting point regarding some of the mechanical adjustments the Mariners are working on with Bedard. Specifically, they are trying to adjust the turn in his delivery to minimize stress on his throwing shoulder without revamping his throw and making his pitches easier to read. It will be interesting to see whether the downtime has allowed Bedard's body some additional recovery. He has been plagued by soft tissue injuries in recent years and has not been the model of physical endurance. A shortened season after a lengthy time off may serve him well. He's not out of the woods yet, though; he has many hurdles to cross before he becomes a consideration in the Mariners' rotation.
Edinson Volquez, Cincinnati Reds (15-day DL, April 4): Volquez is another pitching ace who underwent Tommy John surgery last year on his throwing (right) elbow, but he did not go under the knife until August, making his return this season a question mark at this point in time. Although we've heard that the Reds hope to have him after the All-Star break, there's still no indication whether that means July or September, and there's no way to predict with any certainty. Typical recovery takes about a year, give or take a month or two (or longer) depending on whether any setbacks arise during the rehab process. Beyond that, it often takes a pitcher time in games to truly return to form, and he often doesn't put up typical numbers until the following year.
Currently, Volquez is throwing limited pitches at controlled speed off a mound and is doing all the right things so far. The biggest hurdles are yet to come, however, so it remains to be seen just what he can accomplish as far as returning this year.
Scott Kazmir, SP, Los Angeles Angels: (15-day DL, retroactive to March 31) Just when it seemed as if Kazmir might blow by a couple of minor spring training injuries to start the season on time ... he didn't. Not that there appears to be much to worry about. ESPNLosAngeles reports that, according to manager Mike Scioscia, "There's no setback with Kaz. It's just a matter of time and him getting stretched out to pitch a little deeper into a game."
Kazmir came into spring training with a hamstring strain which slowed him a bit. Later in the spring he developed some shoulder fatigue. Neither was believed to be serious, but it did delay the build-up of his throwing. As of now Kazmir is expected to make a rehab start Friday and is then expected to rejoin his team when they face the New York Yankees on the road April 13. Kazmir, with the help of pitching coach Mike Butcher (with whom he worked when both were with the Tampa Bay Rays), has made some adjustments that he believes will make him a bigger threat on the mound this year. He also focused on extensive offseason strengthening. Once Kazmir's season gets underway, he might restore his fantasy value if he can just stay healthy.
Relief pitchersBrad Lidge, RP, Philadelphia Phillies (15-day DL, retroactive to March 26): Lidge is coming off not one but two surgeries this offseason. First, he underwent elbow surgery in November to repair a torn flexor tendon and remove a loose body in his throwing (right) elbow. In January, he had surgery on the medial meniscus in his right knee. Lidge indicated that pain in the knee throughout the 2009 season led to changes in his throwing mechanics, which ultimately contributed to his elbow injury. The good news this spring is that Lidge has made steady progress with his rehab and had not experienced any pain ... until recently.
Lidge has had some elbow soreness, which is not unusual for him as he builds up his arm strength, but there were concerns that it might have been related to his recent procedure. Not so, said team physician Michael Ciccotti. According to The Philadelphia Inquirer, Ciccotti emphasized that the recent cortisone shot to help calm inflammation in Lidge's elbow was delivered to the lateral or outer portion of his elbow. Lidge has no discomfort on the medial side (where the repaired flexor tendon is located along with the ulnar collateral or Tommy John ligament), and his elbow is stable.
Lidge threw 25 pitches in a Sunday bullpen session and had "no pain, no issues," according to Phillies general manager Ruben Amaro. If all goes according to plan, Lidge should return in April. Whether it's in the next week when he's eligible to come off the DL or, more likely, a little later in the month, Lidge should be in good health and figures to have a strong season. Remember, the last time he entered the season on the disabled list (2008 after right knee surgery), Lidge managed to put together 41 saves and a 1.95 ERA before the year was through.
At this point there is plenty of reason to be optimistic, but bear in mind that occasionally lingering problems evolve from trivial beginnings. Diamondbacks ace Brandon Webb is just the most recent example of a similar pattern ... and he's still not back. The Rockies have to have their fingers crossed that Street's issue is indeed of the simple variety, and if that's the case, look for him to be available for competition in mid-to-late May.
Kerry Wood, RP, Cleveland Indians (15-day DL, retroactive to March 26): Wood suffered a moderate strain to a muscle in his back (latissimus dorsi) in spring training, and the team's medical staff indicated that he would be out a minimum of six weeks. Although Wood said he hoped to be back sooner, there is really no reason to expect that. Even if the injury is not terribly serious, the message from the Indians appears to be that they will not rush him back.
Nor should they. Wood's injury history is well documented, and although everyone is thankful that the injury is not to one of the rotator cuff muscles or within the shoulder joint itself, the latissimus plays a significant role in controlling the throwing arm. A strain or weakness in one area can lead to compensations in another, something Wood cannot afford. Allowing him to recover fully before resuming the work of throwing makes perfect sense. Given what the team has projected, do not expect to see him in the closer role before mid-May. In the meantime, Chris Perez will handle the job.
Joey Devine, RP, Oakland Athletics (15-day DL, retroactive to March 26): Devine had a less-than-divine 2009 when a bout of elbow pain in the spring later deteriorated into a need for Tommy John surgery. The silver lining in his dark cloud was that surgery was early enough (April) to allow him to be available for most of the 2010 season. Devine has had a very strong rehab progression back from surgery. Other than some minor tendinitis, which is not unexpected with this particular recovery, Devine's road to return has been smooth.
Now come the big tests. Devine's first bullpen session is scheduled for Wednesday, and this is a big transition, as it involves throwing from a mound. After the bullpen sessions come the simulated batting practices and eventually real innings. If all continues well, Devine could rejoin the roster in late April. It's worth bearing in mind that pitchers generally require some time before they truly return to competitive form, but so far things are lining up in Devine's favor this year.
HittersIan Kinsler, 2B, Texas Rangers (15-day DL, retroactive to March 26): Kinsler is battling a right high-ankle sprain, an injury that can be notoriously tricky when it comes to return to full activity. Whether he comes off the DL when eligible on April 10 is still very iffy. Kinsler was able to take some swings with the bat early this week but still has not been cleared to run or perform any lateral movements.
Athletes often begin to feel better in their recovery from this injury and think they are closer to return than they really are. When they are subjected to increasingly difficult movement challenges, they often find that the ankle is still a little weak and uncomfortable. The worst-case scenario would be to return too soon only to have a second, more protracted visit to the DL. So while Kinsler told the Fort Worth Star-Telegram on Monday that he hopes to begin a rehab assignment this weekend, his body may not be quite up to that task.
Lance Berkman, 1B, Houston Astros (15-day DL, retroactive to March 26): Persistent swelling in Berkman's left knee after a contusion suffered during spring training led to an arthroscopic procedure in mid-March. Unfortunately, he has had some lingering issues with swelling in the knee, resulting in multiple drainages to extract the fluid. On Monday, Berkman had it drained for the fifth time and also received a cortisone injection to help control the inflammation. The next day, Berkman told the Houston Chronicle that the swelling seemed to be staying down a bit, an improvement from the earlier drainages. Although he's taken batting practice, he is still a ways removed from returning to play. He will have to demonstrate that he can increase his activity without causing another flare-up. At this point, he appears to be at least a week or two from rejoining the team.
The bigger concern going forward will be whether Reyes can maintain his health across the season. There is no doubt that he is in great physical shape and is eager to prove that he is back in full capacity. There is some doubt, however, that his hamstrings will cooperate with the demanding grind of baseball. For fantasy owners, this is a risk-reward relationship here. Let's hope the reward wins in the end.
Carlos Beltran, OF, New York Mets (15-day DL, retroactive to March 26): Beltran has been working his way back from January surgery to address cartilage damage in his right knee, the same one that caused him to miss the majority of the 2009 season. Beltran has said that his knee is finally pain-free and he is making big improvements in strength and control.
The big tests will come with the pounding, something he has not tried until now. Beltran is scheduled to begin running Saturday, and according to reports in the New York Post, Mets general manager Omar Minaya says Beltran will need another four to eight weeks beyond that before he could rejoin the team.
It seems that the earliest Beltran could return would be mid-May; however, it would not be surprising if he does not return before early June. The hope is that a careful, steady rehab will help ensure that once he does come back, he can stay healthy for the remainder of the season. That's still a question mark, given that his knees are not quite what they once were, although likely much improved over last year. As he increases his baseball-related activities, we should get better insight as to how healthy Beltran truly looks. This is definitely a situation to watch.
Alex Gordon, 3B, Kansas City Royals (15-day DL, retroactive to March 26): For a youngster with huge potential, Gordon has not been able to reach his targets yet because of injury. Last year he dealt with a torn labrum in his hip that required surgery and missed a big chunk of the season. After an offseason of intense work with the Royals' strength and conditioning team, Gordon seemed poised to jump start 2010.
And then there was the headfirst slide on March 6 while stealing second base that resulted in a broken thumb. There's a reason managers cringe at the headfirst slide; while they seem to be a little faster, there is an increased risk of broken fingers and thumbs or cleated hands. Luckily Gordon's thumb, is nearly healed. The DL move for Opening Day was to allow Gordon some more playing time in the minors to ensure that he is fully ready to return to competition. If all goes well expect to see him back with the team by late April, probably sliding feet-first.
Freddy Sanchez, 2B, San Francisco Giants (15-day DL, retroactive to March 26): Sanchez's season with the Giants ended early last year when he was shut down in September thanks to a meniscus tear in his left knee. He ended up undergoing surgery for his knee shortly thereafter but somewhat surprisingly later underwent surgery on his left shoulder. In December, Sanchez had a procedure to address the labrum and the AC joint in his nonthrowing shoulder, but the lengthy rehab meant that he would miss Opening Day. Giants manager Bruce Bochy said that Sanchez, who remains at the team's spring training camp in Arizona, is still three to four weeks away from a minor league assignment, according to the San Jose Mercury News. For fantasy owners, this translates to a projected return of somewhere in mid-to-late May. Hopefully the wait will have been worth it, as Sanchez should exceed his performance from late last year now that his injury issues have been addressed.
If you have any other injury questions, feel to drop a note in my mailbox and I may answer it in my next blog entry.
The All-Star break provided a welcome reprieve, a little rest and recuperation for everyone (including yours truly). Even those in their fantasy league basement can still hold out hope for a playoff appearance.
Naturally, there are fewer injuries to report this week after a little time off, right? Wrong! Apparently the disabled list is trying to make up for lost time, adding (or threatening to add) players left and right since play resumed after the All-Star break. League GMs, not to mention fantasy owners, are suffering headaches galore as they try to boost their positions during the second half of the season.
Which injuries should have us really concerned, and which ones can allow us to breathe a little sigh of relief that they weren't more serious? We start on the West Coast.
Manny Ramirez, OF, Dodgers: Just as he began to get his groove on after a 50-game suspension, Ramirez gave everyone a scare on Tuesday when he was hit on his left hand by a Homer Bailey 94 mph fastball. Fortunately, X-rays taken shortly after the injury revealed no fracture to his fifth metacarpal, the bone on the outside of the hand that connects the wrist to the fifth finger, where Ramirez absorbed the brunt of the impact. Given that a fracture could have resulted in another extended absence, the Dodgers have to be breathing a sigh of relief.
Ramirez had some soft tissue swelling, which is to be expected, and as a result, he will sit out Wednesday's game. The Dodgers caught another lucky break in that they'll have a day off Thursday, so Ramirez will have an extra day of rest for the hand without sitting out of the lineup. Assuming the swelling subsides reasonably quickly, look for him to make a return Friday when Los Angeles hosts Florida.
Grade 2 (moderate) muscle strains represent a wide range of tissue damage, and it's possible that Berkman's particular injury is on the lighter side of that range. Nonetheless, it is very easy for these injuries to worsen, particularly if a player tries to push off the leg while the tissue is still compromised. The Mets' Jose Reyes tried to come back too quickly from a similar injury and had a setback before later injuring his hamstring. Berkman might not be associated with the explosive speed of a Reyes, but he relies on the calf muscle for both offensive and defensive performance nonetheless.
The Astros may elect to use him in a pinch-hitting role before bringing him back to the field, but even then, he will need to be able to round the bases without fear of reinjury. General manager Ed Wade seems to be well aware of this, telling the Chronicle, "... if the choice is take a couple more days and let him get back to 100 percent, then that would be the appropriate thing to do." Fantasy owners should plan to have a replacement for another week to be on the safe side, but keep an eye on Astros' daily lineups as well.
Tim Wakefield, P, Red Sox: Back problems are no small issue for a pitcher; just ask Randy Johnson. Wakefield, who at age 42 is in Johnson's peer group, was placed on the DL with what the team is calling a lower back strain. The diagnosis suggests that this is a minor incident, and Wakefield seems to agree, telling WEEI.com that he expects to miss only two to three starts.
Wakefield apparently developed back spasms while throwing a side session Saturday, and the pain lingered enough to warrant a trip to the DL. Back spasms, although incredibly painful, are not especially serious in and of themselves. However, the underlying cause of the spasms can be the key to just how disabling the injury will be. Overexertion of muscles resulting in an acute strain (which can be related to something as simple as fatigue or inadequate warm-up, for instance) is a minor issue. A degenerative problem such as a disc injury or a problem with one of the small spinal (facet) joints, something one might see in an athlete in his 40s, can begin to manifest itself initially by a muscular spasm in the area.
Wakefield's time to recover and completeness of his recovery (i.e., no setbacks) will offer more insight as to whether this is something to be concerned about long term. In the meantime, it is worth nothing that spine injuries, even minor ones, can be unpredictable and easily exacerbated. In other words, securing some insurance would not be a bad idea.
Nelson Cruz, OF, Rangers: Cruz was scratched from Sunday's lineup because of soreness in the ring finger on his right hand resulting from Saturday night's dive into first base. The injury later proved to be a small fracture. Although the ailment itself is not considered particularly serious, the consequences to Cruz's swing of the bat could be. Cruz has not played since Sunday, although he did take some swings before Tuesday's game and could return to action Wednesday.
A word of caution is warranted here. According to the Rangers' official Web site, Cruz said as recently as Monday that he could not grip a bat well because of swelling in the finger. Cruz's teammate Michael Young faced a similar injury last year, also the result of a headfirst dive into first, and struggled at the plate for the remainder of the season. Young acknowledged that the pain that radiates through the fracture site when the ball and bat make contact can cause an athlete to change his mechanics as a means of compensating. Cruz's toughness definitely will be tested. Fantasy owners may want to see how Cruz fares when he returns before committing to him in their lineup.
On the mend
• Cubs pitcher Ryan Dempster is making some progress in his activity as his broken right toe heals. Dempster threw 60 pitches in a bullpen session before Monday's game and reported no ill effects or undue soreness afterward. He followed that up with a solid simulated game outing Wednesday, when he again threw 60 pitches without incident. Dempster, who has been out since July 7, is scheduled to have a repeat X-ray of the toe Thursday, according to the Chicago Tribune. If the bone is healing well, he could return to the rotation as soon as Sunday. The key here is that pitching coach Larry Rothschild says Dempster is not favoring the toe and is able to bring his body weight over his push leg with no trouble at all. Assuming the X-ray shows satisfactory progress, there is no reason to think Dempster can't jump (OK, maybe not jump, since that's how he landed on this list in the first place) right back into the mix.
• Yankees pitcher Chien-Ming Wang is going the wrong way on this list. On the Mend implies that guys are getting better, not worse, but Wang suffered a setback in his strained (right) throwing shoulder, hence the decline in his status. There is no timetable for his return, and quite frankly, he may just want to scrap this season and start fresh next year. After struggling at the outset, a problem later determined to be associated with hip weakness left over from last season's foot injury, Wang appeared to be righting the ship somewhat, only to develop shoulder bursitis and a muscular strain. It's quite possible that in the earlier part of the season, Wang struggled to compensate for his lower extremity weakness, thus leading to the beginnings of the shoulder issue. No matter what the origin, this situation does not appear likely to resolve itself any time soon.
• Across town in New York, is it possible that some good news is on the horizon for the Mets? It sure looks that way, as pitcher John Maine emerged feeling good from a three-inning simulated game in Florida, according to the New York Daily News. Maine, who has been on the DL since mid-June with what was called a "pinched nerve" in his shoulder, has been slowly working his way back to the mound ... again. Maine already had fought his way back after offseason shoulder surgery last year, only to be faced with problems two months into 2009. A few cortisone shots and many rehab exercises later, Maine appears to be on track for a return sometime in August, assuming he can make his rehab starts without incident.
At 40 years old, these things tend to be a little slower to recover, so don't be surprised if the team takes the cautious approach. This comes on the heels of pitcher Fernando Nieve's addition to the Mets' ever-growing DL with a right quadriceps injury sustained during an awkward landing on first base. Nieve's MRI showed a muscle tear, which translates to an absence of more than a month. Meanwhile, shortstop Jose Reyes did run the bases in a simulated game in Florida, but as Newsday reports, manager Jerry Manuel acknowledged that it was not even at half speed. Just a reminder as to how problematic these muscle strains can be.
• Twins pitcher Kevin Slowey, on the DL since early July with a strained wrist, had a good bullpen session Monday after suffering a setback just before the All-Star break. The latest outing was encouraging and suggests that he could be nearing a rehab assignment this weekend. If there are no further setbacks, it appears that Slowey could be on track to return in August.
• It might be worth keeping an eye on Blue Jays pitcher Shaun Marcum as he makes his way back from Tommy John surgery on his right (throwing) elbow. Marcum has been pitching in rehab games, and although he is still working on returning to form, he has been able to deliver some strikeouts. Perhaps most importantly, he reports that the arm feels good and has had no major setbacks. The Jays hope to have him back in the rotation in August, and he is widely available in ESPN.com fantasy leagues. Although it often takes a pitcher until his second year postsurgery to return his full command, it does not preclude him from having good outings before then.
And finally ...
For those willing to take a chance on someone, why not try the Dodgers' Jason Schmidt? Although one decent outing does not a successful return make, consider that many thought Schmidt might never pitch again. After two consecutive shoulder surgeries to address a torn labrum, and then to resect the acromioclavicular joint, Schmidt's two-year path back to the majors has been marred by disappointment and setbacks. He and the Dodgers had to be encouraged by the fact that he was able to last five innings in his comeback performance Monday. Schmidt's velocity is not what it was -- and it may never be again -- but the key will be whether he can reinvent himself as more of a finesse pitcher to add years to his career. The jury is still out, but he's widely available in ESPN.com leagues and may be worth picking up, as he certainly has a firepower offense behind him that may help secure him some wins -- assuming, of course, that he stays healthy.
Florida Marlins: Hanley Ramirez
Last year Ramirez made this list because there were concerns about his left (non-throwing) shoulder after offseason surgery to repair a torn labrum. Ramirez held up in 2008, although his productivity languished a bit compared to 2007. This year there are new concerns about his shoulder ... the other one. The Miami Herald reported that Ramirez came to camp much bigger this year after an offseason weight-training and swimming program. He then developed some right-side rotator cuff tendinitis which caused him to sit out a few games. Not to worry. By the close of spring training Ramirez was back playing shortstop and hitting homers, even stealing a base or two for good measure. He is 25, so his best years are still ahead of him.
Washington Nationals: Nick Johnson
After missing more than a full year with a slow-to-heal leg injury, Johnson made an emotional comeback in 2008, only to exit in June with a wrist injury. Johnson underwent surgery to address a ligament injury in his right (non-throwing) wrist and spent the remainder of the offseason rehabbing and retooling his swing under the watchful eye of Nationals hitting coach Rick Eckstein. Johnson has shown that his swing is healthy this spring; if his body can hold up its end of the bargain in 2009, the Nationals could be in for a treat.
Like that Energizer Bunny, Jones takes a lickin' and, well, minus a few days off here and there, just keeps on tickin' with remarkable consistency. Sure, he'll get banged up, but as a team leader, he's going to play through as much pain as he can. Last year's nagging quadriceps and hamstring strains finally forced him onto the DL in July, but he still finished the season batting .364. This spring an oblique strain squeezed him out of the World Baseball Classic, but fear not: Despite being 37 years old, he'll be back in the lineup come Opening Day. Yes, he remains an injury risk, but the Braves' willingness to extend his contract indicates their belief that the reward outweighs that risk.
New York Mets: Johan Santana
Some worried that Santana's offseason arthroscopic knee procedure might affect him, but it was a bout of elbow pain that set off alarm bells earlier this spring. A few weeks later, those alarms have all but subsided thanks to Santana's performance in recent outings, along with his declaration that he is symptom-free. The Mets certainly have to hope so. He is set to pitch on Opening Day in Cincinnati and will no doubt be a big draw to the new Citi Field, not to mention a key to the Mets' postseason aspirations. Whenever a pitcher has elbow pain there's reason to be cautious, but in Santana's case it's not time to be overly concerned -- yet.
Philadelphia Phillies: Chase Utley
Much was made of Utley's offseason hip surgery and how far into the 2009 season it would be before he could return. Well, surprise, surprise. Utley has been a model patient, working diligently to exceed his rehab targets while being mindful not to overdo it and create a potential setback. Utley has clearly demonstrated his readiness to return by not only offensively hitting for power this spring, but also defensively by sliding, throwing hard across his body and even diving for balls without hesitation. Manager Charlie Manuel has already proclaimed Utley a member of the Opening Day lineup, and he will continue to be a regular fixture thereafter.
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He is awesome when he plays. But his health history leaves everyone on the edge of their seats wondering when the injury bug is going to strike again. Harden had his highest number of starts in four years in 2008, and his shoulder, which had limited him previously, appeared much improved. It's also worth noting that his outings were carefully managed, and he will continue to be monitored for pitch counts in 2009. So far this spring, the only thing to affect him was an unpleasant round of food poisoning. The Cubs have to be keeping their fingers crossed that this is the worst thing Harden has to deal with this year.
Milwaukee Brewers: Trevor Hoffman
Yes, Hoffman might be older than a couple of his teammates combined. Sure, he's starting the season on the DL with a strained oblique. But don't count this guy out. The all-time saves leader appears to have a relatively minor version of this injury and has already returned to playing catch. As a closer he needs fewer innings to prepare for the season, so he could join the club within the first two weeks. Baseball years do add wear and tear to the arm, however, and oblique injuries can recur. Hoffman will be consistent when present; the Brewers just hope he can be consistently present.
St. Louis Cardinals: Chris Carpenter
Carpenter's past two seasons can be summed up as follows: bone spur removal, Tommy John surgery, nerve problems in shoulder, nerve transposition surgery at the elbow. After more than two years, Carpenter can finally say that he feels good. And it shows. His performance this spring has been both impressive and inspiring. The Cardinals are optimistic, albeit cautiously so, but it does appear that Carpenter is headed for a stellar season.
Houston Astros: Lance Berkman
The Astros' first baseman began experiencing soreness in his left (throwing) shoulder in February. As recently as last week he was having trouble lifting his hand above his shoulder. The team is calling it biceps tendinitis, and Berkman is brushing it off as no big deal. They had better hope it is just a little spring training aggravation and not a sign of something that continues to flare up during the season. After all, those chronic, nagging injuries generally start out as small annoyances. Only time will tell, but there is reason to keep a close watch on Berkman's status; it may become more of an issue if he cannot get back to the field at the season's start.
Cincinnati Reds: Bronson Arroyo
When you hear the diagnosis of "carpal tunnel syndrome" it usually conjures up the image of an overworked software programmer whose hands are going numb from endless hours at the keyboard. But this injury is affecting the Reds in a different way. The electric-shock-like pain in Arroyo's thumb and index finger is keeping him from writing; playing guitar; and, most important for the Reds, pitching well. The plan, along with anti-inflammatories and intermittent rest, is for Arroyo to pitch through this, something he has done in the past. But the level of symptoms he is experiencing, on top of the fact that this is a chronic condition, makes it impossible to guarantee that Arroyo will be able to do so. Don't be surprised if he is forced to endure a stint on the DL early on.
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Wilson was at an all-time low in 2008. He played in his fewest games, largely as a result of injury. After a torn calf muscle and broken right (throwing) index finger derailed most of his season, Wilson wasn't sure he would still be in Pittsburgh this year. But in Pittsburgh he remains, and although he's not going to be a rock star, the hope is that he'll be healthy enough to continue to provide primarily a solid defensive presence. Despite missing a few days with a bruised knee in spring training, he's hoping he'll have his best attendance record in years in 2009.
Arizona Diamondbacks: Eric Byrnes
Byrnes, formerly known for his speed, had a terrible 2008 when both wheels came off, as in both hamstring muscles were injured. Byrnes opted for a conservative treatment approach (meaning no surgery) and has recently been showing that his legs are healthy this spring. Although Byrnes is not currently slated to be an everyday player for the Diamondbacks, the ability to slot him in anywhere in the outfield makes him valuable off the bench. He still has plenty left in the tank, and is already looking speedier than before he was injured last year. Don't overlook him.
Los Angeles Dodgers: Manny Ramirez
With all the concern apparent in Dodgerland when it initially seemed as if Manny might not be signed in 2009, there had to be similar concern when Manny was sidelined by a hamstring strain almost as soon as he joined the team. No doubt beads of collective sweat began to form in the Dodgers' front office. That concern has been for the most part alleviated as Manny has returned to both hitting and fielding duties. But, you may ask, don't hamstring problems tend to recur? Yes -- more beads of sweat -- but in this case, there are several things working in the Dodgers' favor. First, the injury was a minor strain. Second, because of the timing of the World Baseball Classic, Manny could actually be brought along more slowly, limiting his running early in his recovery, enhancing the healing process. Third, the Dodgers have an all-star medical staff. Relax. Manny can just be Manny.
Colorado Rockies: Troy Tulowitzki
Tulowitzki had a rough 2008 season. First, he was sidelined for weeks with a torn left quadriceps (not his fault). Shortly after his return from that injury, a laceration requiring 16 stitches to his right (throwing) hand kept him out for two additional weeks (his fault -- he slammed his bat, and it broke and bit him back). After an offseason to heal his leg fully and to settle down his frustration with last year's numbers, Tulowitzki should be in good shape for a strong 2009 season.
San Francisco Giants: Noah Lowry
Health issues have challenged Lowry in the last few years, most recently wiping out his entire 2008 season. This has to be disheartening for a young pitcher who showed so much promise when he first joined the bigs. Remembering that first season is perhaps why he continues to plod along through each rehab stint. Lowry, shut down last year with compartment syndrome in his left (throwing) forearm followed by elbow surgery, has already been bothered by shoulder pain this spring. A visit to Dr. James Andrews resulted in an injection into what was otherwise termed a structurally sound shoulder. Lowry is still optimistic that he can provide an option for the Giants later this season, but cumulative arm injuries do not historically bode well for pitchers.
San Diego Padres: Chris Young
Young has Ivy League smarts and toughness. No one could doubt the mental fortitude of this Princeton graduate after he came back to the mound just 10 weeks after taking a pitch to the face. The impact resulted in not only a broken nose, but also a skull fracture. Despite post-surgical sinus and ear infections, a strain in his throwing forearm forced him onto the DL again in August. Given his injuries last year, Young's spring tendinitis and poor outings have some concerned. For his part, Young says that both are typical of his spring performance and that he will warm up as the season approaches. Last year's injuries should have no carryover effect. Young has every reason to be optimistic in 2009.