Stephania Bell: Mark Teixeira
There is no shortage of players in either of those categories, so let's dive right in.
Keep a watchful eye on
Omar Infante, 2B, Kansas City Royals (jaw): It’s not just the pitchers who absorb the hits to the face; hitters are also vulnerable. Infante took a scary fastball to the jaw Monday, leaving him bloodied but fortunately not seriously hurt. Infante required stitches to repair the laceration to his chin. Scans performed later revealed no fractures to the bony structures, but rather a soft tissue injury (sprain) to the opposite side of the jaw from where the baseball landed.
The jaw is a bilateral hinge joint where movement on each side is connected through a single bone, the jawbone or mandible. Displacement from a force landing on one side can therefore stress the joint tissues on the opposite side. In Infante’s case, the blow from the baseball on the left side of his face led to a sprain of the temporomandibular joint (abbreviated TMJ, where the temporal bone of the skull and the mandible meet, just below the ear) on the right. Infante also passed all concussion tests and was equally fortunate to escape this episode without a major head injury.
According to the Kansas City Star, a team spokesman for the Royals offered the following statement: “Based on the Kansas City medical team’s initial diagnosis, it does not appear he’ll miss a significant amount of time.”
Infante will continue to be monitored closely, and it could be a few more days before a decision is made with regards to the disabled list. As unpleasant as this injury is, Infante and the Royals know this could have been much worse.
Ryan Zimmerman, 3B, Washington Nationals (right shoulder): Zimmerman is again experiencing soreness in his right shoulder, leading to errant throws. That scenario led to his early exit from Saturday’s game and a follow-up MRI. Nationals manager Matt Williams described Zimmerman’s shoulder as “arthritic,” per the Washington Post, not necessarily surprising given his history with the joint.
Zimmerman struggled with the shoulder in 2012 and underwent surgery after that season to clean up the acromioclavicular (AC) joint, the joint at the point of the shoulder. He described the difficulty in making his normal arc of throwing motion when the shoulder was problematic, which explains his intermittent lack of accuracy. The hope was that this challenge would be behind him following surgery, but that has not proven to be the case. For now, the team is approaching his status as day-to-day.
For more on Zimmerman’s injury and what to expect, check out my video with Eric Karabell and his Insider blog post on Zimmerman.
Yasiel Puig, OF, Los Angeles Dodgers (left thumb): Puig seems destined to make regular appearances here given his style of play. The question will be how serious the injury is -- or could be -- at any given time. Puig injured his thumb on a headfirst slide into first base Saturday and was out of the lineup Sunday. Initial X-rays were negative and a follow-up MRI confirmed only a minor ligament injury (Note: Manager Don Mattingly described the injury as a strain, according to the Los Angeles Times; ligament injuries are generally classified as sprains).
The key piece of information is the apparent lack of severity. Mattingly said of Puig’s situation, “It seemed more like a day-to-day thing than a DL thing.” The headfirst slide is often responsible for tears of the ulnar collateral ligament of the thumb, and in severe cases surgery is required. That does not appear to be the case for Puig at this time, but he may miss a day -- or several -- depending upon how the thumb responds.
To the DL
A.J. Ellis, C, Los Angeles Dodgers, (knees): Ellis underwent arthroscopic surgery Tuesday with team physician Dr. Neal Elattrache to address a torn meniscus in his left knee. He sustained the injury Saturday when trying to score from second base.
Given that this procedure involved removing the piece of damaged meniscus as opposed to repairing the tissue, the timetable for Ellis’ return is shorter. He is projected to miss four to six weeks, a slightly more conservative timetable than for a non-catcher. With the demands of the position (sustained crouching, repetitive motion into and out of a deep squat), there is a little slower return to action than for another position player, but his overall short-term prognosis is quite good.
Ellis did have a meniscal procedure on the same knee in 2012, and in his role as a catcher may be more susceptible to long-term knee issues, particularly cartilage wear. For now, however, the Dodgers can look forward to his return sometime in May.
Mark Teixeira, 1B, New York Yankees, (right hamstring): Teixeira left Friday’s game in the second inning with the hallmark “I hurt my hamstring” sign, pulling up his stride and reaching back instinctively to the back of his thigh as he tried to get to first base.
While the injury was described as a Grade 1 strain by the team, indicating it is minor, the Yankees are taking no chances on allowing it to get worse. Teixeira may only miss the minimum -- or slightly longer -- but the bigger concern may be his own apprehension with regards to his previous wrist injury. Teixeira appears to still be finding his swing coming off last year’s surgery to repair a torn tendon sheath in his right wrist. Maybe removing him from play for a couple of weeks will allow him to regroup on both counts.
Joe Saunders, SP, Texas Rangers (left ankle): Is it possible the Rangers have sustained yet another injury? For Saunders, the good news is that this is not an injury to his throwing arm, nor does it look to be a long-term concern. Saunders was hit by a comebacker, leaving him with a bruised and swollen ankle.
A balky ankle would throw off his pitching motion and make fielding difficult, so the DL stint (retroactive to April 5) makes sense.
David Robertson, RP, New York Yankees (groin): Robertson suffered a minor groin strain Sunday, and the Yankees have proactively placed him on the DL. While the injury does not appear serious, the groin -- part of the core musculature -- is critical for stability to pitchers who spend most of their time in a one-legged stance. An injury here, even a minor one, can lead to compensations, which can in turn lead to arm problems. It's better to rein him in now and allow this to improve, rather than take any chances at risking something bigger.
In honor of the 2013 MLB All-Star Game and accompanying festivities at Citi Field in New York City this week, it’s time once again to compile a roster of All-Injured All-Stars. Members of this roster are selected from:
a. Players who were chosen for this year’s All-Star game but could not participate due to injury
b. Past All-Stars who might have had the potential to earn another trip in 2013 were it not for the injuries that beset them this year.
Just as was the case in 2012, this year’s list offered multiple options at nearly every position in both the American and National Leagues. In other words, there is no denying the impact of injuries on the game. Not everyone who could possibly qualify is listed. Some are making a repeat appearance after making this list last season (a dubious distinction denoted with an asterisk). The selections here, just as with the actual All-Star roster, are debatable. But as the manager of the injury roster, the selections are at my discretion.
And now, I hereby present the 2013 All-Injured All-Stars.
Brad Penner/USA TODAY Sports Ryan Howard's health likely will be an issue for the next few years.
1B: *Ryan Howard, Philadelphia Phillies: Howard made the 2012 All-Injury roster as he was recovering from an Achilles tendon repair, a recovery slowed by setbacks in the spring. This year, the three-time All Star started the season on time but was placed on the DL on July 6 with a meniscus tear. Howard underwent surgery and is projected to be out for six to eight weeks (the Phillies hope to have him back and playing with the club in that time frame), a reasonable projection if all goes well with the rehab process. Still, the Achilles rupture and the meniscus injury have both been on Howard’s left side, which raises the level of concern about how that leg will treat the 33-year-old going forward.
2B: Aaron Hill, Arizona Diamondbacks: Although Hill has technically returned from the DL, there is little doubt that his injury derailed the All-Star second baseman’s season after a solid start. That too, the injury is not completely out of the picture. Hill sustained a nonunion fracture in his hand after being hit by a pitch. Ultimately, he was given clearance to try to play through it if the pain didn’t limit him. He has been able to do so, although the team is taking precautions to have him avoid overusing it. The risk remains that it could be aggravated during the course of the season and force him out of the lineup again.
SS: Rafael Furcal, St. Louis Cardinals: Last year at this time, Furcal was making an appearance in the All-Star game; this year he has not made an appearance in a major league game. After spraining his ulnar collateral ligament, Furcal tried to go the conservative route, but during spring training this year, his elbow failed him. After undergoing Tommy John surgery and spending the rest of this year rehabbing the elbow, Furcal hopes to return next season.
3B: Aramis Ramirez, Milwaukee Brewers: Ramirez has been plagued by a problematic left knee since the spring. The Brewers have attempted to manage the problem by giving him intermittent days off. The challenge with the knee sprain, sustained back in March, is that if there is any residual instability (which there appears to be, based on how his knee has behaved), it can easily become aggravated by an awkward movement that causes the knee to give way, such as a diving defensive play, a quick directional change or a slide while running the bases. Despite his attempt to play regularly through the injury, the All-Star third baseman has been limited at times by the knee and recently aggravated it to the point of requiring a second DL stint. In fact, teammate Ryan Braun was brought off the DL a few days sooner than expected when it became clear Ramirez would be heading back. The symptoms from this latest episode will likely settle fairly soon, and Ramirez should be able to then increase his activity and return to the lineup. But what the two trips to the DL along with the controlled management of his playing time tell us is that we can expect the uncertainty around Ramirez and his knee to continue throughout the season.
C: Yadier Molina, St. Louis Cardinals: We’re cheating a little bit by placing Molina here since it appears he will play in the All-Star game, despite the threat of injury. Molina’s knee began to bother him about a month ago, suddenly worsening last week and making it difficult for him to run. An MRI revealed no structural damage and after a few days rest, Molina returned to the lineup this weekend, seemingly without issue. It’s hard to imagine that an injury that has plagued him for the better part of a month would suddenly have disappeared, especially for a catcher whose job demands take a toll on the knees. It’s terrific that the National League’s leading vote-getter will be there for the fans. Let’s hope it doesn’t mean he won’t be there for them later this season.
Kamin-Oncea/USA TODAY Sports After missing very few games early in his career, Matt Kemp has dealt with DL stints each of the past two seasons.
OF: *Carl Crawford and *Matt Kemp, Los Angeles Dodgers; Justin Upton, Atlanta Braves: Crawford seemed to bounce back this season after spending most of 2012 on the DL, first for lingering wrist pain and weakness following offseason surgery, then for a torn ulnar collateral ligament that ultimately required season-ending Tommy John surgery. The injury bug appeared to be in the rearview mirror in 2013. Unfortunately, that changed in June when Crawford suffered a hamstring injury that sidelined him for several weeks. Just a week removed from the DL stint for his hamstring, Crawford was out of the lineup with back stiffness. Although an MRI turned up “nothing really significant,” according to manager Don Mattingly, Crawford has yet to return. At 31, it’s more difficult for Crawford to bounce back from these nagging types of injuries, making it more of a worry that the hamstring or the back -- or both -- could be problematic for Crawford for the remainder of the season.
Kemp’s performance in 2013 wouldn’t have earned him a spot on the All-Star team this year, even if he were healthy, but his talent has made him a regular in years past. Last year, a hamstring injury that flared up as soon as he returned from his initial DL stint caused him to miss more time than he ever had in his major league career. Now he is set to challenge that statistic this season with consecutive DL appearances for different injuries (a hamstring strain on the opposite side of last year’s injury followed by AC joint inflammation in his post-operative shoulder). The injuries only compounded the rough start Kemp was experiencing following his offseason labral repair. It always seemed likely that Kemp would improve in the second half of this year as he rediscovered his power swing. Now the hope is that he can simply be healthy enough to have the opportunity to do so. As of now, the end of the month appears to be the target for Kemp’s return, and the Dodgers are hoping to see the pre-2013 version of their star outfielder.
The entire Braves outfield is hurting right now, but it is Upton who has the most All-Star appearances of the three, hence his name at this position. Upton strained his calf muscle, but by all accounts, it sounds minor and he could return within the week.
SP: *Roy Halladay, Philadelphia Phillies; *Chris Carpenter, St. Louis Cardinals: Is it a coincidence that these two are repeat honorees? Probably not, especially given that their situations last year portended greater concern for their health heading into this season.
In 2012, Halladay was sidelined with a strained lat, an injury he was able to return from in just under two months. This year, when his performance suffered in an eerily similar manner to last year, Halladay was quicker to acknowledge there was perhaps an underlying physical problem. Indeed, Halladay was dealing with damage to his rotator cuff which required surgery to repair. After undergoing surgery, Halladay has embarked on an intensive rehab program. He has made it clear that he hopes to return this year, although it is not likely to be before September.
Carpenter underwent thoracic outlet surgery in 2012 to alleviate nerve compression that was causing weakness and pain in his throwing shoulder and arm. Surprisingly, he recovered well enough to rejoin his team for the postseason, but he did not pitch like his usual self. After taking some time to re-evaluate whether he even wanted to return to baseball, Carpenter dedicated himself to a focused rehab process … again. Despite several setbacks along the way, he is nearing the point where he could contribute to the Cardinals’ stable, as a starter. Carpenter is set to begin a rehab assignment Monday, according to the St. Louis Post-Dispatch, which could pave the way for a late-season return.
RP: J.J. Putz, Arizona Diamondbacks: Technically, Putz has returned to his major league team after missing extensive time due to injury. An exception was made to include him in the list because he isn’t truly back yet, as evidenced by some of his lingering struggles. A sprain of his ulnar collateral ligament in his throwing arm had the former All-Star sidelined for virtually all of May and June. Shortly after returning, Putz blew a save, leaving us to wonder whether he had really fully recovered or whether he was just rusty. For now, he is operating in a support relief role, but the big question is whether he can pitch on a regular basis without any recurring elbow pain.
1B: *Kevin Youkilis, New York Yankees: Youkilis wasn’t going to make this year’s All-Star team, but he’s certainly made enough of them in the past to warrant making this All-Star roster. Hip and back problems have limited Youkilis intermittently for years, and this time, his back would not let him get comfortable. He ultimately had to go the route of back surgery in June and is expected to be out for approximately three months. It’s worth noting that the recovery timetable following this procedure is very fluid, so any setback could throw off that schedule. Despite his age (34), Youkilis is taking a chapter out of teammate Derek Jeter's book and expects to come back, although it remains to be seen whether he’s able to do so this year.
2B: Omar Infante, Detroit Tigers: After getting taken out by a hard slide in a game in early July, Infante’s injury was initially called a contusion. It was later announced that he had sprained his ankle, and Infante was placed on the DL but was expected back immediately following the All-Star break. Now it appears the ankle is recovering a little more slowly than expected, and manager Jim Leyland cautions that Infante may require a little more time. While this doesn’t have the sounds of a particularly serious injury, Infante still needs to move well enough to make defensive plays in addition to running the bases. A few extra days now will translate to a smaller likelihood of lingering problems in the second half.
Elsa/Getty Images Derek Jeter has played just one game this season, and he was hurt in that one.
SS: Derek Jeter, New York Yankees: No matter how hard he tried to return to the lineup to start the season, it just wasn’t meant to be for Jeter. After undergoing surgery to stabilize his fractured ankle last fall, Jeter appeared on track with his progression until pain during spring training interrupted his running program. Imaging studies revealed a second small crack, and Jeter’s program was put on hold to allow the bone to heal. As the bone healed to the point where he could resume running, Jeter progressed rapidly through his rehab progression. In fact, he progressed so well that the team opted to have him return prior to the All-Star break. He lasted less than one complete game.
During his first game back, Jeter’s 39-year-old quadriceps muscle tightened up on him, and he was forced out for the day. The Yankees are hopeful that this represents only a minor setback for the veteran given that it is a Grade 1 (mild) strain. After some rest and a few days to recover, it’s possible he could be ready to go after the break, although the Yankees may ease him back with alternating days off and DH usage.
3B: Alex Rodriguez, New York Yankees: It’s not surprising that the multiple-time All-Star is on the DL at this point. When he underwent January surgery to repair the labrum in his hip, Rodriguez was expected to be out until after the All-Star break. Still, it was uncertain whether his rehab would proceed smoothly and allow him to be on track for a July return. Minus the distractions associated with both the Biogenesis scandal and his recent rehab status updates on Twitter, Rodriguez has experienced a fairly smooth recovery. The last physical hurdle he needs to cross before rejoining the Yankees is a complete rehab assignment, and he is well on his way. On Monday, he graduated to Double-A Trenton as part of his progression towards major league competition. According to the New York Post, Rodriguez says his legs “feel good” and the plan, as he understands it, is to rejoin the team July 22. Although he hasn’t shown much at the plate thus far -- after being out of baseball for the bulk of the last nine months -- the rust is not surprising. While his physical condition is improving, there may be other hurdles -- other than of his hip -- which prevent him from contributing for the remainder of this season.
C: Francisco Cervelli, New York Yankees: Admittedly, Cervelli is a reach here as he has never been an All-Star. But with no one else really competing for a slot, he gets the nod as the starting catcher. Cervelli has been on the DL since late April after suffering a fracture in his right hand, which required surgery. (Incidentally, the Yankees seem to be leading the league in hit-by-pitches resulting in fractures among starters.) After finally recovering enough to take batting practice, Cervelli was just shut down again due to a stress reaction in his right elbow. It now looks like he will be sidelined until August, and it’s hard to imagine him being effective immediately after being limited from baseball activity for so long.
OF: Melky Cabrera, Toronto Blue Jays; Curtis Granderson, New York Yankees; Shane Victorino, Boston Red Sox Oh, what a difference a year makes. At this time in 2012, Cabrera was the All-Star Game MVP, and his performance helped secure home-field advantage for his team at the time, the San Francisco Giants, in their World Series appearance. It was a World Series that Cabrera would end up not participating in, due to the fallout from his suspension for testing positive for PEDs. Cabrera then switched leagues in the offseason when he signed with the Blue Jays. This year, he finds himself on the DL with what is being called left knee tendinitis. The good news is that he has begun a rehab assignment and should be able to rejoin his team shortly after the All-Star break, barring a setback. After going from the highest high to the lowest low last year, then following it with injury this year (which, so far, appears to be minor), Cabrera has to be ready to turn the page in the second half.
Granderson can’t catch a break this year. Or, maybe he can actually do it a little too well. After starting the season on the DL with a wrist fracture sustained when he was hit by a pitch during spring training, Granderson made his season debut in May. It was short-lived, however, as Granderson lasted just days before sustaining another fracture, also the result of being hit by a pitch. This time, he sustained a break to a bone in his hand that required surgical stabilization. For a while, Granderson struggled to grip the bat, and his progress back to baseball activities was slow as a result. As of now, he has begun taking swings but still needs to return to batting practice before a rehab assignment is even in the picture. Granderson still appears to be a few weeks from rejoining the team, and even then, some apprehension about exactly what he can deliver at the plate -- at least initially -- is justified.
Victorino has been in and out of the Red Sox lineup for much of the season with some variant of low back, hip or hamstring pain, which all seem interrelated, per manager John Farrell. The problem with this complex injury is that, as it moves around, it becomes more difficult to treat and slower to resolve. It’s just as well Victorino isn’t part of the All-Star festivities as his body can certainly use the rest. Given that Victorino has already missed a month’s worth of games this season combined with the fact that this problem has not gone away, there is definitely reason to be worried about how his body will hold up for the second half.
Ron T. Ennis/Fort Worth Star-Telegram/Getty Images Yu Darvish won't pitch in the All-Star game, but will he be able to go when eligible next week?
SP: Yu Darvish, Texas Rangers; Clay Buchholz, Boston Red Sox: Darvish would have been a fan favorite in this year’s All-Star Game, and matchups between him and some of the NL's heavy hitters would have been eagerly anticipated. Unfortunately, those matchups won’t be happening because of Darvish’s recent placement on the DL with an upper back strain. He has struggled with giving up runs in recent outings, and the team is describing his ailment as fatigue in his upper trapezius. It’s not your typical diagnosis, and it suggests he is experiencing associated neck or upper back stiffness. The question is how long the injury has been bothering Darvish and whether his performance of late can be attributed, at least in part, to his health. While the Rangers sound confident that he will return when eligible on July 22, consider that Red Sox ace Clay Buchholz is reportedly dealing with a similar problem and has been out for over a month. It may not be quite as benign as the team is making it out to be. We won’t really know much until Darvish tries to resume throwing.
Speaking of Buchholz, he started off the season in spectacular fashion, but that came to a crashing halt after an odd injury sidelined him in late May. Buchholz claimed an awkward sleeping position resulted in soreness in his AC joint. Within a week, the problem evolved into a neck issue that was not initially considered serious, but Buchholz has yet to return. In fact, he has yet to make a rehab start; that has been delayed until after the All-Star break. The expectation is that Buchholz will be ready to return by late July, but his recovery process has not been smooth. Until he is able to return to competition and string together consecutive starts, there remains some concern.
RP: Jesse Crain, Chicago White Sox: Oh, the injustice. Crain was named to his first All-Star game only to be sidelined with an injury to his throwing shoulder. Crain was placed on the DL in early July after experiencing tightness in his right shoulder while warming up. The soreness continues to linger when Crain attempts to throw, but it’s unclear just how serious the team thinks this particular episode is. Crain does have a history with his shoulder, having undergone surgery several years ago to address rotator cuff and labral damage. It’s never encouraging to hear about problems resurfacing in a thrower’s shoulder, but it’s too soon to establish whether this is a minor incident that will resolve itself with rest or the beginning of a decline.
Jason Szenes/Getty Images Mark Teixeira finishes the season hitting just .151 with three homers and 12 RBIs in 15 games.
Mark Teixeira, 1B, New York Yankees: From the time Teixeira suffered a partial tear of a tendon sheath in his right wrist this spring, the concern was not only whether he could recover enough to return to play, but whether that recovery would prove temporary. He did eventually return to play, but lasted only 15 games before the discomfort in his right wrist proved too much to overcome. Beyond any pain associated with the inflammation in his wrist, Teixeira was not able to swing at full strength when hitting from the left side of the plate, not surprising given the torsion the right wrist is subject to during that motion.
The tendon sheath serves as a layer of protection for the tendon it surrounds, shielding it from friction against the adjacent bony surface. The tendon, the extensor carpi ulnaris, contracts to move the wrist in the desired direction and helps provide stability during a swing. While the sheath does not contribute to wrist function directly, it is critical to safeguarding the tendon. Damage to the sheath, depending on the location and extent of it, can result in pain, inflammation and, in some cases, instability of the tendon as it can move out of position with extremes of wrist motion. All of these issues can result in a sensation of weakness or loss of power, something Teixeira indicated he was experiencing.
The good news for Teixeira is that he has to look no further than within his AL East division to see a fellow player who has successfully returned following similar surgery. Toronto Blue Jays outfielder Jose Bautista underwent surgery in September and by January was hitting in a cage. Bautista started the season on time and has had no issues with his wrist thus far. While no two surgeries are identical and a projection will be better formulated following Teixeira’s operation, he can be optimistic about his chances of full health for the 2014 season.
Mike Janes/Four Seam Images/AP Images Dylan Bundy probably won't be ready to pitch until later in the 2014 season.
Dylan Bundy, P, Baltimore Orioles: In May, Bundy experienced a setback while on a limited throwing program following his initial incidence of elbow discomfort in April. At that time, Bundy was seen by Dr. James Andrews and received a PRP (platelet-rich plasma) injection. The hope was that it would allow him to return to function but the outlook was uncertain at best. Despite an MRI that showed “no significant structural damage,” the detection of function-limiting ligament wear is limited at best. In actuality, it is the player’s own signs and symptoms that best dictate just how serious an ulnar collateral ligament injury is. Whether it manifests as pain, stiffness, a drop in velocity, a loss of command or some combination therein, the pitcher’s inability to throw effectively is what ultimately removes him from the mound, regardless of how muted an MRI finding might be.
This appears to have been the case with Bundy, who went through the normal course of treatment -- mostly rest and rehabilitation, along with an injection in the second phase -- in an effort to retain his season. Unfortunately, Bundy’s arm dictated when his season would end, which, it turns out, was before it ever really got started. Now he faces a long road back following reconstructive surgery, but he will do so with the confidence of a healthy elbow. Bundy may not pitch in games before the second half of next year, but given the high level of success following surgery, his outlook now is more promising and more predictable than it was in April.
All projected return timelines should be considered fluid.
It certainly seems that is the case now. Teixeira was removed from Saturday's game in the fourth inning, not so much because of a specific incident that aggravated the injury, but because of continuing discomfort and weakness. According to ESPN New York, an MRI on Sunday revealed inflammation in the area, but no new tear. Teixeira received a cortisone shot and will sit out for a few days. No move to the disabled list is specifically planned, though it has not been ruled out.
The bigger issue for the Yankees is what they can expect from Teixeira going forward. Manager Joe Girardi's comments from Saturday evening were very telling. "He came to us and said he just feels like there's not a lot of strength there," Girardi said. "I think he just doesn't feel he has the whip that he normally has hitting left-handed." Since the injury is to Teixeira's right wrist, the strain on the injured sheath is greatest when he bats from the left side of the plate, which is also how he hurt himself in the first place. If his strength is impaired and the wrist remains irritated months after sustaining the original injury, not to mention after having nearly two full months off, it's hard to envision it improving significantly now. It's possible the "S" word (surgery) could start to enter the conversation.
After getting hurt Sunday while trying to steal yet another base, Cabrera has been scheduled for further evaluation of his left hamstring. Although the results have not yet been reported, Cabrera had the sound of someone who knew from prior experience that this was not good. According to the Padres' official website, Cabrera said, "I knew something was wrong right away. I have experience with hamstring problems, and this one is unfortunate." Fantasy owners should be prepared for a DL stint.
According to the Washington Post, manager Davey Johnson said he expects Harper to test the knee with some on-field activities early in the week, then potentially begin a rehab assignment later in the week. Of course, everything depends on how Harper's knee responds to the uptick in work. If all goes well, it sounds like the Nationals could be eyeing a return in the not-too-distant future, but considering Harper's path has been a little bumpy so far, no timetable can be set in stone.
Kemp looked as if he was inching closer to rejoining his teammates when he did some pregame running work with them last weekend. He was still experiencing symptoms, however, which led to the Dodgers pushing back more aggressive activity. A rehab assignment date remains fluid, although it could begin late this week if Kemp is showing signs of progress.
There is little doubt that Kemp's major setback to his opposite hamstring after trying to return too soon last year is likely causing some apprehension this time around. And his performance at the plate certainly hasn't been encouraging. Fantasy owners should not plan on having Kemp available this week, and even if next week starts to look like a possibility, it might be worth waiting to see how he performs first.
It sounds as if the Brewers expect him to resume playing in the presence of the symptoms, even if they remain unresolved when the DL window is up. The only problem there is that even if they don't expect the injury to worsen, there's no guarantee his power at the plate will return, at least on a consistent basis. Braun acknowledged that the thumb was bothering him enough to affect his performance, even after trying to make adjustments to his grip. It sounds as if Braun might return when eligible, but whether he's the Braun fantasy owners have come to expect is anybody's guess.
When it was discovered that Hill had a non-union fracture in his hand, the plan became to try to progress his activity to see how well he could function despite the condition and any associated discomfort. So far, so good. Good enough, in fact, for the Diamondbacks to allow Hill to progress from a simulated game to a rehab assignment with Triple-A Reno. Hill played seven innings Saturday for Reno and will be in line for more innings early this week. It is not clear how many rehab games he will require before he's ready to return to his team, but there finally appears to be hope that it could come soon.
Fantasy owners should keep in mind that he will not be 100 percent recovered from the injury, although he might be able to function at or close to his normal level. There is the possibility the hand could become painful again at any time, and Hill may still require an offseason procedure. For now, however, it just comes down to whether he can do enough to contribute to the team. It sounds like we shall soon see.
Utley's strain was originally diagnosed as a Grade 1 (mild) type, but the Phillies have been understandably cautious, not wanting him to exacerbate the injury and have it turn into something more severe. If he returns this weekend, it will mark just about a month since the injury or just under the average length of DL stay for an oblique strain. Given that his injury was minor, there is a good chance that it will be completely behind him when he does make his return.
The normal focus heading into any game is who is in the starting lineup. But this year is anything but normal, especially for the Yankees, when it comes to starting lineups. Injuries have hit the Yankees so hard in the offseason, with a couple scares early in the season too, that their DL roster could be confused with a starting lineup. Since many Yankees stars will be out for Wednesday's game against the Indians (7 p.m. ET, ESPN2 and WatchESPN), it seemed appropriate to provide some quick updates on their collective road to recovery.
Curtis Granderson, OF (injured Feb. 24, due back mid-May): Even Granderson was surprised when the "bruise" from a J.A. Happ fastball in a spring exhibition game turned out to be a fracture. Granderson has remained focused on conditioning ever since so that once the healing in his arm permitted it, he would be able to get baseball-ready in short order. Manager Joe Girardi says Granderson could hit soft toss or off a tee as soon as this weekend, keeping him on track for a mid-May return.
Mark Teixeira, 1B (injured March 5, due back in May): Teixeira hopes he will avoid the fate of Blue Jays outfielder Jose Bautista, who also suffered a partially torn tendon sheath, which ultimately required surgery. Teixeira's right wrist was immobilized after his injury in the hopes that the sheath would heal itself, and he says he did not experience any instability of the tendon itself -- something Bautista did feel, which led him to surgery. All reports of Teixeira's progress have been excellent so far. On April 1, he was permitted to remove the brace (other than for workouts), and he has been focusing on strengthening exercises for his wrist and forearm. He still has not been cleared to swing a bat, and doing so, especially from the left side -- the side he bats from primarily and also the way in which he was originally hurt -- will be the ultimate test. Even if the early swings are uneventful, the big challenge will be when he returns to hitting in a game situation, going all out on his swing repeatedly. Teixeira hopes he can return by the start of May, but there will be no rush. After all, if the sheath re-tears or he proves unable to function at the plate, he will find himself following in Bautista's footsteps into the operating room.
Alex Rodriguez, 3B (estimated back around All-Star break): There hasn't been much to report on Rodriguez because, well, he has remained mostly hidden from view. When he did emerge to meet the media on Opening Day, Rodriguez merely confirmed that he was dedicating himself to the rehab of his surgically repaired left hip. He was guarded about his progress, saying he was in "Stage 1" of his recovery. Based on the surgical procedure to address hip impingement along with a labral repair, it is reasonable to expect Rodriguez to be ready around the second half of the season. But until he is participating in baseball activities and approaching minor league games, it's too early to make any definitive claims.
Pitchers:Phil Hughes, SP (returned April 6): After a bulging disc in his back derailed Hughes' spring, the Yankees were just glad to have him back the first week in April, even if the outing was unspectacular. Perhaps they are happier that he appeared to suffer no physical setback and is in line to take the mound again Thursday.
Hiroki Kuroda, SP (no missed time): This is what you call dodging a bullet. Kuroda was hit by a line drive on the middle finger of his pitching hand, fortunately sustaining no break in the bone but a scare nonetheless. There was concern whether he would be able to make his subsequent start, but Kuroda pitched Monday, pain and all. At least the Yankees avoided sending yet another key player to the DL.
Michael Pineda, SP (surgery May 2012, due back June/July): Pineda's debut season with the Yankees went exactly the opposite of how everyone envisioned it and ended abruptly with him undergoing surgery to repair a torn labrum. The rehab has been long and arduous, and Pineda has used the time to get in better physical shape, something he unquestionably needed to do. While there are never any guarantees as to how a pitcher will perform following shoulder surgery, recent signs of Pineda's recovery and his young age are encouraging. He has been throwing bullpen sessions, even incorporating breaking pitches in the past month. He still has a ways to go before he can definitively return to healthy status, but there is reason to be optimistic he will contribute in the second half.
Meanwhile, in the Indians training room ...
I certainly couldn't leave Cleveland completely out of the conversation. While the Indians can't compete with the Yankees when it comes to starters on the DL, they do have one injury concern.
Carlos Santana, C (DTD): Santana bruised his left thumb Monday when he absorbed a fastball from Chris Perez. X-rays came back negative, but given that the impact was such that even Santana thought he broke it initially, don't be surprised if he's out for a few days.
With the regular season just about to start, here's a list of notable injury situations and their timetable for a return. Fantasy owners can and should adjust their lineups or draft strategies accordingly.
1. All projections reflect expectations as of March 29 and should be considered fluid after that date.
2. Opening Day ready = Expected to be "active" on Opening Day, not necessarily in lineup on Opening Day. For pitchers, first game depends on where slotted in rotation.
Brett Lawrie, 3B, Toronto Blue Jays (due back April): Intercostal strain will sideline him into the first week or two of the season, but a cautious return should help prevent a setback. Bigger concern is tendency to play with reckless abandon. Fun to watch, but may increase risk.
Pablo Sandoval, 3B, San Francisco Giants (Opening Day ready): An irritated ulnar nerve forced Panda to rest for several days in March, but he claims he's ready to return. I admire his enthusiasm but can't say definitively that this is behind him.
Chase Headley, 3B, San Diego Padres (due back late April): Left thumb fracture will delay Headley's regular-season debut by about a month. The good news is that it shouldn't hinder him after he returns.
Curtis Granderson, OF, New York Yankees (due back mid-May): No surgery needed for Granderson's small fracture. No reason to worry about his ability to produce once he returns to the lineup.
Hanley Ramirez, SS/3B, Los Angeles Dodgers (due back mid- to late-May): Ramirez will miss a couple months of playing time following surgery to repair his torn thumb ligament. The concern is that his performance at the plate could suffer a bit longer.
David Freese, 3B, St. Louis Cardinals (due back April): His back injury doesn't appear serious, but the Cardinals want Freese to see more at-bats before his regular-season debut. Recurrence is possible, but the minor nature of this episode keeps the worry factor low.
Derek Jeter, SS, New York Yankees (due back April): Jeter's post-surgery soreness is not unusual. In fact, it will likely take a few months for his ankle to feel normal again. He may return in April but he may not really return until June.
Mark Teixeira, 1B, New York Yankees (due back May/June): A partially torn tendon sheath is what Jose Bautista had ... and then he had surgery. Teixeira's wrist may heal with rest, but if it doesn't, the power on the left side of the plate won't be there and he may not last long, either.
Corey Hart, 1B/OF, Milwaukee Brewers (due back May): The key to Hart's post-surgical knee staying healthy is not returning too soon. The team has been good about controlling his activity thus far, so don't expect them to rush him now. Late May is the most likely scenario.
Brian McCann, C, Atlanta Braves (due back April/May): He's recently returned to hitting, but restrictions on McCann's post-labral repaired throwing shoulder remain in place. Once he returns, it may take a bit to ramp up, but look for a strong second half.
Alex Rodriguez, 3B, New York Yankees (due back around All-Star Break): If he's rehabbing as diligently as he says, Rodriguez should be poised for an uneventful return. The hip may be healthy, but he's still an aging player with mounting injury concerns.
For a more thorough progress report of pitchers returning from injury or surgery, see this blog entry.
Jaime Garcia, St. Louis Cardinals (Opening Day ready): He opted for rehab instead of surgery for a small (left) rotator cuff tear and has been fine through a handful of spring outings. Starting season strong, but will he last?
Roy Halladay, Philadelphia Phillies (Opening Day ready): Halladay insists there's no injury, but his performance this spring is a concern. Last year he said there was no injury, either. Then he went on the DL and missed nearly two months. This could be the start of the talented veteran's decline.
C.J. Wilson, Los Angeles Angels (Opening Day ready): Underwent arthroscopic surgery in October to address a bone spur and has had no issues with the elbow this spring. Consider this: He's had only two DL stints in his big league career. Aging but durable. Low level of concern.
Phil Hughes, New York Yankees (due back early April): A bulging disc in his back derailed Hughes' spring. He has bounced back quickly, but let's face it, injuries are always going to be a concern with Hughes.
Matt Garza, Chicago Cubs (due back May): Ended last season with stress fracture in right elbow, started this spring with strained lat. Sum total of injuries raises concern.
Shaun Marcum, New York Mets (Opening Day uncertain): Elbow issues last year, now shoulder and neck this spring. Don't like where this is headed. Even if he avoids the DL now, it may only be a matter of time.
Brandon Beachy, Atlanta Braves (due back June/July): On track post-Tommy John surgery. No major concerns, just temper expectations to the typical ups and downs of the first year back.
Relief PitchersJason Motte, St. Louis Cardinals (no timetable, expected to start season on DL): Diagnosed with a "small" tear in his flexor tendon, Motte is reportedly feeling better. He will have to prove he can throw without pain before returning, then hope the injury doesn't worsen across the season.
Ryan Madson, Los Angeles Angels (due back April): After Tommy John surgery last April, Madson is closing in on a return. But the normal inconsistencies that a pitcher first displays after this operation -- and a guy named Ernesto Frieri -- suggest Madson isn't a lock to close.
Casey Janssen, Toronto Blue Jays (Opening Day ready): After November surgery on his AC joint, a slow spring initially threatened Janssen's Opening Day status. He's recently turned a corner but there's still a bit of concern about how an uptick in work (think: frequency) will affect him.
The biggest challenge with a calf injury is running. It gets particularly tricky a few days after a minor injury when an athlete starts to feel better walking around, fielding and hitting. But the big test is explosive running. Generally, the signature move is driving out of the batter's box on the way to first, not surprisingly where [he] suffered the injury in the first place. The muscle contracts hard to advance the weight of the body when pushing off to run, particularly during the first few steps of sprinting. The concern, naturally, is having a minor injury become something bigger.
And now the minor injury has become something bigger. New York Yankees first baseman Mark Teixeira, who initially strained his left calf muscle on Aug. 28, aggravated it his first night back in the lineup and is expected out for at least another 10-14 days.
The introductory paragraph was not written at the time of Teixeira's original injury, although it easily could have been. No, that paragraph was excerpted from a blog post in June 2011 about Teixeira's teammate, shortstop Derek Jeter. Jeter, like Teixeira, injured his calf coming out of the batter's box, and Jeter also suffered what was termed a grade one, or minor, strain. Jeter's injury happened in midseason, however, and a stint on the DL, albeit a reluctant one on Jeter's part, ensured he would be out for at least two weeks. In fact, he missed three.
Teixeira's injury came just as the Yankees found themselves entering the final month of the regular season in a division title race. Teixeira had expressed frustration with the timing of the forced absence as much as with the injury itself. As he felt the calf improving, he was eager to rejoin the lineup and contribute. In what might be considered a bit of a foreboding note, Teixeira acknowledged after first testing his leg running the bases during rehab that he was not yet 100 percent. As he told the New York Post, "game speed and practice speed is a little different anyway. It's really tough to ever fully go out practicing." Precisely.
When Teixiera had to go at game speed, he didn't have quite what he needed in his leg. On what turned out to be a game-ending double play in his first game since the initial injury, Teixeira hurt the calf trying to beat out the throw to first base. It was hard to know whether Teixeira was more upset by the way the game ended or by the aggravation of the injury, but he made it clear his leg was not cooperating. According to ESPN New York's Andrew Marchand, Teixeira said he was not "even close" to 100 percent. He underwent an MRI on Monday and consulted with the Yankees' team doctor, Chris Ahmad. The Yankees are calling Teixeira's injury a grade one (minor) strain, but given that he has already suffered one setback after 10 days' rest, his return may be slowed. If the Yankees are in the postseason mix, they will need a healthy Teixeira who can run full speed and round the bases without hesitation. And a second setback could potentially eliminate his availability for the entire year.
In other words, it would not be surprising if Teixeira remains out the rest of September. The Yankees hope they will all be playing together in October.
It may be the trade deadline in baseball, but there is certainly no cutoff for injuries. Another week in baseball yields another set of ailments.
• After losing third baseman Alex Rodriguez for more than a month to a broken bone in his hand, it would have been a huge blow for the New York Yankees to lose their other corner infielder for an extended time. Thankfully for them, it appears that will not be the case.
First baseman Mark Teixeira gave the Yankees quite the scare when he developed pain in his left wrist, first on a swing and a miss Sunday night before further aggravating it during a diving play Monday, according to ESPN New York's Andrew Marchand. Initial X-rays were negative, and an MRI on Tuesday revealed no specific structural damage, just inflammation, according to the team. Teixeira received a cortisone injection and will be re-evaluated in three days.
In the absence of a specific structural issue, which is more likely to be soft tissue (tendon, ligament, cartilage) than bone given the mechanism of injury, the primary concern is the presence of any fluid in the joint that takes up space in an already compact area. The fluid can block normal motion of the joint, causing pain. It's worth noting the injury is to Teixeira's left wrist and that he first felt the pain when batting right-handed -- similar to the Toronto Blue Jays' Jose Bautista, although not as dramatic. The wrist joint in the bottom hand is subject to far greater movement toward the pinkie or fifth finger side during a bat swing than the top hand. (The motion is known as ulnar deviation because the hand is deviating toward the medial forearm bone, the ulna.) Any decrease in available motion in this direction, whether due to inflammation or tissue damage, can cause sharp pain when swinging the bat, particularly near full extension.
In Teixeira's case, the hope is that the cortisone and a few days of rest will resolve the wrist inflammation and that he will be able to resume swinging a bat soon. It appears there will be no potential move to the disabled list until Teixeira has a follow-up evaluation.
• The display of flexibility by Pablo Sandoval last Tuesday as he performed a full split to complete a double play at first base was an awesome sight, until he stood up. Sandoval was clearly uncomfortable as he gingerly walked off the field. An MRI confirmed a left hamstring strain, and the team was initially hopeful that a few days of rest would do the trick. But as is often the case with these injuries, a DL stint was determined to be the best course of action to prevent this from lingering into potential pennant race time in the National League West.
The good news is he has already been spotted playing catch, and it doesn't appear as if this injury will keep him out for an extended time. Sandoval already missed more than a month this season after surgery for a broken hamate bone in his left hand. Still, hamstring injuries being what they are, the only way Sandoval will know it's behind him is once he has returned to play successfully without a setback (see Matt Kemp of the NL West rival Los Angeles Dodgers). His first eligible date of return is Aug. 10, so expect to see him resume running in the days prior.
• Miami Marlins outfielder Logan Morrison is on the DL with inflammation in his right knee, but the big question seems to be whether he'll return this season. At least that's a question Morrison has raised, according to the Palm Beach Post.
Morrison has had chronic troubles with his knee since last year. Tendinitis in the knee led to a platelet-rich plasma injection, but persistent symptoms resulted in December surgery. Arthroscopic surgery, an option in cases where chronic changes in the patellar tendon, which anchors the quadriceps muscle to the shinbone, result in ongoing discomfort, was performed with the expectation that Morrison would be ready to participate in spring training. He did participate intermittently but was never quite 100 percent healthy throughout the spring. In fact, he has never truly appeared to have overcome the issue this season, receiving regular rest to manage the pain and balance his struggles at the plate. As for what awaits him next when it comes to treatment, it is a bit unclear. Morrison has hinted at surgery, but that is not a foregone conclusion.
No matter what the course of treatment, given that he has not been able to get past the issues with his right knee over the past six months, it would stand to reason that he will not suddenly improve in the next two. While he may improve sufficiently after some extended rest to return on a limited basis, don't be surprised if this is the last we see of Morrison in 2012.
• One guy we know won't be coming back this season is Baltimore Orioles second baseman Brian Roberts. Roberts, who has missed the better part of three seasons due to injury (2010: back, concussion; 2011: concussion; 2012: concussion, hip), will undergo surgery to address a torn labrum in his right hip. Roberts made his 2012 debut June 12 after a lengthy recovery and rehabilitation process post-concussion. Less than a month later, he sustained the injury to his hip.
Roberts attempted a rehab effort in the hopes he could return to finish out the season, but his first minor league rehab outing changed his mind. Depending on the extent of the procedure, the rehab process could take the bulk of the offseason and into the spring. There has been no suggestion that Roberts intends to end his career, but the cumulative injuries could force his hand.
TAMPA -- Spring training is a chance for teams to practice everything, including playing at night. That's what happened Tuesday when the New York Yankees played host to the Boston Red Sox, albeit at George M. Steinbrenner Field instead of Yankee Stadium. With the number of veterans in the Yankees' starting lineup, there are bound to be some durability concerns. A few have taken steps to make sure that any chatter about them this season surrounds what they do on the field, not the time they miss.
Getting Rodriguez to say much about the procedure or how he feels it has specifically impacted him proved challenging. He deferred to the doctor who performed the procedure, Peter Wehling, whom he referred to as "a very smart doctor." Rodriguez's summary of how his body feels during this spring training year came down to three words: "I feel good." How is it different this year than in the past? "All I can say", said Rodriguez, "is I feel good." Not exactly insightful commentary, but the true measure of success will ultimately be how he holds up this season. Last year Rodriguez missed roughly six weeks following surgery to address a meniscus tear in his right knee, and he also dealt with a sore left shoulder and a thumb ailment. At the age of 36, with parts of 18 seasons of major league ball under his belt, it would stand to reason that Rodriguez's body is being confronted with the physical toll of such longevity. Clearly Rodriguez is taking steps to try to ward off those effects; only time will tell whether those steps are, in fact, working.
Across the infield, first baseman Mark Teixeira is noticeably fit this spring. He says he normally loses about five pounds each offseason, but this year he has dropped about 15. He credits his diet with helping the weight "just sort of melt off" and notes that while he doesn't eat poorly during the season, he can eat much better in the offseason. "I try to eat all organic foods, nothing processed, including a lot of cold-press juices," said Teixeira. He says he considers himself blessed with only landing on the DL twice in his career and believes that eating healthy along with his conditioning is a factor. Teixeira insists that other than paying more strict attention to his diet, he hasn't changed anything about his training to prepare for the season. As he enters his ninth season in the league, it will be interesting to see how his body holds up. There's no question that he looks as healthy as ever heading into 2012.
Then there's the medical marvel of closers, Mariano Rivera, who threw 13 pitches while delivering a scoreless inning in relief and looked to be pretty much in midseason form. At 42 years old, Rivera has managed to avoid significant injury in his lengthy career, something most pitchers cannot claim to have accomplished. He has had an operative procedure on his shoulder (a relatively minor surgery on the AC joint in 2008) and has not been on the DL since 2003. He did undergo surgery this offseason, but it was to remove polyps from his vocal cords. When asked if there was any noticeable difference for him pitching during a spring game versus a regular season outing, given that he looked as comfortable as if it were July, Rivera acknowledged the subtleties of continuing to work the strike zone. While he enjoys spring training, still, Rivera said, "You have to come here to work."
The Yankees stable of "mature" players is sizeable, including the likes of shortstop Derek Jeter and pitcher Hiroki Kuroda. Their expected level of contribution indicates the team is counting on the veterans' collective ability to stay healthy. They certainly look to be in great form this spring, but when all is said and done, only time will tell.
The tragic loss of young Nick Adenhart in Los Angeles had everyone reflecting on the importance of living the dream and doing what you love. The triumphant return of Chris Carpenter to the mound for the Cardinals proved that you can come back after almost a two-year hiatus with hard work, dedication and belief that you still have it.
The sad news of Harry Kalas' passing reminds us that there are numerous folks behind the scenes whose contributions help to define the sport. Many of those folks are never seen (or heard) by the public, especially when it comes to those responsible for the medical well-being of the athletes. When it comes to keeping an athlete on the field, there are numerous doctors, athletic trainers, physical therapists and others who play a huge role but remain largely out of public view.
And on that note, here are the players I'm looking at this week in the world of injuries:
In fact, comments Lowrie made about his wrist in February seem somewhat foreboding in retrospect. In a report by The Providence Journal, Lowrie explained the decision to rest his wrist for a month in the offseason. "We decided not to do surgery just because there wasn't enough time. I probably wouldn't have been ready for spring training if I [had] had the surgery."
Lowrie went on to explain to the Journal exactly how the injury affected him at the plate. "From the left side, and I'm not one to make excuses, it really hindered my ability to swing with any sort of power. My wrist was just not strong enough to keep the barrel above the ball."
Lowrie has been returned to Boston for further testing, and a true timetable will become more apparent once the results are known. The concern here is that after an offseason of rest, Lowrie is experiencing similar pain, and there can be no doubt that it is affecting him at the plate. If several months of rest did not alleviate the problem, it's unlikely 15 days will do so, either. The question becomes what structure or structures actually are causing the symptoms, and what is the appropriate course of treatment? A non-union fracture might require surgery, but inflammation of soft tissues could be addressed with rest, bracing and anti-inflammatories. Until the condition is further explained, this remains speculative, but fans should prepare for the prospect of an extended absence from Lowrie.
Of course, the Red Sox are further incapacitated at shortstop because Julio Lugo remains on the DL as he recovers from meniscal surgery. Lugo underwent surgery on his right knee during spring training and is progressing well, but he's still likely another couple of weeks from rejoining his team.
Mark Teixeira, 1B, Yankees: Speaking of sore wrists, Teixeira has been dealing with soreness in his left wrist for several days now. Fortunately for the Yankees, Teixeira's ailment does not appear to be serious, and the hope is that rest will allow it to calm down. He has been diagnosed with tendinitis in his left wrist, apparently aggravated by batting right-handed. Teixeira suspected he initially strained his wrist when diving for a ball last week, but the inflammation then appeared to be limiting his swing.
In an effort to prevent it from worsening, the Yankees rested him for a few games, but he is expected to rejoin the lineup Tuesday. A recent MRI confirmed the absence of any major structural injury, and Teixeira told MLB.com that the stronger anti-inflammatories he has been taking recently have him feeling much better. Assuming he makes a successful return this week, this does not appear to have the makings of a significant injury.
Ichiro Suzuki, OF, Mariners: Ichiro has been recovering nicely from the bleeding ulcer that sent him to the DL to start the season. Last week, we said there was reason to believe Suzuki would return as soon as he was eligible to be activated off the DL, and it appears this will indeed be the case. He indicated he will be in the lineup when his team takes the field Wednesday, and the team no doubt will be happy to have him back.
Ichiro did not appear to have missed a beat when he made his first extended spring training start, going 7-for-10 in his first outing and appearing none the worse for wear afterward.
The good news for Ichiro and for fantasy owners is that this ulcer should not present a recurring problem. Ichiro's rapid response to treatment -- coupled with the fact that these conditions can be medically managed very effectively -- suggests a low likelihood that this will interfere with the remainder of his season.
Jesse Litsch, SP, Blue Jays: I don't like the way this looks. It began with a poor start a week ago and some forearm soreness. Then there was a second poor outing Monday, and by the fourth inning, it was clear something was wrong. Litsch signaled as much, and after a visit with the Jays' athletic trainer, he left the game holding his right arm against his body. The Toronto Star reports that the team is temporarily calling this an elbow strain, and Litsch will undergo an MRI.
This is a recipe for bad news. First of all, he followed a decent spring with two poor starts. And in addition to decreased velocity and trouble with control, Litsch also had discomfort, making this appear more serious. The pain was bad enough to force him to exit early, and the instinctive supporting of his arm by his side is not an encouraging sign. Clearly, the test results will help determine the next steps for Litsch, but brace for a likely shutdown from throwing to rest the arm.
Dewayne Wise, OF, White Sox: Even his manager, Ozzie Guillen, gave him credit for saving the game Monday. If you saw Wise's amazing play in the outfield, you probably also saw him cringing in pain afterward. As Wise extended his arm to steal a hit from Ramon Santiago, potentially saving three runs, he rolled awkwardly onto his right shoulder, separating it. An acromioclavicular (AC) joint separation, as this is called, is a sprain of the ligaments that stabilize the clavicle, or collarbone, with the acromion, the bony tip of the shoulder blade. That AC junction forms the outermost point of the shoulder, and injury to the ligaments there makes it painful to move the arm, particularly across the body or overhead.
Wise has been placed on the DL with what the Chicago Tribune is reporting as a Grade III (complete) separation, and according to the White Sox's Web site, Wise is expected to miss anywhere from six to eight weeks while the ligaments heal. He will initially be placed in a sling to support the painful shoulder and will then work on regaining his range of motion and strength. The most challenging element will be regaining the strength to make a long throw from the outfield. This is not typically an injury that requires surgery, although it can come to that for some "overhead" athletes, particularly if they continue to experience weakness or discomfort as they return to throwing.
Although the team certainly expects to have Wise return to the lineup this season, his rehab process bears watching to see how he progresses once he is allowed to resume throwing.
Brian Moehler, SP, Astros: He certainly didn't have a great start to the season, yielding seven runs on eight hits in his first outing. And the news only gets worse from there, as it appears Moehler has an injury to contend with, as well. After Moehler left Monday's game early in another forgettable start, the team indicated that he will undergo an MRI on his right knee, which apparently has been bothering him since spring training.
The injury has been described thus far as a sprain on the Astros' official Web site, although there has been no indication of a specific initial injury. Moehler did indicate, though, that the knee had been bothering him "off and on" for a few weeks. Moehler is a right-handed pitcher, so this injury is affecting his push-off leg. If there is any instability, it certainly would affect the power of his delivery. With an ERA of 27.00 in two starts, it certainly seems as though something isn't right, and this could very well be the explanation.
Until the test results are in, it's unclear what his potential timetable to return will be. As of now, the Astros have not even indicated whether Moehler will make his next start.
Milton Bradley, OF, Cubs: Bradley is expected to miss several days because of a groin strain, and the Cubs have to hope it won't be longer than that. Bradley is no stranger to soft-tissue injuries, having experienced his share of muscle strains, not to mention a torn ACL and partially torn patellar tendon, over the past few seasons. And, of course, he is not getting any younger.
Although the groin strain is considered mild, this is one of those injuries that can rapidly turn into something more serious if a player pushes it too soon. It's possible that this could turn into a trip to the DL if Bradley's symptoms show signs of lingering. That's worth keeping in mind if he's on your fantasy roster.
On the mend
The New York Times reports that, so far, Rodriguez has taken swings off a tee and from light toss, fielded some routine ground balls and done some light running. The real point of interest will be when he is ready to return to game playing. Rodriguez says he feels the next seven to 10 days are very important as he enters the next phase of his rehab. Manager Joe Girardi has been careful to say that he maintains the expectation of a mid-May return for Rodriguez and that he does not want to push unnecessarily. So far, the steps A-Rod is taking suggest he could meet the target, but his biggest tests on the hip -- power hitting, hard running, diving and sliding -- have yet to take place. It's still a lot to accomplish in a short time. We will be watching closely ... especially now that he's in Tampa and we can actually do so.
Just last week, I placed the Angels' Kelvim Escobar in the "good news" department. Since then, the team has talked about shutting down his throwing for a few days. I'm not throwing in the towel here just yet. Remember, Escobar was well ahead of schedule in his rehab after labral surgery. His soreness is in the front of the shoulder (less worrisome), and his activity has simply been scaled back to ensure that this does not turn into something more serious. Escobar still could return in May, and even that would still place him ahead of his original timetable.
Meanwhile, Braves pitcher Tom Glavine is paying a visit to the one and only Dr. James Andrews this week. Glavine, who is coming off surgeries on his elbow and his shoulder, experienced discomfort in his shoulder this past weekend that forced an early exit from a minor league rehab start. Glavine is not speculating about his future, saying only that he's "remaining optimistic that [he] just popped some scar tissue," according to the Braves' Web site. At 43, it's a lot to hope for, but it would be nice for Glavine to end his career on his terms. This is not exactly confidence-inspiring, but I would not call him finished just yet.
And finally, Royals outfielder Jose Guillen was placed on the 15-day DL Friday because of a partially torn hip flexor. The concern with this 32-year-old's injury is whether it will turn into multiple DL stints or whether Guillen can really return as expected. There are a couple of reasons to be optimistic. First, according to general manager Dayton Moore, "Jose wanted to play through it, but this is the right thing to do for him and the team." If Guillen thought he could play through it, it could not have been too awful. Second, Moore indicated that the team was operating from a position of being proactive when he said that the team did not want to risk losing Guillen for months or, even worse, to surgery should the outfielder continue to play in cold weather early in the season, and perhaps worsen the injury. In other words, they'll take a more conservative approach and lose a few days now instead of weeks or months in the meat of the season. By the sound of it, the team is viewing this episode as minor.