Stephania Bell: Ryan Zimmerman

Blame it on the headfirst slide, again.

The latest victim from just such an encounter with the bag this season is Bryce Harper, or, rather, Harper’s thumb. He is expected to undergo surgery Tuesday to repair the ulnar collateral ligament in his left thumb and could be sidelined until July, according to ESPN Insider Keith Law.

Harper made a dive toward third base Friday night to beat the throw on a triple, jamming his thumb into the bag in the process. Despite initial X-rays being reported as negative, the injury was not without serious consequences. The news is not a great surprise, as an X-ray would reveal injury only to the bone structure. While some thumb UCL injuries can result in damage to the bone near the ligament’s attachment, it is not the case universally (or, for various reasons, the damage may not be visible on initial films). Complete evaluation of these injuries typically requires additional imaging, such as MRI or CT scan, along with consultation with a hand specialist. Harper consulted with noted hand specialist Dr. Thomas Graham in Cleveland on Monday, after which the news of his impending surgery emerged.

[+] EnlargeBryce Harper
AP Photo/Nick WassBryce Harper jammed his thumb while sliding headfirst into third base Friday against San Diego.
The estimated timeline for Harper’s return falls within what can reasonably be expected following injuries such as this, depending on the degree of damage and the extent of the repair. When Los Angeles Angels outfielder Josh Hamilton tore his UCL earlier this month, also on a headfirst slide, I noted that two to three months is often the standard time frame issued when an athlete undergoes UCL surgery, with fluctuations dependent on the severity of injury and the specifics of the surgery. (Here are more details on the nature of a UCL injury and a hand surgeon’s perspective on recovery.)

With several key players sidelined already this season by thumb injuries resulting from headfirst slides -- the aforementioned Hamilton, who is not expected back for another month, Harper’s teammate Ryan Zimmerman, who suffered a fractured thumb diving toward the base on a pickoff play and is likely out until late May, and Los Angeles Dodgers outfielder Yasiel Puig, who missed only a few days earlier this month with a less severe injury -- the debate about the value of the headfirst slide rages onward.

There has been much discussion about whether there is any speed advantage for a headfirst slide, and the general consensus (based on studies comparing times for each) is that there is no significant difference between the two. But what about the injuries? Is the headfirst slide substantially more costly when it comes to severity of injury and days missed than an injury resulting from a feet-first slide?

To date, there has been no published study addressing these specific questions in Major League Baseball. There was a study published in the American Journal of Sports Medicine in 2000 that compared incidence and technique (head- versus feet-first) in sliding injuries among collegiate baseball and softball players. In this study, the injury rate in baseball players was higher for feet-first slides (7.31 per 1000 slides) than for headfirst slides (3.53 per 1000 slides). Additionally, the amount of participation time lost as a result of sliding injury was greater for feet-first slides than for headfirst slides, although only four injuries (between baseball and softball players combined) resulted in more than seven days of lost time. Of note, however, is the fact that headfirst slides were more likely to result in injuries to the head and upper extremities. It’s not surprising given the expected contact of the player’s hand with the bag (or even another player), but it supports the increased likelihood of thumb, hand and arm injuries when a player is injured during a headfirst slide.

It’s difficult to meaningfully extrapolate the information to the major league level. It does suggest that further examination of this topic among professional baseball players would be worthwhile, to establish whether the perception that the headfirst slide is inherently more dangerous is, indeed, anything more than a perception.
As the injury news pours in this season, we'll take a quick-hit look at the fantasy-relevant players who are battling health issues. We'll be splitting them up into players we're keeping a watchful eye on -- those who have suffered injuries recently but have not been placed on the disabled list -- as well as those who have been placed on the DL.

To the DL
Beltre


Adrian Beltre, 3B, Texas Rangers (left quadriceps): The Rangers placed Beltre on the disabled list Sunday (retroactive to April 9), making April 25 the first day he would be eligible to return (Rangers are off on April 24). The move doesn’t come as a huge surprise given the Rangers had made it known they were leaning that direction.

While the injury was classified as a Grade 1 or mild strain, the bigger picture -- as in the timing of this injury relative to the scope of the entire season -- undoubtedly factors into the team’s decision. According to ESPNDallas.com, general manager Jon Daniels acknowledged as much. "That's probably the smarter thing, to err on the side of caution," Daniels said. "The last thing we want is to be without him for an extended period of time." The hope is that Beltre will be able to return when eligible.

Extended absence is a reasonable concern with a player who has a history of soft tissue injuries, particularly on that left side. While Beltre has managed his prior injuries well enough with a few days' rest to avoid the DL, the increasing number, frequency and, well, age elevate the level of concern.

Beltre has primarily experienced hamstring strains in his past, but this quad issue first appeared during spring training. The opposing dynamic of the quadriceps and hamstrings along with increased presence of scar tissue and an overall decrease in tissue flexibility pose a risk.

During spring training, manager Ron Washington had already hinted at increased DH days for Beltre, especially during day games following night games. Not only is that likely to be in place, it wouldn’t be surprising if there were increased days off for strategic rest as the season progresses. For a player who’s averaged 149 games a season over the last four years (playing 154 or more for three of those years), sitting and watching is not his style. That may be something Beltre will have to adjust to, however, to preserve his health for the long haul.
Zimmerman


Ryan Zimmerman, 3B, Washington Nationals (right thumb): Another dive to a base, another thumb injury. When Zimmerman made the unsuccessful attempt to dive back to second base Saturday, the blood on his hand indicated something was wrong. It turned out to be a fracture in his thumb that will require four to six weeks to heal. Bone is one of the more predictable tissue types when it comes to repair, so the timetable issued by the team appears reasonable, presuming a clean break and no unusual setbacks. General manager Mike Rizzo said Zimmerman will consult with a hand specialist Monday as a precaution.

While his loss is a blow for the Nationals, there may be a silver lining. Zimmerman was already struggling with discomfort in his right shoulder, the source of an errant throw just one week prior to this injury. An MRI revealed only inflammation, but the chronic nature of Zimmerman’s shoulder issues had the team giving him practice time at first base. Now that he is sidelined by the thumb injury, his shoulder will get some well-timed rest.
Cobb


Alex Cobb, SP, Tampa Bay Rays (left oblique): Cobb sure looked good in his Saturday start, but apparently, by the end of his outing, he didn’t feel so great. According to the Tampa Tribune, Cobb felt something pull in his side early in the game but was able to continue. An MRI taken later revealed a strained left oblique, and Cobb was placed on the DL Sunday.

Cobb’s injury is typical of the type of oblique injury pitchers suffer, that is to the side opposite their throwing arm. The average DL stay for pitchers suffering an oblique injury is just over a month. Timetables can vary obviously depending on the precise location and degree of injury as well as the individual’s rate of healing, but a month’s absence is a reasonable expectation. Cobb’s return date is not likely to be any sooner, but it could roll into five or six weeks before his next major league start.

Adequate down time to ensure the injury heals properly is critical for anyone, but especially a pitcher. Continued attempts to push through an oblique injury lead to compensations by other, often weaker muscle groups, which then can lead to other problems (read: arm). Depending on the time required for the oblique injury to resolve, the amount of throwing a pitcher will need to return his arm strength to normal can vary. It will be important to monitor how Cobb responds once he is allowed to resume throwing, particularly downhill.
Anderson


Brett Anderson, SP, Colorado Rockies (left index finger): Anderson had some bad luck on Saturday. There are enough ways for a pitcher to get injured; during an at-bat is not the usual one. Unfortunately for Anderson, what was initially thought to be a contusion (or deep bruise) turned out to be a break of his index finger on his throwing hand. He is now expected to miss the next four to six weeks as the bone heals. The challenge for him initially will be overcoming any stiffness in the finger and restoring his normal grip after having the digit immobilized.
As the injury news pours in this season, we'll take a quick-hit look at the fantasy-relevant players who are battling health issues. We'll be splitting them up into players who we're keeping a watchful eye on -- players who have sustained injuries recently but have not been placed on the disabled list -- as well as those who have been placed on the DL.

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.


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

All projected return timelines should be considered fluid.

Hitters

Troy Tulowitzki, SS, Colorado Rockies (DTD): The good news is that Tulowitzki's latest ailment does not appear to be serious; the better news is that his surgically repaired groin is doing just fine. The hot start to Tulowitzki's season has likely helped put to rest any lingering concerns about the injury that ended his 2012 campaign prematurely. Unfortunately, Sunday's game brought a different scare. Tulowitzki strained his left shoulder on an awkward slide in the third inning, forcing him out of the game. According to the Denver Post, the injury is being described as a strained rotator cuff. It appears he will only be sidelined for a couple of days to allow any inflammation and soreness to subside, and there are no plans to place him on the DL at this time.



Ryan Zimmerman, 3B, Washington Nationals (placed on DL 4/20, could return Friday): Zimmerman was placed on the DL with a strained left hamstring. While the injury was not considered serious, there are never any guarantees when it comes to these ailments. Zimmerman described it perfectly to the Washington Times: "Usually you can tell the difference between something that's bad and something that's not that bad, but with hamstrings you never know." What Zimmerman and the Nationals do know is that he has progressed well during his down time, performing running and hitting activities over the weekend. According to the Times, Zimmerman will play in rehab games Tuesday and Wednesday. If those outings are uneventful, he will rejoin the Nationals on Friday, when he is eligible to return. As is always the case with hamstrings, the only true measure of recovery is return to play without incident, but Zimmerman may be able to put that to the test soon.

[+] EnlargeHanley Ramirez
AP Photo/Wilfredo LeeHanley Ramirez has been out since injuring his thumb in the World Baseball Classic championship game March 19.
Hanley Ramirez, SS, Los Angeles Dodgers (placed on DL 3/20, could return Tuesday): Ramirez injured his thumb playing in the final game of the World Baseball Classic and underwent surgery to repair a torn ulnar collateral ligament (yes, in his thumb). Credit the work the Dodgers had him do while in a modified cast -- including throwing -- with his quick recovery since the cast has come off. Ramirez regained his range of motion quickly, began hitting within days and progressed to throwing shortly afterward. He has already appeared in rehab games over the past weekend and has hit well. Granted, he's not facing major league pitchers yet, but the fact that he is ready to play both offense and defense will certainly have him beating the original target date of mid-May (eight weeks post-surgery). By how much will he beat it? The Dodgers aren't saying for sure, but April 30 is Ramirez bobblehead day at the park. Just sayin.'

Mark Ellis, 2B, Los Angeles Dodgers (DTD): Ellis pulled up while running to first base Friday and it was determined later that he had strained his right quadriceps muscle. According to the Dodgers' official site, Ellis worried initially that it might be something more serious, but as he was able to jog on it, he recognized that it was not severe. He has already been able to swing a bat and throw the ball without any discomfort and is hopeful he can avoid a trip to the DL. Of course, the big issue with a quad strain is straight-ahead running, something Ellis has not yet tested at full speed. It appears he will be given some additional recovery time of a few days but if he remains relatively symptom-free and can increase his activity, he could potentially return by the end of the week.

Kevin Youkilis, 3B, New York Yankees (DTD): Last week, we said concern over Youkilis experiencing tightness in his lower back would be justified given his history. At the time, however, manager Joe Girardi downplayed it, saying he expected Youkilis back within a couple days. Well, those two days turned into a week and after a return on Saturday when he went 0-for-3, Youkilis was again experiencing stiffness the following day. He is scheduled for an MRI Monday. Concern is officially warranted. ESPN New York's Andrew Marchand notes how this could affect a timeline for Youkilis should he need a trip to the DL. Girardi acknowledged Sunday that all backs "can be tricky" and this situation with Youkilis reminds us that it is often the case with chronic low back pain, where "management" becomes the goal, as opposed to "cure." Right now the Yankees are in wait-and-see mode with their third baseman, but it appears the team will err on the side of caution. With Alex Rodriguez out until at least the All-Star break, it would be a significant blow to lose Youkilis for multiple weeks at a time.

Shane Victorino, OF, Boston Red Sox (DTD): The tricky back is in play with Victorino as well. What looked to originally be a one- to two-day affair has now extended past a week thanks to a flare-up, and may require a longer recovery. Victorino left the game early on April 20 with back spasms and after returning to action on April 22, was forced to leave the April 24 game early when the symptoms recurred. According to the Boston Globe, Victorino's improvement has only been "slight" in recent days, and with the team heading to the harsh turf of Toronto this week, his absence could be extended. It is not clear whether this will translate to a DL stint, but that does not seem to be ruled out. At the very least, it looks as if Victorino will rest a few more days before being tested in a game outing.

Neil Walker, 2B, Pittsburgh Pirates (DTD): Those nasty spikes. Walker sustained a deep cut near the knuckle of his right index finger Friday while attempting to break up a double play, and he was forced out of the game. He received six stitches in what Walker described as "the deepest cut I've ever had for stitches," according to MLB.com. He was incredibly fortunate to escape without any damage to extensor tendons in the hand, which lie very close to the injury site. The team did not place Walker on the DL, in the hopes that he could return late this week. While he may not have the stitches out, if he can bend the finger enough to swing the bat effectively and throw accurately, he will return to the lineup. Walker is expected to test those skills Monday, and if all goes well, expect him to be back in the mix later this week.

Michael Saunders, OF, Seattle Mariners (placed on DL 4/11, could return Monday): Saunders has been recovering from a right AC sprain suffered when his shoulder encountered the outfield wall a few weeks ago. After returning to batting practice little more than a week post-injury, Saunders was able to gradually increase his throwing in subsequent days. He began a rehab assignment over the weekend, and the hope is that he will be activated Monday. As long as Saunders has shown he can make the necessary throws and bat effectively, there is no reason for lingering concerns regarding this injury. But it would probably be for the best if that right shoulder and the outfield wall can keep their distance for a bit.



Erick Aybar, SS, Los Angeles Angels (placed on DL 4/13, could return by midweek): Aybar was sent to the DL with a bruised left heel which was causing him trouble swinging the bat from the right side of the plate. He has since returned to running and hitting, all without incident thus far. Aybar has seen action in extended spring training games, but the Angels have opted to give him some more at-bats before returning him to the team. He will play in a Triple-A game Monday, but it's not yet clear whether this will be his final hurdle. The heel issue appears to be largely behind him; at least the extended rehab time allows him to test it in multiple situations. Aybar's return to the lineup is expected shortly, perhaps within the next couple days.

Pitchers

Justin Verlander, SP, Detroit Tigers (DTD): The Detroit News reports Verlander said he developed "a little bit of a blister" on his right thumb near his fingernail, which was enough to bring him out of last Thursday's game after seven innings. Verlander shrugged off the notion that it would compromise his next start. Despite the thumb, Verlander had a decent outing, and there is no real indication for concern, particularly given that this is something he has contended with in the past. Blisters or other forms of skin breakdown can certainly threaten a pitcher's status, depending on the severity and location. This does not appear to be one of those times.

[+] EnlargeR.A. Dickey
Kim Klement/USA TODAY SportsR.A. Dickey (4.50 ERA, 1.31 WHIP) currently rates just 112th among all pitchers on the 2013 ESPN Player Rater.
R.A. Dickey, SP, Toronto Blue Jays (DTD): Last week we heard about neck and back stiffness giving Dickey trouble, a decidedly vague qualification. It hasn't improved -- nor have Dickey's recent challenges on the mound -- and he is headed for an MRI to try to gain some additional information. Dickey has been pitching through consistent discomfort, according to Shi Davidi of Sportsnet. There is no doubt that pain, tightness or stiffness in the neck will influence the function of the shoulder and potentially the entire upper arm. One question is whether it is an inhibition of arm strength due to pain or whether there is true weakness as a result of nerve compromise associated with the neck. More information should be forthcoming, but given the lack of improvement both subjectively in how he feels and objectively in how he's performed recently, don't be surprised if Dickey is headed for a more definitive absence.

Brett Anderson, SP, Oakland Athletics (DTD): Anderson sprained his right ankle on April 19, forcing him to leave a start after just one inning of work. It initially appeared as if it would be a non-issue since Anderson made his subsequent start. It was a rough outing, however, and he only lasted four innings. On Sunday, the team announced Anderson's Monday start would be skipped because of the ankle which, according to the San Francisco Chronicle, was aggravated during Wednesday's appearance. Although Anderson has indicated the ankle feels much better and he hopes to only miss the one start (his next outing would come Saturday this week), even subtle issues on a pitcher's landing leg can be enough to throw off his mechanics. With Anderson so recently removed from Tommy John surgery, there is no reason to press through an issue which should otherwise resolve quickly and risk greater consequences.



Josh Johnson, SP, Toronto Blue Jays (DTD): Sometimes players just know. After being scratched from his last start Friday due to triceps tightness and given his injury history, many were concerned as to what an MRI might show. Not Johnson. Shi Davidi of Sportsnet reported Johnson expected the MRI to come back clear. Turns out he was right. According to John Lott of the National Post, Johnson's MRI showed no ligament damage, only inflammation, and he is expected to resume his throwing program soon. While that program will likely be increased based on tolerance, it is too early to definitively say whether he will miss his next start, although it seems likely. Most importantly, on the scale of major injuries this does not appear to be a significant worry for Johnson.



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

All projected return timelines should be considered fluid.

Hitters

[+] EnlargePujols
Victor Decolongon/Getty ImagesFantasy owners will have to keep a close eye on Albert Pujols' foot in the upcoming days.
Albert Pujols, 1B, Los Angeles Angels (DTD): "I'm dying." Those were the words of Pujols himself Sunday when describing trying to play through plantar fasciitis in his left foot. Not particularly encouraging. Every athlete who contends with plantar fasciitis will describe extraordinary pain (like "stepping on a nail" or "walking on broken glass") and knows it is virtually impossible to get relief, unless he stops activity altogether. As for now, the plan is for Pujols to try to manage the condition, meaning he will receive treatment directed at pain relief, stretching, supportive footwear and anything else that might help all while continuing to play, albeit limited to DH duty. Unfortunately, every time the foot hits the ground stretching the inflamed fibrous tissue of the arch, Pujols is reminded of the pain. At some point it simply may be too much for him to bear and his foot could force him to take some extended down time.

Ryan Zimmerman, 3B, Washington Nationals (placed on DL April 20): Zimmerman had been experiencing cramping in his left hamstring for several days before being forced out of last Wednesday's game early. He did not play Friday or Saturday, instead undergoing an MRI, which led to placement on the DL. While it sounds as if the strain is not serious, it was hampering him not only with his running but also while hitting. Manager Davey Johnson noted Zimmerman was not comfortable landing on his left leg when hitting. One has to wonder if some of his recent throwing inconsistencies can also be attributed, at least in part, to discomfort in his left leg. According to Amanda Comak of the Washington Times, the Nationals are hopeful that Zimmerman will only miss the minimum time, but hamstrings can be finicky. The key for the Nationals is preventing this from turning into a bigger injury, undoubtedly part of the rationale for a DL placement.

Dan Uggla, 2B, Atlanta Braves (DTD): Sometimes being a veteran means understanding when to take yourself out of a game proactively. It appears Uggla did just that on Saturday when he felt something in his left calf while trying to run out a ground ball. According to the Atlanta Journal-Constitution, Uggla let manager Fredi Gonzalez know he was having discomfort in the calf and was concerned it could get worse if he stayed in the game. Uggla then sat out Sunday's game also but was hopeful he could return Monday. Calf strains tend to be increasingly prevalent as athletes move into their thirties (Lance Berkman, Derek Jeter, Albert Pujols) and early rest may be the best medicine in trying to minimize downtime.

Asdrubal Cabrera, SS, Cleveland Indians (DTD): Slipping on the dugout steps is not how an athlete wants to incur an injury. Unfortunately that's precisely how Cabrera ended up with a contusion of his left wrist, and it's lucky it wasn't worse. X-rays taken of his wrist were negative, but as the Cleveland Plain-Dealer reported, it started to bother Cabrera during Saturday's game, so he came out early. Falls on an outstretched hand can often result in a fracture of the forearm or wrist bones but it appears Cabrera escaped both. He sat out Sunday's game and could sit longer if the wrist is still painful so fantasy owners should monitor his status daily.

Kevin Youkilis, 3B, New York Yankees (DTD): When Youkilis left Saturday's game early because of tightness in his lower back, those familiar with his history may have been a little nervous. That concern would be justified because Youkilis has a fairly extensive history of low back problems including an episode, which required a trip to the DL in 2011. This flare-up appears to be of the minor variety with manager Joe Girardi telling reporters he thinks Youkilis will be available Monday night.

Shane Victorino, OF, Boston Red Sox (DTD): Victorino also left Saturday's game early due to tightness in his lower back. He sat out Sunday's doubleheader but is expected to return to the lineup Monday. Early Sunday, manager John Farrell had considered using Victorino in the second game, suggesting he was making rapid improvements. Ultimately he was given all of Sunday off but it appears he will be back to face the Oakland Athletics.



Freddie Freeman, 1B, Atlanta Braves (placed on DL April 7, activated April 22): It looks as if the decision to rest Freeman early -- despite his displeasure -- has paid off. ESPN's Jim Bowden reported Monday that manager Frank Wren indicated Freeman has been activated and is ready to play against the Colorado Rockies on Monday night. Freeman had been sidelined with a right oblique strain, but it was always considered minor; the Braves were trying to ensure that it remained that way. After a couple of uneventful rehab games, Freeman has been deemed ready to return.

Michael Saunders, OF, Seattle Mariners (placed on DL April 11, could return late in week): A crash into the outfield wall resulted in a sprained right shoulder for Saunders. Although the team did not issue a timetable initially, it looked as if it could sideline him for an extended time. There are some encouraging signs that Saunders is progressing nicely however, most notably that he took batting practice last Friday. According to Geoff Baker of the Seattle Times, Saunders hopes to return when eligible (April 26) but will need to test throwing with his injured shoulder first. One of the most difficult things to do after an injury such as this is raise the arm completely overhead. Throwing with power will perhaps present more of a challenge than hitting so fantasy owners should monitor his activity closely throughout the week.

Pitchers

Jhoulys Chacin, SP, Colorado Rockies (placed on DL retroactive to April 20): Chacin was off to a solid start but has been sidelined with a lower back strain that forced him out of Friday's game early. According to the Rockies' official website, Chacin is scheduled to undergo an MRI on Monday. As for now there is no timetable for his return in place. The Rockies have recalled right-hander Rob Scahill from Triple-A Colorado Springs to take his place.

[+] EnlargeKyuji Fujikawa
David Banks/USA TODAY SportsKyuji Fujikawa could be back this week to boost the Cubs' bullpen.
Kyuji Fujikawa, RP, Chicago Cubs (placed on DL April 13, could return when eligible, April 28): Fujikawa suffered a right forearm strain, sending him to the DL, but according to Jesse Rogers of ESPN Chicago, Fujikawa has already begun testing the forearm throwing. If all continues well, Rogers reports Fujikawa will get a couple of rehab outings under his belt this week and could return this weekend.

Brett Myers, SP, Cleveland Indians (placed on DL April 21): Myers has been fighting some tendinitis in his throwing elbow, but the picture has recently become more complex. The Indians announced via Twitter that Myers was placed on the DL Sunday with tendinitis and a mild UCL sprain. The report also indicated Myers would be shut down for two weeks and would not throw until symptom free. While the suggestion that the UCL sprain is minor is encouraging, it ultimately comes down to function. The fact that Myers experienced a drop in velocity is worrisome, but he also indicated he was not having any pain while pitching. At the very least, fantasy owners should expect him to miss four to six weeks (shutdown time followed by throwing progression), although the timeline ultimately will be dictated by how his elbow responds.



Ted Lilly, SP, Los Angeles Dodgers (opened season on DL, expected return April 24): Lilly underwent a labral repair of his left (throwing) shoulder last September and was slowed in the spring by the flu. He felt he was ready to pitch in the majors when Zack Greinke went down with a clavicle fracture, but the Dodgers preferred to keep him on a rehab assignment, moving Chris Capuano to the starting rotation instead. As it turns out, Capuano was moved to the DL with a calf strain last week and Lilly was able to get some extra innings under his belt. According to Dylan Hernandez of the Los Angeles Times, Lilly has confirmed he will start Wednesday against the New York Mets. Given the Dodgers' starter woes, a healthy -- and effective -- Lilly is badly needed.

Chad Billingsley, SP, Los Angeles Dodgers (placed on DL retroactive to April 16, could be out for the season): Did we mention the Dodgers are having some woes with their starting rotation? It looked initially as if Billingsley had survived the scare with his throwing elbow that cropped up last season. He underwent PRP injections in the fall, rested his right elbow, then resumed a progressive throwing program. The Dodgers waited during the offseason, expecting perhaps a bump in the road to recovery as often happens with partial UCL tears, but nothing went wrong with the elbow ... until now.

Billingsley managed well all through the spring but had a delayed start to the 2013 season due to a bruised index finger sustained while he was attempting a bunt. He eventually joined the rotation April 10 but it wouldn't last long. After two starts, Billingsley experienced some renewed elbow pain and now finds himself back on the DL. The bigger concern is that this may signal the beginning of the end of his season. If in fact the UCL tear has progressed to the point where Billingsley cannot function well enough to throw, he will be headed for Tommy John surgery. Given the recovery time from reconstructive elbow surgery, Billingsley stands a chance of losing time into next season if he does not address it quickly. No one wants to send an athlete to surgery when it isn't warranted and there will undoubtedly be careful evaluation of all sides of the equation, but the writing seems to be on the wall. Don't count on seeing Billingsley back in the lineup anytime soon, if at all.

Shaun Marcum, SP, New York Mets (placed on DL April 1, could return late this week): Marcum has been sidelined since the start of the month with what the team called "nerve inflammation" in his neck. After receiving injections early to help with pain and inflammation, Marcum has been on a slow and steady rehab course. There have been no reports of any setbacks thus far, an encouraging sign. According to ESPN New York's Kieran Darcy, Marcum will throw 70-75 pitches in a rehab outing Monday and, if all goes well, could return to face the Philadelphia Phillies on Saturday. This is all positive news for Marcum and the Mets, but it is worth noting that these types of ailments lend themselves to recurrence.



Brett Anderson, SP, Oakland Athletics (DTD): Anderson has been contending with a sprained right ankle, which resulted in a shortened appearance Friday and a complete day of rest Saturday. Susan Slusser of the San Francisco Chronicle reports that Anderson threw a bullpen Sunday, which went well, and he appears "likely" to make his Wednesday start. The biggest concern with an ankle sprain on the landing leg of a pitcher is that it not throw off his mechanics and risk injury to his throwing arm. The A's must like what they see if they're considering a prompt return.



Nationals third baseman Ryan Zimmerman is acutely aware of how much his struggles with his right (throwing) shoulder affected him last season. The pain, which limited his hitting early on, and the restriction in his AC joint, which affected his ability to throw, were well known. The mental strain brought on by the situation was not as well-known but was equally difficult for Zimmerman.

"You're struggling in front of 50,000 fans," Zimmerman said. "As baseball players our place where we're comfortable is on the field. And then I wasn't. It's not something I had ever experienced before."





Zimmerman first began experiencing discomfort in the shoulder last spring, but it was mild and intermittent and he didn't think much of it. The pain worsened during the season, and the first area of his game affected was his hitting. "I was compensating by guarding to avoid the pain," Zimmerman said, demonstrating how he would avoid fully extending on his swing so he could keep his shoulder back in close to his body. (Incidentally, that position retracts the shoulder blade, or scapula, which also controls the position of the AC joint.) Two early cortisone shots did not help, and as the season progressed, Zimmerman knew something needed to change because he had become, as he calls it, "an easy out."

"We tried one more shot in a slightly different location," Zimmerman said, "and there was an immediate difference." At that point, hitting was no longer painful, and that was evident in the form of his sudden turnaround at the plate. But throwing became a huge problem.

Zimmerman


Zimmerman


Zimmerman said he couldn't feel where his arm was supposed to be to make a throw. He demonstrated moving his arm to different release points, searching for the right spot in space to position himself to throw the ball. The pain was no longer an issue, but restriction in the joint limited his movement and he experienced a lack of control and coordination of his arm. His defensive play clearly suffered as a result and Zimmerman just tried to get through the season, even taking one more injection to help diffuse the pain.

He knew surgery in the postseason was inevitable, but he wasn't sure until the October procedure was complete what exactly was required. Initial MRIs had shown inflammation in the area, but an MRI arthrogram (in which dye is injected into the region to better enhance the image) taken just before surgery hinted at a larger rotator cuff concern. Thankfully, the cuff turned out to be fine and the bulk of the problem was limited to the AC joint. Zimmerman says his surgeon, Nationals team physician Wieme Douoguih, essentially cleaned up the area by shaving down the edges of the bone and creating more space in the joint.

Zimmerman noticed the new motion right away, even remarking that he felt a little loose, especially near the front of his collarbone (where it attaches to the sternum or chest). As a result of overcompensating for stiffness at the far end of the joint, near his shoulder, Zimmerman's body had found a way to get more motion at the near end, not necessarily desirable. "I felt a lot of clicking in the front," Zimmerman said, pointing toward the sternoclavicular (SC) joint. He was quick to add that once he began to regain strength around his chest, upper back and shoulder, that mobility and the "loose" sensation have subsided. The joint now feels completely normal.

There is no longer any pain like before, according to Zimmerman, although he does acknowledge that he still gets sore and he is still regaining his strength. Hitting is not an issue at all, and his throwing is improving as he works through a progressive throwing program. Zimmerman appreciates that manager Davey Johnson has allowed him to increase his activity at a gradual pace, recognizing there are 162 games in the regular season and spring training is long.

On Tuesday, Zimmerman threw across the diamond for the first time since surgery and looked like he had indeed found that natural release point once again. The look on his face after batting practice said plenty, but he summed it up in a single phrase. "There's a lot more to smile about this spring."

Ramos returns behind the plate

Ramos


Ramos


Since tearing the lateral meniscus and ACL in his right knee last May, Wilson Ramos has been on the long road to recovery, culminating in Tuesday's appearance -- his first since the injury -- behind home plate. Ramos has done all the requisite drills. He's blocked balls behind the plate, he's run the bases, he even added sliding just last week. But until this week, he had not functioned as a catcher in a game situation in nearly a year.

Ramos was clearly beaming when I spoke to him at his locker. Not only did he say he was "excited" about playing in a game at least five times, but the smile on his face conveyed how much he had been anticipating this moment. He acknowledged that today represented a big step. "It's not the same as blocking, bullpens," Ramos said, adding, "It's faster, you are more excited." He gestured with his hands and looked around as if he were scanning the field to make his point. "Thinking about plays, where the ball is coming from, where you need to throw ... it's more ... excited."

The play that sent Ramos to the DL for months was so seemingly minor; he still appeared bewildered that the result was so drastic. He leaned over casually to scoop up a ball when his knee collapsed. The next thing he knew, his season was over. After meniscal repair in June, Ramos underwent ACL reconstruction approximately six weeks later. The main focus in therapy initially, as is typical, was regaining motion. "Up and down, up and down with my knee," said Ramos. As he moved through the phases of rehab, he could feel his knee getting stronger but remained apprehensive about performing some of the higher-level drills.

"I was nervous about sliding," Ramos said, "because I always bend my right knee, not my left." But after he got through slide drills and realized he was fine, Ramos was eager to get back behind the plate. He says the power in his right leg is not quite the same as his left, but that is to be expected. So is the stiffness he still feels in the morning, which disappears as he warms up. The knee will continue to improve even after the regular season is underway.

Tuesday marked a major milestone for Ramos as he caught three innings, even if the opponent was a largely minor league Houston Astros squad. He moved freely behind the plate, blocking several balls by dropping to his knees without hesitation.

And that is a good reason to be excited.

Haren gets in better shape

Haren


Haren


Dan Haren went on the DL for the first time in his career last season due to back stiffness. Despite his stoicism, the ailing back was clearly impacting his performance. He was able to return shortly after the 15-day minimum and remained relatively healthy across the remainder of the season, even if his results on the mound were somewhat inconsistent.

Haren stayed on a rehab program throughout the offseason, working several days a week with a physical therapist in California. He seemed to clearly grasp the importance of maintaining a combined strength and flexibility regimen to keep himself healthy going forward. "I like to understand what's going on," Haren said regarding why he took such an interest in the particulars of his rehab program. "Then I can report back to the [athletic] training staff what works and what doesn't."

He also recognized there was more to the issue than his spine.

"As you know, with back problems, you're not just treating the back, you're treating everything around it," Haren said. He worked on flexibility for his hips in particular. (His hip was said to be a reason some teams shied away from trading for him at the end of last season.) He also targeted core strengthening and he lost some weight. Most importantly, he says he feels great this spring and he intends to maintain his new regimen. Haren knows firsthand that regardless of how durable he has been, with age comes the risk of the wear and tear of the job catching up to the body. He's hopeful that his attention to his rehab and conditioning program will keep that at bay a while longer.

2012 All-injury All-Star team

July, 10, 2012
7/10/12
6:28
PM ET


In honor of the festivities taking place in Kansas City today around the 2012 MLB All-Star Game, it seemed appropriate to compile a roster of All-Injured All-Stars. The qualifiers for this roster were selected from:

• Players who were chosen for this year's All-Star game but could not participate due to injury
OR

• Past All-Stars who might have had the potential to earn another trip in 2012 were it not for the injuries that beset them this year.

The sad fact is that this was a relatively easy list to compile. Outside of one or two spots that required a stretch to meet the inclusion criteria, it was not difficult to find candidates for each position in both the American and National Leagues. Does that make this year any better or worse than previous years? I'm not sure, but it does remind us how much injuries can impact the game. Not everyone who could possibly qualify is listed. Naturally, as with the actual All-Star roster, there will be debate. But like the managers in the All-Star get to select their lineups, these are my picks, undoubtedly influenced by the number of times their names make an appearance in questions fielded during chats, podcasts, blog entries and Twitter posts.



May I present to you the 2012 All-Injured All-Stars?

National League

Howard


Howard


1B: Ryan Howard, Philadelphia Phillies: Howard finally made his 2012 debut just before the All-Star break after he ruptured his Achilles tendon in his last at-bat of last year's playoffs. Complications following an infection slowed his recovery. The Phillies are hoping for offensive contributions from Howard -- and he has delivered a couple of hits -- but since his return, the team has yet to earn a victory. Howard is still not a daily player as he is easing back into the lineup, and even he acknowledges his leg is not likely to return to 100 percent until next year.

Utley


Utley


2B: Chase Utley, Philadelphia Phillies: Like his fellow infielder on this roster, Utley started the season on the DL and only recently returned to action. Working through chronic patellofemoral pain (pain under the kneecap), Utley underwent an intensive, focused rehabilitation program to be able to get back to baseball. It was slow and deliberate, but how long he will be able to hold up once he is playing on a regular basis is unknown. The Phillies like what they see so far; a couple of home runs, a few RBIs and, most importantly, no setbacks. If only that can last.



Tulowitzki


Tulowitzki


SS: Troy Tulowitzki, Colorado Rockies: Tulowitzki was bothered intermittently by groin pain this season, but a setback during a rehab assignment led to eventual surgery to debride scar tissue from around a nerve. Tulowitzki was projected to be out approximately 6-8 weeks following the procedure, which translates to an August return. Until he resumes baseball activities, it will be difficult to assess how close he is to seeing any game action.

Zimmerman


Zimmerman


3B: Ryan Zimmerman, Washington Nationals: Zimmerman has certainly been playing like an All-Star ever since receiving his latest cortisone injection in his right shoulder. The big question on everyone's mind is whether it will last. Zimmerman initially had trouble with the shoulder in April, which ultimately landed him on the DL. Even after the time off, Zimmerman continued to have discomfort and it showed at the plate. In June, there was discussion about a cortisone shot or even another DL stint. The shot seems to have done the trick, though, and hopefully when post-All-Star play resumes, Zimmerman's shoulder will still be feeling good.

Lucroy


Lucroy


C: Jonathan Lucroy, Milwaukee Brewers: Admittedly, this is a bit of a reach, but Lucroy was batting .345 when he went out with a broken hand in May and there was abundant chatter about his potential selection to the 2012 All-Star roster. Exhibit A from the Milwaukee Journal-Sentinel in May: "He has five homers and 29 RBIs in addition to his gaudy batting average, putting him in the conversation for an All-Star Game appearance." Who knows what might have been? Instead, Lucroy is working his way back toward a return. He has been throwing and running, and was recently cleared to start swinging a bat, putting him on pace to return in late July.



Kemp


Kemp


Lucroy


Stanton


Werth


Werth


OF: Jayson Werth, Washington Nationals; Giancarlo Stanton, Miami Marlins; Matt Kemp, Los Angeles Dodgers: Werth qualifies for the most dramatic injury after he broke his left wrist when his glove caught in the grass as he was attempting to make a sliding catch. To complicate matters, this was the same wrist on which Werth had undergone a prior surgical procedure in 2006. The initial timetable for Werth was projected at three months, but the good news is that he is expected to start swinging a bat sometime after the All-Star break. Let's see how his wrist tolerates those swings before thinking about upping his return date.

Stanton was a late scratch from both the All-Star Game and the Home Run Derby when he was removed from Saturday's game with soreness in his right knee. After undergoing surgery Sunday morning to remove loose bodies, it will be a few weeks before he is ready to return.

Kemp has missed more time this year than he has at any point thus far in his career because of a finicky hamstring strain. Known for his ability to play virtually every day over the past few years, Kemp was reluctantly forced onto the DL in the hope of preventing a more serious injury. He then had to return to the DL when the hamstring acted up in only his second game back. Kemp's timetable has been slower this time around and he was deliberately kept on a lengthier rehab assignment to force more situational running. Everything seems to be pointing to his return to the lineup this Friday when the Dodgers are back in action.

Carpenter


Carpenter


Halladay


Halladay


SP: Roy Halladay, Philadelphia Phillies; Chris Carpenter, Cardinals: The Phillies tie the Nationals with the most members on this NL roster, but the Phillies win in terms of the importance of the players lost to their team (no hard feelings, injured Nationals). To go along with starting infielders Utley and Howard, the Phillies lost one of their most durable and consistent starters in Halladay, who was forced onto the DL with a strained lat. Despite his denials, it seemed as though the injury was affecting him, even if in a subtle manner, since the spring and ultimately the discomfort caught up to him. Halladay has been sidelined since late May but has been steadily progressing in his throwing program. He is expected to make a rehab start Thursday, and the Philadelphia Inquirer reports that if all goes well, he could then rejoin the Phillies for a Tuesday start against the Dodgers.

Carpenter has been either very good or very injured. This year, unfortunately, it was the latter and he was plagued by weakness in his throwing shoulder since the spring. Tests confirmed thoracic outlet syndrome (which he has actually been dealing with for several years but has progressed to the point where he can no longer pitch) and Carpenter is scheduled for surgery later this month. The rehab is long and there are no guarantees, but Carpenter hopes to be able to pitch again next season.

Wilson


Wilson


RP: Brian Wilson, San Francisco Giants: What a difference a year makes. Last year, Wilson was participating in the All-Star Game. This year he is recovering from Tommy John surgery No. 2. Wilson struggled late last season and even had his elbow examined after it was causing him discomfort. The hope was that the offseason rest had helped sufficiently, but it didn't take long to find out that was not the case. Just two weeks into the season, Wilson was done and headed for Dr. James Andrews' office. Whether he will be available to pitch at the start of next season remains uncertain.

American League

Youkilis


Youkilis


1B: Kevin Youkilis, Chicago White Sox: Whether it was his back injury that landed him on the DL this spring or his general malaise while in the murky Boston Red Sox situation, Youkilis was not performing up to par. The three-time All Star -- who also spent the offseason recovering from surgery to address a core muscle injury -- was not going to be making this year's Midseason Classic. It's worth noting, though, that his performance thus far with his new club has certainly been reminiscent of the Youkilis of old.

Pedroia


Pedroia


2B: Dustin Pedroia, Boston Red Sox: A partial tear of a thumb muscle is likely to blame, at least in part, for Pedroia's struggles at the plate in June. Pedroia was not voted into the 2012 All-Star Game, which may be just as well, because he suffered yet another thumb injury just last week. A diving play resulted in an injury to the volar plate of Pedroia's thumb, the fibrocartilaginous tissue deep in the joint that helps block hyperextension. He is expected to miss several weeks.



SS: None: There were no real candidates for this position based on the inclusion criteria. Something tells me this should make AL shortstops a bit nervous about the second half of the season.

Longoria


Longoria


3B: Evan Longoria, Tampa Bay Rays: Longoria partially tore his left hamstring at the end of April, and his return at this point is anything but certain. In June, he appeared on course, but a rehab outing was cut short when Longoria again felt discomfort in the hamstring. Since that time, there have been wavering suggestions as to when Longoria might resume baseball activities, something which has yet to occur. According to the Tampa Bay Times, manager Joe Maddon said he has no idea when Longoria can return. He then offered perhaps the most precise summation of the challenge of dealing with a partially torn hamstring: "It's a tough injury to overcome and a tough injury to battle back from."

Martinez


Martinez


C: Victor Martinez, Detroit Tigers: The former All-Star underwent surgery in January to repair both the lateral and medial menisci along with a microfracture procedure. His progress has been understandably slow in order to protect the delicate spots on the knee where the microfracture was performed. Based on a recent MRI and clinical evaluation to assess his progress, the Tigers have indicated the soonest (note: soonest) Martinez would return is middle to late September.

Sizemore


Sizemore


Ellsbury


Ellsbury


Crawford


Crawford


OF: Carl Crawford and Jacoby Ellsbury, Boston Red Sox; Grady Sizemore, Cleveland Indians: Just imagine what this outfield could look like when healthy. It's actually difficult to do, as these three players have dealt with extended absences over the past few seasons.

To be fair, Crawford's absence in 2011 was a virtual one; he was healthy but merely a shadow of himself. Then in the offseason, he injured his left wrist and had to undergo surgery to debride a fibrocartilage tear in the joint. A slow recovery was followed by a setback, and just when he seemed on the verge of beginning a rehab assignment, he had elbow pain. It turned out to be a partial tear of his ulnar collateral ligament. No surgery was immediately required (there is some discussion about Crawford having surgery eventually) and he recently embarked on a rehab assignment. That assignment was interrupted by a mild groin strain, and again Crawford's return date has been pushed back. The Red Sox are hoping they will have him in the second half of July.

Ellsbury was hurt early in the season on a collision, which resulted in a shoulder subluxation. He too has started a rehab assignment, and while there is no firm commitment to a date, it sounds as if he could rejoin his team by the weekend.

As for the three time All-Star Sizemore, his healthy days seem to be far fewer than his unhealthy ones in recent years. This year, he is recovering from back surgery, and there is always some question about the true health of his knees. He has actually started a running program and a rehab assignment could be in the not too distant future. No one is counting on a specific date but the Indians would love to see him back on the field at some point in the second half.

Haren


Haren


Sabathia


Sabathia


SP: C.C. Sabathia, New York Yankees; Dan Haren, Los Angeles Angels: Sabathia did not want to go on the DL for his mild left groin strain, but the Yankees did not want him to be hurt in September. And so he went. After all, better to rest a minor groin issue now than have compensations turn into a shoulder or elbow injury later. The good news is that he is doing well and is expected to return shortly after the All-Star break.

Haren has never even been on the DL until now. Considering he's pitched in the majors for 10 years, there should be a special All-Star category for that alone. Haren did admit that the stiff back that sent him to the DL has been bothering him since the spring, and he felt his performance was hindering the team. The Angels are hoping for a brief stay.

Rivera


Rivera


RP: Mariano Rivera, New York Yankees: Rivera, a medical marvel when it comes to pitching and baseball, suffered the unlikeliest of injuries when he tore his ACL while shagging fly balls during pregame batting practice. The 42-year-old closer quickly made it known that this would not be his exit from baseball. While no one has ruled him out from a late-season return, even Yankees general manager Brian Cashman has said he does not expect him back in 2012. No matter what the return date, the fact that he is making such good progress is encouraging.



VIERA, Fla. -- It was a dark and stormy day ... until Washington Nationals ace Stephen Strasburg took the mound at Space Coast Stadium, that is. Torrential rain and gusty winds looked as if it could threaten Strasburg's Sunday start, but an hour before game time, the clouds were gone and the sun was shining.

Perhaps the turnaround in the weather just in time for Strasburg to make his spring debut is a sign of good things to come, and his first performance of the 2012 Grapefruit League season was solid. From a health perspective, his outing was uneventful (as expected, considering Strasburg is almost 18 months removed from Tommy John surgery on his right elbow). Given that he made several late-season starts in 2011, Strasburg has already proven that he has recovered sufficiently enough to face major league hitters. Still, with the prospect of pitching for his first full season since the injury still on the horizon, the natural questions facing Strasburg at this point are the same for any pitcher following this surgery. Will he recover his trademark velocity? Is he going to struggle with command or lack consistency? While one 44-pitch spring training outing is not going to yield definitive answers, there's every reason to be optimistic about Strasburg's progress and projections going forward.

[+] EnlargeStephen Strasburg
Brad Mills/US PresswireStephen Strasburg was able to get five starts in at the end of 2011, posting a 1.50 ERA in them.
Strasburg's velocity looked on par, but his command was a bit shaky against the Houston Astros. Although he had good location on some of his early pitches, the third inning was not so kind. After striking out Chris Johnson to start the inning, Strasburg gave up a home run to catcher Chris Snyder, followed by a double to center fielder Jordan Schafer, who then advanced to third on a wild pitch. Strasburg retired 'Stros shortstop Marwin Gonzalez on strikes before exiting the game. After the game, Strasburg acknowledged that he was "a little erratic at times" but added that he knew his command would get better with more repetitions and fine-tuning his mechanics.

Given where Strasburg is in his overall recovery process and fresh off the offseason, his command challenges were not unexpected, and the takeaway from this start was largely positive. His delivery looked smooth and effortless. Even Strasburg described this first outing as "pretty much a breeze" as far as how his arm felt. He noted that all the work he put in during the offseason seemed to help prevent any between-inning fatigue, and he was pleased with his initial effort. He also noted that it was "big" for him to be able to come back late last year with no setbacks, giving him the confidence to focus on the year ahead. The Nationals already have indicated they will limit Strasburg to 160 innings in 2012, just as they did with their other young ace, Jordan Zimmermann, when he returned from the exact same injury. It's as if the road map for Strasburg has been nicely laid out by his teammate, and given Zimmermann's success, don't expect the Nationals to detour from that plan, barring some sort of setback.

While Strasburg was certainly the most notable player for me to check in on Sunday, there are a couple of other guys worth a mention. Nats first baseman Adam LaRoche is coming off surgery to repair a torn labrum in his left shoulder, an injury that ended his 2011 season last June. LaRoche has been swinging a bat and throwing in spring training and originally had his sights set on a Sunday return. But it now appears LaRoche will instead make his spring debut on Wednesday, according to the Nationals' website. So far his progress has him on track to be ready for the start of the season, assuming he doesn't have any setbacks.

While I didn't get to see much of LaRoche, I did get a look at Nats third baseman Ryan Zimmerman, who was in the starting lineup against the Astros. Zimmerman struggled early last season with an abdominal strain before undergoing surgery in May for a sports hernia. Once he returned to action, it took some time for him to regain his power, but he rebounded to have a strong second half. Translation: Zimmerman enters the 2012 season fully healthy.

In the pitching department, Nats relief pitcher Brad Lidge delivered a scoreless seventh inning Sunday. Lidge, formerly of the Philadelphia Phillies, started each of the past two seasons on the disabled list. In 2010, he was coming off elbow surgery; in 2011, he was battling a rotator cuff strain. If he can get through spring training without any issues, he likely will serve as a middle reliever in front of Nationals closer Drew Storen.

According to Strasburg, the Nationals under manager Davey Johnson are gradually building up as they approach the regular season, focusing on getting better every day. Given the length of the season, that's certainly a tactic that could pay off in terms of the health of their players. At least that's what the Nationals are hoping for.



Did something happen in New York last night? In case you were under a rock, New York Yankees shortstop Derek Jeter, just six hits shy of his crusade toward 3,000, left the game in the fifth inning with a right calf strain. Jeter underwent an MRI, and it was later described as a Grade 1 (minor) calf strain. While minor, it was enough for the team to put him on the disabled list for the first time since 2003, when he suffered a dislocated shoulder.

[+] EnlargeJeter
Jim McIsaac/Getty ImagesDerek Jeter goes on the disabled list six hits short of the 3,000-hit plateau.
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. A shortstop such as Jeter may test it when making a big defensive play, but generally the signature move is driving out of the batter's box on the way to first, which, not surprisingly, was how Jeter 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.



Last year, Jeter's teammate, Alex Rodriguez, was forced onto the DL with a minor calf strain when he tried to return to play just days after the initial injury and the leg did not cooperate. He came off the DL when eligible and played the remainder of the season without incident.

• But let's turn to celebrating the return of Washington Nationals third baseman Ryan Zimmerman. Zimmerman has been out since early May after undergoing surgery to repair a torn abdominal muscle, an injury that had been bothering him intermittently since spring training. The Nationals have to be thrilled to be getting him back. He has been hitting the ball well while on his rehab assignment; the most lingering issue for him was getting to where he could throw the ball hard without discomfort. The Nationals wisely had no desire to rush him back, knowing that the success rate following this procedure is very high if allowed to fully recover before returning to sport. Fantasy owners have to be excited as well, as his bat should quickly pay offensive dividends.

• Tuesday will also see the return of Florida Marlins shortstop Hanley Ramirez. The Miami Herald reports Ramirez was activated from the DL after Monday's game, trading places with outfielder Scott Cousins, who heads to the DL with a low back strain. In the NL West, San Francisco Giants third baseman Pablo Sandoval is expected to rejoin the lineup Tuesday as his team takes on the Arizona Diamondbacks. On Monday, we outlined the outlook for both players, including the notion that Sandoval is likely to see some time at first base.

• The Minnesota Twins have been riding an injury carousel all season long, and the news has largely been gloomy. Their fortunes might (emphasis on the word "might") be changing a bit. It appears Tsuyoshi Nishioka could return as soon as Wednesday. According to the Minneapolis Star Tribune, he told that to the Japanese media following him at Triple-A Rochester. Nishioka has been gradually working his way back to baseball since breaking his left fibula in early April. The biggest challenge in coming back from this injury is ensuring Nishioka can play the game all out, without hesitation. So far in rehab games, he has spent significant time at shortstop, and manager Ron Gardenhire indicated that would be his everyday position going forward.

• The Twins also have an eye on catcher Joe Mauer's return. It appears he could be back as soon as Thursday or Friday, according to the Star Tribune. Mauer has been out since mid-April with what was categorized as generalized weakness, and the team has not provided much in the way of detail or timetable since. His increase in innings played recently in rehab outings has hinted at his near return, but the Twins are still not committing to a firm date.



• Then there's Twins first baseman Justin Morneau. After battling lingering post-concussion symptoms since the season-ending injury last July, Morneau was able to recover and return for Opening Day. Unfortunately, he has been challenged with other injuries since. A pinched nerve in his neck, which is causing him neck pain and is affecting his left shoulder, is making playing difficult, yet he is hanging in there.



Recently his left wrist has become problematic, repeatedly swelling, according to Morneau, "whenever I use it." As the Star Tribune reports, a recent MRI showed no significant structural damage, and the plan is to keep Morneau's day-to-day status. While Morneau avoids the DL for the time being, he is certainly struggling to stay active. It's hard to imagine he gets to a point of feeling "great" anytime soon, as these types of ailments respond best to extended rest. Time will tell if he can bounce back enough to contribute on a regular basis or whether the team opts to have him take that extended rest.



Once again following the weekend games, there are some comings and goings in baseball. Some players are coming back from injury while others are departing (in one case potentially for the remainder of the season) due to injury. This week, it appears a few players who have been out for extended time are about to resurface. Wandy Rodriguez returns Monday for the Houston Astros to face the Atlanta Braves after spending some time on the DL with elbow inflammation. The team seems to think he's ready. But will he and the others returning from injury last?



Coming

Hanley Ramirez, SS, Florida Marlins: The Marlins sound optimistic that their ailing shortstop could rejoin the lineup Tuesday night when the team faces the Phillies. Ramirez, currently on the DL for the first time in his career, has been dealing with back pain and sciatica. Even though we did not learn of Ramirez's pain until he was removed from a game in late May, it turned out the back had been bothering him for several weeks prior, which may explain his offensive struggles.

Ramirez did not resume baseball activities until late last week and then engaged in a rehab assignment Friday and Saturday. The plan was for him to work out with the Marlins on Monday (originally Sunday also but that was changed), according to the Palm Beach Post, after which he was expected to be activated Tuesday (his first day eligible). This presumes no setbacks, which, in the case of low back and associated leg pain, unfortunately is not uncommon. While it's encouraging that Ramirez has apparently made enough progress to return after the minimum DL stay, it's not evidence that he's completely out of the woods. Bear in mind that it was just over a week ago when he was forced to cut a workout session short because of pain. The good news is that his swing has reportedly improved which suggests his back is indeed feeling better. Ramirez told the Miami Herald, "My back is better now and I'm going to be able to compete out there." Now the Marlins and Ramirez's fantasy owners will have to hope it stays that way.



[+] EnlargePablo Sandoval
Jeanine Leech/Icon SMIPablo Sandoval was hitting .313 with five homers when he landed on the disabled list.
Pablo Sandoval, 3B, San Francisco Giants: This might also read Pablo Sandoval, 1B, since he is expected to see some playing time at that position as well while Brandon Belt remains on the DL with a fractured wrist. He will not, however, be playing catcher anytime soon. Mostly the Giants hope Sandoval is playing hitter. Period. They have missed his bat in the lineup and with the loss of second baseman Freddy Sanchez (see below in the "Going" section) they need Sandoval to deliver some offense even more urgently.

Sandoval has been recovering from surgery to remove a fractured portion of the hamate bone in his right wrist. The big concern was whether he could effectively hit from the left side of the plate, the more challenging side following this injury given the pressure the bat puts on the surgical site. Even as Sandoval was hitting the ball out of the park on his rehab assignment, he was forced to take subsequent days off because of persistent soreness in his wrist, which is not unusual during the first few weeks of hitting following this procedure. Apparently, everyone is feeling confident that Sandoval is ready to contribute immediately and he is expected to be in the lineup Tuesday when the Giants face the Arizona Diamondbacks.



Ryan Zimmerman, 3B, Washington Nationals: Adam Kilgore of the Washington Post reports via Twitter that the Nationals will activate Zimmerman on Tuesday, presumably in time for the contest against the St. Louis Cardinals. The move would not be unexpected as there were hints late last week that Zimmerman was likely to return soon.

Credit the Nationals for taking the time to ensure Zimmerman's full recovery from surgery to repair an abdominal tear before bringing him back to the majors. According to the Washington Post, manager Jim Riggleman was clear that he wanted to take no chances. "We don't want to push it," Riggleman said. "I really want him to be 100 percent. I don't want any setbacks." The good news is the success rate following this type of procedure is very high. The key is making sure the athlete can perform every aspect of his position without hesitation and without any sensation of pulling or tightness in the surgical area. When Zimmerman first returned to baseball activities, he acknowledged soreness with hard throwing. As his strength and endurance have improved along with the extension of innings he has seen in the minors, it has become less of an issue. Additionally, as the Washington Post reported in early June, Zimmerman has taken advantage of the rehab window to work on his throwing mechanics. There is every reason to think Zimmerman will be able to be effective immediately.

Matt Holliday, OF, St. Louis Cardinals: It's about as confident a statement as one can hope for from an athlete looking to return from the DL. Holliday told the St. Louis Post-Dispatch, "I have full confidence I'll be ready to play Thursday." Thursday will be the first day Holliday, who has been out with a strained left quadriceps, is eligible to be activated. He has tested his quadriceps in the best way possible, explosive directional running. According to the Dispatch, Holliday performed sprints from home to first base, then first to second. Most quadriceps strains in baseball happen during the first few steps out of the batter's box as the athlete attempts to explode towards first. And while it might seem strange that a muscle strain forced Holliday to the DL when an appendectomy didn't, it reflects the difficulty in returning an injured muscle, particularly one so critical for athletic performance, to full power. There is always a little something extra that the body delivers in a game situation so until an athlete has returned and stayed healthy for several weeks following an injury such as this, it's difficult to be confident that it's completely behind him. But when an athlete sounds as confident as Holliday does in his recovery, it should be taken as a very good sign.

Going

Freddy Sanchez, 2B, San Francisco Giants: Sanchez dislocated his right (throwing) shoulder in Friday night's opener against the Cincinnati Reds while diving to make a play. Not only is he on the DL, Sanchez may be done for the season. Giants head athletic trainer Dave Groeschner indicated that Sanchez suffered damage to both the labrum (cartilage ring which enhances stability of the shoulder) and the capsule (fibrous tissue that envelops the shoulder joint). In other words, after this event, Sanchez's shoulder is undoubtedly less stable. It is likely that he will ultimately require a surgical procedure, but the question is when that would take place.

According to AP reports, Sanchez will consult with the Arizona surgeon who previously operated on his left shoulder. The San Jose Mercury News reports Sanchez will undergo a course of rehabilitation to see if he can return to play and postpone any surgery, at least until the offseason. One of the most challenging issues for anyone who has suffered a traumatic dislocation with extensive damage to the joint is regaining adequate mobility in the arm to make it functional while overcoming the apprehension that it will dislocate again. A one-time dislocation in the absence of severe joint trauma can often do well with rehab alone. The more damage to the joint, however, the less stability (on what is already a relatively loose joint) and even minor subsequent subluxations (where the shoulder slips but does not completely dislocate) can be pain-inducing and cause the athlete to automatically guard the shoulder against movement. In other words, it can be very difficult to return to free and easy play. This will be the challenge for Sanchez who, as an infielder, has to dive without hesitation and throw hard regularly to make defensive plays.



Even if Sanchez does have some success with the rehab course, it would likely be multiple weeks before he could attempt to play. He will need to keep the shoulder immobilized in a sling initially, then gradually resume range of motion and strengthening before returning to any baseball activities. Given that a decision as to whether he could return or not might take some time to play out, fantasy owners would be wise to make alternate plans.

[+] EnlargeBartolo Colon
AP Photo/Paul J. BereswillBartolo Colon was throwing a two-hit shutout when he injured his hamstring covering first base.
Bartolo Colon, P, New York Yankees: Look at it this way. At the start of the season, who would have thought Colon would get this far? When it came to discovering the fountain of youth, pitching was one thing. Attempting to run to cover first base proved to be quite another. Colon strained his left hamstring on just such a move, which reminded us that he is indeed 38 years old and, well, shall we say, less than the model of fitness. The Yankees have placed him on the DL and according to ESPN New York, Colon indicated (through an interpreter) that he does not think the injury is serious and he expects to return at the end of the 15 days. Given the way he's pitched so far this year, the Yankees would love to get him back that quickly, but it's his landing leg that's injured. That left leg has to support Colon's body weight and slow down the momentum of his upper half following ball release, which is not a small task. Stay tuned.

Mike Napoli, C, Texas Rangers: Napoli is going to be missed by his teammates and fantasy owners alike, but everyone is hoping he won't have to be missed for long. He is being placed on the DL with a left oblique strain; however so there is no telling at this point just how long his absence might be. There is some encouraging news, though, that Napoli may have jumped on this injury early before it became more severe. According to the Fort Worth Star-Telegram, Napoli first felt discomfort Friday that worsened during Sunday's game. Napoli seemed to recognize the potential for a more severe injury, telling the Star-Telegram he was concerned about continuing to play and aggravating the condition. "I didn't want to do that and miss eight weeks instead of two weeks," Napoli said. Given that statement it sounds as if Napoli may have avoided the type of injury which results in a four-week (or more) absence but naturally it remains to be seen how long before he can ease back into baseball activity.

Aaron Harang, P, San Diego Padres: The foot issue Harang has been trying to work through for the last couple weeks has proven to be painful enough to force him out of service for a while. The Padres have placed him on the DL due to persistent pain in his right foot which has been present since early June. The team website reported negative findings on X-ray and MRI, and said Harang is not sure how he injured it. Nonetheless, the pain in the top of his foot is sharp enough to be bothersome. Harang said of the pain, "It kind of sends a quick shock through my foot." Harang's last start came June 9, so he should be eligible to come off the DL by late June, presuming the foot pain has resolved.



As is usually the case following a series of weekend games, there are some comings and goings in the world of baseball. Some players are coming back from injury while others are exiting, or appear on the brink of exiting, due to injury. If only the return list was greater than the departure list, fantasy owners would be looking forward to adjusting their Monday rosters. While sadly this does not appear to be the case, there are still some nuggets of good news to be found in the injury reports. You just may have to scroll down a ways to find them.

Going

[+] EnlargeHanley Ramirez
Steve Mitchell/US PresswireHanley Ramirez has not played since May 30 but could be activated as soon as next week.
Hanley Ramirez, SS, Florida Marlins: It's official. The Marlins have placed Ramirez on the DL, retroactive to May 30. Ramirez led the Friday blog amidst hints the Marlins would make the decision to place him on the DL at some point that day. Friday came and went without any movement for Ramirez, but it wasn't because he was making a sudden return to the lineup. In fact, Ramirez continued to sit out because of a lower back injury, which had been causing him problems for well over a week. It seems the delayed announcement was linked to the Marlins' decision as to which pitcher would be called up to fill his roster spot. According to the Marlins' official website, with Josh Johnson still out with shoulder inflammation (and no set timetable for his return), it was unclear who would take his Tuesday spot in the rotation. That question now appears to have been answered. According to Joe Capozzi of The Palm Beach Post, the Marlins called up lefty Brad Hand from Double-A Jacksonville. As far as Ramirez goes, it was clear he was hoping to avoid going to the DL for the first time in his career, but the pain was such that he couldn't pinch hit or run. Better for him to step away completely and try to resolve this episode than to press through it. After all, he had not been producing well at the plate. Turns out his back had been bothering him for a month but he kept it quiet until the pain got bad enough he simply couldn't function.

Jake Peavy, SP, Chicago White Sox: The good news is Peavy's surgical repair to his lat tendon has held up brilliantly and his throwing arm is fine. The bad news is a right groin injury sustained during only his fifth start of the season likely will land him on the disabled list. According to the Chicago Sun-Times, Peavy said of his injury, "I'll probably miss more time now. ... the way I feel when I walk, [the disabled list] is a pretty safe bet." At this point Peavy is acutely aware of how an injury in his lower half can affect his upper half. When I talked with him during spring training, he acknowledged that the ankle injury he sustained while with the San Diego Padres had not fully resolved when he went to the White Sox. He said he suspects compensations he made for the leg contributed to abnormal mechanics and ultimately the failure of his latissimus dorsi tendon.



After that experience and the lengthy rehabilitation process he has just undergone, it is highly unlikely he would run the risk of returning to play while compromised. A groin strain is no small issue for a pitcher, no matter which leg is involved. In this case, it's Peavy's right leg, or his stance leg, and he needs strength in the musculature for balance during the wind-up. He needs power and flexibility as he moves further into his delivery and transfers his body weight forward to his left (landing) leg. He also needs to be able to move off the mound quickly for defensive plays. In the fourth inning of Sunday's game it was during a defensive move to cover first that Peavy first felt a "grabbing" pain, according to the Sun-Times. Peavy expected to undergo further evaluation Monday, but it appears fantasy owners should plan on a two-week absence, minimum.

Rafael Furcal, SS and Jon Garland, P, Los Angeles Dodgers: Furcal has to be asking himself what he did exactly to deserve yet another injury to yet another body part. On the DL for the second time this season, Furcal is now dealing with a left-sided oblique strain suffered during Friday's game. Oblique injuries typically require a few weeks of recovery, depending on severity, and given Furcal's history of low back problems, it is critical that he not return too soon. In other words, it's hard to imagine him returning before the end of the month, perhaps even the All-Star break. Sigh. The Dodgers also lost Garland to his second DL stint of the season (he started the season on the DL with, yes, you guessed it, an oblique injury). This time it's his throwing shoulder that's the culprit, and no one ever likes to see that in a veteran pitcher. Garland has been remarkably durable, but now that he is 31 years old, this could be a sign of things to come.

Brandon Belt, 1B, San Francisco Giants: Belt was placed on the DL when it was discovered he had a hairline fracture in his left wrist after being hit by a pitch last week. Consider this another blow to the Giants, who had brought Belt back into the lineup following the season-ending injury to Buster Posey. Although Belt's fracture likely will take another month to heal, he could resume baseball activities before then if he's progressing well.



Coming

Matt Garza, P, Chicago Cubs: Garza has been activated and will start Monday against the Cincinnati Reds. He has been sidelined with an elbow contusion but has felt no pain when throwing recently, including a solid bullpen outing late last week. Pitching in a game situation is always a little more strenuous, though, so it remains to be seen how he will fare.

Derrek Lee, 1B, Baltimore Orioles: The Orioles got Lee back this weekend after he spent time on the DL with an oblique injury. Lee sustained the injury in mid-May and has returned fairly swiftly. It's worth pointing out that although Lee started the season on time, he missed a good portion of spring training because of his thumb, forearm and foot. The missed time may explain, in part, his unspectacular start to the season. If he is fully healthy now, it will be interesting to see what he has in the tank.



Adam Lind, 1B, Toronto Blue Jays: In case you missed it, Lind snuck back into the starting first-base role for the Blue Jays on Sunday, and all he did was go 4-for-4 with two home runs. It appears his back is much better. Lind had been out for nearly a month with intermittent back spasms. Early on, the team hoped Lind could avoid the DL altogether, but after several setbacks the extended time off became the wise choice. In retrospect it certainly seems as if Lind benefited from that decision, and while back pain is always at risk for recurrence, the hope is that the longer reprieve will help him avoid just that.

Somewhere in between

[+] EnlargeRyan Zimmerman
Al Bello/Getty ImagesRyan Zimmerman has not played in the majors since April 9 but is making progress in the minors.
Washington Nationals third baseman Ryan Zimmerman is working his way up the ladder following abdominal surgery in early May. On Sunday, Zimmerman appeared in a rehab game with Class A Hagerstown. After delivering a double, a triple and an RBI, Zimmerman is being moved to Class A Potomac. According to the Washington Post, Zimmerman referred to himself as winded and "sore" after the outing, noting he "was out of breath for a while after that triple." These are all normal responses to returning to game action following the type of surgery Zimmerman underwent, and he will continue to build his endurance and his strength by increasing the level of play. While there is no definitive date for his return, Zimmerman is certainly within the standard timeframe of recovery of six to eight weeks.

Philadelphia Phillies shortstop Jimmy Rollins was seen limping in the clubhouse Sunday after fouling a ball off his right kneecap Saturday. On Sunday, Rollins told the Philadelphia Inquirer, "It'll be a couple of days, but I don't think a DL thing, not at this moment," explaining that the response of the swelling would determine what he was able to do. On Monday, Rollins was not in the lineup and is considered day-to-day.

The New York Mets won't be getting third baseman David Wright back in the lineup this month. After a re-evaluation, Wright says he will have to wait at least another three weeks before resuming baseball activities. Teammate Ike Davis, who incidentally was injured in a collision with Wright in early May, also remains out with a bone bruise in his left ankle. When Davis tried to progress to running, it became so painful that he was forced back into a walking boot. As Davis told ESPN New York, if he does any running right now it's on an underwater treadmill. The good news is that he is hitting and working on other conditioning activities. But the impact of running is something the joint cannot tolerate yet.



Tampa Bay Rays third baseman Evan Longoria gave everyone a scare when he left Saturday's game early with "tightness" in his left side. Yes, it's the same side in which he suffered the oblique injury earlier this year. But Longoria was able to pinch hit Sunday and is expected back in the lineup Monday. Maybe he just wanted to see if anyone would notice. Judging from the collective anxiety of fantasy owners everywhere, the answer is yes, we noticed.



Resume normal breathing everyone, at least until tomorrow.

This edition of Fantasy Focus features injury updates on Hanley Ramirez, Matt Holliday, Francisco Liriano, Wandy Rodriguez, Ryan Zimmerman, Vernon Wells and Howard Kendrick.


Suffice it to say it's been a tough few days for third basemen, and for fantasy owners trying to fill that gap in their lineup. Just when one comes back (Evan Longoria is set to return to the Tampa Bay Rays lineup Tuesday), several more are lost to injury. Like Longoria, fellow third basemen Ryan Zimmerman, Pablo Sandoval and David Freese are all expected to miss extensive time. Here's what we're hearing about the recent trifecta of hot corner injuries as we roll into May.

[+] EnlargeZimmerman
Rhona Wise/Icon SMIWhat looked to be a short disabled-list stint is turning into an extended absence for Ryan Zimmerman.
• Of the three, perhaps the bad news on Zimmerman's injury status was the easiest to see coming. After all, Zimmerman was already on the DL with an abdominal strain and was clearly not near ready to come off it when eligible last week. After seeking a second opinion from Dr. Bill Meyers, one of the true pioneers when it comes to this cluster of abdominal/pelvic injuries and surgical repair, Zimmerman learned that his condition would require surgery and an absence of at least another six weeks.



Zimmerman will have surgery Tuesday to repair a torn abdominal muscle. According to the Washington Post, Zimmerman has a rectus abdominis tear. The rectus, as it is often referred to, is the muscle group that forms the dramatic "six-pack" on folks who are in impressive shape. The tendon of the rectus attaches at the pubic bone (located at the center of the pelvis where the abdomen meets the groin). Tearing of this tissue near its attachment point makes any attempt at power movement from the pelvis or the trunk weak and painful. This explains why Zimmerman could not throw or run effectively as he tried to work his way back from the initial injury.



To recap, Zimmerman initially suffered a minor strain during spring training. Little more than a week into the start of the season Zimmerman severely aggravated the injury on a headfirst slide into second base. Days later he was placed on the DL and he has been there since. The severity of these injuries is often difficult to determine at the outset. Failure to recover with conservative treatment often ends up being one of the best indicators for surgery. Imaging tests are useful for ruling out more sinister problems, such as tumors or fractures, but are often not definitive when it comes to determining the need for soft tissue surgical repairs. As Zimmerman acknowledged, despite the disappointment of now finding he will miss even more time, he has not second-guessed the process. According to the Post, Zimmerman said, "Surgery is always the last thing. It's the last resort every time. You want to rehab it, and we gave it that chance."



The success rate following this type of surgery is high. The key initially is to allow scar tissue to form, which stabilizes the area, and the athlete is then brought along gradually as comfort allows to regain strength and power. The average timetable is six weeks but can vary depending on the extent of the procedure and the individual athlete's healing process. Nationals general manager Mike Rizzo told the Post they hope to have Zimmerman back in six weeks, "if all goes well." For what it's worth, St. Louis Cardinals infielder Nick Punto underwent a similar procedure in late February and was recently activated at just less than eight weeks post-surgery. No one should mark the return date for Zimmerman in stone just yet.

• Speaking of the Cardinals, they also saw third baseman David Freese go down this weekend after he was hit on the left hand Sunday by an inside fastball. It now appears that Freese's absence will be lengthy. FoxSportsMidwest.com writer B.J. Rains reported via Twitter that Cardinals general manager John Mozeliak has indicated that Freese will be out 9-12 weeks. While disappointing, the news that Freese will undergo surgery is not a huge surprise. Freese's immediate pain upon being struck conveyed the seriousness of the injury, and X-rays onsite confirmed the presence of a fracture. Surgery with hardware implantation is often required to ensure proper alignment and help facilitate the healing of the bone. The fracture can take up to six weeks to heal and then there is the issue of restoring full mobility and grip strength. Delivering power through the bat swing often takes longer still. Much will depend on how Freese's healing progresses post-surgery, but plan on two months absence at a minimum.

[+] EnlargePablo Sandoval
Jeanine Leech/Icon SMIPablo Sandoval was hitting .313 with five homers when he landed on the disabled list.
• As we move farther west, we find yet another third baseman out with a hand injury. Pablo Sandoval has a fractured hamate bone and the San Francisco Giants have projected his absence at four to six weeks. We discussed this specific injury when the Philadelphia Phillies lost outfielder Domonic Brown during spring training. Brown underwent surgery in early March and was just removed from the disabled list, and subsequently optioned to Triple-A.

In an interesting twist, Brown's teammate Ben Francisco, who has benefited in terms of playing time during Brown's absence, has experienced this very injury. When I talked with Francisco about the injury during my spring training visit with the Phillies, he noted that the surgical area remained sore for some time afterward. Francisco pointed out that the athletic training staff did a great job of padding his bat, but even after he had technically healed, it took a few additional weeks to regain his power. Certainly, Sandoval was delivering some power for the Giants at the time of his injury and his loss will be apparent. The hope has to be that neither the interruption of play nor the surgery itself will impact him beyond his DL stay.

• Third basemen weren't the only ones who suffered over the weekend. Perhaps the most dramatic injury was the result of an outfield collision between the Houston Astros' Angel Sanchez and Carlos Lee. As Lee went to the ground to try to make a play, his ribs absorbed the blunt force from the knee of a sliding Sanchez. Lee had to be carted from the field and spent the night in the hospital. The good news was that no fracture was observed, but the Astros' website reported that a CT scan revealed a left rib contusion for Lee. Make no mistake: A contusion (or deep bruise) can be just as uncomfortable as a break in the early stages. Lee will have difficulty with deep breaths, reaching, twisting and lying on that side for a while. Although the team is calling him day-to-day, it would not be surprising for Lee to become a DL addition if the pain proves to be lingering.

Video: Zimmerman, Mauer updates

April, 28, 2011
4/28/11
7:04
PM ET
In Thursday's edition of Fantasy Focus, Stephania Bell discusses the eventual returns of Ryan Zimmerman, Joe Mauer, Johan Santana and others.
In Thursday's edition of Fantasy Focus, Stephania Bell has forecasts on when Ryan Zimmerman, Rafael Furcal, Kendrys Morales, Grady Sizemore, Jake Peavy and Andrew Bailey may return from their injuries.

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