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Thursday, February 14, 2008
Updated: March 12, 8:37 PM ET
Injury talk: Key hitters to track

By Stephania Bell
ESPN.com

There are several routine injuries that are known to affect hitters on a regular basis: muscle strains, ligament sprains and just about every possible form of tendinitis. There are also a variety of unique acute injuries that hitters contend with, however, that run the gamut of infinite medical possibility. Unfortunately, this makes it perhaps more challenging to determine which players are at greatest injury risk, even when we know their past history.

Nonetheless, there are a number of hitters who head into the 2008 season with the specter of injury looming over them. So who will "go the distance" this season and from whom should you keep your distance on draft day? We examine several key hitters who had some type of ailment in the past year and assess their risk versus reward.

Just as traffic signals tell you whether to stop, slow down or proceed, we will do the same with each hitter to guide your fantasy decision. A "Green" means we have high confidence that the player will bounce back and deliver this season. Of course, we can't predict future injuries, but based on the player's injury management in the offseason, these are athletes for whom we have high expectations. A "Yellow" means to proceed with caution (not speed up, like some of you do when driving). This player might have high upside but comes with the risk of not being available for the entire season. And finally, a "Red" means to, well, stop. Avoid the player because the risk outweighs any potential reward. Shop elsewhere.

Hanley Ramirez
You wouldn't have known it by his performance, but Hanley Ramirez had shoulder problems in '07. But he should be good to go in '08.
Hanley Ramirez, SS, Marlins: Ramirez suffered through painful shoulder subluxations on his left (nondominant) side after a big swing and a miss in July. Believe it or not, there is a condition sometimes referred to as "batter's shoulder," and Ramirez's ailment seems to fit the bill. The pain often comes on a swing and a miss because during the follow-through, the lead shoulder goes through a wider arc of motion than it would if the athlete hit the ball. Also, contact of the bat with the ball slows down the swing just enough, and provides "input" to the shoulder to key the stabilizing muscles around the shoulder to fire, and therefore decrease sliding of the arm in the socket. After Ramirez suffered the more severe episode in July, the arm was more susceptible to recurring pain with similar swings throughout the season. As it turns out, Ramirez had similar pain in this shoulder previously, specifically over the two years prior, but always felt better after some rest. Last year that was not the case, and the problem persisted.

Offseason surgery to repair a partially torn labrum and stabilize the shoulder should have removed the cause of any mechanical irritation within the shoulder joint itself, and the postoperative rehab should have given Ramirez the strength necessary to protect the shoulder. Unlike pitchers, on whom labral repairs are much more problematic because of the way they use their arms, position players have a quicker recovery and less risk of future issues with their shoulders. Besides, Ramirez throws with his right arm, so his defensive play should not be affected. Ramirez is a youngster with a boatload of offensive talent, and addressing this shoulder issue in the offseason should only make him a more potent weapon.

Albert Pujols, 1B, Cardinals: Pujols played through an assortment of muscle strains last year (calf, hamstring) and seemed to tough it out, even when he was clearly not feeling his best. Not anymore. Pujols said it himself: He will not put his body through the same kind of torment this year. This was revealed at the same time he announced he would not seek surgery on his problematic elbow, the one he reportedly can no longer fully extend. A bit foreboding, don't you think? When an athlete announces before the season starts that he will not subject his body to the same stresses that he has in the past, and he sounds a bit exasperated from what he has put himself through, that does not inspire a lot of enthusiasm that he'll play 140-plus games, no?

So how worried should fantasy owners be? Well, the fact that Pujols has some elbow pain and limitations would be of more concern if his responsibilities were on the mound. As a first baseman, he has shown that he can handle his duties without much interference. In fact, he showed he could remain a dominant hitter despite the presence of some musculoskeletal aches and pains. The key to Pujols' success is maintenance. If he can keep his body at a steady state, he should be able to survive the majority of the season while playing the way we have come to expect. If, however, he has a setback, such as an acute episode of inflammation at the elbow, or a worsening of his current condition, then the circumstances change. Pujols is more likely to take that stint on the DL to allow his body the rest and recovery it needs in an attempt to prevent the issue from being severe the remainder of the season. At 28, Pujols is no longer a young man, but he has plenty of playing time left in him. The uncertainty here is his durability across the entire season, especially when he already has made it clear he will step back as needed to protect himself.

Given how much his elbow reportedly bothered him last season, and that he no longer is in his early 20s, Pujols carries more risk this year than in his previous seasons. But there is no denying the offensive upside of a player of this caliber. Fantasy owners face some risk in drafting him in that he is likely to hit the DL more than once this season, even if it's just for self-preservation. Expect him to play well when he plays, though, and given his power, he still might be a risk worth taking to many of you.

Troy Glaus, 3B, Cardinals: Glaus developed foot problems in spring training last season and was never really 100 percent the rest of the season. Glaus dealt with plantar fasciitis (inflammation of the tissue that helps support the arch of the foot) in his left foot, and in September, he also reported a "pop" in the foot, which was reported by the team as possible tearing of adhesions or scar tissue. Blue Jays GM J.P. Ricciardi described Glaus' worst pain as being near the heel and the bottom of the foot. The team felt it had exhausted all of its options in terms of his treatment until a trip to Anaheim, where it learned of a surgical possibility. Ultimately, Glaus underwent a decompression surgery on a nerve to the foot (meaning tissue that could be putting undue pressure on the nerve is released in an effort to decrease pain), as it was thought that this could be the underlying source responsible for Glaus' overall symptoms.

The surgery was deemed successful and Glaus reportedly has been doing hitting and light running, and he's expected to be ready to go by spring training. Of note here is that Glaus now will play his home games on natural grass in St. Louis rather than the artificial turf at Rogers Centre, which should help his foot. He is 31 years old, meaning his tissues might not be as resilient as they once were, but if the source of his symptoms really has been addressed with the surgery, there is no reason to suspect that this will be a problem in 2008. Nonetheless Glaus has had other health issues in the past, and he's no spring chicken. His potential power should be a boon for the Cardinals if he can stay on the field this year.

Joe Mauer
The physical stress of being a catcher might keep Joe Mauer out of our lineups from time to time.
Joe Mauer, C, Twins: Mauer and his left side did not seem to be in sync last season. It started early when he was diagnosed with a stress reaction in his left leg. A stress reaction is a precursor to a stress fracture; all the same symptoms (namely sharp, localized pain) are present, but there is no evidence of a fracture. Increased activity in the bone suggests it is attempting to repair itself on a microscopic level before a visible fracture results. Treatment is simple: Rest the ailing body part to prevent progression of the injury. Not much is known about how Mauer might have developed this injury, but it is worth keeping in mind he had a major meniscus injury in his left knee in 2004 that required surgery. Catcher, of course, is not the easiest position on the knees since it requires being in a crouched position much of the time. Add to that the explosive nature of popping out of the crouch to make a play, which increases loading through the knee joints. In the absence of a portion of the meniscus, Mauer is increasing the forces through that exposed part of the knee joint with everyday activities, and it's quite possible he has developed some compensations that have altered the way he puts load through that side of his body.

It would certainly appear that way when you consider Mauer also suffered a strained quadriceps muscle and a strained hamstring, both on the left side, during the 2007 season. The good news is that he still has that sweet stroke, and when healthy, he'll put up great numbers. There was some speculation that he might be moved from the catcher position to DH in an effort to preserve his knees and everything that has attachments to or above them, but that did not occur. The fact that he plays catcher places him more at risk despite his being a youthful 24 years old. Fitness and conditioning can go a long way in preserving his career, and Mauer will need that to help protect his joints. Considering he's effective when healthy, we can only hope he'll stay that way in 2008. But until proof to the contrary arrives, the caution flag for injury waves in the background for Mauer.

Rocco Baldelli, OF, Rays: Baldelli was plagued last season with not one but two bad hamstrings that kept him on the DL for months, eventually ending his season. Just as he seemed poised to return, he would aggravate one side or the other to the point in which he could no longer run. Unless you're a pitcher, you need to run in baseball. (One could argue National League pitchers do need to run, but the truth is everyone forgives them if they can't.) If you're an outfielder, you need to run on offense and on defense. The Devil Rays took all sorts of steps to solve the hamstring mystery, including retraining Baldelli's running style. There is reason to hope Baldelli will turn a corner with this situation and come back to put together a solid career. Unfortunately, however, based on his 2007 season, there isn't enough evidence to support the notion that he can endure the season without one of the two hamstrings failing. Hope from afar; let someone else take the gamble. (Editor's Note: Baldelli will start the season on the disabled list due to a mysterious ailment which leaves him extremely fatigued after short workouts. We will update as more information becomes available.)

David Ortiz, DH, Red Sox: Big Papi's big hurt last year was a strained shoulder caused by an attempt to slide, but it was a torn meniscus that caused him more disability, making it painful for him to swing hard and run the bases. He persevered right through the World Series despite being visibly slowed by irritation in the knee. Now that he has undergone surgery in the offseason to address the tear and has been rehabbing his way back to health, there is every reason to believe Ortiz is headed for another productive season. At 32 years young, Ortiz should be able to motor on … as long as he avoids the headfirst slides.

Gary Sheffield
Never mind his age or shoulder injury in 2007, Gary Sheffeld will still let it loose at the plate in '08.
Gary Sheffield, DH, Tigers: Who says being 39 years old is something to be concerned about? Not Sheffield, that's for sure. He suffered a shoulder injury in 2007 when he collided with Placido Polanco and had problems with the shoulder the remainder of the season. He underwent cortisone shots and periods of rest, but he couldn't quite get the power back in his arm, and the Tigers eventually shut him down for the season. During the offseason, Sheffield underwent surgery to repair a minor labral tear, but as a hitter, this is not a big deal as surgeries go (see Ramirez above). All signs point to Sheffield being ready to go by spring training -- according to a recent report by the Detroit Free Press, Sheffield is swinging the bat pain-free -- and the Tigers expect he could be in the outfield on Opening Day. Power without pain. A great combination.

Aubrey Huff, 1B, Orioles: Huff reportedly strained his groin while working out in the offseason but initially did not think it was serious. However, he eventually underwent surgery to repair a hernia in early January. After such a surgery, athletes need to stay away from vigorous activity for a period of time (Huff will be kept from baseball-related activities for six weeks post-surgery). The biggest concern after hernia surgery is allowing enough time for the abdominal tissues to heal so that there is no risk of re-injury. Once that point in time has passed, there shouldn't be any major concerns about this being an ongoing issue. Huff should be able to get on the field around the time spring workouts begin for the Orioles' position players and will have plenty of time to get in shape for Opening Day. Huff did not have a great season last year, and the Orioles have to hope he will rediscover some of the power he once had with the Devil Rays. But from an injury standpoint, there is no reason to suspect he can't. Whether he is able to resurrect his hitting skills is another story.

Vladimir Guerrero, OF, Angels: Guerrero ended his season as a DH after being limited in outfield play by a triceps injury. It began in September as an inflamed right triceps and was intermittently referred to as "tightness" and tendinitis. No matter the label, the end result was that Guerrero's outstanding throwing arm was out of commission for the last few weeks of the season. The triceps, the three-headed muscle on the back of the arm, has attachments to the elbow and the shoulder and helps control the stability of the shoulder in the joint. When the arm is rapidly extended, which happens with a hard throw from the outfield, the triceps is working hard to decelerate the motion. Any inflammation or irritation of the muscle or its tendon will cause pain and weakness, rendering the hard throw ineffective. Consequently, Guerrero could manage to hit, but could not perform in the field. The much-needed offseason rest should have done the trick for him, however, and he should not see any lingering effects in the arm this spring.

Ryan Zimmerman, 3B, Nationals: Zimmerman developed pain and swelling in his hand after taking some swings during the offseason, and it turned out to be a broken bone that was causing it. Zimmerman broke a piece of the hamate bone, one of the small carpal bones of the wrist that has a "hook" or projection that sits very superficially in the palm. Hamate injuries are not uncommon in hitters, as this hook portion can develop a crack as a result of repeated contact or shearing with the bat. The solution often, as was the case for Zimmerman, is surgery to remove the offending piece, and the resolution is typically good. Zimmerman did have some blood that accumulated around the area post-surgery and had a separate minor procedure to remove that. Now he appears to be recovering on track, has been doing some light hitting and expects to do "everything" in spring training, according to a recent AP report. Just 23 years old and motivated, Zimmerman should have no lingering issues with the hand this year.