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Tuesday, February 28, 2012
Updated: March 1, 4:33 PM ET
2012 preseason injury watch: SPs

By Stephania Bell

As you prepare for your 2012 fantasy baseball season, injury stories from last season are undoubtedly a factor. A number of players either had their seasons end prematurely due to injury or limped into the offseason with health concerns. Now spring is around the corner, and you need to know how concerned you should be. Since the top predictor of injury in one year is injury the year before, it's hard to feel confident about anyone who lost significant time in 2011. That said, some athletes appear to be on the verge of bursting back on the scene this spring while others cast shadows of uncertainty all around them. Here's what we're hearing about some of the players with major injury concerns surrounding their names.

We'll be splitting up the injury reports by position to make it a little easier to find information about the players drawing the most attention.

Starting Pitchers

Stephen Strasburg
Stephen Strasburg struck out 24 and walked just two in 24 innings over five starts at the end of the 2011 season as he returned from Tommy John surgery.

Stephen Strasburg, Washington Nationals: The 23-year-old pitching phenomenon is entering this season strong as he continues his progression post-Tommy John surgery. Strasburg tore his ulnar collateral ligament in August 2010, and his rehab following surgery has largely proceeded without a hitch. Strasburg even returned late last season to deliver some innings in the majors, a move questioned by some who thought it was risky. From the rehab perspective, however, it made perfect sense; it was simply the next level of progression in the return to pitching following this procedure. In fact, one could argue the big league appearances proved he could throw competitively at the top level. The only element remaining is building his game endurance, something that will develop over the year. As the Nationals did with young Jordan Zimmermann in his recovery from the same surgery, they will limit Strasburg to approximately 160 innings. As to whether the Nationals might adjust how those innings are spread out to help lengthen Strasburg's overall season (think: playoffs), Adam Kilgore of The Washington Post reported that general manager Mike Rizzo said that is not an option. Count on the Nationals to protect their investment by controlling Strasburg's time on the mound, but all signs point toward expecting good things right out of the gate.

Johan Santana, New York Mets: Santana underwent surgery in 2010 to repair a torn anterior capsule (fibrous tissue that helps provide stability to the joint) in his left shoulder, and while his progress was strong last year, a couple of stalls due to soreness and fatigue, not uncommon in this recovery process, kept him from returning to the big leagues. Now there is much anticipation about what he will do and when he can do it this year after the additional recovery time of the offseason. As of this writing, Santana is scheduled to make a start in a spring training game within the week, and the team is optimistic he could be ready by Opening Day. But as Santana told ESPN New York's Adam Rubin, "I'm not trying to hurry anything. I'm just going to go one step at a time. If it's there, great. If it's not, I'll work my way up. That's what we're looking for." Sounds like the intelligent approach of a guy who's been forced to take things slowly for the past year. The hope is that his return to the big league mound will be uneventful, as in free from setbacks. It would not be surprising if Santana is not pushed deep into games initially while he regains his competitive form.

Josh Johnson, Miami Marlins: The concerns about Johnson's shoulder heading into last season played out in a more dramatic way than anyone expected. Johnson went on the DL with shoulder inflammation in May and never made it back. While there were never any reports of any significant findings, Johnson could never progress past a certain point. Every time he returned to throwing from the mound, it seemed to trigger a setback, until eventually there was no time remaining on the calendar. But it's what Johnson did differently this offseason that might factor the most into how 2012 plays out. Last year Johnson indicated he focused on building strength -- as in total body strength -- and on his 6-foot-7 frame, he easily could become an even more imposing physical presence on the mound. Still, that might not be the ideal goal for his particular job demands.

Josh Johnson had a 1.64 ERA in nine 2011 starts before injuries ended his season prematurely.

This offseason, however, Johnson worked with a physical therapist on very specific strengthening of the musculature that supports his throwing arm. This type of exercise will not make it outwardly appear as if one has spent serious time in the weight room. It will, however, focus on the neuromuscular coordination of the muscles most important to a pitcher, the ones that often go untrained or at least under-trained, when one veers more into heavy lifting. Add to Johnson's new regimen the effect a new park in south Florida could have: less playing in extreme heat and no more rain delays, thanks to a roof, all of which can influence a pitcher's preparation and performance. While concern carries over from last year, given that Johnson was never able to return in 2011, the additional time of the offseason along with an altered training program is at least encouraging. Apparently the Marlins believe that as well, since Johnson is already expected to be their opening day starter.

Tommy Hanson, Atlanta Braves: As with Josh Johnson, Hanson's season ended as a result of shoulder problems. It was reported last season that Hanson had a small rotator cuff tear, one that was characterized as typical for a pitcher as a result of wear and tear. Hanson returned to pitch after spending some time on the DL in June but was forced out again in August and was unable to return afterward. As if that wasn't enough, Hanson was involved in a car accident en route to spring training, which resulted in a concussion. Fortunately, it appears Hanson is recovering swiftly and, as of this writing, is expected to begin throwing from a mound soon.

There definitely is cause for concern with Hanson, just as there was with Johnson last year, in that his season ended with an injury to his throwing arm and no clear resolution. According to the Atlanta Journal-Constitution, one of the steps Hanson took in the offseason to eliminate potential contributing factors to his shoulder woes was to modify his delivery. Working with pitching coach Roger McDowell, Hanson apparently is using his legs to better assist in driving his delivery. This should offload not only his shoulder, but also his elbow, which often can suffer the most catastrophic blow when the shoulder is impaired and mechanics are compromised. It remains to be seen just how effective his adjustments are and how healthy he truly is, something that can be learned only as the season progresses.

Adam Wainwright, St. Louis Cardinals: It's safe to say Wainwright's spring likely will be much improved over last year's. Last year, his season ended before it got started when he suffered a torn ulnar collateral ligament and underwent Tommy John surgery. If there was to be any silver lining on that dark day, it was the fact the injury happened so early, leaving Wainwright enough time to recover for the 2012 season. He has been progressing on track and hopes to be ready by Opening Day. By now we know, however, that these schedules remain fluid based on how the athlete performs and feels after each successive outing.

Daisuke Matsuzaka, Boston Red Sox: Matsuzaka was enduring his share of struggles when his season ended prematurely as a result of an elbow injury. He ultimately underwent Tommy John surgery in June, and it might have been one of those blessings in disguise. One of the biggest benefits for a pitcher who goes through this surgery is the time and attention the rest of the body gets as it "relearns" how to deliver a baseball. The surgery itself and the subsequent elbow rehab are fairly straightforward. But most pitchers, many of whom have been throwing since their youth, have not experienced such a lengthy downtime from their sport. Their bodies rarely experience adequate recovery time, and mechanics are often tweaked but rarely re-engineered. The process of rehabilitation post-Tommy John surgery forces the reconditioning of the entire body from the legs and trunk to the whole throwing arm, not just the elbow. It is a big part of the reason pitchers often say they feel better throwing the ball following this procedure. In Matsuzaka's case, this opportunity might really help him.

ESPN Boston's Joe McDonald has been observing Matsuzaka at spring training and says he looks as fit as he's ever seen him. McDonald says Matsuzaka has been throwing bullpen sessions but adds that manager Bobby Valentine says Matsuzaka will not pitch in a game this spring. Given his timetable, Matsuzaka likely will be nearing game-readiness around the All-Star break. If he's going to contribute significantly, it will come in the second half of the season.

Clay Buchholz
Clay Buchholz won 17 games in 2010 but was limited to just 14 starts total in 2011.

Clay Buchholz, Boston Red Sox: Buchholz suffered a back injury in June 2011, later determined to be a stress fracture, which prevented him from returning last season. Buchholz had been making significant progress with his rehab late last year, however, and had the Red Sox reached the playoffs, it's possible Buchholz could have returned out of the bullpen. Since that never materialized, Buchholz was not seen by the baseball audience late last year, but his rehab efforts did allow him to begin his offseason program sooner. This spring he already has thrown more than a dozen bullpen sessions, and, according to ESPN Boston's Joe McDonald, Buchholz says this is the best he's felt in a while. The type of injury Buchholz had is certainly something he can be expected to fully recover from and return to competitive form. It sounds as if he is doing exactly that.

Brett Anderson, Oakland Athletics: Anderson is yet another on the long list of Tommy John surgery recipients, and he is not expected to be ready to compete until roughly halfway through the season. Anderson underwent surgery in July and, as of this writing, is beginning to throw bullpens. His progress is definitely a good sign, and the track record on recovery from these surgeries is excellent. The unknown is typically when the velocity and command ultimately will be restored. Stay tuned for updates as the season progresses.

Jorge De La Rosa, Colorado Rockies: The ulnar collateral reconstruction camp grows ever larger. De La Rosa underwent surgery on his left elbow in May, particularly poor timing since he was off to such an amazing start to the 2011 season. The hope is that he will be primed to return by June, but it could take additional time for him to recapture the form of last year.

Juan Nicasio, Colorado Rockies: Nicasio's injury might have been one of the scariest sights in baseball ever. A comeback line drive drilled Nicasio in the head, causing him to fall to the ground, resulting in a fracture of his C1 vertebra, the vertebra that sits just below the skull. The fracture was surgically repaired, and, thankfully, there was no neurological damage. In fact, Nicasio was up and walking in the hospital just days after the surgery. As early as October, he was throwing from a mound, along with weightlifting and other cardiovascular conditioning. Perhaps most amazing is the reality that Nicasio is completely healthy and ready to compete, prepared to face hitters and take on what for most of us would be an unsurmountable fear. As of this writing, Nicasio is scheduled to pitch soon in an intrasquad game in which he will face live hitters. Troy Renck of the Denver Post tells the amazing story of Nicasio's recovery, and it certainly has everyone believing not that he can return to pitch again, but that he will.

Dallas Braden, Oakland Athletics: Braden underwent left shoulder surgery last May, ending his season after just three starts. The procedure, a repair to the shoulder capsule (fibrous tissue that envelops the joint and helps provide stability), has been known to sideline pitchers for well more than a year. So far, the outlook on Braden appears to be far more positive. Already with a handful of bullpens under his belt, Braden is on track to return sometime this spring, potentially late April or early May, depending on how he responds as his workload increases. While the news is exceptionally encouraging, it's best to temper expectations, as the trickiest part of the return -- increasing endurance while throwing all pitches at full velocity -- is yet to come.

Stephania Bell is a physical therapist who is a board-certified orthopedic clinical specialist and a certified strength and conditioning specialist. She is a clinician, author and teacher with extensive experience in the area of orthopedic manual therapy and sports medicine.