Preseason injury watch: Outfield
The 2013 fantasy baseball season is right around the corner. Aside from tracking which players have traded uniforms and ballparks, gauging the health of those with injury concerns is of paramount importance. Each position has a few key fantasy players -- we've addressed only those players in the top 150 for now -- with question marks by their names entering the spring. Although teams limit the details of players' medical histories, there is still significant information to be gleaned from an understanding of the athlete's condition and status-report updates as to his activity. As the season approaches, these situations will evolve because many players recovering from injury or surgery will progress their activity accordingly or, in some cases, encounter delays or setbacks.
Curtis Granderson, New York Yankees (updated Feb. 25): Granderson entered spring training healthy, but unfortunately for him and the already-injury-riddled Yankees, his name was quickly added to the injury list, courtesy of a J.A. Happ fastball in just the second game of spring training (on Feb. 24). The result: a fractured forearm. According to ESPN New York, Granderson suffered a break in his right ulna, the more medial (innermost) of the two forearm bones that run from the elbow to the wrist.
The Yankees have projected a 10-week absence, which sounds reasonable. There has been no mention of surgery to repair the break which suggests it is of the small, non-displaced (the bony ends remain in proper alignment) variety. Granderson's comments about the injury were also encouraging. "It was just one specific spot," Granderson said. "Nothing moved up or down. No numbness. No tingling. Just that spot." No numbness or tingling indicates the ulnar nerve was not threatened. The localized spot of pain supports the notion that the injury was not as severe as it might have been. In fact, the initial thought was that Granderson had suffered merely a bruise until X-rays taken at a local hospital revealed the fracture. The ulna unfortunately has very little soft tissue padding over it, hence its vulnerability to a fracture on direct high impact.
Treatment in non-surgical cases involves a period of protection, such as bracing or splinting (Granderson was reportedly wearing a removable brace immediately post-injury), which allows the bone to heal and takes approximately six weeks. As soon as good bone healing has been established, it's primarily a function of progressing through sport-specific activities, including some rehab games to restore baseball conditioning along with timing at the plate and reps in the field. If everything goes as planned, there's even a possibility Granderson could return sooner, although no one should count on the timetable to shift dramatically. The other bonus is that the injury is not at the joint, which could have been more threatening to his swing. Once Granderson removes any post-immobilization stiffness and regains full strength in his wrist and forearm muscles, there should be no lingering concerns.
Matt Kemp, Los Angeles Dodgers: After playing in nearly every game for four straight seasons, Kemp was forced to the DL not once but twice in 2012 after suffering a significant hamstring strain. By the latter part of the season, his upper body was giving him trouble as well. Kemp underwent surgery to repair a torn labrum in his left (non-throwing) shoulder in October. In January, he was hitting off a tee and participating in soft toss. As of mid-February, he had taken batting practice only a few times, and he acknowledged his activity was being ramped up gradually.
Since the injury is to Kemp's lead batting shoulder, one key to him regaining his power will be the ability to follow through on his swing without any restriction. The pain will no longer be there now that the tissue has been repaired, but it often takes time to reconnect a hitter with his natural swing after such a procedure. Adrian Gonzalez, now a teammate of Kemp's, underwent a similar procedure following the 2010 season. Gonzalez said it took time to regain his natural motion at the plate after trying to compensate for the pain in his shoulder by shortening his swing.
While Kemp says he expects to be ready for Opening Day, it's not wise to assume he will come out of the gate strong. His activity throughout the spring will help indicate how he is progressing, but it wouldn't be surprising if it takes into the season for him to fully return to form. The hope is that the offseason has also allowed his hamstring time to fully recover. The risk of Kemp suffering a hamstring strain increases given the prior incident, but he has made it clear his goal is to stay healthy in 2013. There's no reason to think Kemp can't return to his All-Star form; the only question is how long it will take before he does it.
Jose Bautista, Toronto Blue Jays: Bautista underwent left wrist surgery in September to repair a torn tendon sheath, which helps stabilize the tendon and decrease friction. As sportsnet.ca reported, Bautista originally injured "the sheath that holds the tendon on the pinkie side of his left wrist" while hitting a foul ball in mid-July. The tendon sheath in question is that of the extensor carpi ulnaris (ECU), the muscle that functions to extend the wrist and bend the wrist toward the pinkie side. The tendon, which anchors the muscle to the bone, is covered by a tissue sheath that helps decrease friction forces of the tendon as it moves relative to the bone. Damage to the sheath and surrounding tissue can result in instability or a snapping of the tendon as it slips relative to the adjacent bone with wrist movements. The athlete is often acutely aware of the instability with the particular aggravating motion -- in Bautista's case, swinging the bat -- which can range from uncomfortable to painful. Bautista had a DL stint after the original injury, tried to return, but aggravated the wrist again and ultimately opted for surgery. The procedure was to repair the damaged tissue and restore stability to the tendon to allow for free and natural motion.
Bautista's scheduled rehab time was three to four months, and he has progressed as hoped. The first order of business was regaining range of motion in the wrist, followed by strengthening. In early January, Bautista was hitting in a cage, at which point he told the National Post he already felt 100 percent and game-ready. Naturally, the team's goal has been to move him gradually along through a progression, utilizing spring training to do just that. He has been taking batting practice in spring training and continues to report feeling good doing so. (ESPN.com's Jayson Stark watched Bautista take batting practice recently and told me he was hitting the ball into the palm trees beyond the field, adding, "He looked normal.")
Any wrist injury is always a cause for concern with a power hitter, but not all wrist injuries are created equal. The key to retaining power is regaining adequate motion through the wrist to allow the hitter to maintain his normal swing. Any restriction in motion will alter how he moves through his swing, potentially cutting it short and decreasing power. Bautista's injury was not to the tendon itself, but rather to the protective sheath around it. After the original injury last year, the torn tissue would aggravate his wrist as he attempted his batting motion. Repairing the tissue removes the source of the problem. If he has been able to recover the motion to swing the bat freely -- by the sounds of things, he has -- then the potential for him to return to his prior level of play is high. There aren't numerous comparables in terms of that identical injury, but Tampa Bay Rays outfielder Sam Fuld happens to be one. He underwent his surgery in April of last year, returned in July, and until he suffered a hamstring injury he was hitting well. He might not be the power hitter Bautista is, but his ability to return and make defensive diving plays as well as swing the bat without incident is a good sign. By the time spring training comes to a close, Bautista's performance will be able to speak for itself, but there certainly is reason for optimism.
Carl Crawford, Dodgers: From 2003-11, Crawford's number of games played per season was always in the triple digits. In 2012, that number dropped precipitously. Recovery from wrist surgery delayed the start to his season, and elbow surgery ended it, leaving Crawford with only 31 major league games on the year. Now he is hoping for a fresh start on a new coast with another team.
The good news: The wrist that ailed him had actually been faring better before the elbow became a problem. The other good news: His elbow should no longer be an issue after having Tommy John surgery in August. As an outfielder, he will still need to build up his throwing distance, but he won't place the same demands on his elbow that a pitcher would. That makes it not only easier to return to action, but also bodes well for the continued health of his elbow.
As of February, Crawford had begun his throwing program and was taking batting practice. He and the Dodgers continue to target Opening Day. For hitting purposes, there should be no problem other than getting back in a groove after so much time away. On the defensive side, the long-distance throws may be the last thing to come. Fielders returning from this injury are sometimes returned to play with the directive to throw to the cutoff man until their arm strength is fully restored. Either way, this has to be a better year for Crawford, right?
March 17 update: Crawford experienced a setback with his surgically repaired elbow early in spring training. It started as tightness in his forearm and then became irritation of the ulnar nerve. Fortunately for the Dodgers, a brief shutdown appears to have done the trick (at least thus far), and Crawford has been steadily increasing his activity. On Sunday, March 17, Crawford saw his first major league spring action (as a designated hitter). While he didn't get a hit, it was a positive step for him to be playing in a game. His activity still needs to be ramped up, and he needs to show eventually that he can play the field. For the time being, however, the scare that cropped up recently appears to be under control.
Allen Craig, St. Louis Cardinals: Craig missed time at the start of last season while still recovering from knee surgery the prior November. Craig had some "hardware" installed in his right patella (kneecap) to repair a small fracture, and the rehab was lengthy. Once he did get on the field, though, he performed well, at least until a hamstring injury forced him to the DL again. The knee issue should be behind him now, and he has had plenty of time to rest the hamstring. As such, there's no reason to hold last season's injury against him.