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.
Jason Heyward, OF, Atlanta Braves (placed on DL April 21, could return this week): Heyward went on the disabled list following an emergency appendectomy, so at least there's comfort in knowing this is not going to be a recurrent problem. Now it's just a matter of when he will return … and when he'll be effective.
Heyward has been on a rehab assignment for several days at Triple-A Gwinnett, and other than some soreness that warranted a day off, his stint has been uneventful from a health perspective. It also has been uneventful at the plate, that is until Sunday, when he finally started hitting. The Braves don't have an exact date for his return, but he's expected to rejoin the team at some point this week.
AP Photo/Seth WenigCurtis Granderson could return to the Yankees as early as Tuesday.
Curtis Granderson, OF, New York Yankees (opened season on DL, could return this week): It's only fair that the Yankees actually get a player back from the DL after adding more and more players to it this season. Granderson's recovery and rehab have been totally uneventful, just the way the medical staff likes it. He has been crossing "to do" items off the list during his rehab assignment: He has faced both left- and right-handed pitching, played defense and played both day and night games. Perhaps most importantly, Granderson has not shown any lingering apprehension from getting hit by a pitch this spring. As he told the Yankees' official website regarding his rehab at-bats, "There was no recall of the injury. There's going to be pitches inside, I'm going to get hit again, but you got to stay in."
The Yankees would like it if he stays healthy and stays in. There's every indication he will come back and be productive immediately, and that return could happen any day now, potentially as early as Tuesday, when the Yankees open a series at home.
Coco Crisp, OF, Oakland Athletics (placed on DL April 30, could return this week): Crisp strained his left hamstring trying to run out a ground ball in the A's seemingly never-ending Monday night game nearly two weeks ago. Fortunately, the strain appeared mild and Crisp could potentially attempt to run the bases soon, according to the San Francisco Chronicle. Obviously his tolerance of running will help determine his readiness to return -- manager Bob Melvin told reporters Crisp might not need a formal rehab assignment -- but as is always the case with hamstrings, until he runs in games without a setback, it will be impossible to tell just how healthy he is.
Chris Young, OF, A's (placed on DL April 30, could return Wednesday): The A's hope to get another outfielder with a soft tissue injury back soon. Just as Coco Crisp recovers from his hamstring, Young is working to get past a left quad strain that has sidelined him the past couple of weeks. After passing the necessary rehab clearances, Young is expected to get some at-bats in extended spring training games during the early part of the week, according to the A's official website. If all goes well, he could return when eligible on Wednesday.
Neil Walker, 2B, Pittsburgh Pirates (placed on DL retroactive to April 27, expected to return Monday): Two weeks ago in this space, I wrote about how the Pirates hoped to return Walker within days if he could swing the bat effectively. Clearly he could not, and the decision was made to place him on the DL. After beginning a rehab assignment last Thursday, it seems Walker has shown he has moved past the injury, and his return appears imminent.
Michael Cuddyer, OF, Colorado Rockies (placed on DL retroactive to May 9): Cuddyer had already missed three games with what he referred to as inflammation in his neck, related to a disc problem. Now it's clear he will be missing a few more. This is not Cuddyer's first episode of neck pain, but it appears to be the first time it has forced him on the DL. The hope is that the symptoms are limited to his neck and that it won't progress into his shoulder or arm. Rest is the best option for him in the short term, but given the variability of these types of ailments, a definitive timetable is difficult to determine. The soonest he can return is May 24, if his neck cooperates.
Jayson Werth, OF, Washington Nationals (placed on DL retroactive to May 3): This doesn't come as a huge surprise after Werth's hamstring continued to bother him despite missing the past eight games. If there is any good news, it's that it can be backdated to the last time Werth saw the field, making him eligible to return May 18. Whether he will be able to actually run at full speed by the end of this week remains to be seen. The Nationals have also indicated they believe dehydration was a factor in Werth's repeated muscle cramping.
The hope is that all will be under control and back to normal by the end of the week, although fantasy owners might want to wait until next week to insert him into their lineup.
Adrian Gonzalez, 1B, Los Angeles Dodgers (day-to-day): Gonzalez has been dealing with a minor muscular strain in his neck, recently aggravated when he and an umpire crossed paths as he was attempting to field a ground ball. An MRI revealed little of significance and Gonzalez returned to play late last week. However, he promptly aggravated it again, then sat out Sunday's game.
This is what falls under the header of "annoying" injuries, frustrating to the athlete because of the come-and-go pattern and difficult to predict in terms of behavior and severity. It does not look as if Gonzalez is in danger of going on the DL, but fantasy owners will want to check daily lineups until he is playing consistently.
Austin Jackson, OF, Detroit Tigers (placed on DL retroactive to May 12): Another outfielder, another hamstring injury. It seems to be quite the injury trend this week. Also a trend: Teams opting to send players to the disabled list for seemingly minor strains early in the season, not wanting to risk a more severe injury. That makes sense. Teams as a whole seem to be offering their players a couple of days to test the effects of rest, but if there are any lingering warning signs, they waste little time scaling the athlete back (in the form of a DL stint). The hope then is that the player will miss the minimal amount of time, and Jackson's case is no different.
AP Photo/Winslow TownsonShane Victorino (lying down) collided with the outfield wall Sunday at Fenway Park.
Shane Victorino, OF, Boston Red Sox (day-to-day): After missing a week due to spasms in his back, Victorino returned to action May 3. He seemed to be faring well until he ran into the outfield wall Sunday, ultimately requiring a trip to the hospital to be examined. As bad as it looked -- and perhaps felt -- Victorino appears to have escaped major injury. According to ESPN Boston, X-rays on his ribs came back negative, and manager John Farrell says Victorino should be ready to play Tuesday after the team's off day Monday. The hope is that this collision will not wake up the painful spasms in his low back again, and so far there has been no word of that. If Victorino does return Tuesday, that will be a good sign that he should be available going forward.
Desmond Jennings, OF, Tampa Bay Rays (day-to-day): Jennings has missed a few games with a minor groin strain, but the Rays seem fairly confident they will have him back Tuesday. Jennings has downplayed the injury since it first cropped up last week, suggesting he could play if necessary. Given that it's May and not September, manager Joe Maddon opted to rest Jennings for several days. The proof that it is not anything to worry about will come when Jennings returns to action for consecutive days without incident.
Zack Greinke, SP, Los Angeles Dodgers (placed on DL April 12, could return Wednesday): When Greinke was injured in the brawl with Carlos Quentin, no one knew what to expect since a clavicle fracture in the non-throwing arm of a pitcher is not exactly your everyday injury. As soon as the Dodgers announced he was undergoing surgery to stabilize the fracture, his prognosis for return actually improved, as it appeared he would not face as much down time from throwing.
Turns out that was an accurate assessment. Despite the Dodgers' (understandably) conservative eight-week projection, Greinke appears poised to possibly return this week, which would mark 4 1/2 weeks post-surgery. He has passed the point of having discomfort and pitched in high Class A ball last Friday. His velocity is up where he left off at the time of injury, and he appears from a functional standpoint to be ready to pitch in the majors. The final remaining hurdle is whether the bone has healed to the point where the team is comfortable with him absorbing contact. (The high Class A outing afforded him the opportunity to pitch with a DH in the lineup; when he returns to the Dodgers, he will need to hit, run and potentially absorb contact should there be a collision). Expect those clearing tests to be performed over the next 24 hours and a decision to be forthcoming shortly after. If the team opts to hold Greinke out of a return to the majors Wednesday, he would likely get another rehab start this week and rejoin the team next week.
Brett Anderson, SP, A's (placed on DL April 30, could return Friday): After originally spraining his ankle in mid-April, it looked as if Anderson could avoid a DL stint with some rest. But he got called into service in the A's marathon game a couple of weeks ago and it set him back, forcing the DL stint. With a pitcher so recently removed from Tommy John surgery, it's probably for the best that he allow the ankle to recover sufficiently to not threaten his throwing mechanics and, consequently, the health of his arm. According to the San Francisco Chronicle, Anderson is likely to rejoin the rotation Friday.
Ryan Madson, RP, Los Angeles Angels (opened the season on DL, could return this week): Madson's return following last April's Tommy John surgery has been delayed due to the soreness he experienced this spring. The delays aren't highly unusual, but it does bode for a gradual progression even as he returns to his major league team. Madson has been pitching in extended spring training and will begin a rehab assignment this week. He might not spend much time there, as the team could bring him up to the majors to build further endurance in that setting. As the Los Angeles Times has reported, he will not be the closer immediately upon return, and how the Angels opt to use him will likely depend on what they see from him as he resumes big league action.
Eric Hartline/US PresswireHe's been out of sight, out of mind, but it shouldn't be forgotten that Johnny Cueto finished 13th among all pitchers on the ESPN Player Rater in 2012.
Johnny Cueto, SP, Cincinnati Reds (placed on DL April 15, could return within one to two weeks): Cueto's original ailment was reported as a triceps injury, then was modified to a lat strain (more typical for a pitcher). But as he was recovering from that injury, he developed soreness in his oblique, a pitcher's nemesis, forcing a slowdown in his return schedule. Now Cueto seems to have cleared most of the major obstacles in his recovery and has initiated a rehab assignment. His next rehab outing is slated for Tuesday, and the Cincinnati Enquirer is reporting he could return to the Reds' rotation May 19.
It's entirely possible the team opts for another rehab start, depending on what they see during his outing this week and how Cueto feels after consecutive starts. Either way, it appears that, barring a setback, his return is not far off.
Andrew Bailey, RP, Boston Red Sox (placed on DL retroactive to April 29, could return within a week): Bailey is eligible to return from the DL on Wednesday, but the club could still opt to send him out on a rehab assignment, pushing back that return. Bailey went on the disabled list with a biceps strain, a bit more worrisome than the one that sidelined teammate John Lackey because of the location of Bailey's symptoms (higher, closer to the shoulder). As noted in this space last week, Bailey has been plagued by a series of injuries, but he started the season strong for the Red Sox. With Joel Hanrahan now out for the remainder of the season, it would seem Bailey has the opportunity to recapture his closer role from Junichi Tazawa, if he can stay healthy. Considering his history, particularly in light of this current ailment, that's a big if. Even if Bailey returns without a rehab assignment, the bigger question will be how long he can go without a potential flare-up.
Chris Perez, RP, Cleveland Indians (day-to-day): As he began to warm up Sunday before entering the game in relief, Perez experienced what the team is calling "stiffness" in his throwing shoulder. Manager Terry Francona opted not to press his luck and rested Perez instead. At this point, it doesn't appear to warrant major concern, but it does warrant you keeping an eye on the situation. Unless he's scratched again this week, consider this just a bump in the road.
Jake Westbrook, SP, St. Louis Cardinals (placed on DL May 12): Westbrook becomes the latest pitcher to hit the disabled list with inflammation in his elbow. According to ESPN's Jim Bowden, Westbrook received a cortisone injection in his elbow. Expect several days of rest with a gradual increase in activity to see if he can resume throwing. Until he reaches that point, it will be difficult to project the length of his absence.
Wei-Yin Chen, SP, Baltimore Orioles (day-to-day): After getting his team off to a good start Sunday, Chen was forced to leave the game early because of a strained oblique. He was scheduled to undergo an MRI Monday, and it would not be surprising if this results in a trip to the DL. The typical absence for a pitcher runs on the order of a month, so if it is serious enough to warrant the trip, plan on not having him available for approximately four weeks.
It isn't as bad as it could have been. At least not yet.
According to the Arizona Republic, Putz is going to be shut down from throwing because of a sprained ulnar collateral ligament, a strained pronator and irritation of the ulnar nerve, as determined by MRI. The goal in the short term is to calm the elbow discomfort and control inflammation while maintaining his cardiovascular conditioning and shoulder strength to the extent possible. As manager Kirk Gibson said of the plan for Putz over the next two weeks, "He's certainly not going to be picking up a ball."
In 2009, Putz went on the disabled list in conjunction with surgery to remove loose bodies from the elbow. At the time, he received precisely the same diagnosis with regards to the UCL ligament, flexor muscle and ulnar nerve in the elbow. As the Republic noted, doctors compared Putz's most recent MRI with images taken four years ago and did not see significant enough change to warrant surgery at this time. Still, the decision for more aggressive and invasive treatment is often guided by the athlete's symptoms, not the picture alone. While the Diamondbacks hope Putz can return after some forced rest and rehabilitation, if the elbow doesn't respond, they will be forced to reconsider the options.
Putz's MRI findings are certainly not uncommon for a 36-year-old pitcher. But it's precisely because he is 36 -- combined with the fact that this is not his first experience with these symptoms -- that makes this episode more concerning. In fact, Putz was placed on the DL with ulnar neuritis (inflammation of the ulnar nerve, the same nerve currently giving him trouble) in 2008 and missed more than a month. Five years later, irritation of the nerve (manifested as tingling) is one of the symptoms that have flared up, forcing him off the mound.
In approximately two weeks, Putz will be re-evaluated, and a determination will be made whether he can pick up a ball or to continue the conservative route of treatment.
Even if the symptoms have subsided to the point where he can resume throwing, it will be a gradual process requiring additional time (likely weeks, not days) to return to the mound. When Putz experienced similar problems in 2011, he missed almost a month and sounds as if he anticipates a comparable timeframe, according to the Diamondbacks' official website. "It's pretty similar," Putz said. "Hopefully it won't be any [longer] than that."
Putz doesn't seem too concerned about the possibility of undertaking more drastic measures if his symptoms don't improve. At least not yet.
It is never good news when a pitcher says he is headed for shoulder surgery, given the inconsistent results and uncertain outcomes associated with procedures in that area and in that population. So when Philadelphia Phillies ace Roy Halladay announced Wednesday that he will undergo surgery on his right (throwing) shoulder to address a bone spur, fraying in his labrum and a partial rotator cuff tear and said he thinks this is "very good news," it took everyone by surprise. Halladay added it is his understanding that he has a "good chance" of returning this season.
"I have a good chance to come back and pitch this year and hopefully be a lot more effective," Halladay said. "They said that my range of motion will be better, my location will be better and hopefully the velocity will be better."
So which is it? Gloom and doom, or sunshine and roses? The truth, as they say, is somewhere in the middle.
Thearon W. Henderson/Getty ImagesRoy Halladay (2-4, 8.65 ERA) informed the media Wednesday that he has a bone spur in his right shoulder but still hopes to pitch again this season.
There's no denying that it is never desirable to operate on a thrower's shoulder. The results are all over the map. As ESPN's Jayson Stark wrote, for a pitcher facing shoulder surgery approaching age 36, the future could be "ominous." Stark cites data published in a recent FanGraphs article by Eno Sarris as proof of the grim outlook for pitchers in Halladay's age bracket who went on the disabled list for a shoulder injury.
Part of the challenge, however, in evaluating comparables when it comes to pitchers and shoulder pathology is that the injuries themselves can be highly variable. The extent of damage to the soft tissues -- such as labrum, biceps tendon and rotator cuff -- and the precise location can influence recovery. The health of the shoulder joint and the strength of the musculature both directly and indirectly responsible for shoulder function play a role. And just as the anatomical variants are unique to each pitcher, so are the intangibles -- the work ethic, the mental toughness, the belief in one's own recovery -- all of which likely contribute to a return to play in a manner that is impossible to quantify. So yes, it is concerning that Halladay is headed for surgery, but it isn't necessarily a career death sentence.
And what about the upside?
While any surgical procedure on a thrower's shoulder carries inherent risk, it is entirely possible, likely even, that this is the treatment option that could allow Halladay to extend his already impressive career. The findings Halladay described (labral and cuff damage) are not uncommon in veteran throwers who have pitched more than 1,000 innings, much less the 2,700-plus innings he has racked up over his professional career. If indeed the presence of a spur -- a bony growth typically formed in response to repeated stress -- is accelerating the soft tissue damage, taking down the spur should provide some relief to that tissue. Cleaning up the associated soft tissue structures also provides reinforcement to the thrower's shoulder. The strengthening regimen Halladay undertook during the offseason targeted the musculature supporting his shoulder with the goal of preserving his health. Although it couldn't completely prevent the inevitable given the degenerative changes in his shoulder, it may help speed his recovery following this procedure. Consider it "learning" that his shoulder girdle has already acquired and can build upon following surgery.
Combine the recently acquired strength with the overall physical health Halladay has exhibited across his career. Three DL trips were entirely unrelated to his throwing arm. They included a leg fracture as a result of being hit by a ball (random), an appendectomy (not a durability issue) and a groin strain (a minor ailment that resolved quickly). Problems with his throwing arm have landed Halladay on the DL three times in his career. The first episode was tendinitis in 2004, perhaps an early flicker of the more profound problems he is facing currently. Last year's trip to the DL with a lat strain seemed to foreshadow the consequences of wear and tear that Halladay can no longer avoid. Suffice it to say Halladay has put in far more days on the mound than many of his peers and has an outstanding health track record for a pitcher. This bodes well for his ability to recover.
As do those intangibles. Halladay is not speaking like someone who is concerned that his career is in jeopardy. He sounds like someone who is setting a goal of returning this season and who, barring an unexpected discovery during surgery, plans to achieve it. It is not automatic that he will return this year, but based on what Halladay outlined as the planned procedure, it is also not impossible to think he could come back late in the season. We do not typically hear of pitchers returning from shoulder surgery better than before; rather we hope for them to be able to return to close to their prior form. Yet Halladay spoke Wednesday of turning back the clock via surgery. The athlete's mindset is not insignificant when it comes to accomplishing rehab goals, and Halladay certainly has the necessary outlook.
There is little doubt that Halladay's range of motion will be better after surgery, just as he predicted. The unknown until he retakes the mound will be whether his location and velocity will be restored to the point where he can be dominant once again. History tells us that the odds of returning to form following shoulder surgery are not in a pitcher's favor. History also tells us that Halladay has defied the odds thus far in his career. It seems like the greater risk may be in betting against him.
A few more updates since posting Monday's injury cheat sheet.
Andrew Bailey, RP, Boston Red Sox (placed on DL May 6): Inflammation in his biceps is the latest ailment for Bailey, who is guaranteed to miss at least two weeks but could miss more, particularly if the area involved is near the shoulder. According to the Boston Herald, Bailey hopes to be held back from throwing for only a couple of days, but if the symptoms were enough to warrant a DL placement, the downtime is likely to be longer. The team hardly wants to bring him back in two weeks just to see him exit again with an exacerbation of the condition or, even worse, further damage.
Jared Wickerham/Getty ImagesAndrew Bailey has a 0.81 WHIP in 13 appearances this season.
Bailey came to the Red Sox in 2012, but the specter of injuries that plagued him in Oakland has continued to be an issue in Boston. In his first season with the club, a torn ulnar collateral ligament in his thumb required surgical repair and kept him out until August. This season, he started strong and was given the opportunity to close when Joel Hanrahan injured his hamstring. His strong performance would have kept him in the role had his arm not flared up.
The first order of business for the Red Sox is getting Bailey healthy enough to perform. Whether he can resume the closer role will have to be answered later and may depend on Hanrahan's status. Hanrahan, who just returned last week from a stint on the DL because of a right hamstring strain, had lost his closer role because Bailey was pitching so well. Then, just as he got the job back (following Bailey's injury), he exited Monday's game with forearm tightness.
While the vague diagnosis of a forearm strain, which is what the team is describing Hanrahan's injury as, can be either benign or serious depending on the source of the symptoms, it raises concern. Hanrahan has experienced pain in his throwing elbow and forearm before, even going on the DL to start the 2010 season because of a flexor-pronator strain, but told reporters after leaving Monday's game, "This is the first time it felt like this." Not exactly encouraging words.
Now both Bailey and Hanrahan are down, and the Red Sox will yield the closing spot once again (to whom is not yet clear).
Zack Greinke, SP, Dodgers (placed on DL April 12, expected back in late May/early June): Greinke went on the DL with a fractured collarbone sustained in a hit delivered by an angry Carlos Quentin, who had charged the mound. Greinke underwent surgery within days to repair the bone, and now it's just a matter of pain management. In fact, the surgery to repair Greinke's clavicle was performed with the goal that he would experience less overall downtime. Since he injured his non-throwing side, the main hurdle for Greinke post-surgery was pain. He must be able to complete his throwing motion without provoking the surgically repaired area such that it leads him to compensate.
The goal seems to be working. Greinke began playing catch shortly after surgery and has resumed harder throwing recently. The short interval of downtime post-surgery was key in keeping his throwing arm from losing the buildup work of spring training.
If he continues progressing at his current rate, it's possible that Greinke could return later this month, sooner than the eight weeks originally projected. Given the rash of injuries that have plagued the Dodgers' roster, they would no doubt welcome his presence.
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.
Brian McCann, C, Atlanta Braves (opened season on DL, expected to return May 6): McCann has been on the radar of many fantasy owners looking forward to his season debut. It appears that day has arrived. According to news reports, manager Fredi Gonzalez says McCann will be active and with the team Monday when the Braves open a series in Cincinnati. McCann underwent surgery to repair the labrum in his right (throwing) shoulder in October and has been working his way back since. Although he has been hitting throughout the spring, the slower component of his return was throwing. McCann says he is now making the necessary throws, telling reporters this week, "The way I'm throwing now is basically the way I was throwing before I got hurt." While that is all good news as far as performance expectations, the Braves have indicated that McCann would not return to an everyday role immediately. Fantasy owners should keep tabs on the Braves' daily lineups for the next few weeks to check McCann's status.
Hanley Ramirez, SS, Los Angeles Dodgers (placed on DL May 4, timetable uncertain): No sooner did Ramirez rejoin his team than he departed again, this time with a strained left hamstring that required him to be helped off the field. After wasting no time proving his surgically repaired thumb was a nonissue, as evidenced by him going yard in his season debut, Ramirez injured his lower half running the bases Friday night. Difficulty putting weight on it reflected the severity of the injury. Manager Don Mattingly did not shy away from the likelihood Ramirez would miss more than the minimum stay, telling reporters, "It's going to be a while." In fact, Mattingly referenced Dodgers outfielder Matt Kemp's injury of last year. Kemp, who was injured at virtually this same time of year, returned after a minimal DL stint only to reinjure his hamstring two days later. He then went back on the DL for more than a month.
Interestingly, Ramirez had not been sidelined for extended time with a left hamstring strain previously; however, he did have a 2011 DL stint for sciatica and numbness in his left leg associated with a lower back problem. It is not unusual clinically to see hamstring strains on the same side as previous sciatic episodes; whether they are directly or indirectly related -- or completely unrelated -- is often difficult to determine. The bottom line is that Ramirez will not be rushed, but as is always the case with hamstring injuries, until he returns successfully without a flare-up, there will be reason for concern about the potential for recurrence.
Michael Bourn, OF, Cleveland Indians (placed on DL April 15; expected to return late this week): It seems as if the "spike to the hand" is the injury du jour in baseball this season. And the injuries are proving to be a bit more challenging to return from than one might think. (Last week in this space, we discussed Pirates second baseman Neil Walker, who has a similar injury and was placed on the DL after having difficulty swinging a bat.) Bourn sustained a laceration to his right index finger when he dove into first base and his hand met the foot of pitcher Matt Thornton. It required five stitches to close the wound, and the DL move was not a surprise; the time allowed the finger time to heal.
What may come as more of a surprise to many was how difficult the injury can be to hit with. Bourn must close his fingers around the grip, which can be a challenge following a laceration. Bourn was finally able to take live batting practice Friday, and he's expected to begin a rehab assignment Monday. Manager Terry Francona told Jordan Bastian of MLB.com that Bourn likely will need three games before he can rejoin the team. The organization likely want him to get enough at-bats to test how his grip is holding up against live pitching and for him to feel comfortable with his timing.
Angel Pagan, OF, San Francisco Giants (day-to-day): Pagan got an early warning sign that his right hamstring was not feeling quite right Saturday night, and he sat out Sunday's game as a result. The good news for Pagan and the Giants is that it was not as severe an injury as that of Dodgers shortstop Hanley Ramirez or Marlins outfielder Giancarlo Stanton. As the San Francisco Chronicle noted, by coming out of the game shortly after feeling a "twinge" Saturday, the hope is that Pagan did not suffer significant tissue damage. Although he told reporters he hopes to play Monday night, manager Bruce Bochy said, "He's not going to be out there if this thing bothers him at all." Given the relative ease with which these injuries become more serious and the time off becomes more protracted, it would not be surprising if Pagan is held out for at least day or two to allow the hamstring to settle.
Jayson Werth, OF, Washington Nationals (day-to-day): Werth is trying to press through not one but two ailments. He suffered pain and swelling in his left ankle and foot area when he fouled a ball off it Tuesday. Fortunately, X-rays showed no fracture, and he has been able to play, despite some discomfort. His hamstring, however, is another story.
Werth began experiencing cramping in the back of his thigh earlier in the same game he fouled the ball off his foot, making his slightly early exit fortuitous. It appears that wasn't enough, though, to keep the hammy from pestering him some more. It tightened up further on Thursday, and Werth has not played since exiting that game early.
One of the most challenging decisions for a medical staff is how long to hold out an athlete who is experiencing discomfort in the hamstring. While the player may feel nothing at rest or during warmups, it is virtually impossible to simulate the maximum effort of in-game play, which is most likely to aggravate it. The obvious concern is potentially losing an athlete for an extended time to a more serious injury. That said, it's difficult to force the athlete to sit when he can pass all the pregame tests and has no symptom complaints. At this point, there is no indication Werth is headed for the DL, and he might even be able to return to the lineup Tuesday after sitting out the weekend series. This doesn't have a great feel about it, as the lingering concern for fantasy owners will be just how well -- and how long -- his hamstring will hold up.
Roy Halladay, SP, Philadelphia Phillies (DTD): Halladay has admitted to experiencing shoulder discomfort and will be traveling to Los Angeles for a consultation with Dr. Lewis Yocum. According to ESPN's Jayson Stark, Halladay began feeling discomfort in the shoulder the morning after his April 24 start. Halladay said the soreness "just kind of progressed over the last two weeks or so." Now they will try to get to the bottom of what exactly is causing this soreness. When speaking with reporters Sunday, Halladay also indicated this was the first time he had experienced this particular ailment, suggesting it was not the same sensation he had last year when he was diagnosed with a latissimus dorsi strain. The team has not yet confirmed a move to the DL, but it seems inevitable. At age 35, with the accumulated pitching mileage on his throwing shoulder, there was reason to be concerned heading into this season that Halladay's body would start showing signs it was unable to keep up with the physical demands of another baseball year. It is likely he will be shut down from throwing for a period of time; hopefully after his visit to the West Coast, we will learn more.
May 6 addendum: The Phillies have officially placed Halladay on the DL, recalling left-hander Joe Savery from Triple-A Lehigh Valley to take his place on the roster.
Bundy tried to resume a throwing program after the forced rest in early April, but even throwing from a short distance on flat ground was enough to resurrect his symptoms. He was seen earlier this week for a second opinion by Dr. James Andrews, who administered a platelet-rich-plasma injection and recommended the six-week hiatus.
So what are we to make of this latest setback?
AP Photos/Tony Farlow/Four Seam ImagesDylan Bundy checked in at No. 3 in Keith Law's Top 100 prospect rankings prior to the 2013 season.
It's hard to draw any definitive conclusions other than the obvious one: Pain, stiffness or tightness in a thrower's elbow combined with a lack of velocity is enough to provoke legitimate concern. It's worth remembering that the initial MRI on Bundy's elbow revealed no significant structural damage. That said, the MRI isn't always perfect; some issues do not manifest themselves on imaging. Many pitchers will experience intermittent episodes of something abnormal in the throwing elbow or forearm area yet will go on to recover and return to throwing without incident.
It's also worth noting when evaluating the phrase "no significant structural damage" that the presence of tissue changes is more common than not in pitchers as a result of the wear and tear they subject their arm to by performing their craft. Recent studies have shown up to two-thirds of professional pitchers may have demonstrable changes in the ulnar collateral ligament on imaging yet have no symptoms whatsoever. Translation: Many throwers are out there on a daily basis, doing their job, with elbows that are not altogether "healthy." It is only when the picture and the symptoms combine to tell a common story that medicine has something definitive to address.
Furthermore, while the PRP injection may be of help to Bundy, it is also possible that his symptoms will persist. The jury is still out on the sum total of the effects of PRP, but it is seen by many as a treatment option with virtually no downside since it involves using the patient's own blood components -- and nothing synthetic -- as a means of trying to facilitate healing. There is much more to be learned about what the optimal treatment parameters and ultimate benefits of PRP injections are.
In the meantime, the Orioles have to hope that the combination of PRP and extended rest will allow Bundy's elbow to hit the reset button on the start of the season. After the rest period, the team will attempt to move him through a throwing progression, which will continue until he either returns to the mound or the symptoms recur. If Bundy's elbow continues to be problematic, the next course of action will be determined at that time. Until then, a concerned Orioles organization will hold out hope that this episode will be in the rearview mirror soon enough.
The most recognizable name on the Miami Marlins roster will no longer be visible in the starting lineup for at least a few weeks. Giancarlo Stanton, the power-hitting outfielder who looks like he would be equally comfortable on a football field, will not be on any field in the near future as he rests his ailing right hamstring.
Stanton has been diagnosed with a Grade 2 (moderate) strain, an injury he suffered in the 10th inning of Monday night's game against the Mets as he tried to beat out a grounder. As Stanton crossed first base, he displayed the universal "I just pulled my hamstring" sign when he abruptly shortened his stride and reached instinctively for the back of his thigh. Stanton then fell forward to the ground, pounding his fist in clear frustration. He was able to get up and amble off the field gingerly, but it was obvious to anyone watching this was more than a mild cramp.
The Marlins' prompt move to transfer Stanton to the DL confirmed the seriousness of the injury; there would be no wait-and-see period for Stanton, as is usually the case when a mild strain is suspected and the team is hoping for a quick return. After undergoing an MRI on Tuesday, Stanton's hamstring injury was officially designated as a Grade 2.
Brad Mills/USA TODAY SportsGiancarlo Stanton will have to wait even longer now to turn around his slow start.
A Grade 2 strain conveys a wide spectrum of possibilities in terms of the extent of tissue damage, making it difficult to ascertain how long Stanton's recovery will take. While Grade 1 is considered minor with little to no true tearing of muscle or tendon fibers, a Grade 3 is considered a complete tear where enough of the fibers are torn to render the muscle or tendon completely nonfunctional. A Grade 2 injury is everything in between. These are the injuries that are typically referred to as partial tears. The range for recovery can be as little as three weeks or as long as three months. Some of the variables that will affect recovery are how much pain and spasm is present, how much bleeding of the tissue there is (which shows up as bruising along the back of the thigh) and whether the tear is located in the muscle belly itself or the musculotendinous junction (where the muscle and tendon meet).
Initial treatment is directed at minimizing pain and swelling while protecting and preserving pain-free range of motion. As the athlete regains normal range of motion and the ability to walk without a limp, strength exercises can be progressed. The activity eventually progresses to running, ultimately incorporating sprinting and sharp deceleration along with directional movements and peaking with a return to baseball activity. There is no magic way of knowing with absolute certainty when an individual is ready to return to play. That decision is made based on functional pain-free performance of gradually increasing intensity. Then, fingers are crossed in the hopes that the body withstands the demands of actual competition.
As for Stanton, he did struggle with a right hamstring issue late in the 2011 season, but it was never enough to send him to the DL. He missed a handful of games at the time but was able to recover during the offseason. In 2012, he underwent surgery to remove loose bodies from his right knee, which led to him missing a month in the second half of the season, but the hamstring itself was not reported to be a problem. Earlier this month, Stanton had a bruised shoulder, which seemed to be affecting him at the plate and ultimately sidelined him for six games. Finally, it seemed things were looking up. He hit his first home run of the season Saturday, followed by a second and a third on Sunday. Now this. His discouragement was evident when he told reporters after Monday's game, "If we could just erase all of April, that would be lovely."
April can't be erased, but if Stanton is able to recover well and return strong, it may be able to be overlooked, at least by fantasy owners. The hope is that his age (23) and physical conditioning will aid in his recovery and that the injury will not result in excessive scarring, which could make re-injury more likely. He will not be rushed, precisely to avoid aggravating the injury, meaning everyone -- Stanton included -- will need to be patient.
At this point, it appears likely to be June before we see the familiar name of Stanton back in the Marlins lineup.
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.
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.
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.
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.
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.
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.
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.
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.
Mets general manager Sandy Alderson announced that catching prospect Travis d'Arnaud has a non-displaced fracture of the first metatarsal (the long bone of the forefoot which connects the midfoot to the big toe) in his left foot and is being further evaluated by team doctors in New York City Friday. According to ESPN New York, D'Arnaud sustained the injury while behind the plate during a Wednesday game and is currently in a walking boot.
Chris Trotman/Getty ImagesTravis d'Arnaud has twice been traded for Cy Young award winners, first going to Toronto as part of the Roy Halladay trade, then to the Mets in the package for R.A. Dickey.
D'Arnaud missed a good chunk of last season with a torn PCL in his left knee; now he is contending with another injury to the same side. While the team has not officially listed a timetable, expect d'Arnaud to miss at least two months. There is the matter of the bone healing, which typically takes between four to six weeks. It is critical to regain full range of motion in the foot in order to walk without even a minor compensation. Then there is the return to normal running and baseball activities. Since d'Arnaud is a catcher, his unique position-specific demands place significant load on the first metatarsal. In the crouch position behind the plate, resting with weight shifted forward, there is already load through a catcher's foot. The explosive force necessary to then move quickly to standing translates dynamic stress through the foot and up through the leg. Every pivot or sideshift through the foot places shear on that area of the foot. Even routine running, where the last part of the body to leave the ground is the big toe, places load through the first metatarsal.
If the All-Star Break was a target date for bringing d'Arnaud to the majors, it is certainly no longer automatic.