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Stephania Bell

  (11:03 AM)

Happy Friday everyone! Welcome to the injury chat. Lots of good questions lined up already - and I am seeing evidence that football is right aorund the corner. Off we go!

Dave (MI)

Any news on when Liriano will play for the Twins?

Stephania Bell

  (11:04 AM)

Dave: No specifics but it looks to be sometime this week. Today would be the soonest call-up, but it might be sometime over the next several. With a .26 ERA in his last 5 starts, it sure seems like they should get him up here soon. Btw, elbow is solid. It was just a question of him finding his stuff again - which I think has happened.

tom b (Pittsburgh, PA)

stephania (the PT) Is oswalt going to pitch like oswalt on monday. I have waited all week to ask you about him. Thankyou.

Stephania Bell

  (11:07 AM)

Hi Tom B: Thank you for patiently waiting all week. Unfortunately, I can't give you a definitive answer. The first question is whether he WILL pitch Monday. The team is going to re-assess him Friday (today) after he attempts to throw 100%. He threw a bullpen Weds (about 40-50 pitches) but only threw at about 75-80%. The good news is that he tolerated it well. But he has had setbacks before when throwing hard off the mound. And he has a back/hip problem, nagging. The only way to be confident about him is to see evidence that he can pitch all out and sustain that over a few outings, so you're taking a gamble up front if you use him on your roster. I would wait and see.

John (Minny)

Stephania, I've heard conflicting reports about Marvin Harrison's injury. Any updates?

Stephania Bell

  (11:12 AM)

Hi John: Well we never did get a lot of detailed info about Harrison's injury along the way. But suffice it to say that he dealt with inflammation in his knee throughout the season after taking the hard fall onto his kneecap. Sounded like chronic bursitis, for which the best medicine would be full and complete rest. Now that he's had that, I would think his chances for starting the season strong are quite good, and the fact that the team doctors cleared him to practice supports that. Harrison also had off-season arthroscopic surgery on his other knee, but it sounds as if this was minor. Two things to keep in mind: 1) We won't see much out of him at camp, especially early b/c even given the clearance, the Colts are not going to take any chances on flaring him up before the start of the season. 2) Even if he starts strong, the fact that he has had issues with both knees makes it more risky that those issues crop up again - a hard knock on the turf for example, could be enough to trigger an episode. I still like his prospects, but there is more risk with him this year than in the past.

Corey S: Montgomery, NY

With David Ortiz coming back to the Red Sox what are the expectations of him. Are they expecting him to be a power hitter who will hit .300 right away or should we be more patient?

Stephania Bell

  (11:15 AM)

Hi Corey S: Great question. Always concerns when you see wrist/hand/finger injuries about the power upon return. Actually, the location of Ortiz's injury has me less worried b/c it is not a fracture problem inside the wrist joint or the hand, more of a connective tissue problem. My concerns were further eased by the fact that he hit 3 homers in 3 days on his rehab assignment, starting on Day One. I think his swing looks strong and I expect him to be productive immediately. And you think he's not aware that he's like 1-17 vs the Yankees so far this year? Could be a good weekend for him.

Josh (Toronto)

Stephania,With Soriano back with the Cubs (hopefully for good this time!) should I expect him to be running? I noticed he only stole 5 bases between injuries this year before he went down with the hand injury.

Stephania Bell

  (11:18 AM)

Hi Josh: Great question. I talked with Soriano at Media Day before the All-Star game and asked him about his legs, specifically b/c I think he has been much more tentative, more apprehensive with running this year after having the muscle strains at the end of last year and again this year. He told me that having the additional rest time for the hand gave him more time to concentrate on his legs while the hand was healing. He said he had no more worries about the legs (his own confidence that he could run all out and not pull something was part of the issue) and that he was more worried about his hand at this point. Based on that, I expect to see him run more in the second half.

Jc (Dunedin FL)

Hey Stephania I had a question about Ryan Church and his migraines. From my experience they tend to be manageable through medications and neck exercises which they said he has been using and are working. Are the neck exercises more for his c-spine or his brain stem or a combo of both. Thanks.

Stephania Bell

  (11:25 AM)

Hi JC: Great questions you're asking - and a lot of other folks very interested in Church. I think the bottom line related to what we're seeing with Church is that there is still much that we don't know related to concussions, and migraines. The team felt fairly confident that his most recent symptoms (early July) were more migraine related than post-concussion related, but they sent him to a specialist in Cleveland for another opinion. The fact that he's had lingering symptoms so close to having the concussion (and he had more than one this year) makes them want to be extra cautious. Just don't want to fool around when it comes to the brain. And different folks respond to different types of things for migraines. Some headaches are definitely cervical spine (neck) related and some are vascular (or blood flow) related. That's why some respond to certain medications, others respond to neck exercises - and there may be some combination of both. There was an amazing photo in SI of Church when he suffered the hit that led to the concussion and the force on his neck was incredible. So it wouldn't be a surprise that his neck may also be a contributing factor. Very tough for a medical staff to sort it all out - and I think now the Mets are being extremely cautious not to bring him back too quick this time. Looks like August.

Matt W. (Edwardsville, IL)

How much should I expect out of Chipper from here on out. How serious is his newest (and probably not last) hamstring injury, and how long do you figure this will bother his hitting.

Stephania Bell

  (11:29 AM)

Hi Matt: oooh - tough call. Chipper now has an injury to his other leg with the hamstring. Whether it's a result of compensating or just coincidence is hard to say (he does tend to get the muscle strains), but now he's not strong on either side. All we've heard is hamstring strain , not the severity, but he was saying he was quite sore Thursday. I talked with him at the All-Star game about the quad and he acknowledged that it was definitely not healed and that when he has to run all out, he knows that the pain he feels is telling him that it is not right. His position is that as long as he can do what he needs to do to be an effective contributor he will play, when he can't he'll sit. I don't expect him to be active this weekend - maybe he will assess his progress to determine whether he needs the DL at this point. I think he may be in for the time off.

MW (NY)

Will ronnie brown be back at 100% this year?

Stephania Bell

  (11:31 AM)

MW: Ronniw Brown is ahead of schedule and looking good, but the stats on RBs, on average are that their productivity drops by about 1/3 the year after ACL surgery. And the team is expecting him to split carries with Ricky Williams, who is getting lots of favorable reviews from the Dolphins so far. I hope to go to camp in the next couple weeks and see for myself, but at this point I would say that I do not expect him to be producing as he was when he got injured last year.

James VA

Is Wood supposed to return on the 29th or is that just the earliest time possible?

Stephania Bell

  (11:35 AM)

Hi James: I think he will return the 29th or very close to it. Actually when he was at the All-Star game he said the hand felt good and thought he could potentially have pitched there but wanted to play it safe. Then it sounded as if it wasn't quite healing all the way as fast as the team would like and he couldn't throw certain pitches. The good news is that he saw a hand specialist and there was nothing remarkable there - so they're giving him a few extra days (they can only back up the DL stint 10 days max) so they backed it up as far as they could to give him a couple extra days - and probably a little extra time to work since he hasn't pitched since July 11 I believe.

Mike (San Diego)

What's the update on Pujols? Do you still think he'll eventually get the forearm surgery and miss extended time?

Stephania Bell

  (11:39 AM)

Mike: I asked Pujols about the elbow at Media Day, specifically because so much was made of it before the season and then it never really surfaced as an issue. He says he still feels it every day, he knows that he could blow it out at any time, but he doesn't think about it b/c he doesn't want it to affect how he plays the game. He can't fully straighten it, he has some pain there, but he continues with his treatment and exercises and hopes for the best. When he had the calf injury it forced him to rest the elbow which he admitted may have been a blessing in disguise. So right now, I would say it's not an issue until the time where it becomes so painful that he can't do his job. And that could be any day - or he could go two or more years the way he is. I do not see him opting for the surgery unless it gets to that point because of howmuch time it would cause him to miss. And it appears that he has a solid perspective on it.

John (MD)

Anything new on Harang?

Stephania Bell

  (11:44 AM)

Hi John - and all the rest of the folks asking about Harang: Wish I could give you a definitive date but there isn't one. The latest news is that he threw from 70 feet Tuesday and had no soreness in the forearm the next day. Harang admitted to still being tentative when he started the session Tuesday b/c he wasn't sure if he'd feel something, but then as he went along and it felt good, he could loosen up. This tells me he's not quite ready - and that they will need to see him throw again, without soreness during or after, to be convinced. THe distance is good, but he will need at least follow-up side sessions, maybe even a rehab start, (my opinion) before he goes. So I'm guessing it will be at least another 5-7 days - just a guess, nothing official.

Joe (MA(

hi stephania - how does josh johnson seem to you? is he a good play against the cubs today?

Stephania Bell

  (11:47 AM)

Hi Joe: I think he's producing what you'd expect in a return from TJ surgery. The elbow is fully healed, but he is getting used to pitching competitively again. To that end, his pitches may not always be where he wants them, but so far he has been fairly solid. I'm not sure I start him against the Cubs myself.

Matt (Memphis, TN)

Stephania.. I can't make Carp's rehab start tonight, please tell me he'll make another start here!! Also do you see him making a fantasy impact the last 2 months?

Stephania Bell

  (11:51 AM)

Hi Matt: Well, I can't promise you...Sounds like Carpenter wants to get in a couple more rehab starts, but if all goes well tonight, there is a chance that he is back in the majors this week. Now that's good news for St. Louis fans, but don't get overexcited. Remember, there is always an adjustment period after the TJ surgery. Even Carpenter acknowledged that he was still struggling with command issues in the rehab starts. I think he will definitely contribute, but I don't think he'll be the ace right away. I would keep him on my fantasy bench if you have him, b/c I think his value will come to you late August.

Ian (Newport Beach, California)

Hey Stephania, question about two guys Bedard and Harang. Aaron just threw from 70 feet with no residual soreness, so how long till we see him back on the mound for the Reds?Bedard, on the other hand, was found to have an impingement in his shoulder, so what excatly is that and what is his prognosis for a return as well? Thanks a lot!

Stephania Bell

  (11:57 AM)

Hi Ian: Well we talked about Harang already. But to your Bedard question - lots of folks wondering about him. I'm generally not encouraged by all of the challenges he's had this season. The latest with the shoulder tells us that he does not have any major structural damage (good news), but he still cannot get through a throwing session b/c of pain (not so good news). Impingement is a term that we use fairly generically to describe when something is being pinched in the shoulder. There is a very small space where the rotator cuff tendons, biceps tendon and bursae sit all relative to the bony arch over the top of the shoulder. In certain positions, (like arm overhead) that space is further decreased and if there is even minor inflammation the space is further decreased again, all of which results in a pinching type pain when the arm is in these overhead/rotated positions (impingement). The solution? Rest, addressing any mechanical or strength issues that may be contributing and then gradually increasing the workload. Never fast, and a varying timetable depending on the individual case. Not great news for fantasy owners.

Eric (FL)

Quick ?: Drop Hafner?

Stephania Bell

  (11:58 AM)

I would. Only 65% now with no certain timetable. Risky.

Bernard (Chicago,IL)

What should Bears fans expect from Kevin Jones this year?

Stephania Bell

  (11:59 AM)

Insurance. That's all. Late surgery for ACL and he's an outside runner (meaning more cutting, deceleration). Just don't see him being full bore this year, but he helps provide an option besides the rookie Forte.

Jon (MD)

Is manning going to b the same on the field after his first major surgery in his career?

Stephania Bell

  (12:01 PM)

Hi Jon: Yes. Assuming they get rid of the infection (and he's on IV antibiotics and staying away from camp for exactly that reason), once the wound heals, he's good to go. This is not an injury that is "inside" the knee joint, it is more superficial, which is huge in terms of recovery. He's had ot before with the other knee and was back in a month. They will be extra cautious to make sure no infection, then once cleared, look out...

Doug (NY)

What's your take on the whole Posada injury? Can he really rehab the shoulder for a couple of weeks and then step in and be an effective hitter? Or is this only just delaying the inevitable?

Stephania Bell

  (12:06 PM)

Hi Doug: It's a great question - and there's an equally good chance that whatever opinion I might have, could be wrong. Tell you why. SOmetimes we see these guys with terrible looking MRIs - and they rehab for a while and come back to be amazingly productive, even if just for a short time. It sounds like all along throwing has been more problematic for him than hitting, so if he quiets the shoulder again and focuses on things to get him back to hitting, there is a decent chance he can still contribute on that front, which is obviously important to him, and why he wants to delay the procedure. He will have off-season surgery, that appears fairly certain. But I think he wants to try and contribute this year knowing that the road to recovery from surgery is filled with uncertainty as well, so why not give it a go, he can;t make it any worse, and if he has to miss a little at the start of the 2009 season, that wouldn't be the worst thing.

Stephania Bell

  (12:07 PM)

Wow - you all are still firing away with the awesome questions. Unfortunately I have to go, but as always, you give me a lot of material. I hope to address some more of these guys in my blog this weekend. I'll be traveling to football camps starting this week as well so hope to have more to update you on from that front. Have a great weekend - stay healthy!!!