Good morning everyone - welcome to our Friday "injury" chat. Certainly there are plenty of injury topics on everyone's mind. And many of you have already submitted some excellent questions. So with that in mind, let's get started.
Stephania - When will Chris Carpenter be back and will he have fantasy value? Thanks!
Hi Brian: I love the name "Kalamazoo" Is there any better town name than that? Carpenter will be back after the All-Star break and his recovery has been going well so far. He may have some fantays vakue but you take a bit of a gamble. Most pitchers take another 6-12 months to get their command ad velociy back, so as long as you temper your expectations, and don't pay too much, it could be a good pickup for you.
HELP, when can we really expect Rich Harden to return, and what type of injury does he have? I know he has started throwing, but they haven't set a return date yet. Thanks
Charlie: So Harden has a strained subscapularis, which is one of the rotator cuff muscles, but it sits on the undersurface of the shoulder blade, and the place where Harden was feeling the discomfort was on the back, undersurface of the scapula (shoulderblade). The reaosn that's relevant is that we would be much more concerned if the pain were near the top or front of the shoulder where many of the more serious shoulder problems (and Harden's past issues) lie. So as an injury, I think this was a minor setback, but having been through his history, the team did not want to take any chances. They don't set a timetable b/c they want to see how he responds to the incremental throwing program, but I would expect him back within a week of his eligibility to come off the DL.
Stephania, please help. What are your thoughts on Bedard right now, read alot of articles from PTs mentioning something about Bedard's motion scouring the hip and that we could be seeing the onset of a degenitive hip. Thoughts on this and what his value is right now? Thanks soooo much and have a great day!
Hi Ted: You have been doing your research! There are several possibilities - and without actually seeing the patient I am forced to speculate a bit, b/c many of the differentials would be determined by physical exam. The team, understandably, does not reveal all the details of what they've found, but they are talking about inflammation in the joint. Bedard's motion certainly requires a lot of compression and rotation (basically the scouring you refer to) of that hip and he is full weight-bearing through it during the motion, adding more compression. There are pitchers who have had labral tears in the hip and degenerative joint conditions in the hip (Isringhausen for one), so it is not unheard of. There also can be contributing factors from the spine, and I would want to be sure that his lumbar spine, which can either refer pain or at the least influence the hip, was clear. I am a Bedard owner in my big fantasy auction league and I am very concerned, especially with the lack of definition around this. I am not giving up on him yet though - too valuable.
Good morning injury master! Great work on the Alfonso Soriano story yesterday. My question is: Throughout the offseason, Soriano kept saying his leg injuries and recovering from them were more mental than physical, yet Soriano now finds himself on the DL because of leg problems. Will he ever return to the speed player that earned him that huge contract, or will his physicall, and mental, limitations hold him back from this point on?
Hi Sam: Thanks for reading that. Great question! BTW, wearing my Cubs hat as I type today. I think Soriano is indeed battling both mental and physical issues now. Clearly he has the muscle strains, but now with straining three major muscle groups in the lower extremities within a year, that has to get to his head. So he becomes more fearful of really letting go and then perhaps he is more guarded (read: tightens up more), which in turn reflexly sets him up for further injury. The unfortunate part is there is no easy solution, especially now that he is in season. Hopefully this strain is of the more minor variety and will not hold him back as much as the quad from last year. I also think he has to ignore the comments about his "hop" and try not to press as a response to what people are saying, but really get with his coaches and figure out a routine that will help him maximize his speed and prevent injury. I think he can get back to his old self - but it is a project. Not sure if it happens this year.
What's the latest news on John Lackey? Do you think that when he comes back he will be the same pitcher we've grown to love?
Hi Colby: Just spoke with the Angels yesterday and here's what they're saying. Lackey is progressinf nicely. He threw a simulated game two days ago, came out of it well, and if he feels well today will do it again. They still project him as a few weeks away (we projected that at the beginning of the season) b/c he needs a few rehab starts. Remember he only had one spring training start so they need to give him that before rejoining the rotation. They have brought him back gradually though and he has yet to have a setback, so I expect him to be the pitcher you've grown to love.
Hi Stephania, What is going on with Howie Kendrick? He has a bum hammy but we do not know if he is headed to the DL or going to be in the line up soon. What do you know? Thanks.
Hi Chris in Alexandria: (And this answer is also for Frank in Rochester, Doug in Tampa and Marco in McAllen - and of course for any of the rest of you interested in Kendrick): Along the same note of speaking with the Angels yesterday, they tell me that his strained left hammy is much better but they are still calling him day-to-day. Day-to-day is a very realistic approach for these muscle strains, b/c each day they assess the pain/tightness, etc and then they increase the workload accordingly, then they have to see how the athlete responds the next day. I would say that it's a good sign that they are saying he's feeling so much better b/c it sounds as if he will aovid the DL.
BJ Ryan has been shaky despite not giving any ER in his two appereances. What are your thoughts on him going forward regarding his command, velocity and health?
Hi John: (Yay Princeton!) Ryan has performed about as I would expect in his return. Despite his early progress which was ahead of schedule, the inconsistency in velocity,command is very typical of pitchers returning after this procedure and is as much a function of getting their "feel" back in major league game situations, as it is rehab on the arm. I think going forward he is in good shape, but they will rest him as needed to avoid overuse in the first month or two. I think by june he will be looking stronger.
Hi Stephania, Whats up with Moises Alou and Ty Wigginton, no one seems to be talking about them? Productive seasons?
Hi Matt: Alou is recovering from his hernia surgery, and recently was reported to be feeling so good that he was slightly ahead of schedule. It's no secret that Alou is getting older, and he has had his share of muscle strains, but the good news with a hernia is that once it's healed fully, he should do very well (not a typically recurring problem). He is scheduled to have a minor league rehab appearance this weekend and appears to be headed for a return within the next week or two. Wiggington is recovering from his fractured left thumb and although he's been hitting, he says catching is the harder task for him. He did have a longer catch session this past Wednesday and said it felt better although he can still feel it. He says he thinks he'll be back when he's eligible to come off the DL which is 4/21. I would give him a week back in the lineup to see how the thumb affects him, but if he looks good, then I don't anticipate ongoing problems since it is his left.
Hi Stephania, what is status of Mark Prior? Is he still targeting a June return? Jason Grey thinks he will get hurt again as he hasn't changed his mechanics, your thoughts?
Hi Jeff: This is definitely an ongoing source of discussion. To answer the first part, the latest reports continue to suggest that Prior will be targeting a June return and he has had a remarkably solid progression back from surgery without setback. The Padres are playing it nice and safe and not rushing him, all of which is critical. I believe my colleague Jason is referring to the high elbow that Prior has where he ends up at maximal internal rotation of his shoulder (during his wind-up) with his elbow at a higher point than his shoulder. This is definitely a source of concern as this position maximally compresses many of the structures in the shoulder where Prior actually had his surgery. It is not a great position. The hope is that he will drop his elbow a bit as even a minor adjustment here could be a big difference. My feeling however is that he pitched the same way for a long time. The mechanical fault is not great for him in the long-term but I don't think it will show up this year.
Please comment on the state of the Braves pitching. Will Smoltz make it through the year? Is Soriano going under the knife? Will Hampton ever pitch again???
Frank: Come down off the ledge. I think your Braves are in better shape than you do. Yes, I believe Hampton will be there and I loved him coming out of spring training. Yes, he will likely deal with some intermittent muscle strains, but I think he'll make it back and pitch effectively. Soriano threw from flat ground this week, is feeling good, and expects to return when his DL time is up. Now we need to see him throw a bullpen and get into the more aggressive stuff before we get too excited, but I'm feeling positive. And Smoltz - although I think the neck/trapezius thing may rear its head from time to time and I think he's smart enough to jump on it proactively if it does and not overdo - well, he just happens to look fantastic, especially for a 41 year old in this game.
Hi Steph...long time listener, first time caller. Can you give me an idea if Rollins is just temporarily tweaked or is this an injury that will plague him and his fantasy team owners all season? Thanks.
Hey David: Beginner's luck. Your question is on the air. It's a good question b/c these ankle injuries can be so finicky. I think the fact Rollins is taking a few extra days with this actually bodes well for the future and not the other way around. This is a guy who understnad his body well enough to take good care of it so that he started 230 consecutive games or thereabouts, so he has known that his ankle still doesn;t feel right jumping laterally, especially to the left, something he has to do to play defense or steal bases. It is well within the realm of normal for him to still be feeling that, even after a minor sprain, so from a timetable perspective I'm not concerned. And - if he were to go out there and force it, he definitely runs the risk of a mroe severe sprain that could take him out for months. Once you have a decent sprain, there's always the chance the ankle is a bit more sensitive, but the way he's playing it, I expect him to really be ready and be effective when he comes back.
My wife's in DPT school and she was telling me that Putz's injury could take a really long time to heal... that only rest will heal the injury. It could be 2 months for that particular rib injury. your thoughts? I'm obviously worried!
Hi Eric: Congrats to your wife. And she's right - when it comes to costochondritis, or any other rib injury, it can take months. But the Mariners insisted that Putz had a mild case, and it is possible for those to resolve, completely, within a couple weeks. So far his activity suggests that he is progressing nicely. He threw 41 pitches off the mound this week and reported no problems which is a pretty good test. Now the challenge is to get him back to be ready to pitch in a game situation. It's not clear whether he'll just throw a simulated game or actually get a rehab outing or two, but it appears he will return before the end of April, about what we projected when he first went out with the injury.
Hey Steph, any word on Carlos Pena?
Hi Brian: And this is also for Tom in SF, Steve in Madison, Brian in DC, Dave in New York, Greg in Philly - and the rest of the Pena fans: He was removed in the fourth inning with what is being called "tightness" in his hamstring. Now a Grade I strain is often felt as a tightness or a pull, but the athlete senses something is there and beginning to lock up. A minor strain indicates that there could be some microtearing of tissue, in other words, nothing huge, but a precursor to a biggger injury if the athlete pushes it. Hence the caution. Have not heard any more yet but we will definitely be keeping an eye on the situation. It does not appear major at this time, and there was no sign of a major injury during the game, but probably everyone being careful. And if you look around at the number of hamstring injuries and how debilitating the serious ones are, this makes sense.
Seems as though Scott Kazmir and Matt Garza have/had the same injury. What's the difference between radial nerve irritation and just plain arm soreness?
Hi Tim: Actually quite different. Kazmir had elbow inflammation (a "strain") that happened during spring training (not so uncommon as pitchers return to throwing). He actually said at the time that he thought he snapped his elbow into hyperextension, which could certainly result in inflammation and soreness. When you have a pitcher and anything at the elbow you take precautions. As Kazmir was returning, the team was concerned that he develop adequate arm strength so they actually held him back a little more than he felt he was able to do. In the interest of his long term health not a bad idea, but his injury appeared to be more related to tissues right at the elbow joint itself. Garza had irritation of the radial nerve, so his pain was not at the elboe, but rather along the path of the nerve, into the forearm and lateral finger s and thumb and more of a numbness than pain. He also had difficutly with grip as the muscles innervated by the radial nerve were not functioning as well. The nerve can get aggravated if it is compressed between tight muscles (like in the forearm) or overstretched. Once they let the inflammation settle, get him back on a good flexibility program, he should be good to go. Occasionally these problems become chronic if there is scar tissue in the area. No indication of anything like that with Garza at this point.
Hey Stephania, How about Victorino? People are saying that this is one of those lingering injuries where he will miss more time after returning. Love you name by the way
Danny: Thanks for the name love. Victorino's injury is a concern b/c he had a similar injury in the same leg last year that kept him out for over a month and nagged at him beyond that. Now the team has gone out of its way to point out that the MRI showed the injury to be in a slightly different area, but it's still the same muscle in the same leg, so it worries me. The good news is that they wasted no time putting him on the DL, as a proactive measure to contain this. But don't be surprised, even if he comes back strong, which I expect him to do, that this could recur. It will be an ongoing concern for him.
I dropped Chad Cordero due the bad forecast riding on the media about his arm strenght but I am afraid if the man can come back. I would like a comment about Cordero.
OK Manuel - Welcome from Caracas - and you are the final question for today! Cordero's situation is puzzling. After the opening night when he could not appear b/c of shoulder problems (later termed tendinitis), it looked a sif he'd be back fairly quickly. But in his last outing he really had nothing on the ball. Cordero says he was cold and didn't warm up enough in Shea, but that doesn't really account for that much of a drop. It is at least a concern, one that the Nationals share, which is why they will not use him as closer until they see evidence of increased arm strength. I think it is risky to keep him on your team at this point b/c of the uncertainty of the situation. I would need to see that he is really back before I jumped on board.
Wow - thanks everyone for the great questions. There are so many outstanding questions - I feel like I could keep on chatting. But it's not my turn anymore so I am going to sign off. I promise - at least one gets posted in my blog that will be out tomorrow. Thanks so much for the thoughtful questions - please keep coming back!! Have a great weekend - and may all your fantasy players stay healthy!