Under the Knife: Latest MLB Injury Updates

Will Carroll@injuryexpertSports Injuries Lead WriterApril 9, 2013

Under the Knife: Latest MLB Injury Updates

0 of 10

    We're a week into the baseball season and I have 25 names to write about in today's UTK. Big names like Derek Jeter, Mark Teixeira, Ryan Braun and Jered Weaver have missed at least a portion of the first week, losses that they and their teams can't get back.

    Someday we'll take a look at their season stats on Baseball-Reference.com and wonder why their numbers were just a bit low. It takes a bit of a deeper look to understand that missed playing time, missed innings pitched, missed plate appearances are the usual reasons. 

    It may be just the first week of the season, but a win is a win. Losing a game in early April means that there's a game that needs to be won later in order to make the playoffs, when the pressure is higher for everyone.

    The same holds true for injury stats. Missed time early in the season tends to snowball or even go into a "death spiral," a time when the medical staff gets so overwhelmed reacting to a rash of injuries that preventative work falls behind, leading to more injuries.

    The idea that a medical staff could get overwhelmed should be laughable, but most staffs operate with two, maybe three athletic trainers at the core. There's only so much time, despite the fact that it would be easy and cost-effective to simply add another athletic trainer to the mix. 

    I had the chance to see several of these staffs at work this week, and unfortunately they're already working hard. Injuries never take days off. Then again, neither do I.

    On to the injuries...

Chase Headley (Thumb)

1 of 10

    Injury: fractured thumb


    Expected recovery date (ERD): May 1

    Chase Headley went for images* on Monday, and the results will determine the next step in his recovery from a fractured thumb. Headley's fracture is at the tip of his thumb, so once the images show clear healing, he'll be able to make quick steps towards a return.

    Assuming the images are good, Headley will begin to amp up his baseball activities and will likely be able to do everything almost immediately except for hitting live pitching. He would likely need some sort of bracing or padding for fielding, but those are easily fabricated. 

    With a normal timeline, Headley will be able to hit at some point around April 20 and rapidly progress from there. With no setbacks along the way, he may be headed out for a rehab assignment around the 23rd and back to the Padres shortly thereafter.

    There's no real milestone here to watch for besides activity and a return to hitting. The location of the fracture makes this a very binary injury, meaning that he can't play yet, but once he can, he'll be back to level quickly. I'd expect to see him pick up where he left off last season, making him a great trade-steal candidate right now.


    *I tend to use the term "images" rather than any specific diagnostic term, such as MRI or X-ray. The reason is that these are often used in sequence and the result is far more important than the specific type of test. Different doctors will use these tools in different ways, but in all cases, they are looking for a way to see inside the body short of using surgical means. 

Jered Weaver (Elbow)

2 of 10

    Injury: fractured elbow


    ERD: June 1

    Jered Weaver's injury was an odd one. He was quick enough to get out of the way of a shot right back at him, but fell on his non-pitching arm in doing so. It was an awkward fall—as you'd expect with a quick-twisting move on a sloping surface—which resulted in what looked like a hyperextended elbow. Weaver was removed, but he was nearing his pitch limit anyway, so we really aren't sure whether he could've continued.

    The Angels were initally worried about whether he'd make his next start, but images on Tuesday morning showed a fracture near the elbow, according to Fox Sports' Ken Rosenthal. The fact that it is to his non-throwing arm is significant, but he will still miss at least a month. The non-throwing arm, or glove-side arm, is important for balance and consistency, so a change there could cause problems, especially for a pitcher with such a long delivery as Weaver.

    While this doesn't look to be a long-term issue, Weaver will have to be handled carefully until his elbow is back to normal. My guess is that the Angels will be as conservative as their record allows them to be.

    Garrett Richards is the likely fill-in, though the Angels have been using him as a key reliever through the first week of the season with success. Adding any uncertainty to the delivery of a good-but-inconsistent pitcher like Weaver isn't something that a pitching coach on the hot seat is going to want on their watch. 

    Click here for more info on Weaver's injury.

John Lackey (Arm)

3 of 10

    Injury: strained biceps


    ERD: April 20

    John Lackey's reaction was the worst part of his arm injury. He looked like he'd been shocked, jumping and grabbing at what appeared to be the area near his surgically repaired elbow. Lackey said it himself—his first reaction was "a year-and-a-half of getting to this point and having to do it again." 

    Lackey won't have to do that. Despite the reaction, the injury is minor, reminding us once again that how an injury appears seldom correlates with seriousness. Lackey cramped up more than anything, though there is a minor strain in his biceps. 

    The Sox will need to be careful with him both to protect the elbow and make sure the strain doesn't get worse. It currently looks like Lackey will miss one start, but if it doesn't look like he's going to be ready for the second, he'll likely be pushed to the DL. Alfredo Aceves will take the starting spot for now, though the Sox have options if this goes longer. 

Brian Roberts (Knee)

4 of 10

    Injury: hamstring strain

    ERD: May 10

    I often discuss how the term "injury prone" is overused. At some level, however, the term is apt. Some players have bad luck, bad genetics or something that simply doesn't allow them to stay healthy. For some, like Brian Roberts, age is likely a component; players begin to decline quickly at a certain point. 

    Things had gone well this spring as Roberts came back from post-concussion symptoms and various other injuries that had kept him out for the better part of two seasons. His return was expected to improve the Orioles lineup, but he had to be healthy for that to hold true.

    It didn't last long.

    Roberts injured himself on a slide, hitting second base hard and causing his knee to buckle. Roberts reported that he heard a pop, leading many to think the worst: an ACL sprain. Instead, images showed it was "merely" a hamstring strain. The injury was to a tendon that isn't necessary and is often used to replace the UCL in the elbow during Tommy John surgery.

    Roberts will need about a month to rest and heal, as well as get used to the changed anatomy in the back of his leg. With Roberts, it's safer to go on the long side of any rehab timeline, so seeing this one stretch into mid-May wouldn't surprise me. Watch for when he returns to the infield, making sharp lateral motions and his ability to run the bases at speed for signs he's close to a return.

    One last note: this is a knee injury despite it being a hamstring tendon that is involved. The function of the tendon is redundant, but involves flexing the knee joint itself. 

Jeff Niemann (Shoulder)

5 of 10

    Injury: strained shoulder

    ERD: done for season

    If you look back at Jeff Niemann's pro career, it's more astounding that there was a period when Niemann was injury-free and productive more than it is that he's having shoulder issues now. Niemann came out of Rice damaged by a workload that bordered on insane. Getting back to a productive level took years and was an early sign that the Rays might have been ahead of the curve medically. They've definitely borne as much with the massive reduction in arm injuries over the last decade.

    Niemann traveled with the team to Texas, where he met with Rangers team ortho Keith Meister, who was involved with Niemann's initial surgeries. Niemann will have images taken on Tuesday, but reports are that he will have surgery as soon as Wednesday. The fear is that the damage is extensive and that more than just his season will be done. 

    Niemann's shoulder problems had pushed him out of the rotation, but it does cost the team some depth. Instead of shifting Niemann if a starter goes down, Chris Archer will likely be the first fill-in. The Rays will monitor Niemann's rehab closely, but with his injury and contract status, it would surprise me to see him back with the Rays. He'll need a top-flight medical staff to make it back and keep him together, so the Rangers might be a possibility given his relationship with Meister.

David Ortiz (Heels)

6 of 10

    Injury: strained Achilles tendon, bilateral


    ERD: April 20

    Things are going well for David Ortiz. As expected, Ortiz played in a live game at the Ft. Myers complex on Monday, going 2-for-4. It was a controlled game rather than the more normal simulated game, more for the players still at the complex than for Ortiz. Still, it's a very good first step that points to him being ready for a rehab assignment by the end of the week, assuming no setbacks.

    That is a tough assumption, given the recurrence rate and the bilateral issues that Ortiz has had this spring. Ortiz doesn't need to run so much, and the worry is that any running will cause more issues. The hitting appears to be fine, though it will take more proof than a double for me to buy in as far as power not being an issue. 

    Ortiz seems to have made adjustments and is certainly motivated to overcome his health issues. He'd be a big addition to the Sox offense, assuming we're going to see anything close to his peak production. If John Farrell is smart, Ortiz will be matched up more wisely and the DH slot used a bit more creatively than they have for the last decade. Ortiz isn't a "lineup in pen" kind of player any more, especially if the Achilles issues remain in play.

Freddie Freeman (Core)

7 of 10

    Injury: strained core (oblique)


    ERD: April 22

    Injuries are never convenient, but sometimes they're easily accommodated. Freddie Freeman has a minor core injury, said to be an oblique strain on his right side. It was affecting him as much in the field as it was at bat. Given the Braves roster and how Justin Upton is carrying the offense right now, the Braves made the smart, conservative move and pushed Freeman to the DL. 

    This core strain is minor and should take less than the 15 minimum days to resolve, but by resting Freeman and making sure that Fredi Gonzalez isn't tempted by his bat on the bench, Freeman should be fully healed when he returns.

    In the meantime, the Braves will get a look at Chris Johnson at first, opening up time for Juan Francisco at third base. Evan Gattis has been solid as backup catcher and he may get a look at first as well, which would make it a bit easier for the Braves to carry three catchers once Brian McCann returns. 

Mark Teixeria (Wrist)

8 of 10

    Injury: sprained wrist


    ERD: May 5

    Mark Teixeira is making progress in his recovery from his wrist injury. In fact, he may be ready to come back earlier than expected, and with surgery ruled out at this stage, it's quite possible that he will be ready to start a rehab assignment in the next 10 days. Of course, it's not really the return date we're worried about as much as it is the return to level. If Teixeira's on the field but doesn't have his power or has a slow bat, that's no good for the Yankees.

    The next key for Teixeira will be an examination this weekend that will possibly give him the clearance to amp up baseball activities. If he gets through those—and it should be apparent to the Yankees medical staff quickly—then a rehab assignment would start shortly thereafter, likely at the Yankees' Tampa complex, and a shift up to a higher level for a few games would occur before activation. 

    There's the possibility that Teixeira could be ready by May 1, but I want to build a setback into this kind of recovery timeline. Watch those milestones and look for any sign of power, including doubles/gap power. Lots of slap or opposite-field hits would be a negative. The Yankees are known to use Zelocity monitors, which should give them some early measurements. 

Roy Halladay (Shoulder)

9 of 10

    Injury: none


    ERD: no missed time

    I'm going to get pretty technical here, so if you're not a biomechanics geek or a Phillies fan, you'll probably want to move on. If you are a Phillies fan, you'll probably want to move on anyway, though I know there's often a side of masochism to those Philly cheesesteaks.

    Jeff Sullivan does a great job breaking down Roy Halladay's start at Fangraphs and notes his lowered arm slot. Halladay has always been a sidearm pitcher with a shoulder tilt that makes him look like a low three-quarters pitcher. It's a subtle difference and truly meaningless through most of his career. For all pitchers, arm slot is essentially meaningless as long as it is both consistent and effective. 

    I believe that Halladay has adjusted his arm slot down deliberately, either to reduce pressure on his shoulder, which would indicate some kind of damage inside, or to regain movement on his pitches. Since PITCHf/x can show us that, we'll know soon if it was the latter, assuming his change is effective. 

    Halladay has relied on control more than stuff or movement throughout his run as one of the most dominant pitchers of the last decade, so a change to improve stuff is not one to "keep up" but one to stay above a level. There's some minimum threshold for stuff; major league right-handers do not succeed for long at less than 90 mph. 

    Halladay's adjustments through the spring have been watched closely, but at this point, Halladay is in the same situation that Tim Lincecum has spent the last two seasons in. He's trying to adjust his mechanics at the same time he's expected to produce. It's very difficult to do and could create a physical tax on his arm that could lead to a breakdown.

The Dots

10 of 10

    Russell Carleton goes a long way in helping explain why the easy explanation of BABIP doesn't work that well. Carleton's work here shows why he is rapidly becoming one of the most important sabermetric writers today. Working through the math with Carleton is well worth the effort if you want to have a real understanding of why pitchers work the way they do ... 

    Buster Olney nailed this one. Derek Jeter's real target date for a return to the Yankees lineup is May 1. It's a bit conservative given the facts we know, but I'm beginning to really question those facts. If the ankle has any existing instability after the surgery and six months of rehab, that's a problem that's not likely to go away ... 

    Ryan Braun missed the weekend with neck spasms but was back on Monday. He hit very well and looked to be having no problems. Spasms are tough to get a read on, but if Braun can stay in the lineup without issue for a week or so, it's fair to consider him normal. Even in and out of the lineup, Braun is too valuable to skip in weekly leagues. It's fair to think that Dan Wright and his staff will be keeping a very close eye on this ... 

    Aramis Ramirez hit the DL with a knee sprain. Ramirez has been describing this as similar to, but worse than the knee sprain he had in spring, which was to his MCL. The Brewers haven't given specifics as to the sprain, but assuming it is once again the MCL, he could miss up to six weeks ... 

    Another Brewer? Yes, Jean Segura has a mild quad strain. The team will be conservative with him to make sure that he doesn't make things worse, but he could be back as soon as Tuesday. Segura has much larger legs than I'd expected and actually reminds me of a young Miguel Cabrera in terms of build, though smaller ... 

    Jose Bautista returned to the Blue Jays lineup on Tuesday after missing the weekend series with a sprained ankle. It appears that the mild sprain was normal and that a couple days of rest and treatment were enough to get Bautista back to a solid base. Look to see if he shows normal power over the next few days, though it's safe to activate him in most formats now ... 

    Mike Trout has put on almost fifty pounds since last year, though people have forgotten that Trout was battling a thyroid condition at the start of 2012. While not much has been said about the management of that condition, it's obviously been effective, though there's starting to be the normal jealous rumblings by other teams that Trout's performance has been enhanced somehow. The key note here is that synthroid and other similar thyroid treatments are medically necessary and not banned ... 

    Eduardo Nunez acted as if he'd been shot after he was hit by a pitch in the chest and upper arm. Despite his extreme reaction, which led many to think it was a collarbone injury, he was back in the lineup. The bruise on his bicep may be affecting his swing, so watch out for more swing-and-misses ...  

    The Cardinals got David Freese back for their home opener, as planned. His back issues have cleared up, but he did miss time, making his 0-for-3 day more of a concern. Watch him closely over the first week of the season to make sure he's healthy and this is just some rust ... 

    The Indians got a bit lucky. Images showed that Carlos Santana did not have a fractured thumb, as feared. Santana does have a nasty bruise and will likely miss a few days while that clears up. It's another reminder of the dangers of catching, or at least the dangers of having a plus hitter back there  ... 

    The Rangers still have Matt Harrison scheduled to make his third start of the season on Thursday. Back spasms have it in jeopardy. He'll make his side work later today before the Rangers and Rays battle again, but the back issues could explain his two subpar starts so far. Keep your eye on it ... 

    The A's dodged two bullets over the weekend. Josh Reddick's images came back negative after the A's medical staff feared he might have a broken wrist. Of course, there are protective wristguards that could prevent this kind of thing, but few players seem to wear them. Brett Anderson also avoided bad news when images on his thumb came back negative. Anderson tried to barehand a screamer coming back through the box, which is a bad idea. Neither should miss significant time ...

    The Nats could get Adam LaRoche back as soon as Tuesday. LaRoche told MLB.com that some muscle relaxers seem to have helped his back. Watch to see that it stays loose over the next few days ... 

    The Jays saw Brett Lawrie start up baseball activities this weekend. He's throwing long toss and running. He'll progress to fielding and hitting this week, with a return shortly after that ... 

    John Danks made a 77-pitch start in extended spring training this week. There was no word on how his velocity was, which is much more key than any other available stats. Reports were positive and his progress is also a positive for the Sox ... 

    Stephen Drew played two games at Double-A Portland with no issues. Drew is expected back in Boston for Wednesday's game, though it is unclear whether he will immediately shift back into the starting lineup while Jose Iglesias is hitting well ... 

    Francisco Liriano is making progress in returning from his arm injury. He'll throw a sim game at the Pirates complex in Bradenton. That puts his early May return on track, with the Pirates hoping he can slot into the back of their rotation at that point ... 

    The Cubs won't get Darwin Barney back this week. He'd hoped to have the stitches out of his knee early in the week, but a bit more time is needed to heal up the nasty cut he has over his kneecap.

    Will Carroll has been writing about sports injuries for 12 years. His work has appeared at SI.com, ESPN.com and many others.