Under the Knife: David Price, Bryce Harper, Alex Rodriguez and More

Will Carroll@injuryexpertSports Injuries Lead WriterMay 21, 2013

Under the Knife: David Price, Bryce Harper, Alex Rodriguez and More

0 of 10

    Injuries have continued to plague some of the biggest names in baseball. With David Price the latest Cy Young contender to come up with a sore arm, Bryce Harper bouncing his head off an unprotected section of fencing and Ryan Howard limping again, we can only wonder about the hours that the medical staff is putting in.

    And while those good men and women work 18-hour days, we're left wondering if anyone else seems to care. I'll pass on stepping back up on my normal soapbox here. You know the next stanza on your own by now. At some point, some team will realize the advantage it can gain.

    In the meantime, we're left trying to find where the advantages are in our own fantasy world. You'll know if your favorite team is serious about managing injuries, but on a fantasy team, it's a game of minimization and prediction. The simplest way to gain an advantage is to understand the severity and effects of the inevitable injuries, so let's get to it.

David Price (Triceps)

1 of 10

    The Tampa Bay Rays have had an incredible run of health. A lot of that is planning. Ron Porterfield has kept this team near the top of injury stats for the better part of a decade, continuing on what Ken Crenshaw (now with the Arizona Diamondbacks) built alongside Dr. James Andrews (yes, that one) and Dr. Koco Eaton. The team has development plans that work as well, with an integrated approach that is really second to none. 

    David Price has been something of an exception to how the team builds pitchers. He came fully formed out of Vanderbilt and hasn't looked back. His easy lefty delivery seemed to protect him, but even the best pitchers can get a bit out of whack. It's convenient to say that his early-season struggles were early signs of injury, but there's no evidence for that. 

    It's more likely that the struggles led to the injury, as Price attempted to make changes that helped effectiveness. Fact is, we don't know because there's no exact method for in-game mechanical measurements. What we have doesn't elucidate things much.

    The triceps strain isn't significant, but the consistently conservative Rays pushed Price to the DL to make sure that it didn't become significant. The team has pitching depth to deal with a few starts absence by its current ace. Jake Odorizzi will get the cameo appearances, but expect Price back at the minimum.

    Funny story that illustrates just how good the Rays have been at minimizing pitching injuries for a long time. A few years back at the ASMI Injuries in Baseball Course, Ken Crenshaw gave a talk about the rehab process he was using for a pitcher coming back from Tommy John surgery, but as with most medical presentations, no names were used.

    Afterward, I asked him how Seth McClung was doing. Ken looked a bit startled and said, "How did you know it was him?" I explained that McClung was the only Ray who'd had Tommy John surgery in two years, so I was hardly Sherlock Holmes for figuring it out. 

Ryan Howard (Knee)

2 of 10

    It took Ryan Howard awhile to come back from his Achilles tear. The infection that got in there was a bad one, forcing doctors to shave away muscle and flood the area with antibiotics. That cost him months in a return, but maybe more.

    Howard has been able to play, but it would surprise no one if that calf altered the way he ran, moved and swung the bat. Those kinds of minute changes are the exact motions that often lead to a cascade injury. A term borrowed from network science, a cascade is when one small change leads to another and, in many cases, does so unconsciously. Even a small change can lead to a bigger problem.

    Howard's problem right now is swelling inside the knee. The Phillies sent him off for an MRI and found a small tear in his meniscus, which is actually better than what some were expecting. The Phillies will give Howard a shot and some therapy, hoping they can find a way to keep him functional and reduce the swelling. 

    Surgery may be necessary, so the risk on Howard just went up significantly. If the meniscus is removed, as standard, Howard would miss about six weeks, though some return earlier. Given his size and the other issues, I feel safer going with the long side of the timeline if the surgeons have to go in. 

Carlos Ruiz (Hamstring)

3 of 10

    Ryan Howard isn't the only one limping in Philly. Carlos Ruiz pulled up on a play where he was going first to third and came away with a hamstring strain that will send him to the DL. I'm curious how much value there was in that extra base, if you happen to have your slide rule handy. 

    According to Todd Zolecki of MLB.com, Ruiz had some images of the strained muscle taken and it's a Grade 2 strain, right in the belly of the muscle. That's bad for speed players and catchers, of which Ruiz is the latter. They'll have to make sure that it's healed so that the explosive motion of a throw to second doesn't re-injure him, something that opposing teams will test.

    Ruiz has always been a bit of an energy boost to the Phillies team, but with the future at the position getting closer, they may have to start looking at Sebastian Valle and Tommy Joseph more. In the meantime, Erik Kratz will get most of the starts in Ruiz's absence.

    The Phillies were very healthy when they were winning. With this mix of players, it's going to be tougher for their good medical staff to keep them healthy.

Alex Rodriguez (Hip)

4 of 10

    Remember Alex Rodriguez? While some baseball fans are trying to forget him, the Yankees third basemen is making good progress in his return from offseason hip surgery, according to The Associated Press (via ESPNNewYork.com). 

    Rodriguez is taking normal batting practice at the Yankees' Tampa facility, as well as fielding grounders. This is his third week of on-field work, and he could be ready for some in-game action in the next couple weeks. 

    Rodriguez appears to have good strength and mobility in the hip, with normal progress everywhere else. His return is still targeted for the All-Star break, though he could actually be a bit ahead of that physically. It's unclear what the Yankees would do in that case, but with the team in first place, they may hold off on the media storm Rodriguez's return will bring.

    In other Yankees updates, both Mark Teixeira (wrist) and Michael Pineda (shoulder) are playing in extended spring training games. Teixeira is at least a week away from starting a rehab assignment. He's shown good bat speed, but no power.

    Pineda is showing good velocity, but not much in what scouts call "pitchability." That could well be rust.

    According to Ken Davidoff of the New York Post, Pineda will have two more XST starts before his own rehab assignment, meaning he won't be back until July. 

Corey Hart (Knee)

5 of 10

    Corey Hart once resisted being put on the 60-day DL, hoping he could make it back earlier, perhaps even in April. The move was made necessary by a roster crunch, but Hart didn't beat it anyway.

    While he could come back on May 30, it looks like he won't start a rehab assignment until early June.

    According to Adam McCalvy and Kevin Massoth of MLB.com, Hart is taking batting practice and running, though he still says his running is awkward. The Brewers have him pretty locked in at first base, so his running will be less necessary. The roster has some flexibility, so even without the DH, Hart will be able to get some rest or be pulled for defense if necessary.

    The Brewers got lucky for a bit with Yuni Betancourt's hot bat holding first base, but at 4-for-43 over the last few weeks, it's clear that Hart is an upgrade, even if he's not 100 percent. Look for any sign that the power is there, which should indicate that the knee is holding up through Hart's long swing.

Johnny Cueto (Core)

6 of 10

    It's interesting enough that Johnny Cueto thinks he needs to change his mechanics, something he'll have to do without any sort of biomechanical analysis or assistance. To me, I'm more curious why he didn't start the change while he was rehabbing. 

    Cueto returned to the mound after an oblique strain held him out over a month, and he showed the same twisting mechanics that he had before the injury. If there are changes, they're either not apparent or something that's coming in the future.

    Working on mechanics in season is very difficult, especially for a pitcher with a complex delivery like Cueto. Throwing off the timing or using different muscles can be both physically dangerous and skew results as a pitcher struggles to find release points. It's seldom done, and even less so successfully.

    Cueto's oblique appears to be healed. The danger of recurrence is there, but tends to be front-loaded. Mechanics aside, Cueto should be back in your fantasy rotation in all formats. 

Jaime Garcia (Shoulder)

7 of 10

    When Jaime Garcia's shoulder injury first occurred, he went to four different doctors to have it checked. Dr. James Andrews was the only one who thought it could be rehabbed, and Garcia liked the sound of that.

    It worked for a while, but it appears that things have gone wrong inside again. That means Garcia is headed back to Gulf Breeze for a visit with the good doctor, per Scott Miller of CBS Sports. 

    Garcia will have surgery, with Dr. Andrews, and is done for 2013 and perhaps longer, depending on what is found in the shoulder. Tyler Lyons will step into the rotation for a while, though Jake Westbrook is close to a return and would be the most likely longer-term replacement. 

    The bigger downside is that the depth of the rotation is being eaten away by injury. That's going to put more pressure on Shelby Miller, who is in his first year. If he hits the kind of wall that Lance Lynn hit late last year in his rookie season, the Cards have less to reach down and get.

    There's still a wild card out there in Chris Carpenter's potential return. While some speculated that Carpenter might come back as a reliever, he's going to follow a starter's return plan as he starts throwing again this week. He's a very speculative play, but might be worth a stash if you have a free slot on your fantasy roster.

Josh Johnson (Triceps)

8 of 10

    Josh Johnson is making some pretty solid progress in his return from a triceps strain. (In this case, the strain is high enough on the muscle to truly be considered a shoulder injury, but we'll stick with the nomenclature that the Jays are using since it seems to be precise.) He made his first rehab start, as noted by Danny Knobler, at Dunedin (Class A Advanced) and showed no issues aside from hitting his pitch count quickly.

    Johnson showed good velocity and decent control, which are the keys here. The Jays had him on a strict 50-pitch limit and will add to that conservatively. He could need three more rehab starts to get up to the stamina levels he'll need at the majors. 

    The Jays resisted calling Johnson up early for an opening this week, preferring to think longer-term. The Jays' season plan has been derailed by injury thus far, but it appears that they think they're close enough to make a run once Johnson, Jose Reyes and a few others are healthy. Keeping them healthy will be key to that plan and something the Jays just haven't been able to do, especially with pitchers.

Ryan Vogelsong (Hand)

9 of 10

    It wasn't a comebacker, but a "come at ya," as one scout described it.

    Ryan Vogelsong was batting, and one inside pitch on his hand has him out for a month or more. He will need surgery to repair the fractured pinky finger. 

    According to Chris Haft of MLB.com, the pitch fractured two bones and dislocated a joint where the finger meets the hand. Vogelsong described the injury as crushing, so it may require surgery to fixate the bones. The injury is on his pitching hand, so there will be worries about control once he does return, though the pinky isn't very involved in the main functions of pitching. 

    The replacement for Vogelsong is unclear, with a couple rookies possibly being called up or Shane Loux in the short term. The Giants rotation has been shuffled a bit, so seeing Vogelsong injured, especially as it looked like he'd corrected some recent flaws, is another blow to their hopes of defending their title. Whoever it is that replaces him in the rotation will be there until at least the All-Star break, and maybe a bit more.

Bryce Harper (Head)

10 of 10

    As Bryce Harper has gone in and out of the lineup with a head injury and a sore knee, there have been many calling for Lee Kuntz's head. Kuntz, the head athletic trainer for the Nationals, says that Harper does not have a concussion despite some symptoms that would match such. 

    Harper passed both the SCAT2 and ImPACT tests after the hit to the wall, but showed some symptoms, including a nausea that he described as like being carsick. Kuntz also said that Harper never lost consciousness, while Davey Johnson showed a powerful ignorance, saying that Harper couldn't have a concussion since he was hit on the chin. 

    I'm not one for conspiracy theories. This comes down to whether you believe Kuntz is telling the truth. Harper's status is in his head and no one knows better. If he hits a home run, that tells us nothing. I'm just going to believe in a man whose life has been dedicated to keeping his players healthy for now.

    Harper is back in the lineup, though not yet 100 percent. The only worry now is that Harper's style makes this kind of thing possible on the next fly ball near a wall.