Under the Knife: Latest MLB Injury Updates

Will Carroll@injuryexpertSports Injuries Lead WriterJuly 23, 2013

Under the Knife: Latest MLB Injury Updates

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    NFL camps open this week and since 2005, when Aaron Schatz convinced me that covering football injuries would be "fun," I've done double duty. It was that whole Bo Jackson pitch he made. I'll be doing the same at Bleacher Report, though you've already seen me cover basketball, MMA, pro wrestling and soccer here, so adding in the NFL season will hardly phase anyone.

    I mention this because the baseball injuries don't stop just because the NFL season starts. It's always bothered me how many people, especially in the fantasy industry, shift away about this time. I get that the big money in that market is football based, but if you can't finish, why start? 

    UTK won't change. It will be here every week, all the way through baseball season. I'll still cover the big injuries with the same kind of in-depth coverage I have all season. In other words, football season just makes me work harder, not differently. 

    There's a ton of injuries impacting teams around MLB right now and I'm sure they've had an effect on your fantasy teams as well. Powered by commitment to you, let's take a look around the leagues:

Roy Halladay (Shoulder)

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    It seems that many people were surprised or at least caught off guard that Roy Halladay was back on a mound this weekend. It's just a side session, but the reports were positive from those that observed him throwing. They can generally be summed up as "he looked normal," and at this stage of a rehab, normal is very good.

    Halladay had surgery back in mid-May to correct mild fraying in his labrum and rotator cuff. This return to the mound is almost exactly on schedule, though we're at the point in this where he could get ahead of the pace if his results are solid.

    Halladay is mostly a control pitcher, but his velocity was impacted by the issues inside his pitching shoulder. While we can't expect to see that return immediately, we should be looking for signs like the "popping mitt" that was reported that it's coming back. 

    It's not unreasonable to think that Halladay could be back by mid-August. He'll need to have several more side sessions, to recover normally, and then have at least a few rehab starts in order to show his stamina is back. Given his normal efficiency, this shouldn't be as much of a task for Halladay as most. Halladay's progress is going to inform any decision the team makes about buying or selling at the deadline.

    It's interesting to think that we might have a bit of a race to get back between Halladay and his good friend Chris Carpenter. The former teammates have remained close and while I say "race" jokingly, it wouldn't surprise me if they took it a bit more seriously. 

Alex Rodriguez (Hip/Leg)

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    Let's get this out of the way: There is no way—none, zero, nada—that Alex Rodriguez is going to be permanently disabled by a quadriceps strain. If the muscle was torn and needed to be surgically re-attached, I'd think it could cost him a year, maybe a bit more. But for a disability carrier, that's hardly a "rated condition," which is what they call something that will require a lifetime payment for a permanent disability. 

    The Yankees reportedly have a disability policy on Rodriguez's contract. That deal, which has four years and about $90 million left on it, could well be insured, though that policy would likely have exclusions and protections giving the insurance company rights, especially on determination, that will become significant down the line. It will be difficult, but not impossible, to collect on this.

    One of the most recent examples of a similar situation was the Astros' fight to collect on a similar policy on Jeff Bagwell. Bagwell was forced to retire due to a shoulder injury, one that was famously examined by James Andrews, who got up from his own hospital bed to examine Bagwell. That one ended up in court and had a lot less money on the line than this. 

    Rodriguez was in rehab games and on track to be back early this week for the Yankees prior to the quad strain, so there's some evidence that the hip that was repaired this offseason has made progress. The next step in Rodriguez's rehab seems to be more informed by the non-medical aspects of Rodriguez's situation than the medical ones, so putting any kind of timeline on this is tough. 

Derek Jeter (Ankle/Leg)

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    Derek Jeter was pushed to the DL due to his mild quad strain. It wasn't an unexpected move, though many around the Yankees world were disappointed. Jeter's partial-game return showed that he still had good skills, but now the question is whether his body can hold up.

    I have a lot more about Jeter's injury here, but in this space, I think we need to consider whether or not Jeter will need a shift to the DH slot on a more regular basis. The signal we got from that one game is yes and that Joe Girardi wouldn't hesitate to do so if it gave him the best matchup.

    It's that last part that's tougher to address. Is Jeter a better DH than Travis Hafner or, when healthy, Kevin Youkilis? It's a corollary to the concept that some percentage of Jeter is better than some percentage of Luis Cruz or Jayson Nix. Balancing those two is what Girardi and the Yankees analytics staff will have to work on when Jeter returns.

    What? You didn't know the Yankees had an analytics staff? Every team does, and Mike Fishman has been with the Yankees for a while. You didn't really think that Girardi put together that binder on his own, did you?

Clay Buchholz (Shoulder)/Andrew Bailey (Shoulder)

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    I'm not sure that's the correct spelling of the childhood security blanket, but it is the word that a team executive used in conversation a couple years ago. His team had sent one of their pitchers to Birmingham to be checked out by Dr. James Andrews, for the second time that season. The pitcher just needed to hear it from Dr. Andrews, rather than a medical staff that it was clear he didn't trust, despite the fact that they were saying the same things. It was cheaper to just send him down and, in essence, give him his wubbie.

    That's a bit of the spin on why Clay Buchholz is heading to see Dr. Andrews this week. Buchholz has been out since early June and while the injury isn't unclear, the lingering and slow healing have raised some doubts. Add in the continued buzz that even a newly reconstructed medical staff doesn't have the trust of the players, and this isn't a visit to get too worried about on a purely medical basis.

    Buchholz's bursitis inside his shoulder should be cleared up by now, so the question needs to be why he's still having issues. Worries about nerve issues or cervical spine issues have been raised in regard to this, but there's little in the way of specifics. 

    Buchholz's strength and range of motion in his pitching arm are normal now, according to reports from Pete Abraham of the Boston Globe, so it will be very interesting to see what comes out of Buchholz's trip to Gulf Breeze and whether the Sox set up a schedule for his return. (Update: Wubbie, per Pete Abraham again.) 

    The Red Sox also lost Andrew Bailey for the season and perhaps beyond. His pitching arm had damage to the labrum and the capsule, a bad combination. A recent comp for that would be Johan Santana, which can't be considered a positive. The surgery will be done Wednesday by Dr. David Altchek, the doctor who did Santana's surgery. 

Matt Holladay (Hamstring)

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    Halladay up, Holliday down. Yeah, for some reason I get Roy Halladay and Matt Holliday confused, at least in their spellings. Matt Holliday heads to the DL with a hamstring strain after not recovering through the All-Star break. As the Yankees did with Jeter, the Cardinals waited to see if he would recover. The retro move puts him in position to be back on the active roster this week.

    The worry here is less about a mild hamstring strain and more about a 33-year-old player who seems in physical decline and who has several years left on a big-dollar deal. Holliday has always been known as a high-effort guy despite his size, and those two things in combination make for an odd mix (Mike Trout fans, take notes). 

    Holliday should be back, but looking at his physical issues over the past few years, the worry for the Cardinals is that this is but the latest episode in an increasing pattern. The Cards don't have the option of shifting Holliday to DH, but first base might have to be considered down the line. The team has always been open to flexible, out-of-the-box roster, lineup and even defensive solutions, so there's no better place for Holliday to be if that's necessary.

    Expect Holliday back shortly after the minimum, perhaps this weekend or early next week. He might be slowed a little bit, but Holliday should be a plus for any lineup at this stage. With the Cards fighting hard in the NL Central, every game missed, every piece of run creation lost, might be a difference-maker.

Yoenis Cespedes (Wrist)

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    Home Run Derby curse? It's been shown that it doesn't really exist, but that doesn't help '13 Derby champ Yoenis Cespedes. Cespedes came out of the All-Star break with a sore wrist, so some will twist the narrative to fit the facts. 

    Cespedes says he did not injure the wrist during his Derby performance, though it's unclear exactly when it happened. The mild sprain is enough to keep him from taking full swings, which is smart considering how much force he generates. Even a low-grade sprain is going to be problematic with as hard as he swings the bat. 

    The A's will wait at least a couple days before even considering putting Cespedes on the DL. He could take batting practice as soon as Monday, which would put a return on the fast track. Wrists are tough ones that have a tendency to recur and linger, especially for power hitters.

    Once Cespedes does get back in the lineup, watch for signs of power. He's got so much that he could give up some and still hit gappers and bombs, so it's tougher to judge. His kind of light-tower power seldom turns into warning-track power, so that change would indicate a much more serious issue. The A's do tend to be pretty conservative, so seeing Cespedes miss a few more games wouldn't be out of character.

Jason Grilli (Elbow)

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    The Pirates have a great story in Jason Grilli. It wasn't that long ago that I was talking to him about his marketing business and not about him being an All-Star. Grilli came off the mound in Pittsburgh Monday in obvious pain, something the Pirates have to be worried about.

    Early word is that Grilli is experiencing "forearm discomfort." That doesn't tell us much and given the way he reacted after the injury—and pitched prior to it—I'm still very worried. Grilli will have more evaluations and likely some imaging on Tuesday, but he's certainly not going to be available for at least a few days at best. The worst case? Well, let's not go there just yet. 

    The Pirates have a lot of bullpen depth, with the available arms of Mark Melancon and Tony Watson ready to be used and with guys like Vic Black ready at Triple-A Indy. It's still not Grilli, a guy who's gone from "really?" to "really!" in a hurry. You have to root for a guy like that and hope that his comeback story doesn't end like this. 

Ryan Ludwick (Shoulder)

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    I suggested on Twitter over the weekend that Ryan Ludwick's return was something that the Cardinals and Pirates might have to "answer." The concept that getting an injured player back on the roster is the same as acquiring a player is one that I've been on both sides of at times. A trade brings in something new; a return brings back what a team planned to have. 

    Ludwick could come back and be the power source that the Reds have lacked this season. Joey Votto and Jay Bruce are a solid one-two combo, but last season, it was a one-two-three. With Shin-Soo Choo at the top, the roster constructions of Dusty Baker have made things look a bit topsy turvy at first glance, but runs are runs. It doesn't matter if the RBI are collected by Votto or Brandon Phillips, as long as the runs are crossing the plate. 

    Of course, it's not that simple. Ludwick is back after injuring his shoulder on Opening Day and Matt Kemp is just one example of how difficult it can be for hitters to come back from shoulder issues. Watch to see if Kemp is showing any signs of power and that his swing-and-miss percentage isn't going up. It doesn't matter at what level that shows, just that he's still got the tool in the toolbox. 

Yu Darvish (Shoulder)

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    The Rangers haven't had the rotation they thought they would all season long, but it's getting closer. That sequence will start with Yu Darvish coming back on Monday. Darvish had missed the minimum with a mild strain of his trapezius, a small muscle on top of the shoulder. It was a smart move and smart use of the All-Star break that bought Darvish a bit more rest while minimizing his impact on the rotation.

    Darvish's mild strain shouldn't affect anything, though I do expect that the Rangers will hold his pitch counts and workload down slightly, something they would likely do anyway. They've been a bit more open with the idea of Darvish going later in games this season, though they still don't have any direct data on his fatigue levels. No, I won't soapbox you or Mike Maddux on this, but know that the problem is there and solved that easily. 

    In his first start back, look for Darvish to have his normal smooth delivery, to show his grab-bag of pitches and to get back to his normal velocity range. His control is often shaky in the first couple innings, so don't worry too much about one or two innings at the start of the game. If he's showing any signs of discomfort, such as shrugging his shoulder or tugging at the jersey, that's a bigger issue.

    The Rangers should also get Alexi Ogando back on Tuesday. As well, Colby Lewis will be starting up the road at Double-A Frisco while Matt Harrison is throwing off a mound, putting his return on track for mid-August. Neftali Feliz is also expected back before long, though he'll go to the pen alongside Joakim Soria. For all the talk about Matt Garza, the Rangers get a lot of pitching help soon without trading away prospects. 

Matt Kemp (Hamstring)

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    My editor, who obviously has Matt Kemp on his fantasy team, asked me if Kemp was ever going to play in more than 10 games this season. "It's like he's made of 100 parts and none of them are in sync," he texted me.

    He's right, and worse, this kind of pattern tends to be a sign of rapid decline rather than a situation where the player is just on a run of bad luck. I've talked in this space about the "Ironman effect," where a player that is exceptionally healthy for a long period of time (think Cal Ripken or Johnny Damon, and maybe Derek Jeter, though I don't think so) tends to have a rapid and sustained decline once they do start getting injured. 

    Matt Kemp is only 28 years old, but this sort of pattern can happen even younger. With all of Kemp's injuries, they are traumas. The shoulder, the hamstring, the ankle—all of things things just happen and current medical science knows of no way to really prevent these types of injuries. (Reduce? Yes, but not prevent.) 

    Kemp returned from his hamstring strain, only to crank his ankle over on a slide after having the kind of day the Dodgers thought they'd see 150 times this season. The ankle sprain isn't significant, but it will keep him out at least a couple games. There's not much the medical staff can do aside from make sure he's as physically prepared as possible and hope for a little luck.