Under the Knife: Latest MLB Injury Updates

Will Carroll@injuryexpertSports Injuries Lead WriterJuly 31, 2013

Under the Knife: Latest MLB Injury Updates

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    The trade deadline is coming, and with it, there are injury questions. Medical files are now largely electronic, though having seen the system MLB is using, there are always going to be questions about how complete that record actually is. Teams will use anything differently, and there are going to be stylistic differences even in the same training room. It's quicker, but we'll still have debates over players.

    For teams that understand the risks and for teams who think they have an advantage in their own training rooms, we'll see trades handled differently.

    The Rays were willing to trade for a player on the disabled list now—Jesse Crain, the All-Star reliever—because they felt they had a handle on his injury. And they had immense confidence in their own medical staff. 

    In fact, head athletic trainer Ron Porterfield has given the Rays one of the top track records, especially with pitching injuries. They're regularly in the top 10 of the injury stats I keep, and they have a Martin-Monaghan Award on the shelf. (Honestly, I'm stunned they don't have more.)

    This week, when prospect pitcher Taylor Guerrieri was diagnosed with a sprained UCL and became the latest on the long list of Tommy John surgeries in baseball, he became part of a very exclusive club—Rays who have had the surgery.

    While I'm not exactly sure this is the case because minor league injuries are nearly impossible to track, this could be the first Tommy John case for the Rays since Jake McGee. Six years since an elbow problem? That's crazy, and it was a long time since their previous one.

    The Rays do have an advantage, it seems, in getting young pitchers up to the major leagues and keeping them healthy. David Price may have come fully formed from Vanderbilt, but Chris Archer, Matt Moore and Jeremy Hellickson were all part of a Rays system that seems to work. 

    And people are noticing. Nick Paparesta was hired away from the Rays by the Athletics—a team that had struggled with injuries, especially to young pitchers. While they're no Rays yet, there have been noticeable improvements, and—oh yeah—the team is winning. 

    Keep injuries in mind through the deadline deals. Whether it's the players being dealt or a player missing who's necessitating a deal, health is as much a focus of many deals as talent. For now, powered by that non-waiver deadline, on to the injuries: 

Tim Hudson (Ankle)

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    Tim Hudson's injury is one of the most gruesome you'll ever see. I hesitate to even include a link to the video, and I'll advise most of you to not click on it. Hudson's fracture joins the conversation with Jason Kendall's ankle, Cliff Floyd's wrist and Buster Posey's leg as among the worst to watch in baseball history. 

    But let's look at those names again. Kendall came back the next year and became one of the most durable catchers in baseball. Floyd had a long career, and Posey is in the midst of a run as one of baseball's best young players. Gruesome injuries don't necessarily end careers. Hudson could join that conversation after surgery if he chooses. 

    Hudson may be different in that it was widely assumed his career would end at the close of the '13 season by choice. Hudson has had an amazing run, coming from undersized pitcher to undisputed ace at both the A's and Braves. 

    Hudson came back from Tommy John surgery and was able to reestablish himself quickly. It's likely he could do the same from this fractured ankle, but it's going to come down to choice. Hudson is going to have to decide if he'd like to go through another long rehab—if he's going to be able to leave baseball with a tip of the cap rather than a ride on a cart.

Brandon Beachy (Elbow)

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    The Braves have timing in their favor. Just as Tim Hudson goes out, Brandon Beachy is ready to step back into the rotation. The Braves would rather have both, of course, just as they'd rather have had Beachy back when they expected him in May or June. 

    Beachy is making a comeback from Tommy John surgery, and some minor setbacks in the process shut down his starts after the first time through rehab. That's not uncommon, and on this time through, he's shown none of those issues—a big positive. 

    Beachy was expected to be less of an addition to the rotation as a "step in," where he'd come in to fill in for one of the younger pitchers, likely Julio Teheran.

    Teheran is going to have an innings cap in his rookie season, and Beachy was expected to be one of the pitchers filling in that gap. Instead, Beachy will fill in for Hudson, leaving the Braves searching through both the minors and the trade market for that late-season pitcher they'll need.

    Beachy has shown good velocity and improved command in his latest rehab starts, but he was very hittable in his first outing. While a 5:1 K/BB is good, the eight hits and only three and two-thirds innings he put up in his first start didn't match expectations. There are positive signs for Beachy, but he'll have to adjust quickly to keep the Braves on track in the NL East.

Albert Pujols (Foot)

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    Just imagine what Albert Pujols might have done if he'd been healthy for any period of his career. When you look at almost 500 homers, 2,300 hits and almost 1,500 RBI, that's pretty good. Whether you look at his standard or sabermetric stats, he's a no-doubt, all-time great now.

    That's not to say that he's done. I wrote more extensively on Pujols' foot issues yesterday, but there's no reason to think his career is over or that he'll walk away from the last eight years. There's a lot more left in Pujols' career, though it will be almost all reliant on both his ability to keep playing through injuries and on the Angels' medical staff keeping him functional.

    I will add that while there's no evidence regarding Pujols' age, those questions are likely to grow louder. If Pujols' contract ends up an albatross like Vernon Wells' deal, I wonder if that will weigh on Pujols' image the way it did with Wells or even with Alex Rodriguez

Jean Segura (Forearm)

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    Mike Trout. Bryce Harper. Manny Machado. 

    Now, add Jean Segura to that mix. You might not have noticed, given the forgettable season that the Brewers are having, but Segura has not only been a great return on Zack Greinke, he's been one of the best players in the league. Segura also has room to grow.

    When I first saw him on Opening Day, I noted that he had the same kind of build as Miguel Cabrera did when I first saw him in '03. Segura isn't nearly as big, but he has thick legs and a more slight torso. If the top fills out to match the bottom, there's more power in Segura than expected.

    Of course, he also has to stay healthy. The Brewers have been able to keep him that way for much of the season, but an errant pitch inside put a nasty bruise on his forearm, keeping him out a couple days. The Brewers' context allows them to be more conservative with their players, so from a fantasy perspective, an owner needs to expect longer out-times and more off days for Segura, Carlos Gomez and the rest of the team.

    Segura will be fine after healing up. How good he can be remains to be seen, but as with those names at the top of the page, we'll have to see if health is their sixth tool. 

Curtis Granderson (Hand)

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    Alex Rodriguez is his own soap opera. (Though he may be here in Indy on Thursday, and if so, I'll see if he's talkative.) Derek Jeter is back. That leaves Curtis Granderson as the big return hope for the Yankees, and it does sound as if he's closer.

    Granderson was only in the lineup about as long as he was in spring training this year, but his broken finger has held up through a week of rehab games, as has his luck so far. Granderson is moving up to Trenton (AA) and could be back with the Yanks by the weekend if his swing shows no issues. 

    Granderson is behind the expected schedule for a broken finger, but that time is gone. At this stage, the Yankees are hoping that Granderson can stay healthy and give them some production this year.

    Granderson has shown no issues in any phase of the game in his rehab games down in Tampa (A), but he's shown no pop yet either.

    That's the last thing. Though regardless of showing it, the potential is enough for the Yankees (and most fantasy owners) to take a shot on him in the roster.

Jason Grilli (Forearm)

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    In today's Twitter-speed world, sometimes information still comes out slowly. Jason Grilli grabbed his forearm after a bad inning, and the Pirates' world seemed to implode. Wait a few days and not only is Grilli not dead, he's doing quite well, thanks.

    Grilli's injury wasn't to the UCL as many feared, and it turned out to be confined to the muscle (the flexor mass, to be specific) rather than the tendon. This isn't good, but it is bumping up right against the best-case scenario. It's a muscle strain, and while the location isn't ideal, it's like any other muscle strain. Grilli will need to wait it out, get therapy and then build it back up to game-ready status. 

    Grilli's injury isn't good, and there's always the risk with any arm injury that there will be setbacks or cascades, but the pattern for this kind of injury is relatively positive. Grilli will be shut down for at least two weeks, but these kind of injuries can take up to eight weeks to recover from. That means Grilli could, in essence, be out for the rest of the season.

    Relievers don't have as long a rehab process, but recovery is a major issue. It will be tough for Clint Hurdle to trust in Grilli, especially in back-to-back situations—though that really shouldn't be a consideration. If Hurdle (or any manager) is that tied to a role defined by a stat and can't find a way to use all of his available resources, there are plenty of other candidates.

    One other thing to keep in mind here is that Grilli is pitching on bonus time. Few expected him to be back in baseball, let alone pitching for a playoff contender. He could very well pitch at risk, knowing the possible gains exceed the downside.

Jonathan Broxton (Forearm)

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    This really doesn't have anything to do with Jonathan Broxton, but for a team like the Reds with a surfeit of power arms in the pen, they should be able to do more to "shorten" games.

    Instead, Dusty Baker has seemed loathe to use them at all. Some of that is the wear-down that relievers get over the season, but that's something a manager, the pitching staff and the medical staff should be able to handle. 

    Broxton is getting close to a rehab assignment, throwing simulated games recently in Los Angeles. Reports are that it could be as soon as Tuesday and as high as Louisville. (UPDATE: Mark Sheldon of MLB.com confirms this.) 

    Broxton continues to recover from a forearm strain. This should be good news and a "watch this" for Pirates fans. Broxton's official injury is the same as Jason Grilli's—a forearm strain—though initial issues with Broxton were all over the elbow. 

    Velocity is seldom the issue for Broxton, but as with any elbow injury, look for command. I certainly wouldn't want to be one of the first guys stepping into the box against Broxton.

    Also, don't be surprised if Broxton starts a game or two. To ensure work and to normalize the warm-up, teams will sometimes put relievers in the first inning and then have the real starter follow him. Broxton isn't changing roles. 

Mike Morse (Leg)

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    Mike Morse is back in the lineup, but the twice-punished steroid user was booed in his return as fans flung syringes on the field and waved foam asterisks while demanding the Mariners void his contract.

    Oh wait, that didn't happen. 

    No, Morse returned from his quad strain, and like most guys who have had PED suspensions, no one noticed. Mariners fans were likely just glad to get a power bat back in the lineup, especially if there's a market for that kind of bat ahead of the trade deadline. These kinds of injuries seldom recur once healed, so Morse should be in the clear on that, no pun intended.

    Morse missed almost six weeks in returning from the strain. But given his position and style, he shouldn't have much issue getting back his power, as he showed during his brief rehab stint.

    He's a guy you can put right back in your fantasy roster, but remember that Morse, Andy Pettitte, Jason Giambi and others are doing the exact same things that Ryan Braun and Alex Rodriguez did—all without the public scorn and looming suspensions. 

Matt Kemp (Ankle)

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    Matt Kemp is having a year to forget, but for the Dodgers, they can't forget this. This kind of multi-system failure is something that they'll have to figure out.

    The medical staff in Los Angeles are among the most forward thinking in the league, so they're likely charting out the possibility that this is the product of bad luck. And it's a possibility that we've seen the last of the star-level Kemp.

    Kemp's latest injury was bad luck, but being in that position is one that's both a positive and negative. He was on base. He was fast enough to almost score. It's just that when he slid, he slid in such a manner that his ankle cranked over.

    The sprain was relatively minor, and there was some thought that he wouldn't go on the DL at all. I have to think the Dodgers did this to protect him. Reports from MLB.com indicate that Kemp is still limping and has not begun any sort of baseball activities yet. 

    With the date possible to return on August 6 and Kemp saying he'll be ready ahead of the minimum, we'll need to see more evidence, if not a rehab stint.

    While the chance of immediate production is there—along with the hope that some kind of surge will give both the Dodgers and fantasy owners some kind of ROI—the likelihood is that Kemp's slow production this season is real and that returning from yet another injury isn't going to create the atmosphere for any kind of streak. 

Lance Berkman (Hip)

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    Lance Berkman had to be bought out of retirement. His ongoing knee, back and hip problems always made him a risky pickup, but the upside was there. It showed up early in the season, but the long season made it unlikely that Berkman was going to make it through unscathed, even locked in at DH.

    Berkman's hip issue is sounding more and more like a season-ender, as noted here by T.R. Sullivan of MLB.com. While the Rangers aren't being specific about the injury, the symptoms described sound like a continuation of his previous problems with the SI joint.

    This joint, the contact between the back and pelvis, is problematic for any rotational athlete. In baseball, we've seen this with many players, especially catchers like Joe Mauer.

    The Rangers may end up down two bats rather than one if Nelson Cruz is suspended as expected. That puts pressure on Jon Daniels up to the deadline, and if he can't get a bat, the pressure shifts to some of the young players like Jurickson Profar, Engel Beltre and others.

    The Rangers have a metric ton of bats, though many of the best are at lower levels. It's doubtful they'd get "creative" enough to risk pushing a player like Joey Gallo up to play DH, but few other teams have these kind of options.