Top 10 MLB Injury Risks

With less than a month before pitchers and catchers report for spring training, medical staffs around MLB are already working hard to try to keep their best players on the field. There is no offseason in sports medicine. Players today are in better condition and have much more advanced tools at their disposal, even in the offseason.

Some players are at places like Athletes Performance, working with strength and conditioning specialists to get them in that time-honored "best shape of their life." Others are trying new techniques, such as yoga, which is seeing a surge in usage around the game. Still, others are getting over offseason surgery, spending as much time with their physical therapists as they are their family.

I'm not ready to unveil all 30 teams of my annual Team Health Reports just yet, but in running the injury risks that help make up those reports, I've identified 10 players that you should keep a very close eye on. Using my proprietary risk system, they are among the riskiest in the game. You'll have to decide if they're worth the reward.

Wild Card: Mike Trout, Angels

Don't panic, Angels fans. Mike Trout actually isn't that risky and doesn't belong on this list. I just have so many questions about the reigning AL Rookie of the Year and his risk that I felt it needed to be addressed.

Yes, Trout is young. Yes, Trout has an all-out style like Josh Hamilton, but unlike his new teammate, Trout doesn't have a long record of ill health at the MLB level.

That said, he didn't just start diving and sliding, nor is he the kind of hyperactive, all-out player that has to do those types of things to succeed. He's been doing it for a long time, both in the minors and back in New Jersey.

Talking to people that have followed his career back to Little League, I've yet to be able to find any serious injury in Trout's history. If he continues to grow, as many think he will, he may run a little less, a typical pattern that only bothers his fantasy owners. Trout's not without risk, but that is certainly outweighed by the possible rewards.

10. Carl Crawford, Dodgers

If you've followed Carl Crawford over the past couple of seasons, seeing him on this list should be no surprise.

Crawford's stay in Boston was short and spent almost entirely in the training room. Crawford seemed to lose his swing and his health the minute he walked into Fenway Park. Leg and wrist issues derailed his first season, following that up with an elbow injury that forced Tommy John surgery on him in August.

The normal nine-to-12-month recovery is slightly shorter for position players rather than the more common surgery and rehab on pitchers.

Crawford has begun to throw, but if the elbow is healthy, there's still plenty of other questionable body parts on the big-dollar outfielder. We'll have to see if getting out of Boston gets him back to his All-Star form.

9. Kendrys Morales, Mariners

Kendrys Morales made it back after struggling for two years with the flukiest ankle injury in the history of the game. One misplaced jump as the Angels celebrated his walk-off home run led to a broken ankle that required extensive surgery and rehab. (Stunningly, teams around the league didn't take heed and continue to celebrate in much the same way.)

Morales was never speedy, but now he's almost an honorary Molina. He can still hit, but the Mariners are hoping that the ankle will hold up while playing more first base in 2013. That's a big risk, especially with the designated-hitter slot needed for Jesus Montero.

If Morales can't handle playing in the field, Montero might have to play catcher more often. That's spreading the risk in a bad way. 

8. Albert Pujols, Angels

The Angels signed Josh Hamilton and all his risk this offseason. Last year, it was Albert Pujols. The amazing thing about this all-time great is that he's really never been healthy. Pujols avoided Tommy John surgery for years, has fought through plantar fasciitis and dealt with chronic back and knee issues, all while putting up Hall of Fame numbers and winning a couple of World Series rings.

What might he have done if he was healthy?

Pujols had offseason knee surgery, but it was minor. The real issue is that his back appears to have cost him some power. If that slides more, he'll have trouble reaching the magical 500-home-run mark this season; he needs 25.

There's also the ever present rumors of his age. I spoke with Brian Cartwright—the great mind behind the OLIVER projections—and while he is projecting a slow decline for Pujols, the age discrepancy could (if true and there is admittedly no evidence) make him a league-average first baseman before 2016. His contract runs through 2021 and is heavily back-loaded. 

7. Joe Mauer, Twins

The Twins made a big-dollar commitment to local hero Joe Mauer. Unfortunately, it hasn't paid off just yet. Mauer's history of back and leg issues has limited his availability, though he did better last season. The back issue—actually a problem at the SI joint, between his pelvis and spine—is chronic and squatting all day isn't going to help.

The issue that Mauer is dealing with is similar to what was holding up the deal between the Boston Red Sox and Mike Napoli. Mauer's might be worse, since it's chronic and has cost him significant time. The Twins have taken heat for keeping him behind the plate with the gear on, but Mauer is the one that's insistent.

Giving him time at first base is most likely to happen, but the safest option would be having Mauer in the lineup most often as the designated hitter.

6. Pablo Sandoval, Giants

One thing is for sure, Pablo Sandoval won't need to have his hamate removed again. Both sides have been done, and those things do not regrow. The big man was told to work on his weight again this offseason, but the "Kung Fu Panda" seems to like Panda Express as much as he does winning World Series rings.

Sandoval's weight had nothing to do with his wrist problems, but he has come back well. The worry is more for his back and knees, though he's had very little problems with them over his career. His size might be overemphasized, but Sandoval's singular size and injury history makes him very risky for the defending world champs.

One thing about risk is, sometimes, the risky thing never happens. If Nate Silver has taught us anything, it's that life is about probabilities.

5. Matt Holliday, Cardinals

Matt Holliday is a really big man—it frequently surprised many when he stood next to Albert Pujols and was bigger than him—and plays with a football mentality. That won't help him overcome a chronically bad back. Holliday was sidelined during last season's playoff run, perhaps costing the Cardinals another trip to the World Series.

Back problems can be managed, and some players, like Vladimir Guerrero, Ivan Rodriguez and Holliday's former hitting coach, Mark McGwire, stayed productive and dangerous after similar issues. The Cardinals have to hope their big man can keep his big back healthy or there's no big bat.

4. Josh Hamilton, Angels

Josh Hamilton is a walking risk, but when he's healthy, there may not be a more talented player in baseball. Besides his well-documented off-field risks and his battle with chewing tobacco that he claims derailed his season, Hamilton's all-out style of play often leads to injuries. He can't stop running into walls, diving head first into catchers or listening to crazy theories about his eye color any more than he can change his past.

That risk, from his past drug use, has always been a bit overstated. There's no evidence one way or the other that it will have any affect on his play or physical well-being. Just keep in mind that the unknown is a risk and there's no player with more upside or downside than Hamilton.

3. Brian McCann, Braves

Brian McCann only hit .230 last season. That's not good, but when you know that his shoulder was popping out of place with every swing, it's pretty amazing that he could wait until after the season to have it fixed. McCann's labrum and posterior capsule were repaired, but the rehab process is going to take him right up to Opening Day and likely beyond.

The surgery should help his swing, but opposing runners are going to see how it affects his throwing early in the season. Expect more rest, especially if the Braves are facing someone speedy.

The Braves signed Gerald Laird—a capable backup—to help ease the load on McCann, especially early in the season. Watch to see if the Braves experiment with McCann in the infield as well, though Freddie Freeman seems locked in at first base.

2. Alex Rodriguez, Yankees

Alex Rodriguez hobbled in last year's ALCS in front of the entire nation. The Tigers swept the Yankees out of the playoffs, and Rodriguez could not do anything to help pick up the team after Derek Jeter was sidelined by a fractured ankle. (Jeter will be fine and is likely for Opening Day.)

Rodriguez had surgery in mid-January and is not expected to return before the All-Star break. The damage in his hip explains the collapse at the end of last season, but Rodriguez will have to show that he can come back from hip surgery. He's lost plenty since he first had a procedure in 2009.

Even another 18 homers like last season would lift Rodriguez past Willie Mays on the all-time list, triggering the first of his "historic achievement" bonuses, which puts another $6 million in his pocket. 

1. Chase Utley, Phillies

Chase Utley has missed the start of the last two seasons as he worked to rehabilitate his knees. The degenerative condition requires constant maintenance. This means that at any point, Utley's program could be derailed by a collision, bad step or even a good step.

The Phillies' medical staff has done a good job keeping him on the field once he's ready, but expecting him to make it through a full season is a big risk.

The Phillies did consider shifting Utley across the diamond to third base, but that experiment didn't take. Michael Young was signed and will start at third base.