Fantasy Baseball Injury Report: Thumbs Down

Pitchers

Kris Medlen - The Braves dodged a bullet as an emerging component of their starting rotation avoided a serious injury on Tuesday. Medlen strained his non-throwing shoulder in Atlanta's win over Arizona as he attempted to avoid a tag at the plate in the sixth inning. His breakout season has been overshadowed by teammate Tommy Hanson but the right-hander has put together an impressive start to the year, posting a 3.21 ERA and a solid 3-1 record. While injuries to the non-throwing arm are not considered as serious, it can become an issue for National League pitchers who do not have the fortune of the designated hitter and must swing the bat in each start. Post-game X-rays were negative and the Braves anticipate he will be available for his next scheduled start.

Doug Fister - Another pleasant surprise for the early season wasn't quite as fortunate as the Mariners have placed Fister on the 15-day disabled list with shoulder fatigue. Fister had begun the season with a 2.45 ERA and a stellar 0.96 WHIP but ran into some trouble in his throwing arm prior to his last scheduled start on June 5. The team noticed a dip in the velocity of his pitches and eventually got the pitcher to admit he was feeling a bit of discomfort. Shoulder fatigue can occur in numerous muscles including the rotator cuff, the pectoralis muscles, and the rhomboids and easily throw off a pitcher's mechanics. The multiple muscles of the shoulder joint must synergistically work together to successfully throw a baseball to a precise location with force. When one muscle becomes fatigued and sore, the entire rhythm of the muscles is hampered causing a decrease in velocity and accuracy. Furthermore, if particular muscles are sore the actual scapulohumeral rhythm can be limited, resulting in a decrease in range of motion. The Mariners will rest Fister and slowly bring him along until he is able to pitch without discomfort. Expect him to miss several starts with teammate Ryan Rowland-Smith assuming his position in the rotation.

Oliver Perez - The health of the struggling Mets left-hander was called into question earlier in the week when Major League Baseball requested the medical records for Perez. After Perez was placed on the DL with tendinitis in his right knee, there were inquires about the validity of the injury since it came on the heels of his refusal to accept a minor league assignment. However, the league office examined the medical reports and had no problems with the designation. Perez underwent surgery in September to remove scar tissue surrounding the patellar tendon in his knee. It is common for inflammation and tendinitis to develop in the knee following this particular procedure and while the move seems convenient for New York, it a legitimate concern. Perez is no longer fantasy relevant but the move did allow the Mets to active Jon Niese who was stellar in his return to action, allowing one run, six hits and a walk in seven innings while striking out six.

Infielders

Aramis Ramirez - One of the main culprits behind the Cubs' slow start has been their slugging third baseman. Ramirez has struggled at the plate, hitting .168 for the year with just five home runs. Unfortunately for A-Ram he is also dealing with a significant thumb injury that has finally landed him on the DL. The injury first became an issue in late May and has forced him to miss eight of Chicago's last 16 games. X-rays were negative but the right thumb remains tender and painful at its base in an area known as the themar eminence. Injuries to the thumb become an issue as the athlete is unable to perform different pinching motions and various grips. Obviously this is particularly problematic in baseball, specifically while batting and throwing. Ramirez has attempted to modify his grip at the plate but the adjustments have not paid off as he has just two extra-base hits since the thumb became an issue. Fantasy teams with a healthy roster can afford to stash Ramirez and hope an improved thumb and a chance to clear his head will help, but those owners with other injury issues may want to think about dropping the former All-Star in shallow leagues. Chad Tracy will join the Cubs as his replacement on the roster, but his effectiveness at the major league level since undergoing microfracture knee surgery with the D-Backs remains to be seen.

Orlando Hudson - The Twins placed their starting second baseman on the 15-day disabled list, but they expect Hudson's recovery from a left wrist sprain to be quick. Hudson aggravated his wrist on May 30 when he collided with teammate Denard Span. The injury is a bit of a concern for fantasy owners based on Hudson's history of wrist problems. The issues originally began in 2007 following a ligament tear and again in 2008 when he dislocated the same wrist. Both injuries required surgery to repair the resulting damage and prematurely ended each season. Fortunately, a visit with the surgeon who performed the operations went well and Hudson could be back on the field as early as next week. The move to the disabled list was retroactive to May 31 making him eligible for a June 15 return. The move allowed the Twins to active Michael Cuddyer from the bereavement list.

Outfielders

Grady Sizemore - Last week we discussed the specifics surrounding Sizemore's impeding knee surgery. Well the surgery was a success but unfortunately, microfracture surgery was required to repair loose cartilage in his left knee. The Indians expect Sizemore will require six to nine months to make a complete recovery. While this season is over, the former All-Star should return next season and be available at a much-discounted price. Sizemore is only 27 years old and is fully capable of making a successful return but his future remains cloudy, as injuries to the knee, as well as his abdomen and elbow, have limited him to just 139 games over the past two seasons.