As a long and grueling season nears the end, injuries around the league are rapidly mounting. Playoff teams have begun giving their stars extended rest and are cautiously placing players on the disabled list to ensure minor injuries do not become serious problems. Fantasy owners should begin keeping a closer eye on the injury reports, as well as dates in which players are eligible to return to allow themselves to field the most competitive and effective roster down the stretch run and into the playoffs.
Stephen Strasburg - The rookie sensation is back on the disabled list and is likely done for the season less than two weeks after returning from the DL with shoulder stiffness. Following a pitch to Phillies outfielder Domonic Brown, Strasburg doubled over in pain. After a discussion with the head athletic trainer and pitching coach, Strasburg was removed from the game. A subsequent MRI revealed a strained flexor tendon in his forearm but the doctors also ordered an arthrogram. An arthrogram is carried out to provide medical personnel with a more detailed image of the effected area. A contrast dye is injected into the joint and a MRI is taken. The dye provides a bright contrast between structures and makes viewing tiny details, like a torn ligament, possible.
The arthrogram has been ordered so the Washington medical staff can determine the integrity of the elbow joint, particularly the flexor tendon and the ulnar collateral ligament (UCL). The flexor tendon is the common shared tendon of five muscles located in the forearm. It originates at a bony prominence on the humerus known as the medial epicondyle. The medial epicondyle also serves as an attachment site for the UCL, the primary stabilizer of the medial (inside) aspect of the elbow.
The Nationals (and baseball fans everywhere) are hoping the flexor tendon is simply strained and the UCL is intact. If any significant structural damage is discovered, Strasburg will likely need the dreaded Tommy John surgery to ensure the integrity of the elbow. A flexor tendon injury has already ended the season for Oakland pitcher Ben Sheets, who will likely sit out the 2011 season as well, while Reds pitcher Edison Volquez has struggled since returning from a 2009 surgery to repair a torn flexor mass and UCL.
The case of Strasburg is a reminder that the biomechanics of pitching a baseball are not normal and place huge amounts of stress on the shoulder and elbow. Hopefully the arthrogram provides positive news and the young phenom will return to action next season after rest and progressive rehabilitation.
Kevin Slowey - The Twins' pitcher is currently on the 15-day DL with a mild triceps strain in his throwing arm. The triceps is located on the posterior aspect of the upper arm and is responsible for extending the arm at the elbow joint. The triceps is utilized throughout the various phases of throwing but several studies have revealed it does little to generate velocity during the cocking phase. Instead its primary responsibility seems to be during the acceleration phase as it controls the angular velocity of the elbow when a pitcher begins to deliver a pitch. Furthermore, it seems to help stabilize the UCL and minimize the amount of force placed on the ligament. With everything that has been previously discussed with Strasburg, it is easy to see why a triceps strain would worry the Twins. Minnesota will likely play it safe and may not activate Slowey when he becomes eligible. Fantasy owners attempting to solidify their pitching before the playoffs may want to seek help elsewhere.
Ricky Nolasco - Nolasco missed his last start with a torn medial meniscus in his right knee and while it would seem an injury of this magnitude would cause him to be shut down, he hopes to start against the Braves this weekend. The menisci are two fibrocartilage disks, one C-shaped and the other O-shaped, located on the articulating surface of the lower leg bone, the tibia. These disks serve as a shock absorber for the knee and aid in stabilization, a necessity for a pitcher when delivering a pitch. It is hard to believe Nolasco could pitch pain-free and effectively with a significant tear in his meniscus. Even if he avoids a trip to the DL, he remains a risky play. A bullpen session has been scheduled for Wednesday and could determine Florida’s course of action. Remember teammate Chris Coghlan is currently recovering from surgery to repair a torn meniscus in his left knee and is out six-to-eight weeks.
Alex Rodriguez - The Yankees are being overly cautious with A-Rod, placing the former MVP on the 15-day disabled list with a pesky calf injury. The calf is comprised of two muscles, the gastrocnemius and the soleus. Together these muscles are in charge of pointing the toes in a motion known as plantar flexion. The calf is an integral part of acceleration and is necessary while in the field and the batter’s box. Strains to this area can be particularly troublesome and nagging and have plagued several stars throughout this season including Phillies shortstop Jimmy Rollins and Dodgers outfielder Manny Ramirez. The Yankees have classified Rodriguez’s injury as a low-grade strain but are exhibiting extreme caution as they attempt to repeat as World Series champs. The third baseman should return when eligible on September 5 but expect him to receive days off frequently for the remainder of the year. Find a suitable backup to plug in for A-Rod from here on out.
Dustin Pedroia - Pedroia was back on the DL just two games into his return from a fractured navicular bone in his left foot. The Boston second baseman has been experiencing soreness in the area and the club elected to shut him down. He has since undergone further testing and the results have been sent to a specialist for a closer examination. It is important for Pedroia that the fractured bone heals completely. The navicular not only plays a key role in maintaining the medial arch of the foot but also supports the foot during acceleration and running. While he would be a welcome addition to any fantasy squad, it is hard to imagine Boston risking Pedroia’s career. Like A-Rod, fantasy owners should invest in a reliable offensive player and stash Pedroia on the DL if possible.