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Diamond Cuts: Injury-Riddled Phils

Jeff Stotts

Jeff Stotts

Jeff Stotts works as a Certified Athletic Trainer (MAT, ATC, PES, CES). He won the 2011 Best Fantasy Football Article in Print from the Fantasy Sports Trade Association.

Pitchers 

Zack Greinke

Greinke's debut with the Brewers will be put on hold for at least three starts as a broken rib is expected to force the former Cy Young winner to the disabled list. Greinke suffered a fractured seventh rib and bruised eighth rib while participating in an offseason pickup basketball game.  
The ribcage consists of 12 pairs of ribs with the bottom two pairs classified as floating ribs because they do not connect to the breastbone (sternum). The rib bone Greinke fractured is known as a vertebrocostal rib or true rib because its costal cartilage attaches directly to the sternum, in particular the xiphoid process. The seventh rib, along with ribs 1 though 6, rotates on its corresponding thoracic vertebrae to allow for changes in thoracic volume during breathing. Basically it rotates to increase the amount of air the lungs can take by increasing the size of the ribcage. Fortunately Greinke's fracture is a small, hairline fracture and has not compromised the integrity of the joint. However, the injury can cause pain with deep breathing and sneezing as well as discomfort with trunk rotation.  

The injury occurred roughly two weeks and a fracture of this nature generally takes four-to-six weeks to properly mend. The Brewers' medical staff will continue to work Greinke's arm out as best they can but will not allow Greinke to return to the mound until the rib is completely healed. He will then need time to rediscover his mechanics and timing before returning to the rotation. 

The injury is a bit alarming especially when you look at the track record of pitcher's with similar injuries. Fractured ribs have slowed both the Yankee's Phil Hughes and the White Sox's Jake Peavy in recent seasons. Hughes made one playoff start but primarily toiled in the minors after his injury in 2008 and needed extended time to recover. Peavy's injury came prior to the 2005 playoffs while he was still with the Padres. He tried to pitch through the pain but gave up eight runs in his lone start against the Cardinals.  Positional players have also had their problems recovering from rib injuries, particularly Boston's Jacoby Ellsbury and Texas' Josh Hamilton

Greinke's draft day value obviously takes a hit with this injury and I wouldn't be surprised to see it linger longer than the estimated reports. Opportunistic fantasy owners may be able to get the young hurler at a discount but should have a substitute ready for the start of the season. It may even be worth adding another young arm to your stable of pitchers should the injury be more problematic than expected.  

Infielders

Chase Utley

Last week I urged fantasy owners to not be alarmed regarding Utley and his balky knee. Following the most recent press release out of Philly I'm inching closer to the panic button. The Phillies released a statement that stated Utley is battling patellar tendinitis, bone inflammation, and chondromalacia. Chondromalacia is indicative of pathological changes of the articulating surface of the patella. To translate, the cartilage on the underside of the kneecap has become irritated or damaged. The smooth cartilage here is an important component of knee movement, allowing for the kneecap to efficiently move while also serving as a sort of shock absorber. Any damage would cause pain and inflammation in the effected individual. 

Chondromalacia often results from overuse or poor biomechanics at the knee and is generally treated in a conservative (non-surgical) approach. However, surgery would be considered should the damage of the cartilage be too severe or if a significant misalignment of the knee is the source of the problem. The Phillies continue to proceed with the non-operative treatment but a knee scope could be possible. 

The red flags around Utley have been raised with this latest round of information and it would be smart to invest your early picks elsewhere. Utley could return and be productive, but his knee will remain a lurking issue throughout the season.
 
Kendry Morales

Morales' return from a fractured left ankle has been slowed in recent days as the Angels first baseman was hit with a bout of the flu. While he has begun hitting and fielding drills, Morales is still not running at full speed. Instead, he has been working out on a specially designed treadmill that controls the amount of weight placed on the lower extremities.  
Manager Mike Scioscia remains confident in Morales but has given him a March 21 deadline. If Morales is not ready to participate by then, his chances of being ready for Opening Day are slim. The slow progress is not surprising. Tigers second basemen Scott Sizemore suffered a similar injury in 2009 and still needed the occasional day off six months later. Keep an eye on the calendar, but expect Morales to start the season on the disabled list or in a limited designated hitter role. 

Outfielders 

Dominic Brown

The Phillies' injury woes are not limited to Utley, as Brown is expected to miss four-to-six weeks after undergoing surgery for a fractured hamate bone in his right wrist.  

The hamate is a tiny wedge-shaped carpal bone of the hand. It is best known for its hook-shaped process known as the hook of the hamate that serves as an attachment site for several muscles, most notably the flexor carpi ulnaris that flexes the hand at the wrist.  The hook is commonly fractured in golfers and baseball players when a club or bat awkwardly strikes the ground or ball.  

The bone lies in close proximity of the ulnar nerve, making hamate fractures problematic if there is associated nerve damage or irritation. Any ulnar nerve damage would weaken the grip strength of the individual and cause numbness into the pinkie finger. Fortunately, there are no reports indicating Brown suffered any nerve damage. Surgery to excise, or remove, the hamate was successful and the young prospect could be back in as early as four weeks. Other big names to have the hamate bone removed include David Ortiz, Jim Thome, and Ken Griffey Jr.  

The emergence of Jason Heyward last season had made Brown a hot commodity in some leagues causing some owners to overspend or reach on the offensively gifted prospect. However, the injury could be a blessing in disguise for those fantasy owners high on Brown as it will likely drive down his asking price and average draft position. In the meantime, Ben Francisco is the most probable to take over right field duties in Philadelphia.