RotoWire Partners

Diamond Cuts: Back-End Blues

Jeff Stotts

Jeff Stotts

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

Pitchers

John Lackey and Daisuke Matsuzaka

The Red Sox have placed both pitchers on the disabled list with elbow injuries. Lackey has been diagnosed with an elbow strain, meaning his injury is to a muscle or tendon. Dice-K, on the other hand, has an elbow sprain, indicating his injury is to a ligament.

Lackey has recently experienced some pulling in his elbow but attempted to pitch through it. However, after giving up 17 earned runs in his last two starts, the Red Sox elected to be proactive and force Lackey to rest. A fatigued muscle in the forearm could be the likely culprit behind Lackey's decrease in velocity and bloated 8.01 ERA. The break could provide some much-needed relief for a man not only struggling on the mound but also experiencing several tough issues in his personal life.

For Matsuzaka, the pain began in late April when he was removed from an outing against the Mariners after a little over four innings. He reported tightness in the elbow but would appear in relief five days later. He pitched two more outings, but struggled in his most recent start. A limited range of motion in the elbow altered his mechanics and ultimately led to the MRI that revealed the sprain.

The club has stated that both injuries will need time to heal and expect extended rest will do the trick. For fantasy owners still clinging on to hope that either of these guys will bounce back, use these injuries as the last indicator that it's time to look elsewhere.

Hitters

David Wright

The Mets will place Wright on the DL for just the second time in his professional career with a stress fracture in his back. The injury occurred April 19 as Wright dove to make a tag on Houston's Carlos Lee. He attempted to play with the injury, managing the pain and inflammation with medication. However a recent MRI and a subsequent CT scan revealed the fracture and it was determined a DL stint was needed.

Before Wright owners go crazy, a stress fracture in the back isn't as bad as it sounds. The injury is likely a medical condition known as a spondylolysis. In a spondy, a part of the vertebrae known as the par interarticularis is fractured. If the fracture causes a shift in the vertebrae, the condition becomes known as a spondylolisthesis. A conservative course of treatment is utilized and often successful, meaning surgery is not a requirement. The Mets will treat Wright's symptoms and may even brace the area and anticipate rest and corrective exercises will do the trick.

If you need any more convincing, Phoenix Suns point guard Steve Nash has dealt with spondylolisthesis for several seasons but still manages to play. Show patience and stash Wright on the DL and hope for a smooth and quick recovery.

Grady Sizemore

The oft-injured outfielder is once again on the DL with a knee injury. After spending the offseason rehabbing from microfracture surgery on his left knee, Sizemore suffered a right knee contusion while sliding into second base.

A knee contusion can be extremely problematic. A membrane, known as the periosteum, surrounds the patella (kneecap) and fortifies the bone. In a significant bruise, a few of these fibers are damaged and are often accompanied by swelling and pain when moving the effected joint. Unfortunately for Sizemore, the healing process can take awhile. His body's natural defense system treats this injury just like it would a complete fracture and needs time to successfully make new bone tissue.

Furthermore, the patella is a sesmoid bone, meaning it floats within the tendon of a muscle. This allows it improve the mechanical advantage of the quadriceps muscle by improving the distance from the muscle to the axis of the knee. As the patella moves, it comes in contact with various aspects of the joint. A contusion to this area can make this motion painful and limit the athlete's range of motion and even exacerbate the existing symptoms.

Sizemore did not respond to treatment as well as originally hoped and was placed on the 15-day DL, retroactive to May 11. If he progresses accordingly, Sizemore should be available May 26 when he is eligible for activation. The Indians have recalled Travis Buck to fill the available roster spot.

Magglio Ordonez

The Tigers' slugger has been experiencing weakness in his troublesome right ankle and has been placed on the DL. Ordonez fractured the ankle late last season and required surgery to stabilize the joint. The fracture was a bit unique because it was vertical, along the shaft of the bone, and not horizontal or across the bone. Ordonez will travel to meet with the doctor who performed the operation but as we learned with Kendrys Morales last week, it's never a good sign when a specialist is sought out.

Rangers Outfield (Hamilton, Cruz, and Borbon)

All three Rangers Opening Day outfielders are now injured after Julio Borbon joined Nelson Cruz and Josh Hamilton on the DL. Borbon is suffering from inflammation in his left hamstring but fortunately an MRI did not reveal any significant tears. Hamstring injuries for players like Borbon, who rely heavily on their speed, are major red flags. The hamstring muscle group plays a key role in acceleration and gait and an injury to the area often can be crippling. Look for Texas to give the speedster as much time as necessary before he is allowed to return at full speed.

Cruz, working his way back from a quadriceps strain, served as the designated hitter for Double-A Frisco on Tuesday and hopes to appear in the field in the next few days. If the quad shows no lingering signs of pain or restriction, Nelly could be back in the Texas lineup by the weekend. A quick recovery is a good sign for a guy plagued by lower extremity muscle issues the past few seasons.

Hamilton is also nearing his return from a broken arm. The reigning AL MVP fractured the upper portion of his humerus, just below the shoulder, sliding into home in early April. A recent CT scan showed the fracture has significantly healed and team physicians feel comfortable letting Hamilton join Cruz in Frisco. He will likely spend time as the DH there before a longer rehab stint with their Triple-A affiliate in Round Rock. If all goes well, it is realistic to expect Hamilton to rejoin his Rangers teammates by the end of the month. Fantasy owners should anticipate a small dip in power for the slugger until he regains complete strength in the injured arm.