Joe Nathan and Francisco Liriano
Nathan's return from Tommy John surgery has not gone as smoothly as some had predicted. He lost his closing spot just two weeks into the season and now returns to the disabled list with a right flexor strain in his elbow. The issue is likely related to his recent surgery. The flexor muscle bundle originates at the medial epicondyle of the humerus, the same site as the ulnar collateral ligament (UCL). The UCL is the ligament repaired in Tommy John surgery. Fortunately, a MRI revealed no structural damage. A minor bit of inflammation was detected but this is common in a pitcher returning from surgery. His timeline remains murky as the Twins have stated it could take anywhere from 10 days to a month until he's ready to pitch again. It appears Nathan's short-term value remains low as Matt Capps remains the Minnesota closer.
Liriano is also on the Twins' DL with shoulder inflammation in his throwing arm. He was scratched from his last start and unable to perform effectively enough to make it through a bullpen session. As a result, Minnesota elected to play it safe with the player formerly known as the "Franchise" and give him some needed time off. Liriano has a laundry list of injuries, including Tommy John in 2006, and may just need a break to clear his head and rest his ailing body. Aside from his no-hitter, he has been largely ineffective this season, boasting a 5.73 ERA in nine starts. The Twins anticipate a short stay on the DL but it may be wise to give him some extra time to insure he has put his recent issues behind him.
The Marlins and fantasy owners alike have to be worried when Ramirez calls the pain stemming from his stiff lower back, the worst he has ever felt. Han-Ram has fought through a myriad of injuries in his career, including a foot contusion just weeks ago. However, a back injury can be a different monster. Not only do they cause significant pain and limit an athlete's mobility, but, if untreated or improperly treated, the supporting tissues (muscles, ligaments) can become lax and lose their ability to stabilize the hips and spine. The injury than is no longer an acute problem but becomes a chronic, recurring issue. To complicate the issue, Ramirez has reported tingling in his leg suggesting possible disc and nerve involvement. Recent rest and corrective stretching have alleviated some of his pain, but the Marlins will likely keep their star out until Friday. A trip to the disabled list remains a very likely option and Ramirez owners should have a back up plan in case he misses an extended period of time. Consider guys like Atlanta's Alex Gonzalez or San Diego's Jason Bartlett. Both players produced admirably in May and are available in most leagues.
The Mets' first baseman suffered a setback in his rehab from a sprained left ankle and bone bruise. Davis, out since colliding with David Wright in early May, has been placed back in a walking boot and shut down for another three weeks. Ankle sprains may be a common injury to some, but the complications associated with the injury can be tricky.
The makeup of the ankle makes the outside of the ankle vulnerable to injury. The lateral ligaments are the most common ligaments sprained when the ankle is turned inward in a motion known as inversion. Generally, the ligaments are sprained before the body's natural defenses and reflexes right the joint. However, occasionally the force acting on the ankle is so great that the bones on the medial aspect of the ankle actually bang together, bruising the bone itself. Bone contusions require additional time to heal and can make weight bearing during walking or running more problematic.
The Mets want to limit Davis' activity as much as possible to ensure an environment conducive to healing is created. He will then need additional time to rehab and strengthen the joint and return to playing shape. Unfortunately, it appears Davis will be out until at least mid-July.
Alfonso Soriano and Matt Holliday
Quadriceps injuries to two key outfielders have left the rival Cubs and Cardinals without vital components of their lineups. The muscle group commonly referred to as the quad is made up of four muscles that work in unison to straighten or extend the leg. One of the muscles, the rectus femoris, also assists in flexing the hip. For an athlete with a strained quad, their ability to walk and run is hampered with the degree of limitation depending on the severity of the injury. It also is problematic at the plate when driving the body forward during a power swing, not good news for home-run hitters like Soriano and Holliday.
Soriano's left quad strain appears minor, but Chicago went the conservative route and placed their slugger on the DL. They anticipate he will need the minimum 15 days to recover. However, keep in mind Soriano has a history of injury including a left hamstring strain and torn right quad in 2007, a calf strain in 2008, and left knee surgery in 2009. The current injury leaves the Cubs' outfield extremely depleted with both Reed Johnson (back) and Marlon Byrd (facial fractures) already on the DL. Tyler Colvin has been called up to join Kosuke Fukudome and Blake DeWitt with speedster Tony Campana in the mix as well.
Holliday's injury has been problematic since May 18. The Cardinals attempted to limit his activity, using him primarily as a pinch-hitter. However, just one day after returning to right field, he was again scratched from lineup and relegated to spot duty. He remains limited on the basepaths and it would not be surprising to see him placed on the DL to allow the injury to completely heal. Unfortunately for the time being, fantasy owners are left in a tight spot as Holliday remains active but unproductive.