Neftali Feliz and Derek Holland
Prior to the season starting, Will Carroll, a fellow injury analyst and friend of RotoWire, asked if I wanted to contribute to his yearly Health Reports for SI.com. I gladly said yes and began completing my evaluation of several teams, including the Texas Rangers. Based on our work, two pitchers on the Rangers staff received red lights, meaning their injury risk was inherently high based on a multitude of factors including injury history and playing time adjustments. The two pitchers to receive the ranking were Derek Holland and Neftali Feliz, the two Texas pitchers now occupying the disabled list.
Now our results were simply predications, there's no guarantee how, if, and when an injury will occur. However both guys are perfect examples of the System accurately calculating an increased likelihood of injury.
For Feliz the first red flags were raised last season when Texas began their first attempt to move him from the bullpen into the rotation. He suffered shoulder inflammation early in the season and spent time on the DL. He bounced back and put together a fantastic season, not as a starter but as the team's closer. Despite some early shoulder stiffness, this season's attempt to move him into the rotation started off much better. Unfortunately the end results were roughly the same with Feliz once again on the DL, this time with a sprained ulnar collateral ligament (UCL) in the elbow of his throwing arm. Feliz is expected out until mid-July and may be forced back to the bullpen with Roy Oswalt joining the team.
Holland's case is interesting but not surprising. Holland broke into the majors in 2009, pitching 138 innings for the Rangers. The following season his productivity dropped after he suffered a knee injury and battled inflammation in his rotator cuff, which may have been linked to his heavy workload. He defied the odds last year pitching nearly 200 innings and putting together an extremely fantasy friendly second half. His season this year has been unpredictable but took a turn for the worse after he caught a nasty stomach virus. It's being reported the bug has caused Holland to lose 15 pounds over the last few weeks and may be the primary culprit behind the shoulder fatigue that ultimately sent him to the DL. A MRI taken earlier in the week did not discover any structural damage but there's still some cause for concern, especially regarding long-term stamina, given Holland's recent past. Expect the team to closely monitor his innings pitched upon his return.
I was pretty surprised to read the comments from Ken Kendrick, Arizona's managing general partner, regarding Drew and his recovery from ankle surgery.
Chris Liss and Jeff Erickson did a great job dissecting the issue in their latest Charging the Mound column but I want to address the comments from an athletic trainer's perspective.
Kendrick was quoted as saying, "I'm going to be real direct about Stephen. I think Stephen should have been out there playing before now, frankly. I, for one, am disappointed."
I understand Kendrick's frustration but I highly doubt anyone in the Arizona medical staff is going to allow a promising player recovering from a spiral fracture (meaning the bone twisted as it broke) to his right fibula and multiple torn ligaments. Understand that a plate anchored with screws and wires was inserted into the broken fibula to repair the bone and that didn't even address the ligaments which take a significantly longer time to recover. Setbacks in these types of procedures are also common (think Kendrys Morales) and it's often overlooked that Drew also had surgery to repair a sports hernia, a procedure that requires four to six weeks of recovery time.
Additionally, it's hard to make the general public, and sometimes even medical professionals, understand that a "cookbook" approach to injuries and rehabilitation is not possible. No two individuals act or heal the exact same way, making it difficult to draw direct comparisons. You can't compare Drew to Buster Posey because Drew's injuries occurred two months later and were more severe.
Finally, it's important to remember doctors originally estimated Drew would miss up to a year. The injury occurred July 20 giving us nearly six more weeks of expected recovery. It's impossible for anyone but Drew to know exactly how the ankle feels but to be disappointed that he's not playing is extremely unfair.
Fantasy owners curious about Drew can take solace in the fact that the shortstop made his first rehab start for Triple-A Reno on Thursday night, finishing 1-for-4 with a single. The team will monitor the ankle to insure it's responding well. If there are no unexpected setbacks, Drew could return by mid-July.
The reason behind Teixeira's slow start may at long last been discovered after team physicians diagnosed the slugger with nerve damage to his vocal cords resulting from an earlier infection. The damage has left Teixeira with a persistent cough that could leave him vulnerable to muscle soreness or strain. A cough can generate as much as 3.5 g-force units (similar to the amount created on certain rollercoasters), taxing the abdominal muscles, including the obliques, rectus abdominis, and intercostals. A lingering cough can wear these muscles down and even result in a strain. If Teixeira has been fighting the coughs for roughly two months, like it's being reported, fatigue and a dip in power is to be expected. Now that the proper diagnosis has been made, medicine to control the cough has been prescribed. Hopefully Teixeira can rediscover his power stroke and improve his productivity for the remainder of the season.
The A's have limited Cespedes to pinch hitting duties after he strained his left hamstring earlier in the week rounding second base. He immediately pulled up and was replaced in the game by Collin Cowgill. Though they are hoping a DL stint will not be needed, Oakland will have to proceed with caution here to insure the issue does not linger. Matt Kemp will serve as a reminder of how problematic and finicky these injuries can be and it would be smart for Cespedes owners to seek suitable insurance.
The Yankees outfielder suffered yet another setback in his rehab from a strained right elbow and is not expected to return until after the All-Star break. The team has given him plenty of rest hoping time off would allow the injury to heal. Unfortunately it hasn't and Gardner continues to deal with lingering soreness. He will now meet with several doctors including Dr. James Andrews to determine why the joint is not responding as expected. It's beginning to look like this may be a lost season for Gardner and owners still clinging to hope may want to begin looking at other options.