News that the former MVP could miss the remainder of the season should come as no surprise as I've been warning fantasy owners about Pujols and the chronic plantar fasciitis in his left foot since early May. The condition is extremely painful, difficult to manage, and often needs an extended period of rest to get completely better. The diagnosis of a partial tear of the connective tissue only confirms that the constant grind of remaining in the lineup was aggravating the inflamed area.
However with the fascia now torn, Pujols may actually be able to avoid going under the knife. Unless he has developed bone spurs at or near the attachment site, surgery would not be warranted since the procedure has "naturally" been performed. The surgery that Pujols has considered on multiple occasions is known as a plantar fasciotomy. In the procedure, tiny incisions are made in the plantar fascia to decrease the tension and pressure that is causing the constant inflammation. Now that the fascia in Pujols' foot is torn, he should have a decrease in tension and will spend the next six to eight weeks treating the symptoms associated with the inflammation. As the swelling and irritation subsides, Pujols will see an associated decrease in pain. He will likely be limited to a protective walking boot for the immediate future.
While a late-season return could feasibly be possible, it seems the Angels will handle Pujols conservatively. He's already been placed on the 15-day disabled list and as the Angels' postseason chances dwindle so too does the likelihood of seeing Pujols back in the lineup.
The Pirates closer will miss the next four-to-eight weeks after suffering a flexor strain in his right forearm following an appearance against the Nationals. A MRI revealed a mild flexor strain, a diagnosis later confirmed by Dr. James Andrews. While it could have been much worse, Grilli, who underwent Tommy John surgery in 2002 to repair a torn ulnar collateral ligament (UCL), is not out of the woods just yet.
The primary concern surrounding a strain in the forearm, particularly the flexor bundle, involves the origin point of the muscle. The flexor bundle connects at the medial epicondyle, the same location as the UCL. Again there has been no suggestion that Grilli suffered any ligament damage but it is definitely worth mentioning. Grilli's progress through rest and rehabilitation will be closely monitored to insure he does put any undue stress on his surgically repaired elbow. The situation is somewhat similar to rival closer Jason Motte, who ultimately needed Tommy John for an injury that was initially labeled a flexor strain.
In the meantime another member of Pittsburgh's "Shark Tank" will assume the closer role with Mark Melancon stepping in for Grilli. Melancon has already picked up two saves and is worth an addition in all formats.
While Grilli hopes to return from his injury, Morrow's season is over after Dr. Andrews discovered the right-hander has been dealing with radial nerve entrapment in his right forearm. Morrow has been on the DL since late May with lingering pain and soreness in his right arm before this final diagnosis was made. Radial nerve entrapment involves the side of the elbow opposite the UCL and flexor bundle. It most often occurs following a fractured elbow but can occasionally occur when the tendons of a muscle become inflamed following overuse. Just like carpal tunnel syndrome in the wrist, the inflamed tendons fill the space of a narrow tunnel and put pressure on the nerve that follows this pathway. The resulting compression leaves the athlete with weakness in arm as well as pain and sometimes numbness. Radial tunnel syndrome or any other radial nerve entrapment is best treated with rest and anti-inflammatory medication. Morrow could resume throwing in October and should be ready for next season. However he's done little to gain the confidence of fantasy owners as his season once again ends prematurely due to injury.
Domonic Brown: Brown is slated to be re-evaluated Monday after suffering a concussion while diving to complete a catch. He is currently on the 7-day concussion DL and will be eligible to return by the weekend. However he must be completely symptom-free at rest and with activity before he will be cleared to play.
Clay Buchholz: Buchholz remains several weeks away from returning to the Boston rotation but has resumed throwing. He recently threw from various distances and was once again throwing early Monday. He continues to miss time with right neck and shoulder inflammation. The next week is key in Buchholz's return since his previous attempts at a throwing program resulted in a reoccurrence of the symptoms.
Curtis Granderson: Granderson could make his long-awaited return later this week when New York travel to San Diego. Out recovering from surgery to fix a broken left pinkie finger, the Yankees outfielder has finally begun a rehab assignment. He could be a nice late boost to fantasy teams looking to make a final push for the postseason, especially if he can avoid getting hit by inside pitches. Anticipate a small dip in power initially.
Tim Hudson: The Braves starter will miss the remainder of the season after undergoing surgery to repair his broken ankle. The injury occurred on a gruesome play at first in which Mets outfielder Eric Young Jr. inadvertently stepped on Hudson foot. Hopefully this isn't the way Hudson's career ends but watching Derek Jeter and other struggle with similar injuries suggests he has a long road ahead of him.
Jean Segura: It appears Segura has avoided serious injury after being hit by a pitch in the right forearm. He remained in the game following the incident but the area tightened as the game progressed. He was eventually removed from the win over the Rockies but x-rays were deemed unnecessary. He received Sunday off but is expected to back in the lineup when the Brewers begin their series with the Cubs.