Diamond Cuts: Sore Thumbs

Diamond Cuts: Sore Thumbs

This article is part of our Fantasy Baseball Injury Report series.


Josh Hamilton

The Angels slugger suffered a setback in his return from thumb surgery, delaying his activation from the disabled list. Hamilton tore the ulnar collateral ligament (UCL) in his left thumb during a head-first slide in early April. He progressed through rehab and had begun a rehab assignment with Triple-A Salt Lake. However he got jammed on a fastball while going through batting practice and was scratched from the lineup. Further evaluation revealed a bone contusion on his left thumb and the former MVP will not play for the next few days to let the new injury heal.

While the effected tissue in the two injuries seems to vary, it is important that the integrity of the bone tissue injured in his latest ailment does not have a cascade effect on his surgically repaired ligament. A torn UCL often results in an avulsion of the attached bone. The tiny bone fragment is then repaired when the ligament is anchored back in place. Time is needed for the bone to heal and for the anchors to become incorporated into the joint.

When a bone contusion occurs, the outer layer of bone known as the periosteium is damaged. Often tiny cracks occur that must be repaired in the same manner as a true fracture. If the damage associated with the contusion is near the anchor site of the UCL repair, Hamilton's return to play could be delayed as additional time will be need to insure the stability of the area. The


Josh Hamilton

The Angels slugger suffered a setback in his return from thumb surgery, delaying his activation from the disabled list. Hamilton tore the ulnar collateral ligament (UCL) in his left thumb during a head-first slide in early April. He progressed through rehab and had begun a rehab assignment with Triple-A Salt Lake. However he got jammed on a fastball while going through batting practice and was scratched from the lineup. Further evaluation revealed a bone contusion on his left thumb and the former MVP will not play for the next few days to let the new injury heal.

While the effected tissue in the two injuries seems to vary, it is important that the integrity of the bone tissue injured in his latest ailment does not have a cascade effect on his surgically repaired ligament. A torn UCL often results in an avulsion of the attached bone. The tiny bone fragment is then repaired when the ligament is anchored back in place. Time is needed for the bone to heal and for the anchors to become incorporated into the joint.

When a bone contusion occurs, the outer layer of bone known as the periosteium is damaged. Often tiny cracks occur that must be repaired in the same manner as a true fracture. If the damage associated with the contusion is near the anchor site of the UCL repair, Hamilton's return to play could be delayed as additional time will be need to insure the stability of the area. The Angels are optimistic he will be able to hit by Wednesday but don't be surprised to see this situation drag on for a few more days.

Cliff Lee

The Phillies ace was sent to the 15-day DL after suffering discomfort in his left elbow. Fortunately the images from the MRI revealed the UCL was intact. However he was diagnosed with a flexor tendon strain and is expected to miss at least three weeks. Philadelphia will be extremely conservative with his treatment given the flexor bundle's proximity to the aforementioned UCL. Any undue stress placed on the area would elevate Lee's risk of spraining or completely tearing the ligament and forcing a potential Tommy John surgery.

Lee should face a timeline similar to White Sox leftie Chris Sale who missed a month earlier this season with a flexor strain of his own. Fantasy owners frustrated by the setback should be thankful Lee didn't become the latest Tommy John causality.

Carlos Santana

The Indians fear Santana suffered a concussion Sunday when a ball struck him in the mask. He did not play Monday with an illness but the symptoms could actually be the result of a head injury. While baseball has one of the lowest concussion rates in professional sports, the catching position is particularly vulnerable to the injury. Last season over 50 percent of the diagnosed concussions were sustained by catchers, including Joe Mauer, John Jaso, and Yorvit Torrealba. The high rate of injury was one of the primary reasons behind the league outlawing collisions at the plate. However despite their best efforts, concussions still remain a threat and should not be minimized due to a low occurrence rate. If the symptoms Santana is currently displaying are the result of a head injury he would be entered into the league's concussion protocol and be eligible for placement on the 7-day concussion DL. Expect an update on Santana soon with his availability for Tuesday in serious doubt regardless of what an evaluation uncovers.

Check Swings

Prince Fielder and Jurickson Profar: Texas' big offseason acquisition appears to be lost for the season. Fielder is meeting with additional physicians but is expected to undergo surgery to help treat a herniated disk in the cervical region of his neck. It is reported he will undergo a spinal fusion, similar to the procedure carried out on Denver quarterback Peyton Manning. Fielder's associated symptoms include weakness in his left arm, hinting the disc was impinging on nerves in the area. Nerve tissue takes a substantial time to heal and therefore the injury could have a carryover effect into next season. Fielder's recovery should be closely monitored throughout the offseason and will have a direct effect on his 2015 ranking.

The Rangers' offense won't receive an added boost from Profar who restrained the teres major muscle in his shoulder. The setback basically pressed the reset button his rehab and he is expected to miss an additional nine to 12 weeks. These predictions make a late season return possible but it's hard to imagine him having much value this year.

Derek Holland: The Texas pitching staff has also fallen victim to injury. Matt Harrison and Martin Perez have both been lost for the season with back and elbow issues, respectively. However it hasn't been all doom and gloom as Holland is making significant strides in his return from offseason knee surgery. He underwent a microfracture procedure on his patella after a tumble down a flight of stairs but has since returned to throwing. He's been limited to bullpen sessions but simulated action could happen as soon as this week. If all goes according to plan, a late June or early July return becomes a reasonable target.

Mark Trumbo: The Diamondbacks slugger has shed the walking boot from his injured left foot. Diagnosed with a stress fracture in his third metatarsal in late April, Trumbo has made significant progress in his rehab. X-rays taken on the area showed substantial healing but he remains several weeks away from returning. He will now begin working in a therapeutic pool that will minimize the weight placed through the foot but allow him to improve his conditioning. Once the area has shown it can withstand weight-bearing, Trumbo will progress to jogging and ultimately baseball-related activities. Given his current status a July return seems possible.

Yordano Ventura: The Royals are hoping their 22-year old right-hander will only miss a start or two after he experienced pain on the lateral aspect of his elbow. Fortunately the UCL and flexor bundle are located on the medial portion of the elbow and are not in play for Ventura. It seems likely he is dealing with mild inflammation that could be related to tendinitis or some other minor issue. While the Royals may be extremely cautious in their approach, it appears he avoided any serious injury.

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ABOUT THE AUTHOR
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.
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