Carlos Gonzalez and Troy Tulowitzki
Last week I discussed the Rockies problems and hinted that both Gonzalez and Tulowitzki could be done for the season. My suspicions were later confirmed, as season-ending surgery was required in both cases. Tulowitzki was the first to go down, opting for surgery to repair a tear in the labrum of his hip.
The main joint of the hip is the acetabulofemoral (AF) joint. The labrum is a fibrocartilaginous ring that deepens the acetabulum to insure stability of the lower leg in and on the pelvis. Occasionally the labrum will develop a tear from repetitive overuse or following a violent collision or fall. Labrum tears are very painful and can lead to chronic instability in the hip. Surgeons looking to fix the area have two options.
The first is a debridement procedure in which the damaged tissue is simply removed. The second option is more intensive and involves the surgeon reattaching the torn tissue. The frayed pieces are sewn back together and then anchored to the bone of the acetabular rim. The Rockies expect their shortstop to be sidelined for the next five months, indicating a full repair was likely performed.
Tulowitzki is at an interesting junction in his career. He's proven he's a talented player at a shallow position. However his inability to stay healthy has limited his productivity. Since 2005 Tulowitzki has dealt with a quadriceps strain, a hand contusion, a forearm contusion, a groin strain, a more severe quadriceps strain, a hand laceration, back tightness, an elbow contusion, another hand contusion, a back strain, another quadriceps strain, a wrist fracture, groin soreness, a leg contusion, surgery to remove scar tissue impending on a nerve in his groin, another elbow contusion, a rotator cuff strain, a broken rib, oblique soreness, leg soreness, a calf contusion, quadriceps tightness, a foot contusion, a toe sprain, and yet more groin tightness.
Some of these injuries are due to bad luck like the hand laceration or the multiple contusions. Others, like the rash of quadriceps injuries and the most recent labrum tear, appear linked. If the surgery is successful and Tulowitzki is able to fix any biomechanical flaws, then he could hypothetically put these issues behind him. However the aforementioned list is too long to ignore and taking Tulowitzki with a top pick in 2015 remains too risky.
Gonzalez's list of injuries isn't quite as long but he too has struggled to stay healthy over the last few seasons. The most recent problem is his left knee. After managing pain for what was called quadriceps tendinitis, CarGo underwent surgery to fix a tear in the tendon. The quadriceps tendon is the conjoined tendon of the four quad muscles. The patella (knee cap) is embedded within this tendon. Gonzalez underwent surgery to repair the tear and he will face a recovery window similar to Tulowitzki. Moving forward, I'd be more inclined to draft Gonzalez over Tulowitzki but I'd still exhaust my other options in the early rounds.
The reigning National League MVP is expected to be activated as soon as Tuesday after missing time with an avulsion fracture of his 11th rib. The injury itself has been previously discussed and the potential complications still exist. Rib injuries, particularly those to the costocartiliage area, are often very painful and limiting. The primary associated problems come with trunk rotation because the 11th rib serves as an attachment for an assortment of muscles, including the external oblique, the latissimus dorsi, and the serratus posterior inferior. The 11th rib is also very mobile, meaning additional time for healing is needed.
If and when he returns, I suspect McCutchen will take the field wearing extra padding under his uniform. Multiple companies including EvoShield and UnEqual make specially designed rib protectors. UnEqual's line includes a Kevlar-infused vest worn by NFL players like Michael Vick and Tony Romo after they suffered similar injuries. While McCutchen is too good to simply bench, any fantasy owners invested in the outfielder should scale back their expectations.
Yonder Alonso: The Padres will be forced to continue their season without the services of Alonso. The 27-year-old first baseman will not play again after suffering a forearm strain. The injury itself is a bit odd as the affected tendon is closer to the wrist than the elbow. Alonso will seek a second opinion and surgery remains an option.
Aroldis Chapman: The Reds reliever did not pitch Monday due to a sore shoulder. The decision to rest Chapman comes on the heels of a poor performance Sunday in which he surrendered four runs without registering an out. If his balky shoulder is the reason for his lack of command over the weekend expect the Reds to give Chapman additional days off as they attempt to identify the root of the soreness.
Derek Holland: I'm surprised at how much time Holland has missed following offseason knee surgery. While the Texas left-hander did require a microfracture procedure, the involved area often heals quicker. Holland has returned to the mound and is currently pitching in the Rangers minor league system, working his way back into form. However he is not expected to return to the big league level until the rosters expand in September. There's no telling what you will get moving forward but he's worth a flier if you are desperate for pitching.
Dustin Pedroia: The Red Sox second basemen did not play Sunday due to flu-like symptoms but he returned to the lineup Monday, finishing 2-for-5 in a loss to the Angels.
Hanley Ramirez: Ramirez is making progress in his recovery from an oblique strain but still remains at least 10 days away. He has been swinging a bat at "90 percent" and, barring any setbacks, could return by next weekend.
Justin Verlander: Tuesday is a big day for the former Cy Young winner. He will throw a baseball for the first time since shoulder inflammation forced him from a start after one inning. If he completes the short toss program without issues, Verlander could be available by next Friday in Minnesota. The DL would be an option if he were unable to pitch pain-free.