This article is part of our Fantasy Baseball Injury Report series.
The Cincinnati outfielder has been placed in the MLB concussion protocol after being hit in the head while sliding into third base last week. The Reds placed Hamilton on the seven-day concussion disabled list, though the unpredictable nature of concussions makes it next to impossible to pinpoint a true return to play date.
To advance through the protocol, the individual must first report no signs or symptoms at rest. Then he will begin a series of exertional-based tests, including treadmill running and work on a stationary bike. If the concussed player remains symptom-free following the testing, he must then pass a neurocognitive test and receive clearance from a physician. If the individual begins to exhibit any symptoms at any point of the protocol, his progress stalls and he must try again.
Unfortunately, the timeline for completing the league-mandated protocol fluctuates due to a high degree of variability amongst players suffering a concussion. Some players will immediately report symptoms but show no signs of an injury 24 hours later. Others will report no problems following a hard hit or collision but then experience delayed symptoms days after the incident. Furthermore, the effects of multiple concussions are cumulative, meaning those who have previously suffered the head injury need extra time to allow for the symptoms to dissipate. This is particularly noteworthy, as Hamilton's rookie season ended four games early after he suffered a concussion.
Look for Hamilton's status to be updated routinely as he progresses through the protocol. However, those
The Cincinnati outfielder has been placed in the MLB concussion protocol after being hit in the head while sliding into third base last week. The Reds placed Hamilton on the seven-day concussion disabled list, though the unpredictable nature of concussions makes it next to impossible to pinpoint a true return to play date.
To advance through the protocol, the individual must first report no signs or symptoms at rest. Then he will begin a series of exertional-based tests, including treadmill running and work on a stationary bike. If the concussed player remains symptom-free following the testing, he must then pass a neurocognitive test and receive clearance from a physician. If the individual begins to exhibit any symptoms at any point of the protocol, his progress stalls and he must try again.
Unfortunately, the timeline for completing the league-mandated protocol fluctuates due to a high degree of variability amongst players suffering a concussion. Some players will immediately report symptoms but show no signs of an injury 24 hours later. Others will report no problems following a hard hit or collision but then experience delayed symptoms days after the incident. Furthermore, the effects of multiple concussions are cumulative, meaning those who have previously suffered the head injury need extra time to allow for the symptoms to dissipate. This is particularly noteworthy, as Hamilton's rookie season ended four games early after he suffered a concussion.
Look for Hamilton's status to be updated routinely as he progresses through the protocol. However, those in weekly leagues should keep him on the bench this week, as he's unlikely to return when first eligible.
The Pirates catcher has undergone wrist surgery to repair a small bone located at the base of the pinkie finger. The bone, known as the hamate bone, is a uniquely shaped bone that's known for its hook-like projection. The tiny carpal bone is vulnerable to injury amongst baseball players, as the aforementioned projection sits in direct contact with the knob of a bat. If a hitter takes an awkward swing or grounds his bat, stress is often diverted through the hamate, causing it to fracture.
Because the hamate serves as an anchor point for several wrist flexor muscles, injuries to the area can be accompanied by complications. Additionally, the hamate is located near a nerve. As a result, there is potential for nerve damage that could leave the injured individual with lost or diminished feeling in the pinkie and a decrease in grip strength.
Surgery for a hamate fracture often involves the surgeon simply removing the damaged bone. As a result players are often back in action between four and six weeks later. This estimate is right in line with Pittsburgh's expectations.
The long-term effects of surgery to repair a hamate fracture appear to be minimal, though players like Giancarlo Stanton have missed more time than expected following a complication. The small sample of players to undergo the procedure includes Stanton, Hall of Famer Ken Griffey Jr., Boston's David Ortiz and Dustin Pedroia, Jose Bautista, and J.D. Martinez. Each of these players was productive following surgery, though a small dip in power often accompanied the swing in their initial weeks back. Look for Cervelli to be back in action in late July, with Chris Stewart and recently acquired Erik Kratz manning the backstop until then.
The Blue Jays shortstop was pulled from a rehab game over the weekend after suffering what the team is calling a "setback" in his recovery from a strained right quadriceps.
Setbacks are common following muscle strains, especially in the powerful muscles of the lower extremities. The healing of injured muscle tissue occurs in multiple phases, starting with the inflammatory phase. This stage occurs immediately following the injury and includes the initial swelling and subsequent clotting reactions. The proliferative phase occurs in conjunction with the inflammatory phase and initiates the actual repair work of the damaged tissue. During this stage, scar tissue comprised of collagen and elastin is made to fill in the gaps made following the injury.
The remodeling phase is the final step in the process and often varies in length based on the amount of damage accrued in the injury. This is often the most complicated phase of recovery, as the collagen fibers present in the scar tissue are repeatedly broken down and remade to return the muscle tissue to its original strength and alignment. Unfortunately, the new developing tissue remains susceptible to re-injury or aggravation. If the scar tissue is disrupted before it has returned to full strength, the injured player is forced to hit the reset button on the entire process and the multiple phases of tissue regeneration are forced to begin again.
Toronto continues to insist that Tulowitzki did not suffer a true "re-injury," simply referring to the situation as a "setback." Still, look for the Blue Jays to delay his return by at least another a week, given the delicateness of the situation and Tulo's lengthy injury history. Darwin Barney remains Toronto's starting shortstop in the interim.
Check Swings
Carlos Correa: The Astros shortstop suffered a sprained ankle while running out a groundball on Thursday. Fortunately, the sprain was mild, and Correa was able to participate in baseball-related activities over the weekend. The team has the day off Monday, buying Correa an extra day of rest and recovery. Look for him to return to the lineup Tuesday against the Cardinals.
Yu Darvish: Darvish won't pitch Monday after experiencing tightness in neck and shoulder. The issue remains a common problem following Tommy John surgery, particularly in players who return to action utilizing the same mechanics. Given a potential for a link between the current injury and his surgically repaired elbow, look for Texas to slow play his return to the mound.
Felix Hernandez: Last week I warned that King Felix's injury would likely keep him out longer than the allotted DL time. These fears appear warranted, as the Mariners are now preparing to be without his services for at least a few more weeks after the team's medical staff advised that he sit for a total of four to six weeks. The decision comes after Seattle's medical director reviewed a more recently performed MRI. Hernandez remains in a walking boot to minimize stress on the area and has yet to throw since suffering the injury. A return following the All-Star break seems likely and would give the team a chance to carefully manage the final steps of rehab.
Mike Trout: The 2014 American League MVP avoided a potentially serious injury over the weekend. Trout left the team's loss to the Indians on Sunday after getting hit by a pitch. The ball struck his hand, but X-rays taken after the game showed the multiple bones of the thumb still intact. The Angels are calling the injury a right thumb contusion and expect him to play Monday against the Twins. However, fantasy owners should scale back their expectations for the next few days, as this type of injury can have a negative impact on grip strength.
Chris Owings: The versatile Owings has been a surprisingly solid fantasy play this season. Unfortunately, plantar fasciitis in both of his feet has resulted in a 15-day DL stint that will likely require additional time off. The plantar fascia originates at the heel and runs along the bottom of the foot. It's designed to support and stabilize the arch of the foot while providing protection for the bottom of the boot. If the plantar fascia is overstretched or strained, it can become inflamed, resulting in plantar fasciitis. The condition is a painful injury for most athletes, particularly while running and jumping. The condition often becomes a chronic issue that only improves with a significant period of rest.
Owings' situation is complicated by his past, as a previous case of plantar fasciitis limited him for a majority of the 2010 season. With Owings sidelined, manager Chip Hale said he expects both Michael Bourn and David Peralta will see time in centerfield.
