This article is part of our Fantasy Baseball Injury Report series.
Yoenis Cespedes and Jedd Gyorko
Recent studies have shown the injury rates in Major League Baseball have steadily increased in recent seasons. Pitching injuries, specifically torn UCLs, make up a bulk of the days lost to injury, while fielders have a greater chance at lower extremity injuries. One of the primary problems amongst these players is the dreaded hamstring strain, an ailment that can be slow to heal and has a high recurrence rate.
The hamstring isn't an isolated muscle, but a dynamic group of muscles. The group comprises three muscles, including the two-headed biceps femoris. The positioning of the hamstrings allows them to take part in action at both the hip and knee joints. As a result, they are active during walking and running and serve a vital role in acceleration and deceleration. Sadly, this setup leaves them vulnerable to strains. To make things even worse, hamstring injuries include a healing process that is particularly delicate.
The first step in the detailed healing process involves the initial swelling and the body's first clotting response. While this inflammatory phase continues, the proliferative phase begins. It is during this period that the actual repairing of muscle tissue is completed. Specialized cells fill in the gaps where the hamstring muscle fibers failed using protein fibers, like collagen and elastin. This newly developed scar tissue is then continually modified during the final phase of healing. This gradual remodeling will slowly improve the integrity of the new tissue in hopes of returning it to
Yoenis Cespedes and Jedd Gyorko
Recent studies have shown the injury rates in Major League Baseball have steadily increased in recent seasons. Pitching injuries, specifically torn UCLs, make up a bulk of the days lost to injury, while fielders have a greater chance at lower extremity injuries. One of the primary problems amongst these players is the dreaded hamstring strain, an ailment that can be slow to heal and has a high recurrence rate.
The hamstring isn't an isolated muscle, but a dynamic group of muscles. The group comprises three muscles, including the two-headed biceps femoris. The positioning of the hamstrings allows them to take part in action at both the hip and knee joints. As a result, they are active during walking and running and serve a vital role in acceleration and deceleration. Sadly, this setup leaves them vulnerable to strains. To make things even worse, hamstring injuries include a healing process that is particularly delicate.
The first step in the detailed healing process involves the initial swelling and the body's first clotting response. While this inflammatory phase continues, the proliferative phase begins. It is during this period that the actual repairing of muscle tissue is completed. Specialized cells fill in the gaps where the hamstring muscle fibers failed using protein fibers, like collagen and elastin. This newly developed scar tissue is then continually modified during the final phase of healing. This gradual remodeling will slowly improve the integrity of the new tissue in hopes of returning it to its pre-injury strength.
Unfortunately, natural remodeling often occurs in a disorganized fashion. However, a good athletic trainer or physical therapist can combat this haphazard approach by purposely loading the injured muscle during rehab. As a result, the developing scar tissue can be made stronger and the risk of re-injury can be diminished.
Should an athlete return prematurely, the still-improving scar tissue is more likely to fail. This is what makes hamstring injuries difficult to gauge. An athlete can present pain-free with full range of motion but remain in the final stages of the healing process. If the freshly formed muscle tissue is pushed past its diminished yield point (limit) then a re-injury or new injury can occur and the entire healing process begins anew.
New York has learned firsthand the problems associated with hamstring strains as Cespedes hits the disabled list for the second time this year. The current injury is on the same leg (his left) as his previous injury and likely will cost him the remainder of the season. Cespedes' hamstring woes date back to his time in Oakland and likely will influence his value in next year's drafts.
In St. Louis, Gyorko is expected to miss multiple weeks with a right hamstring strain. He doesn't have quite as extensive of a hamstring problem as Cespedes but did miss time during the 2014 season with a mild hamstring issue. The Cardinals believe the injury is a mild to moderate strain, making him a limited fantasy option for the remainder of the season. In the meantime, Greg Garcia and Matt Carpenter will both see time at third base.
Check Swings
Jackie Bradley: The Red Sox outfielder has seen significant progress in his recovery from a sprained thumb and could be back in the lineup when first eligible. The improvement in swelling has enabled the Boston medical staff to move Bradley into a more mobile splint that will allow for more range of motion at the wrist. The increased motion should allow him to begin strengthening exercise before advancing to baseball-specific drills. Fantasy owners should have him back for the start of the playoffs.
Danny Duffy: The Kansas City left-hander has been diagnosed with a low-grade strain of the pronator in his elbow. The forearm is equipped with two muscles that are primarily responsible for turning the palms upward in a direction known as pronation. One, the pronator teres, attaches to the elbow, while the other, the pronator quadratus, anchors to the wrist. Since Duffy's injury involves the elbow, it is likely a problem with the pronator teres. Fortunately, the problem appears mild enough that doctors felt even a cortisone injection was unnecessary. A MRI taken on the joint revealed the UCL remains intact. Instead, Duffy is optimistic that he will only miss one start and be back in the rotation by September.
Clayton Kershaw: The three-time Cy Young winner completed a rehab assignment without any problems and will return to the Dodgers on Friday against the Padres. Kershaw, out since the end of July with a back strain, surrendered one run and two hits while striking out eight. The left-hander should be activated in all formats despite an elevated level of injury risk. Kershaw has now missed time in consecutive seasons due to back problems and likely will require routine maintenance to avoid another setback.
Max Scherzer: The reigning NL Cy Young winner is slated to make a return Monday after missing the past two weeks with neck pain. The stiffness has subsided, but I remain worried about this resurfacing if the root of the problem remains. Scherzer completed a bullpen session with multiple members of the Washington medical staff looking on, including Paul Lessard, the director of athletic training, and chiropractor Dr. Keith Pyne. Scherzer will be tested early, as he faces off against the hot hitting Giancarlo Stanton and the Marlins.
Cody Bellinger: The rookie slugger is expected back in the Dodgers' lineup on Wednesday after having recovered from his mild ankle sprain. Bellinger's return will force Adrian Gonzalez back to the bench, minimizing the veteran's fantasy value for the remainder of the year. Gonzalez has been limited by a herniated disc in his back all season that appeared to flare up over the weekend. Look for Los Angeles to provide Bellinger some extra days off early on to ease him back into things.
Addison Russell: The 23-year-old shortstop will head to Triple-A Iowa on Monday to begin a rehab assignment. Russell has missed most of August with a right foot strain. Expect him to participate in multiple games before returning to the big-league roster. The Cubs may opt to wait until the end of the month with roster expansion looming.
