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Diamond Cuts: A National Problem

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.

Just one month into the 2012 season there have been plenty of injuries to discuss and dissect. Closers seems to have been hit the hardest in the young season as Joakim Soria, Brian Wilson, and Ryan Madson have all been lost for the year. National closer Drew Storen is out through the All-Star break and now his veteran replacement is DL-bound.

Brad Lidge

The right-handed reliever will miss time with what the Nationals are calling an abdominal wall strain. The diagnosis is a bit vague since the rectus abdominis and obliques both make up the abdominal wall, but the treatment is primarily the same. The term sports hernia has also been floated around and, if that were the case, surgery would likely be warranted. Injuries have always been an issue for Lidge and this latest setback only further diminishes his limited fantasy value. Henry Rodriguez will become the full-time closer and should be owned in all formats.

Ryan Zimmerman

Lidge's teammate joined him on the DL with a shoulder injury. Zimmerman recently visited with a specialist at the Kerlan-Jobe clinic in Los Angeles, where he was given a second injection of anti-inflammatory medication. Dr. Neal ElAttrache reviewed the MRI and did not find any significant structural damage in the inflamed acromioclavicular (AC) joint. Zimmerman initially injured the play diving for a ball and has not played since April 20. I broke down the specifics of the AC joint in last week's discussion on Chris Young of the Diamondbacks. Hopefully the inflammation is the result of a minor sprain and will not be a long-term issue. The AC joint is often the sight of shoulder impingement and any damage to this area could be more problematic.

The Nationals remain hopeful that the injection will take care of the issue and allow Zimmerman to return when he is eligible on May 6. On the bright side, the injury created an opportunity for Bryce Harper, who made his major league debut Saturday. He finished 1-for-3 and drove in a game-tying run in the ninth inning. If he is some how still available in your league, stop reading for a second and go pick him up.

Carl Crawford

The $142-million investment the Red Sox made in Crawford has failed to produce. His first year was a major letdown and his second season hasn't even started. He underwent offseason wrist surgery and suffered a setback that delayed his return. His left elbow became an issue in mid-April and an elbow strain was diagnosed. The elbow remained an issue and ultimately required a visit with Dr. James Andrew. A second round of tests revealed a sprain of the ulnar collateral ligament (UCL). Surgery is not an option at this point and Crawford will instead receive a platelet-rich plasma (PRP) injection in an attempt to aid the healing process.

PRP is becoming more and more utilized so let's take a look at what all it entails. In the procedure a sample of the athlete's blood is taken and placed in a device known as a centrifuge. The centrifuge spins the sample so fast that the various elements of blood separate. The component of interest is a protein-concentrated plasma sample, filled with the part of the blood responsible for clotting known as platelets. The PRP sample is injected into the injured area in hopes of improving and accelerating the natural healing process of the body.

Crawford is expected to receive a PRP injection and begin a three-month long rehab protocol designed to strengthen the area while avoiding going under the knife. Fantasy owners unable to stash Crawford may want to consider looking elsewhere considering a late summer return is the best-case scenario.

Michael Pineda

The Yankees were left reeling after it was discovered Pineda suffered a torn shoulder labrum and will undergo surgery on Tuesday.

The glenohumeral joint of the shoulder is classified as a ball-and-socket joint. The joint consists of the head of the humerus articulating in a cavity of the shoulder blade known as the glenoid fossa. This alignment allows the joint to move in multiple planes with a large degree of motion. In this area sits the fibrocartilaginous labrum, providing stability to the joint by deepening the cavity. Unfortunately, the labrum is prone to injury following repetitive overuse or a violent collision or fall. When torn, surgery can be preformed to fix the damage but a lengthy recovery time is often needed.

The amount of time required is dependent on multiple factors including the extent of the tear and any potential rotator cuff involvement. Early reports indicate the tear is located in the anterior portion of the labrum and that the rotator cuff appears undamaged. More information will be available following surgery when the surgeon is able to inspect the joint directly rather through computerized imaging.

Labrum injuries use to be the kiss of death for a pitcher but advancements in medicine have changed that once bleak outlook. Multiple pitchers including Curt Schilling, Clayton Richard, Roger Clemens, and Chris Carpenter have all had productive seasons after undergoing labral repairs and it would be foolish to count Pineda out just yet. However he faces a long road back, ending his 2012 season and likely costing him time next year as well.

Daisuke Matsuzaka

Dice-K is progressing in his rehab assignment as he makes his way back from Tommy John surgery. Matsuzaka has been out since undergoing the procedure in June but is currently rehabbing with Double-A Portland. He struggled in his first outing, surrendering three runs in four innings but bounced back on Saturday, giving up one run and striking out seven in 4.2 innings. He's been assigned three additional starts in his rehab stint and the Red Sox are not expecting him back until June.

Fantasy owners hoping to add Dice-K midseason should be leery. He will need time to shake off the rest and has admitted his conditioning is not where it needs to be. His numbers have declined significantly over the past three seasons and it's hard to imagine they will improve coming off of major surgery.