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Diamond Cuts: Big Names, Big Injuries

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.

Matt Kemp

Two weeks ago I broke down Kemp's hamstring injury and suspected Los Angeles would tread lightly with their All-Star. Kemp rehabbed his Grade I strain and was able to return right on schedule. Unfortunately the return did not go as planned as Kemp is back on the disabled list after aggravating the previous strain and suffering a new one as well.

Sue Falsone, the head athletic trainer for the Dodgers, gave very detailed information when discussing the injury, revealing a MRI taken on the leg revealed swelling in the area of the previous injury and an additional Grade I strain in a different location. A Grade I classification is given when microfibers of the affected muscle tissue tear. Generally an injury of this nature does not result in a loss of function but two strains to the same muscle means a lengthy rehab awaits Kemp.

Falsone was also very candid about the likelihood of Kemp dealing with this issue for the remainder of his career. She noted that bone is the only type of tissue that will ever return to its original strength. To understand what she means let's try to break down the complex healing process of a muscle.

Healing is a multiple phase process that begins with the inflammatory phase, a phase that entails the preliminary swelling and clotting reactions. The next stage, the proliferative phase, overlaps with the initial inflammatory phase. It is during the proliferative phase that the body actually begins to repair and restore the damaged tissue. As the phase continues, scar formation develops as granulation tissue and extracellular matrix begin filling in the injury site with protein fibers, including collagen and elastin.

The proliferative phase generally takes from four-to-six weeks before the final phase, the remodeling phase, begins. The remodeling phase takes a significant amount of time, sometimes as long as a year, to complete. Collagen fibers are repeatedly broken down and remade to increase strength by properly realigning the injured muscle fibers. While the muscle tissue is able to resume its normal appearance and function, the new tissue lacks the full strength of the original muscle tissue. It is because of this fact you often see players like Jose Reyes, Nelson Cruz, and many others chronically battle hamstring issues. Still this doesn't guarantee Kemp will fall victim to the same problems but understand that he does carry a higher degree of risk moving forward.

In the short-term, Kemp is expected out for at least four weeks with a strong possibility of missing more time. Kemp owners in non-keeper leagues may want to consider dealing the outfielder if you can't afford a DL spot moving forward.

Troy Tulowitzki

Tulowitzki is dealing with a similar issue but in a different area. The Rockies shortstop was sent to the 15-DL after suffering a Grade I strain to his left groin.

The groin isn't actually a muscle but a group of muscles known as the adductors. Theses muscles work together to pull the leg inward toward the midline of the body in a motion known as adduction. The adductors are vital for fluid lateral movement and are particularly important for a shortstop while playing in the field.

As discussed with Kemp, Tulo will need to allow the area to heal to prevent the injury from recurring. This most recent strain is not in the same location as the injury he sustained earlier in the season but as evident by Kemp that doesn't guarantee a speedy recovery. The Rockies are optimistic he will make a quick recovery but I wouldn't count on him being ready when he is eligible to come off the DL in mid-June.

Dustin Pedroia

Pedroia is dealing with an adductor injury as well but his isn't in his groin, it's in his thumb. Within the meaty portion of the thumb lies the adductor pollicus, a two-headed muscle responsible for bringing the thumb toward the palm. The adductor pollicus is primarily involved in completing a power grip, explaining why the former AL-MVP is having serious problems holding a bat. The injury has been diagnosed as a torn adductor but it does not appear to be as serious as the adductor injury suffered by Pedroia's teammate Kevin Youkilis in 2010. Youkilis ruptured one of the heads of the adductor and ultimately needed surgery to repair the damage.

The Red Sox are attempting to splint the area using a molded brace. So far it has been effective, allowing Pedroia to take batting practice with minimal swelling after he hits. The team is hoping a scheduled day off Monday will buy Pedroia enough time to allow him to play Tuesday in the first game of an important series against the Orioles. It's encouraging to see the player and team so optimistic, but you should proceed with caution. The area will be vulnerable to aggravation and Pedroia may need extra days off for the immediate future.

Roy Halladay

The Phillies will be without the services of their ace for substantial amount of time after Halladay suffered a strained latissimus dorsi in his right shoulder. Like with oblique strains, fantasy owners are becoming quite familiar with lat strains. Pitchers Josh Beckett, Jon Lester, Huston Street, and Jake Peavy have all missed time with lat strains in recent years while Nationals first baseman Mike Morse played in his first game of the season Saturday after sitting with the same injury.

The location of the muscle remains the issue. As discussed with Street just several weeks ago, the lat runs along the spine before connecting to the upper arm bone, the humerus. The lat plays a part in multiple shoulder movements and side-to-side bending and backward bending in the lower back, leaving a pitcher with an injury to the area severely limited.

Halladay is awaiting word on a second opinion but it sounds like the former Cy Young winner will be out at least six weeks. The timeline could change depending on the outlook given by the second doctor but Halladay owners should still expect a lengthy absence.

Jered Weaver

Weaver suffered a back injury after taking an awkward step while completing his follow-through. The injury has been ruled as a muscle strain and back spasms, a partially misleading diagnosis. Back spasms are not an injury but rather the symptoms of an injury. In other words, Weaver is likely suffering from spasms resulting from the strain. Still that's not what stuck out to me in the injury report. What caught my eye was the description of the strain as a muscle around a disk. This wording suggests the injury is more than just muscle and could involve a fibrocartilage intervertebral disk. If the disk were involved, a much longer DL stint would be required to insure the issue does not become a chronic problem.

Fortunately, Weaver has already begun signs of improving and is hoping to miss the minimal amount of time. However, it would be unwise for the Halos to rush their ace back if there are any signs of disk involvement and I suspect they will handle Weaver extremely conservatively. One wrong move by the 6'7" pitcher and the area could be irritated and the vicious pain-spasm cycle renewed.