RotoWire Partners

Diamond Cuts: Scar Tissue

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 and Hanley Ramirez

The brilliance of rookie outfielder Yasiel Puig was enough to overshadow what turned into a rough week for two key members of the Dodgers offense. Both Kemp and Ramirez suffered setbacks in their respective returns from hamstring strains and could be missing for an extended period.

Before we address each specific player, let's examine how a strained muscle heals. When a muscle is significantly strained the individual muscle or tendon fibers of the muscle tear. The body's natural healing process kicks in cleaning the area. Once the stage is set, specialized cells begin producing various components that will help in the regeneration of new muscle fibers. This scar tissue is not immediately at full strength and is not arranged in a detailed pattern, making it important for an athlete to rehab the effected muscle in specific way. Loading the muscle in a precise manner will allow the developing new tissue to form in a stronger, more accurate pattern.

However the new tissue is still vulnerable to injury even when properly handled. If the scar tissue is not 100 percent and is disrupted, the reset button on the entire process is hit and the injured athlete must again begin the tedious process of tissue regeneration. Understanding how delicate the process can be, should allow for a better understanding of why hamstring injuries are so easily irritated.

Kemp has not played since May 29 when he suffered a hamstring strain in his right leg, the leg opposite the one that endured a hamstring issue last season. He had been progressing nicely through rehabilitation until he attempted to run around the field over the weekend. He felt discomfort in the injured extremity and will now slow down his workload. The idea is to continue to work with Kemp as his body heals but not to allow him to damage the developing tissue. This latest setback all but rules out a Friday return and I'm betting the former All-Star sits at least another week, if not two.

Ramirez is in a similar boat but had been playing for the past five days following his activation from the disabled list on June 4. He has been predominantly limited in the field, serving as a pinch hitter for a majority of the games. Unfortunately he felt some lingering pain and soreness in the injured leg and did not play on Sunday. He is slated for an additional MRI but all signs point to him needing some extra time off to recuperate and rehab.

Giancarlo Stanton

Based on all the information presented with the Dodgers duo surely you understand why I remain skeptical about Stanton having an immediate impact in Miami. Out since late April with a significant hamstring strain of his own, Stanton has methodically worked his way back into shape. Reports indicate that the team is hoping to have him back in the lineup as early as Monday but again I have my doubts. His rehab assignment was rushed due to Mother Nature's failure to cooperate and risk of reinjury remains high until he's played an extended amount of time on consecutive days. Furthermore he has other red flags in his medical history including a previous hamstring strain and arthroscopic surgery on his right knee. I'd look elsewhere, even in weekly leagues, for at least one more week.

Pablo Sandoval

The week of setbacks continue as Sandoval missed Sunday's outing after irritating his troublesome left foot. Though the injury is being reported as a strain, a specific diagnosis has not been supplied. What we do know is Sandoval is not a guy that is easy on his feet. His physical stature demands more of his legs and feet. Additionally his left foot is a key component of his swing, particularly when he bats as a leftie. At this point a DL stint appears inevitable so adjust accordingly.

Check Swings

Ryan Braun: A thumb injury continues to bother Braun and a DL trip remains a possibility. There has been no indication if the injury is to the bone, ligaments, or muscles in the area but it has been a problem for several weeks now. With the threat of a suspension looming, Braun owners may want to start making the appropriate preparations to fill the massive gap an extended absence would leave.

Bryce Harper: Harper will meet with Dr. James Andrews on Monday for further evaluation on his knee. Harper remains on the DL with what is being called bursitis. Keep an eye out for the results of his meeting with Dr. Andrews and closely monitor any reported activity over the next week. An increased workload would be a good sign Harper's return could be right around the corner.

Daniel Hudson: After an impressive 2011 campaign, some believed Hudson would be the breakout star of 2012. Unfortunately a torn ulnar collateral ligament (UCL) limited him to just nine starts last season and he has since been rehabbing his elbow following Tommy John surgery. Sadly after 11 months of hard work a recent MRI revealed Hudson has once again torn the UCL and will need a second Tommy John procedure. He will miss the remainder of the season.

Alexi Ogando: Ogando is back on the DL after making just one start in his return from biceps tendinitis. The Rangers are calling his latest injury right shoulder inflammation. Shoulder inflammation could be linked to his previous injury, as an overworked bicep is often an indicator of a weak shoulder, particularly at the rotator cuff.

Jake Peavy: The former Cy Young winner will miss four to six weeks with a non-displaced rib fracture. The effected area is on the left side of his rib cage and is causing him pain with rotation and even breathing. Patience is the key here, as the bone must be completely healed before Peavy can successfully return.

Anibal Sanchez: Sanchez was scratched from his last start but insists the extended rest will allow him to avoid the DL. He is dealing with tightness in back oh his throwing shoulder, an issue that cropped up early in spring training. For the time being he appears to have avoided serious injury but closely watch how Detroit handles his workload moving forward.