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Diamond Cuts: Pop Goes the Quad

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.

Edwin Encarnacion

The surprise team in the AL East suffered a significant blow over the weekend when Encarnacion injured his right leg trying to beat out a double play. The team-leader in home runs and RBI required assistance off the field. A MRI performed Monday revealed a Grade 2 strain of his quadriceps muscle. Encarnacion's description of the injury, including recalling a “pop” sound, was a hint that the injury was more than just a minor strain. In Grade 2 strains tearing occurs in the muscle belly fibers or in the tendon itself. These types of injuries are often reported as a partial tear since the muscle is damaged but did not rupture or avulse away from the bone. Grade 2 strains are accompanied by a loss of function but not as severe as a total tear.

The quadriceps is actually a group of muscles that work to in unison to not only bend the hip (hip flexion) but also straighten the knee (knee extension). Since the quad is a two joint muscle, extra care must be given during the rehab process to avoid a disruptive muscle imbalance from developing. Failing to do so would open up the slugger for an additional or reoccurring injury down the road.

Before he can return Encarnacion should display full range of motion at both joints with no pain as well as comparable strength to the uninjured leg and be able to perform all necessary baseball-related activities. While this is Encarnacion's first quadriceps injury, he did have hamstring issues during the 2004 and 2013 seasons. Therefore it's vital to his long-term health that he has made a complete recovery before returning to the field. The unforgiving turf in Toronto should also be weighed into his recovery.

Taking all these factors into consideration, fantasy owners would be wise to anticipate a slightly longer absence than the current estimated timeline of two weeks. The number of games missed by Encarnacion will be minimized by the All-Star break but his time on the disabled list still leaves a void in numerous lineups. Everyone involved should still exhibit patience to insure he's available when it really matters.

Joey Votto

Votto is a good example of what could happen if Encarnacion rushes his recovery. Votto missed 23 games earlier in the season with a quadriceps strain of his own. Though he was immediately reinserted into the Reds lineup upon his return, it was clear from his movement and productivity that he was less than a 100 percent. Now, after sitting out a few games due to soreness in the area, Votto is back on the DL and could be out for a longer stretch of time. Extra care has to be given to the joint, as this is the same knee that required multiple surgeries to address a cartilage tear during the 2012 season. The Reds seem to understand the potential severity of the situation and appear poised to give him extra time to recover this second time around.

CC Sabathia

The Yankees pitcher appeared to be nearing a return but a build-up of fluid on his injured knee derailed those plans. Sabathia is set to meet with Dr. James Andrews in the near future but there has already been indication that the former Cy Young winner has extensive cartilage damage within the joint. Cartilage damage, particularly to the cartilage on the bones directly involved with joint movement, is a big problem for any player. This specialized tissue, known as articular cartilage, is unable to adequately repair itself and rarely heals without surgical intervention.

The available surgical options are all dependent on the location and size of the damage. Small piece of tissue can simply be removed but larger defects need a more aggressive form of a treatment and the dreaded microfracture procedure comes into play. Microfracture surgeries are often more intensive and are accompanied by a significant recovery time. Microfracture has gained infamy in the NBA as players like Amar'e Stoudemire and Jason Kidd have required the procedure. It is less common in baseball though Grady Sizemore and Victor Martinez have undergone the surgery.

Sabathia will weigh all his options in the coming weeks but all signs point to this being the end of the road for season and potentially his illustrious career.  Even stashing him on the DL seems futile at this point and it's best for fantasy owners to move on from Sabathia.

Gerrit Cole

The Pirates placed Cole on the DL with a strained latissimus dorsi in his right side. The lat muscle is situated along the thoracic region of the spine and inserts into a small groove in the upper arm bone, the humerus.  Its primary responsibility is to aid with multiple shoulder movements including extension, internal rotation, and bringing the arm away from the body in a motion known as horizontal abduction. Additionally, the muscle plays a role in back motion, helping with side-to-side bending and backward bending (extension) in the lower back.

Pitchers that have previously missed time with lat strains include Josh Beckett, Jon Lester, Huston Street, Jake Peavy, and Roy Halladay. The amount of time missed appears to be linked to the location of the strain and the degree of damage. If the anchor point in the shoulder is involved, like in the case of Halladay, then the individual is often sidelined a longer period of time. If the damage is isolated to the muscle belly, a quicker return is more probable. However Pittsburgh's hope of Cole missing just one start seems a bit optimistic and a three-to-four week absence may be more realistic.

Check Swings

Carlos Gonzalez: CarGo is hoping to be back in the lineup by the weekend after completing a rehab stint with Triple-A Colorado Springs.  Gonzalez has been recovering from finger surgery to remove a benign tumor. His grip appears unaffected as he hit a double and three-run homer Monday in his first appearance back.

Cliff Lee: Lee will pitch Wednesday for High-A Clearwater as he continues to work his way back from a flexor strain. If all goes well he should wrap up his assignment following one more start before returning to the Phillies shortly after the upcoming All-Star break.

Jon Niese: Additional testing on Niese's throwing shoulder revealed inflammation around the acromioclavicular (AC) joint. The AC joint acts as a strut in the shoulder and any limitation would significantly impact a pitcher's delivery. The Mets hope the issue will resolve following a round of anti-inflammatory medication and that he will be able to return following the break.

Jered Weaver: The Angels right-hander was removed from his recent start with lower back spasms though the cause for the spasms has not been reported. Hopefully the LA medical staff was taking the conservative approach and simply removed him from the game before the issue worsened. Keep an eye on him over the next few days to see if he will make his next scheduled start.