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Fantasy Baseball Injury Report: Legal Steroids

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 Blue Jays' slugger has been a disappointment this season as his batting average (.219), slugging percentage (.439) and OPS (.749) are all way down when compared to the last three seasons. However, it appears nagging injuries may be at the heart of his struggles. A hamstring injury limited him in three of four games early last week before a shoulder injury derailed his comeback attempt. Encarnacion was administered a cortisone injection following his departure.

Before we delve into Encarnacion's specifics, letís do a quick review of common injections used in Major League Baseball. Cortisone is the most frequently reported injection and is an anti-inflammatory. It is technically classified as a steroid though it is corticosteroid and not an illegal anabolic steroid. It is used to treat areas of inflammation. It is not a pain-killer, though pain relief is often a side effect of reduced inflammation. Ketorolac or Toradol is another anti-inflammatory, though it is a nonsteroidal drug. While pitchers have reported receiving Toradol in previous seasons, itís infrequently used.

A lubricant or Synvisc injection may also be utilized, given the appropriate circumstances. Lubricant injections are generally used to treat individuals suffering from arthritis or osteoarthritis but professional athletes have been known to use the treatment to help with nagging injuries to the ankle and knee joints. As cartilage within a joint begins to wear down or the body's natural lubricant, synovial fluid, dries up, the function of the joint is negatively impacted. The rough movements within the joint can lead to pain and stiffness and may eventually develop into reoccurring inflammation. The lubricant in the injection mimics healthy synovial fluid allowing for the joint to move smoothly and work appropriately. Additionally, synvisc injections have shown to have anti-inflammatory properties and may help prevent further cartilage breakdown. Rangers outfielder Josh Hamilton and Dodgers pitcher Zack Greinke are just two examples of players that have opted for lubricant injections in recent seasons.

With the pharmacology lesson over, letís get back to Encarnacion. Details about his exact shoulder injury remain limited. While we know he received the cortisone injection, multiple structures in the shoulder, including muscles, tendons and bursa sacs can be inflamed and be treated with anti-inflammatory drugs. He reported soreness Sunday, a common occurrence following administration, but he hopes to be back in the lineup Monday. However, given the uncertainty surrounding the injury and the likely changes in his approach, Encarnacion's fantasy owners should adjust their expectations accordingly and may even want to consider other available options for the time-being.

Check Swings

Javier Baez
While a big league call up appeared to be on the horizon, the Cubs prospect will have to wait at least four more weeks for a promotion after suffering a finger injury with Triple-A Iowa. Baez suffered a non-displaced fracture of his left ring finger. Surgery doesnít look like a necessity, as the broken bone to still in alignment. However, Chicago left the recovery process up-ended by reporting Baez will miss between four and eight weeks. The injury limits his value in non-keeper leagues but shouldnít affect his overall value in keeper or dynasty formats.

Brad Boxberger
The Rays' closer blew his first save of the season last Wednesday and has not pitched since then as he manages tightness in his triceps. Kevin Jepsen took advantage of the opportunity by picking up three saves while Boxberger rested. While Boxberger doesnít expect to require a trip to the DL, Jepsen is worth a speculative add at this point, especially with Tampa Bay insistent on bringing back former closer Jake McGee at a conservative pace.

Corey Dickerson
Dickerson is headed to Arizona to participate in extended spring training games. The pain associated with the plantar fasciitis in his left foot has subsided but the Rockies are wisely exhibiting patience with their young outfielder. Plantar fasciitis is easily irritated so fantasy owners should approach the situation with cautious optimism. He remains at least a week or two from returning, as a minor league rehab assignment will likely be the next step of the process.

Jose Fernandez
The 2013 National League Rookie of the Year made his first official rehab appearance since undergoing Tommy John surgery. Fernandez reportedly hit 99 miles per hour on the radar gun during his 54-pitch, three-inning start. The plan remains to gradually build up his workload over the next four starts. As long as he avoids any setbacks, an early July return remains realistic for the Marlins' ace. Add him if you can stash him.

Josh Hamilton
While Hamilton looked much improved in his return to Texas, injuries continue to limit his fantasy value. After missing the start of the season while recovering from offseason shoulder surgery, the 2010 MVP will miss at least three more weeks with a strained left hamstring. Donít waste roster space with Hamilton at this point and invest in a healthier, more reliable option instead. Delino DeShields Jr. will continue to start in left field for the surprising Rangers.

Hunter Pence
The Giants outfielder has not played since June 2, missing four straight outings with tendinitis in his left wrist. While the injury is not directly linked to the fractured forearm that sidelined him for the first six weeks of the season, itís likely the result of limited reps in spring training and during the healing process. San Francisco is optimistic he will be ready to play Tuesday against the Mets.

Stephen Strasburg
The Nationals right-hander threw 30 pitches in a bullpen session over the weekend, utilizing his entire arsenal of pitches. While he reported feeling good after the performance, the risk of re-injury will loom if the reason for his reoccurring back and neck problems isnít corrected. Washington will begin to piece together their plan for progressing Strasburg back to the mound but donít expect him to return when he is first eligible.

Justin Verlander
It appears Detroit will finally welcome Verlander back this weekend. Verlander, out since spring training with a triceps strain, threw 93 pitches over 5.2†innings in his second rehab start with Triple-A Toledo over the weekend. He gave up one run and four hits while striking out nine. It has yet to be determined when Verlander will get his first start with the Tigers, but heís expected to join the rotation at some point during the weekend series against the Indians. I want to see how he looks in at least one start before I start him with any confidence.