Last season, in the middle of Strasburg’s six-week stretch of reoccurring neck and back injuries, I compared him to a Rube Goldberg machine. A Rube Goldberg machine is a complex device that depends on a series of elaborate motions to complete a nominal task. The most famous example is the board game Mouse Trap, in which everything from a diving man to a miniature bathtub is used to complete a simple rodent-catching device. I went on to compare Strasburg’s body to one of these contraptions, explaining that throwing a baseball with velocity and precision depends on numerous muscles, tendons and ligaments working in a synergistic manner. A breakdown or limitation in any area along the way can result in a cascade of problems for an athlete.
This is precisely the reason why the pitcher’s recent placement on the disabled list with an upper back injury has me worried. Last season, the problems started in the same area, as a strained latissimus dorsi marked the beginning of a series of injuries that worked their way through his body. First it was the lat, then tightness in his neck and then an oblique strain. He pitched well following his return but was eventually forced to skip another start due to soreness in his upper back.
His latest injury has been attributed to a weight room accident that involved his back and two ribs. The 12 sets of ribs that make up the rib cage articulate with the 12 vertebrae of the thoracic region of the spine. Each rib forms two joints, one with the vertebrae it comes in direct contact with and another with the corresponding vertebrae and the vertebrae directly above it. Strasburg reported that two ribs popped out of place, but were realigned and then adjusted by a chiropractor. However lingering tightness in his back ultimately led to his DL-stint.
Unfortunately, a rib subluxation can be an underlying sign of shoulder instability, and Strasburg’s recent problems in the area only further raise the red flags. The Nationals appear to be downplaying the incident, hinting that he could be back in action when first eligible on July 1. However, a conservative approach to recovery would make more sense and don’t be surprised if he sits for bit longer, especially with the All Star break on the horizon. Even when he does return, his inherent injury risk will remain elevated until he can prove the injury won’t have any type of cascade effect on his delivery.
The Toronto slugger’s toe injury that originally occurred June 16 has officially been diagnosed as turf toe after additional tests failed to find any additional bone involvement. Most commonly sustained with forced hyperextension, turf toe is a sprain of the stabilizing ligaments of the big toe. Turf toe is often slow to heal and is easily re-injured making it likely the issue lingers even when Bautista is eventually activated from the DL. Furthermore, the turf of the Rogers Centre should be taken into account and could be a compounding problem for the former All-Star. Look for Bautista to return around the All-Star break.
Gerrit Cole: Cole’s recovery from a strained triceps is taking a bit longer than expected, but the Pirates are making a sound decision by slow playing his return. He has progressed to throwing off of a mound and is planning on completing several more sessions before embarking on a minor league rehab assignment. The associated timeline makes it likely that he won’t return until sometime shortly after the All-Star break. The decision may be frustrating to fantasy owners eager to get Cole back in their lineups, but it’s the right play to reduce his chances of suffering a more significant injury.
DJ LeMahieu and Trevor Story: Colorado’s two surprise fantasy producers each walked away from Sunday’s win with what appear to be minor injuries. LeMahieu exited in the sixth inning with a left knee contusion. Story finished the game, scoring the winning run, but suffered a middle finger injury on the hit-by-pitch play that put him on base. X-Rays performed after the game failed to find a fracture, but the digit is reportedly very swollen and sore. These associated symptoms could easily make gripping a bat difficult despite the bone remaining intact. The Rockies don’t have the benefit of an off-day Monday and may be forced to make a quick callup if both middle infielders are unable to suit up. Both are day-to-day, likely with a game or two missed.
Noah Syndergaard: While an MRI failed to find any significant structural damage to Syndergaard’s throwing elbow, fantasy owners invested in the 23-year-old should still have concerns about his long-term durability. He’s had elbow issues twice already this season. While exams have failed to uncover anything in both incidences, something has to be causing the recurrent inflammation in the area. He's scheduled to throw Monday against the Nationals but likely will be on an extremely short leash for his next several starts. He’s too good to bench, but it’s probably best to adjust your expectations accordingly.
Rangers Rotation: Derek Holland and Colby Lewis joined teammate Yu Darvish on the DL late last week. Holland is suffering from left shoulder inflammation, a major concern for a guy who missed nearly four months of last year with a rotator cuff strain in the area. Texas has yet to reveal an estimated timeline for Holland’s recovery. Lewis’ injury appears to be more serious, as the Rangers have already shifted him to the 60-day DL. Lewis was diagnosed with a strained lat and recently underwent a platelet-rich plasma (PRP) injection to help stimulate the healing process. Nick Martinez and Chi Chi Gonzalez have been called up to join the rotation. Gonzalez’s return to the big leagues may be brief, as Darvish is slated to throw a simulated game on Wednesday and is optimistic about a pre-All-Star break return.