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AL West – MLB Injury Preview

Nic Civale is a Doctor of Physical Therapy and former NCAA Division I Baseball player. He combines his knowledge of anatomy and physiology with that of baseball mechanics to provide expectations for injured players. Utilize The MLB Injury Report to make the most of your fantasy season.

Things look bleak now but there will be baseball in 2022! Why not get a head start and jump in a Fantrax Classic Draft contest? Get a jump on the season with a Best Ball league or maybe a Draft and Hold. Or put some green on the line with a new season-long league to try and conquer. There’s no better time than now to get your baseball on!

AL West – MLB Injury Preview

Houston Astros 

Alex Bregman, 3B 

Alex Bregman was cleared for hitting back in January 2022 following a successful off-season right wrist surgery. As I stated in the fall, I believe it’s possible the surgery was performed to repair a tendinous sheath that travels up into the hand. There isn’t a plethora of details provided about the exact nature of the surgery, but having missed approximately eight weeks before returning to swinging, it seems to line up as a reasonable guess. 

Whether it was a sheath repair, or something to do with a ligament repair, Bregman spent some of the 2021 season trying to adjust his mechanics to be able to play through it. This is a highly likely cause of the diminished stat-lines and poor performance compared to his normal standards. I think Alex Bregman is one of the Major Leaguers who will benefit most from a delayed start to the season. 

This delay only gives Bregman additional time to refine his swing and get back to the mechanics that made him an MVP candidate in 2019. Sure, the rabbit ball won’t be as prevalent in 2022 (so we think), and he probably won’t eclipse 40 HR as he did 3 years ago. But I’m a huge believer in Alex Bregman having a bounce-back season.

Lance McCullers, SP

Lance McCullers recently revealed that he not only had a forearm flexor strain, but that it was “off the bone quite a bit.” Holy cow. This is much more than a strain; when a tendon begins to pull away from a bone, that’s clearly a tear. This segment of a quote isn’t much to go from, but if we assume McCullers is dealing with a partially torn flexor tendon, it is almost scarier than a partially torn UCL to me. A partially torn tendon can be extremely painful, and prone to tearing even more. 

A pitcher relies heavily on the structural integrity of the forearm flexor muscles to propel the ball forward. Structures that compensate for a faulty or under-performing forearm flexor complex include the UCL itself. The reason a flexor tear scares me more than UCL damage is that there are fewer examples of a complete recovery and return to prior levels. UCL tears resulting in Tommy John Surgery are almost not frightening at this point due to the excellent surgeries and rehab programs associated. A muscle torn off the bone via the tendon is far less regimented with fewer concrete protocols. This allows for variance, both positive and negative. 

I think the play for McCullers and the Astros will be to go into the season seeing what he can tolerate, and if it is less than a 4-5 inning workload, consider surgical or other invasive intervention like PRP or cortisone injection. After signing him to a 5-year contract last year, the Astros want their investment to be as productive as possible. This may be the type of injury they want to get ahead of and repair it when it’s more manageable. 

Keep in mind this is mostly speculation from a partial quote from McCullers himself, but there is certainly a scenario in which McCullers sees a surgery room before a Major League mound.

Forrest Whitley, SP 

After a March 2021 Tommy John surgery, Forrest Whitley is aiming for a second half return to competition. Whitley was at one point a can’t miss pitching prospect who saw injuries and sub-par performance halt his progress through the minor leagues over the past three years. Whitley and the Astros certainly hope to see a rejuvenated and rehabbed Whitley come back strong. I actually have a reignited optimism for Whitley, as I do for many pitchers who struggle prior to Tommy John surgery. Who’s to say much of his struggle wasn’t due to this underlying injury? 

If nothing else, he’s worth trying to acquire in dynasty leagues early in the season when managers are trying to fill MiLB slots and are getting tired of him taking up room. Whitley returning to a top prospect would be a wonderful and unexpected redemption story, but not out of the realm of possibility. Don’t expect him in the Majors in 2022, but 2023 could be the year if things go perfectly.

LA Angels 

Jo Adell, OF 

Jo Adell seems to be one of the most under-appreciated break-out candidates of 2022, and I’m not sure why. He had an abdominal strain late last season; I don’t think that is the reason why, and it shouldn’t be. I have no expectations of Adell being limited by last year’s injury, I just had to get it out there because his ADP does not make sense to me. First of all, in 130 at-bats last year, Adell slashed .246/.295/.408 and hit 4 HR with 26 RBI, 17 R, and 2 SB. This is a 550 AB pace of 17HR, 110RBI, 72 R and 8 SB! And a narrative has been created, somehow that this 22-year-old has peaked and will not get even better.

He’s also a consensus former top 10 prospect who has hit no lower than .282 and slugged no less than .518 at any level of the minor leagues. My final argument for Adell is that his supposedly awful K rate was only 22.9% last year, better than Trevor Story, Joey Votto, J.D. Martinez, Trey Mancini, and many more in 2021.

Patrick Sandoval, SP 

Sandoval missed much of the second half of last season with a left lumbar muscle strain. The lumbar spine is the bottom third of the spine, and muscular strains in that region can be extremely debilitating. I don’t think it’s a red flag that he missed so much time. The Angels were probably not too disappointed to have a reason to limit his innings, as he had already eclipsed the second-most innings thrown in his 8-year career (80.1) as he climbed to 87.0 in 2021. The most he’s ever thrown was 122.1 in 2018. Sandoval goes into this season with a clean bill of health; there has been plenty of time to recover from a lumbar strain. The only question is how many innings he will throw due to his limited innings totals in the past.

Griffin Canning, SP 

Griffin Canning missed much of last year with a low back strain. This injury was likely similar to Sandoval’s, mentioned above. With a wide variety of injuries over the past few years, Canning is a difficult pitcher to trust as a reliable option, but he may be the perfect pitcher to target as a dart throw in a late round, or a solid dynasty league pick-up. Canning should be healthy going into 2022, but like Sandoval, we shouldn’t expect a full season workload. The highest inning count Canning has accumulated was 113.1 in 2018.


Daulton Jeffries, SP 

Jeffries amassed 92 innings last year between AAA and MLB. He missed the final few weeks of the season, however after being shut down with ulnar nerve neuritis in mid-September. Neuritis is inflammation of the nerve and the ulnar nerve sits in the medial elbow. When you hit your ‘funny bone,’ that’s actually you hitting your ulnar nerve. This nerve is also very closely positioned to other important structures like the UCL and forearm flexor insertion site.

Oakland A’s team reps said that they didn’t see any structural damage in Jeffries’ arm other than neuritis, so that warrants a fairly significant sigh of relief. But Jeffries isn’t out of the clear, as neuritis is the type of injury that can linger. Stephen Strasburg began his recent injury saga with ulnar nerve neuritis, which has been a long and frustrating recovery. Jeffries isn’t a strong SP option going into the year for these reasons, and for the fact that he does not have a secure role in the Oakland starting rotation. Jeffries has also never eclipsed 80 IP in a single season.


Ken Giles, RP 

Ken Giles should be ready for Opening Day following his Tommy John surgery which took place all the way back in 2020. He will be fighting for a role as Seattle’s closer in a talented and deep bullpen. It’s a high upside play, as Giles was once seen as one of the league’s best closers. He holds a career 2.74 ERA with 12.3 K/9.

Justin Dunn, SP 

Justin Dunn should also be expected to begin the year healthy. He was shut down last September with shoulder inflammation. Similar to Shane Bieber and Pablo Lopez, I’m not particularly concerned about the long-term implications of this particular injury. In fact, I think there are very few MLB pitchers who don’t experience some late-September shoulder inflammation. Monitor Dunn’s workload in Spring Training, whenever that may be, to get an idea of where the Mariners see him in their rotation.


Jonathan Hernandez, RP 

Jonathan Hernandez had Tommy John Surgery last April, and is likely going to be a full-go around June of this season. Hernandez was anticipated to be the Rangers’ clear closer going into last season and would be anticipated to compete for that role again if there is any doubt about who the lock-down closer is at that point in the season.

For more great analysis and rankings, make sure to check out the 2022 FantraxHQ Fantasy Baseball Draft Kit!
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