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Medical Corner – Ohtani Injury Update, Plus News on Thor and a Setback for Injured Ace

Dr. Mike Tanner provides his fantasy diagnosis, updating Fantasy owners on the MLB injuries that are ailing their teams. This week the Fantasy futures of a few high-octane arms hang in the balance.

The Shohei Ohtani Outlook

The fantasy world holds its breath as we wait for the re-evaluation of Ohtani’s elbow. Let’s take a peek behind the curtain on what’s being done.

First, a Grade 2 strain is a ‘partial tear,’ but partial can mean different things. The UCL is about as thick as an average pinkie finger. A partial tear can indicate that even the small aspect of the ligament is torn. The fact that a PRP injection was the initial step suggests there is at least hope surgery won’t be required. PRP injections are gaining momentum as a plausible way to address UCL sprains/partial tears.

Second, this is not a new injury. In early December 2017, he was diagnosed with a grade 1 stain. Grade 1 indicates pain, but no structural damage. The MRI may show inflammation, but nothing is torn.

The Good News

Even if his elbow doesn’t allow him to pitch, it’s reasonable to believe he could still play as a hitter and undergo Tommy John Surgery after the season. If surgery is the solution to his problem, he would still need to sit out all of 2019, so an October/November surgery wouldn’t really delay his return.

The Bad News

PRP injections are only successful 60% of the time and even when they are, recovery takes much longer than expected. The pitcher may not be as effective early on as they regain a feel for their pitches and confidence in high-effort deliveries. Unless the tear is very, very minor, and the Angels can really close the gap on the Mariners in the next few weeks, I believe the Angels will proceed with caution with their star.

Expected Return: 2020 as a Pitcher, Mid-July as a hitter.

Jimmy Nelson, SP, Milwaukee Brewers

Nelson’s offseason progress had him on track to return in early June. In late April, the pace in his throwing program seemed to plateau. He progressed to throwing from 150 feet on flat ground and then really never made it past that point. In May he was re-evaluated by the surgeon and shut down for 10 days. For the record, athletes are only shut down when examination yields a problem, or the athlete is having symptoms. Fast forward to mid-June, and he’s still throwing on flat-ground.

Couple that information with the fact that pitchers who suffer labral tears return to pre-injury performance levels less than 10% of the time, and there is a reason to be a bit discouraged. I am not convinced we’ll see Nelson pitch in 2018 unless his progress changes in a hurry.

Expected Return: 2019, likely in a bullpen/swingman role.

The Latest on More MLB Injuries

Trending Down:

Noah Syndergaard – The longer he is not throwing, the more likely one or multiple rehab stints will be required. Given the importance of the index finger on gripping the baseball, a return after the All-Star break is becoming more likely every day.

Walker Buehler’s bruised ribs shouldn’t be too much cause for concern, but he could easily miss a month between begin shut down and ramping back up. Expect him to return after the all-star break with Maeda & Hill returning.

Trending Up:

Elvis Andrus is ready to go to a rehab assignment and should return in 1-2 weeks. He’s likely owned in your league but is worth a waiver claim if he’s not.

Byron Buxton is running the bases and we don’t really allow that if a fracture isn’t doing well. His activity should ramp up and a possible return in the next 10-15 days is likely.

Kevin Kiermaier returned yesterday and isn’t owned in nearly as many leagues as he should be.

Robbie Ray recently began a rehab assignment and could be back in just under two weeks.

Jeff Samardzija will make a rehab start in Triple-A today and the upcoming schedule is easy enough that he may be a useful pickup (Miami & San Diego).

Johnny Cueto is a week or two behind and is owned in less than 70% of ESPN leagues. Fantrax ownership is 97%, go get him if he’s around.

Need help dealing with this recent rash of MLB injuries? Check out the latest Waiver Wire column for some ways to keep your Fantasy Baseball teams in contention.

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