Nic Civale is a Doctor of Physical Therapy and former NCAA Division I Baseball athlete. He combines his knowledge of anatomy and physiology with that of baseball mechanics to provide expectations for players on, or coming off of, the Injured List. Utilize The Fantasy Baseball Injury Report to manage your fantasy team’s injuries and emerge victorious amidst the chaos!
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Fantasy Baseball Injury Report
The Blue Jays SS received promising reports upon the second opinion of his knee sprain that was sustained on 8/15. Initially, there was a collective fear Bichette could miss the rest of the season. Fortunately for the Blue Jays and baseball fans everywhere, the young superstar in the making is going to be okay. A second opinion resulted in the diagnosis of a Grade I LCL (lateral collateral ligament) right knee sprain. The LCL is one of the least frequently injured ligaments of the knee and luckily does not necessarily receive a significant amount of strain during baseball activities- especially for a right-handed swinger. The LCL prevents the knee from bending in the direction you might describe as bow-legged, and with the proper physical therapy and patience, Bo Bichette should be able to return to action in the next 2-3 weeks barring any setbacks. Here’s hoping Bichette and his gravity-defying hair will be back on display soon. He’s already returned to on-field activities including BP, ground balls, and running drills.
Strasburg received some unfortunate news last week. The neurological symptoms of his right hand have been diagnosed as carpal tunnel syndrome (CTS). Like most neurological pathologies, the prognosis for recovery from CTS can vary tremendously. Strasburg went under the knife for repair Wednesday, August 26. The Nationals are hoping Strasburg is back for the 2021 season, but there is little indication at this point as to when in 2021 he may be ready. The surgery is designed to relieve pressure acting upon the median nerve as it runs through the wrist and into the hand.
There is no guarantee the symptoms will abate any time soon, or in extreme cases, at all. For the first few weeks after surgery, Strasburg will likely be splinted and allowed to move only the fingers of his right hand. Following this, light range of motion exercises can be expected and it will be weeks or months until any strengthening exercises are performed. It will be a slow, but hopefully successful rehab for Strasburg. There is no way of knowing at what point in 2021 he will return to action, but because his symptoms have been a recent development we can be hesitantly optimistic that Stras will be back early next season.
Alvarez will miss the remainder of the 2020 MLB season due to a partial tear of the right patellar tendon, requiring surgery. This vital tendon attaches the quadriceps muscle to the upper portion of the knee cap, or patella. The quadriceps muscle is one of the most powerful muscles in the body and contracts explosively as the knee extends, or straightens. So every time Alvarez swings he contracts the quadriceps to maintain a straightened front leg, providing a stable base for core and arm movements. It is no wonder this injury has been causing Alvarez such discomfort, as he has struggled with mysterious knee injuries the past two years. In addition to the patellar repair, he also underwent a less invasive, arthroscopic surgery to both knees to ‘clean up’ any additional scar tissue or unwanted tissue in the joint.
The procedure is a relatively low-risk and largely positive-outcome surgery. That means Alvarez should return fully loaded next year – which is a scary thought to all pitchers who are destined to stand within 60 ft, 6 inches of him in 2021. For dynasty/keeper teams who are not bidding for the ‘ship this year, I’d unload the roster to try and get Yordan on your squad… which I’ve done myself, and am extremely excited about. Good Luck!
Alex Bregman pulled up limping into second base last Thursday with a right hamstring strain against the Rockies in Colorado. He’s had a history with hamstring injuries, missing two weeks in his 2016 rookie campaign, as well as a few games in April, 2019. Bregman is expected to miss at least three weeks, making him potentially available for a return around mid-September. One of the top 10 fantasy hitters of the past 2 years, Alex Bregman is of course worth holding on to, and very possibly even burning a bench spot if your league has no IL. The Astros are not the powerhouse they were expected to be this year, but surely they will bring Bregman back conservatively so he is available in the postseason.
Ozzie is still riding the injury Crazy Train, unfortunately. He has not yet returned to taking BP as of 8/30 due to his persisting right wrist bone contusion. This is a bit troubling to see; if by this time next week Albies is not back swinging, it will have been over one month without BP. It will be difficult to get his timing back, let alone the bat speed and power. As we have commonly seen with injury management this year, it is more likely the Braves work Albies back into the lineup slowly so he is fully healthy for the playoffs. Mid-September would be an appropriate expectation at this point.
Aaron Judge’s return from the IL lasted only 6 innings, as he was pulled from the 8/26 contest against the Braves due to the return of right calf tightness. Yankees fans can’t catch a break…but no one feels bad for them! We just feel bad for Aaron Judge. The guy has been a class act since entering the league and a thrill to watch when healthy. The Yankees remain a strong team without his and Stanton’s bat in the lineup, but with a re-aggravation of the calf muscle after just 2/3 of a game, it would be reasonable to assume this trip on the IL may take greater than 10 days.
Gleyber Torres may remain out of the NY lineup until the last week of September with a left hamstring/quad strain. If this prognosis is accurate, he is essentially rendered droppable in all re-draft leagues, unless you have the IL room and can hold out hope he recovers hastily. He has returned to on-field movement activities, but it wouldn’t be surprising to see the Yankees work Torres back progressively in the week before MLB playoffs start in October to get a few AB’s under his belt.
James Paxton sustained a forearm flexor strain but avoided any damage to the Ulnar Collateral Ligament (UCL) that is responsible for Tommy John Surgery when injured. Paxton stated he felt he was very lucky to not have sustained a more serious diagnosis, but similar to Torres, we can’t expect much from him before the playoffs in October. If all the above Yankees can come back healthy for the playoffs, watch out!
On a positive note for the Yanks, DJ Lamahieu has returned to the lineup and will hope to stay at the top of the order the rest of the year.
Bryant has struggled to get things going in 2020. Back on 8/12, he suffered an injury to the left sprain of his left ring finger and was put in the IL retroactive to 8/19. The ailing wrist may have something to do with the 20 strikeouts he has racked up in his 14 games, considering the righty swings with his left wrist below the right on the bat and puts a significant amount of force downwards into the knob. With two injuries healing at once, it is difficult to predict when Bryant will return. Ideally, the Cubs remain in contention long enough to let Bryant heal completely and come back fully healthy. This means the better the Cubs do, the longer they can afford to wait on Bryant – and the longer her remains on your bench, or IL slot.
The slugging catcher has struggled to match his offensive numbers from 2019 this year. This has forced fantasy owners to make the difficult decision to cut him from their rosters or hang on and hope for a turnaround. The owners who’ve held on will have to be even more patient as Garver has been sidelined with a right intercostal strain. The intercostals are muscles that run diagonally, connecting the ribs to each other superiorly and inferiorly. As you can imagine, these muscles are used extensively in the swinging and throwing motion. Considering this is a mild strain, Garver is hoping to be back within the next week or two. Hopefully, the time off will help him get his groove back and return to being a top 3 fantasy catcher, but the latest reports state that he is not close to a return.
The young outfielder expects to be sidelined for at least 3 weeks with a bad right hamstring strain when legging out an infield single. Calhoun has had a particularly unfortunate 2020; after being hit in the face with a Julio Urias fastball in the preseason, he had finally started seeing consistent playing time prior to the hamstring injury. We hope to see Calhoun back before the season ends, and returning strong and healthy for some momentum going into next season.
BB has been on the IL since 8/20 with left shoulder inflammation but is expected back in the next week, as he has already played in an inter-squad game (Monday, 8/31). The speedy CF would be a great addition to any roster in need of runs steals, so pick him up if he’s available, and be on the lookout to get him back in your lineups within the net few days
If anyone has heard of chorioretinopathy raise their hands… It’s not a physical therapy diagnosis necessarily, but after researching this condition, my heart sank to see recovery can take 4-6 months. There doesn’t seem to be a clear reason for the development of this fluid. Sal Perez is one of the game’s bright spots behind the plate and beloved by his fellow Major Leaguers. To have him back this year from Tommy John rehab was great to see, and now he is sidelined due to an accumulation of fluid under the retina of his eye. 2020 is just the worst; he could be back in a week or out for the year. Perez will basically just have to wait for things to clear up with his vision and we hope he’s back soon. He visited an eye specialist this week.
Odorizzi is expected to return in 1-2 weeks as he recovers from an abdominal injury sustained after getting hit from an Alex Gordon line-drive. There were no fractures or apparent long term injuries and is expected to throw a bullpen session on 8/31.
The young fireballer scared baseball fans everywhere when hitting the IL on 8/20 with elbow discomfort. MRI results haven’t fully been disclosed to this point, but Pearson has been saying he’s felt good. With the Jays acting as buyers preceding the trade deadline, it may be in their best interest to try to work Pearson back into their rotation or bullpen assuming the MRI comes back clean. Being appropriately diligent, the Jays are getting multiple doctors’ opinions to identify the correct diagnosis.
Chirinos has undergone a successful Tommy John Surgery to repair a torn UCL, and at this point, is expected to miss the majority or all of the 2021 season to rehab. With the Rays’ recent successes, however, Yonny may be a welcome addition to a 2021 Tampa Bay postseason run if rehab goes well.
Kelly was placed on the 10 day IL on 8/24 after being scratched minutes before his start due to shoulder impingement. After further investigation and diagnostics, the injury was eventually clarified as blood clots. Blood clots can be very serious and even fatal, but Kelly has had surgery on the right shoulder, and a catheter was placed to improve the blood flow in the shoulder. He is fully expected to be done for the season, but what is important is that the situation has been taken care of and he is healthy.
The talented Rockies OF has been experiencing lower back soreness and has hit the IL, but has already returned to facing live pitching and is expected back this week
Mentioned in last edition of The IL Report who have yet to return:
- Giancarlo Stanton (hamstring strain)- estimated to be one week away from game action
- Madison Bumgarner (mid-back strain)- threw 85-pitch sim game on 8/29, may return this week
- AJ Puk (shoulder strain)- continuing a progressive throwing program
- Mitch Keller (oblique)- has thrown 2 bullpen sessions in past week
- Charlie Morton (shoulder inflammation)-expected back this week!
- Josh Donaldson (calf strain)- ‘may’ return to lineup this week per manager, Rocco Baldelli. Has not yet reached a full 9-innings in sim-games.
- Ken Giles (forearm strain)- threw bullpen session on 8/28 at ~80-85% effort, yet to throw live BP
- Benintendi (ribs)- no timetable to return. “It’s going to be a while”- Roenicke
- Austin Hays (ribs)- no timetable set for return
- Carlos Rodon (shoulder soreness) – was set to throw 3-inning or 60 pitch bullpen on Sunday, 8/30
Long Term Injuries/ Dynasty Implications
This week’s Dynasty Deep Dive highlights Mike Soroka, one of the game’s brightest and youngest MLB arms. He’s brought Braves fans flashbacks of the deceptive dominance of Glavine and glimpses of the pinpoint accuracy of Maddux. Sadly, he exited the Braves contest with the Mets on 8/3 with a ruptured right Achilles tendon and is not expected back until 2021. Soroka joins a short list of recent MLB pitchers who’ve suffered Achilles ruptures but is by far the youngest of the group.
The three most notable hurlers who have experienced an Achilles rupture in the past decade include Johan Santana, Adam Wainwright, and Zack Britton. They were in or preparing for, their age 32, 33, and 30 seasons, respectively. Santana and Wainwright each saw their careers take a downward turn in just about every major category. Britton has actually seen an improvement in his career numbers, enjoying a drop in ERA from 3.22 to 2.35 and in WHIP from 1.26 to 1.17, per Baseball Reference. No clear trend for future production exists for this case. We must look towards anatomy and physiology and combine this knowledge with the mechanics of a right-handed pitcher, focusing on the right Achilles tendon.
When the right-handed pitcher pushes off of the mound with the right leg, the power and stabilization come from larger muscle groups like the glutes, hip rotators, quadriceps, and to a degree, the hamstrings. The calf muscles that are attached to the heel via the Achilles tendon have a dual purpose; they are stabilizers to support balance when a pitcher is balancing on one leg, and then they provide a small amount of push-off towards home plate as the pitcher hurls the pitch to the catcher. Because these motions are methodical, controlled, and highly repeatable, there is not a very high risk for a repeat injury to the Achilles during the pitching motion. Most Achilles tendon tears happen during a dynamic and forceful push into the ground, which is what happened to Soroka during his season-ending Achilles injury earlier this year. Quickly digging the foot into the ground and pushing off is exactly the kind of major force in a short amount of time required to tear a tendon so thick and strong. So as Soroka returns to throwing activities, it is certainly possible he will feel sore and tight, but the risk for re-injury to the same extent is minimal.
The biggest question, in my opinion, for the speediness of Soroka’s return is what the national league will do with the Designated Hitter. If the DH remains an option for NL teams, Soroka can control the amount he needs to run to some extent while fielding a ball. Defensive shifting and placement can assist in limiting Soroka’s activity. This would be harder to control if he was forced to hit 3-4 times for game and run the bases. I wonder to what extent star pitchers like Soroka, and their ability to run the bases will have an effect on baseball’s decision to retain the DH. Ultimately, Soroka should be expected back in 2021, but it isn’t a guarantee he’s on the opening day slate. As far as his long term performance and dynasty/keeper implications, I wouldn’t hold this injury against him. We saw a decline in performance from Adam Wainwright and Johan Santana when they suffered similar injuries, but we have to acknowledge they were both on the other side of 30, with hundreds more innings pitched than young Soroka.
Coming Soon: A closer look into Corey Kluber’s teres major strain and the type of rehab needed to get back on the field, pitching like the Kluber we all know and love.
Can’t get enough baseball? Check out Eric Cross’s article highlighting the dynamic prospects Sixto Sanchez and Joey Bart.
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