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Vernon Wells’ Broken Wrist

The bad news: Vernon Wells has a broken left wrist , and will miss the next 6-8 weeks.

The good news: The broken wrist is his non-dominant, left wrist. This means he will not have any restriction while throwing, and his top hand while batting (the one that creates a good deal of bat speed) will not be affected.

The exact bone(s) that was(were) broken was not mentioned in the preliminary reports that I have seen. In any event, wrist fractures tend to heal slowly due to the fact that the bones are small, and the blood flow is not the greatest.

Do not drop Vernon Wells, as he should return in mid-July. The only concern will be the weakness of his left hand and forearm due to the immobilization that will likely be required for the fracture(s) to heal.

In the meantime, if you need outfield help, you might as well add someone like Ryan Ludwick, Milton Bradley, Moises Alou (back from the DL), Jermaine Dye (dropped in many leagues), or David DeJesus (under the radar but producing nicely).

Max Scherzer Pitching Analysis

Kyle Boddy, a writer at Driveline Mechanics, has posted an interesting article breaking down the pitching mechanics of Arizona phenom, Max Scherzer. Here is the link.

I like the format of the article, and I like the format of the video voice over. Like Boddy, I feel that the inverted W position is not a good position for a pitcher’s shoulder to be in - or anyone else’s for that matter. That being said, I think it is sometimes difficult to see what exactly is going on at the shoulder and Scapulothoracic joint when people start analyzing mechanics.

In the article, there seems to be some uncertainty at points during the analysis, especially when trying to determine foot strike of his lead leg, as well as where his acromial line is. Some of the content and analysis, especially pertaining to anatomical references, is inaccurate, however. I will explain:

At 10:11, he is discussing the follow-through of Scherzer’s pitching arm side (PAS), and how it does not follow through behind his body. I noticed this right off the bat, and he is accurate in pointing this out, and how the arm comes to an abrupt stop in front of his body.

Where Boddy is incorrect, is that he describes the "decelerator muscles" as the anterior shoulder and pronator teres. In fact, this region (anterior shoulder) and muscle (pronator teres - forearm) are not decelerating anything at this phase of the pitching motion.

The decelerator muscles at this phase are actually in the posterior aspect of the shoulder, i.e. the rotator cuff - particularly the Infraspinatus, Teres Minor, and Supraspinatus - as well as the Triceps (preventing the elbow from flexing), Lower Trapezius/Rhomboids (decelerating the Scapula), the Latissimus Dorsi, which decelerates the trunk as well as the assists in preventing the upper arm from crossing the body), and the Supinator and Wrist Extensors, which prevent the forearm from continuing into forearm pronation and wrist flexion.

Decelerator muscles work eccentrically - that is, as they contract, the muscle lengthens.

In this phase, the Pronator Teres has already concentrically contracted (shortened and provided force to pronate through release). When the forearm is positioned in pronation following a forceful contraction of the pronator teres, the opposing side of the arm will become active eccentrically - i.e. the the Supinator and wrist extensors.

The anterior shoulder is not actively decelerating anything here. The joint structures and passive stabilizers (ligaments, capsule, articulating surfaces etc.) are assisting in deceleration, but the muscles are not.

As for being able to identify the "acromial line", unless a pitcher’s shirt is off, good luck finding that. The acromial line is determined by the position of the Scapula, which is not visible because it is hidden by the jersey. While Boddy is correct that people have "different types" of acromion processes, there is no way of us knowing from this picture, or any other picture. Only x-rays and physical exam could show us that.

In summary, I really do like the format of his article, the video, and the frame-by-frame looks that he provides. The anatomical references and understanding of what is going on in the body is clearly the thing that lacks here. That being said, I like Kyle Boddy’s efforts, his dedication to baseball, and I will continue to read his articles. The video that he provides will prove beneficial to those who want to see a glimpse of what is going on with each respective pitcher, in general.

Neshek Done for the Year

Well, there is our answer - the one that I pretty much expected. Pat Neshek has been diagnosed with a partial tear of the right Ulnar Collateral Ligament (UCL), and will miss the remainder of the season. He will not be allowed to pitch for at least 3 months. Should all the rest and healing not be enough, surgery might be the only answer.

He had felt a "pop" on the inner aspect of his right elbow while throwing a slider in Thursday’s appearance. The MRI results revealed the presence of the tear - effectively ending his season. The picture at left shows his delivery, with the extreme "gapping", or "valgus" of his medial elbow. Valgus force places stress on the medial elbow and UCL, which, coincidentally, restrains excessive valgus force.

Neshek Hears Pop - Elbow to be Examined Further

Pat Neshek, Minnesota’s setup man - as well as one of MLB’s few who write their own blog - suffered a right "elbow strain" during yesterday’s afternoon’s appearance. According to Rotoworld, he apparently winced following one of his pitches - clearly not a good sign, especially if it was the pitch that he heard a "pop" with. The pitch was reportedly a slider.

The immediate reaction is to think that he tore a ligament in his elbow. This is a likely scenario, however, the Twins will wait until further examination of his elbow has occurred before they reveal the more definitive diagnosis. It sure sounds like a ligament, though I hope I am wrong.

Said Neshek, "I felt something tweak…It kind of rolled over real quick like a snap. I’ll get it checked out [Friday] morning and make sure nothing happened."

Other structures in the body can create a "pop" when injured, such as grade 3 muscle tears, avulsion of the tendon/bone attachment, or benign injuries such as a joint merely "cracking".

We should have a more definitive diagnosis by today or tomorrow. The fantasy implications are primarily for those who use Neshek for holds, or for those who own Joe Nathan and have Neshek for a backup plan.

You might think that Juan Rincon would be next in line for holds, or for the backup closer’s job if Nathan were to get hurt, but the Twins have been relying on lesser-known Matt Guerrier lately. This is ill-advised, in my opinion. I would prefer to add Juan Rincon if I had to choose, because he is more suited for strikeouts, and Guerrier has always had the propensity to allow more walks. Rincon has the track record of a low ERA and low WHIP, though 2007 was his worst season ever.

If you need holds, and want to add Neshek’s replacement, I would go with Rincon. Or, you could simply add a relief pitcher from another squad entirely who is throwing well right now. Might I suggest:

Ramon Ramirez/Leo Nunez (KC), Alan Embree/Santiago Casilla (OAK), Kyle McClellan (STL), or Dan Wheeler (TB). Chances are, Casilla is already owned, but the others should be available in many leagues.

Not Worth The Wait

We, as a collective fantasy baseball nation, are usually eager to activate or to add players who are just coming off the DL. There are some instances, however, where we are better off leaving these players on the wire, or simply cutting bait altogether. For example, after the ‘07 season, I vowed to myself that no matter how strong the urge was to draft Rich Harden, that I just couldn’t go back down that road. Here are a few players who are on the mend, but will likely disappoint upon their eventual return:

Curt Schilling, SP, Boston: As a Boston fan, let me first say this: I appreciate everything that he did for this franchise, and without him, we would not have won the ‘04 series. A bit ornery at times, but you always know you’re going to get his true thoughts when he speaks - and that has to be admired. When he retires at the end of 2008 (more than likely), he will be one of the most successful postseason pitchers in history. But all good things must come to an end.

I truly am hoping for a positive contribution from Schilling this season, but it won’t be on my fantasy team. No matter how much he rehabilitates and tries to strengthen his shoulder, I truly feel that he will be a non-factor going forward, simply based on the preliminary reports of how damaged his shoulder was. If multiple Doctors are convinced that surgery is the route to go, chances are, it is. Sure, he might make it back in the second half, but ultimately, you are better off going with a younger, healthier player off the free agent list. Like a Jair Jurrjens.

Rafael Soriano, RP, Atlanta: Combine his seemingly weekly bout of elbow soreness/pain/inflammation with his long history of right medial elbow pain, as well as Tommy John surgery - this is a pitcher to avoid at all costs. Add in the fact that John Smoltz will likely be the closer when he has returned from the DL, and there is really no need to own him, unless your league counts holds. Even then, expect him to land on the DL again (at least once) by the end of the season.

Rich Harden, SP, Oakland: When healthy, he has been one of the most dominant pitchers of the past four years. His inability to stay on the field for any meaningful length of time has been his only barricade to being one of the elite, frontline aces in all of MLB. He seems to do well with prolonged periods of rest on the DL, only to return for a short period of time before flaming out with some form of muscular injury. Knowing this, it is beyond my comprehension as to why the A’s haven’t decided to move him into a short relief role, or perhaps even a closer’s role. This way, he would be afforded ample rest, and would not have to struggle through the sheer volume of pitches that a starter must endure.

Huston Street certainly has not been a model of good health, either, and would be an easier piece to move in a potential trade - opening the door for either Santiago Casilla or Rich Harden. Ultimately, a trade to a team with a need for a closer or relief help would make most sense, with Casilla taking over as the closer in Oakland. As long as Harden is a starter, he is not worth the heartache - you know he’ll only last a few starts before having some form of shoulder soreness or pain. Why bother?

Gary Sheffield, DH/OF, Detroit: All signs point to Sheffield’s shoulder being not quite right. He has had multiple Cortisone injections in the shoulder over the recent weeks - a sign that his shoulder was inflamed to a significant degree. Sheffield’s recent comments about how his shoulder remains stiff, and how he does not have full range of motion following his offseason surgery, are reasons for concern as well.

From a clinical standpoint, I wonder if he has some capsular restriction due to arthrofibrosis, where the scar tissue in the shoulder builds and builds, to the point where the shoulder gets bound down. This creates a situation where the shoulder does not move freely, and can produce a painful pinching in the shoulder. In these cases, the Doctors will usually administer a series of Cortisone injections in an attempt to reduce the inflammation so that the therapy can have a chance to loosen the stiff shoulder. When this does not prove effective, a manipulation under anesthesia, or another surgery (lysis) usually does the trick. At his age (39), I am avoiding this situation completely - especially since he is hitting a robust .176 with a .294 SLG and .640 OPS.

10 Tips for When Injuries Strike

Whenever a player on your fantasy team gets hurt, some of the things that first run through your mind are, "*!*#^!", followed by a feeling of concern, panic, or frustration. Just think how the player feels!

Injuries are the big equalizer in fantasy sports. While more significant in football than baseball, due to the smaller player pool, injuries can derail your promising season before it starts. All that pre-draft preparation? Useless. A first place team can slide down the standings in no time at all due to injuries. Just ask a manager who owns Troy Tulowitzki and Yovani Gallardo. Or Scott Kazmir and John Lackey.

Even relatively minor injuries can put a huge wrench in the works. Example: A-Rod and his Quad injury.

I receive a lot of emails from panicking managers who feel that their season is over. It is not over. There is always a solution to your problem.

Here is a list of some important things to know/do when dealing with player injuries on your roster. This list is not all-inclusive, but are just some of the things that I think about when making roster decisions:

1. Understand the nature of the injury, it’s severity, and how it will affect the player in the short-term and perhaps the long-term. If you do not understand the basics of the injury, you cannot make an informed decision on roster moves. Rotoworld is a great source for timely information. You can then head on over to the Disabled List Informer for the more in-depth analysis from a medical perspective. You can always email me, and I will get back to you.

2. Know who you’re dealing with. If the injury in question is to a player like Rich Harden, Moises Alou, or Chipper Jones, then you pretty much face the reality that a DL stint is imminent. If it is someone who is typically more durable, like a Jimmy Rollins (I know, I know - but this was a really bad ankle sprain) or Jeff Francoeur, then you can treat relatively minor injuries with less caution.

3. Know your depth charts. Know them before the injury occurs. Time is of the essence. On many occasions recently, readers have written to me and said, "I was too late adding Jon Rauch after Cordero got hurt", or "Someone beat me to Manny Acosta." If you do not know the depth charts ahead of time, you are wasting time - and someone will likely be looking for the replacement as well. This is particularly important when dealing with closers and their setup men, as well as when a veteran player gets injured and his replacement is a young, promising prospect. Some managers in your league are out to simply prevent you from adding them.

4. That being said, never add someone’s backup, just for the sake of adding the backup. Unless it is a closer, and you really need saves, or unless it is the prospect you just cannot live without. Hasty roster moves almost never work out. Understand who you are adding, why you are adding them, and how long you can expect to have them on your roster.

5. Thoroughly understand the value that the injured player brings to your team. Then, see if you can do a solid job replacing that lost value with players on your bench. If not, narrow the list of free agents who can do a similar job across as many categories as possible. I like to limit the list to between 3-5 players. Any more than that, and you are going to be pulling your hair out. Unfortunately, I’ve lost much of mine already at the age of 29.

6. Have a bench that already addresses potential injuries. You might have the healthiest team in history, but injuries can happen to anyone. I like to fortify my bench with some multi-position players because I am in a transaction limit league, where the roster flexibility is a huge plus. I also try to evenly split my bench allocation between pitchers and hitters, though I tend to lean pitcher-heavy due to the increased likelihood of a pitcher being injured as opposed to a position player.

7. Find bench position players who get on base, and who contribute across the board. A guy like Ty Wigginton, though not a household name, is a good bench player who can play many positions and also is a steady producer. He won’t blow anyone away, but he will hit .280, get on base, and hit some long balls for you. He also does not strike out a lot. For pitchers, you always want a solid WHIP, regardless of SP or RP. The production will follow. I don’t mind taking good pitchers on bad teams, if they have a decent WHIP. A guy like Jeremy Guthrie, Justin Duchscherer, or Jair Jurrjens sounds good to me.

8. Know your league settings. If you have a yearly transaction limit like I do in two of my leagues (to prevent streaming), you need to be more judicious with your moves. If you have unlimited add/drops, then you do not have to worry as much about making "the wrong move."

9. When someone gets injured on another team, watch and see who they drop. If the injured player is a solid player and the injury is minor, keep mum on the message board and pounce on the opportunity. The same is true for when a team takes the DL tag off a player and has to drop someone from their roster. I find this to be a prime time to find bargains. Sometimes the player will slip through the cracks and make it to the free agent list. Ah yes, the art of the free agent/waiver list - this is where leagues are won and lost, without question.

10. Don’t worry. The other managers in your league will have injuries, too. Occasionally, you’ll get the lucky manager who goes the whole season without a single injury to his squad - but that likely has been you at one point or another. Also, stay positive, and be diligent when scouring the wire. There is always a hidden gem out there on the free agent list. Always. I have won a ton of leagues simply because of my ability to find players who nobody else cared to own for one reason or another.
These are just a few of the guidelines that I use. Use these in adjunct to your current thought processes, and you will be better equipped to handle injuries as they happen, or before they happen.

Reader Poll Results

I would like to thank all of the loyal readers who continue to fill my email’s inbox with questions, comments, and words of praise. And the occasional critiques as well. It’s all good, and I thank you for your interest and for spreading the word!

A while back, I posted a poll over at the old Blogspot site in an attempt to gauge what you guys really wanted to see on the site. After a week, and well over 100 votes (don’t recall the exact number), I wanted to review the results and let you know what will be upcoming on the site:

74% of you loved the site the way it was, and wanted the same information to keep coming.

50% wanted individual "Player Health Spotlights", and I plan to start writing some of these up in the coming weeks. You can check out The Hardball Times for a spotlight on Ben Sheets that I wrote with David Gassko and Dan Loeterman.

Many of you wanted to see articles breaking down the actual injuries, as well as content as it relates to the pertinent anatomy. I am in the process of writing an article regarding the infamous Biceps strain/tendonitis/tear/insert descriptor.

There were also a large number of readers who suggested columns on waiver add/drops, which I just started recently. These will be continually provided throughout the summer.

A good number of you also showed interest in having a draft guide that was injury-based, as well as draft tips for 2009. This will be a daunting task, but I am starting to look at a possible framework for this.

Other topics/ideas that were less desired (but I will still be providing them): stat-based articles, links to health sites, and injury/health research.

I truly appreciate the time you all took to thoughtfully complete the poll, as it gave me some excellent feedback as to what exactly you guys want to read.

~ Chris

Figgins Avoids the DL

For fantasy managers who rely solely upon Chone Figgins for steals, good news this morning : he will not need to spend time on the DL. The MRI results showed only a slight strain of his right hamstrings, and is likely day-to-day. He was already feeling better as of Sunday. Keep and eye on his status just before game time to see if he is in the lineup.

Injury Fallout: Lesser Know Pitchers That Can Help Your Squad

The huge news du jour is that Yovani Gallardo is likely shelved for the season with a right ACL tear, but there has been an onslaught of injury news this week - honestly, too much for me to keep up with on a daily basis. My patients need me in the clinic!

Here are some free agent/waiver tips to help you sort through the mess:

For Those Who Need Pitching

Jo-Jo Reyes, SP, ATL : With the news that John Smoltz is parking his butt in the bullpen upon return from the DL, the Braves have called up Reyes to join the rotation. Relatively unknown, he could provide nice K totals. In 2007, he made a total of 19 minor league starts (AA/AAA) and had a sparkling 12-1 record with a 2.72 ERA. The 110 K’s in 109.1 innings is what has most fantasy managers thinking, "Oliver Perez with some form of control"???? NL-only should grab him, mixed leaguers should wait and see.

Jair Jurrjens, SP, ATL: He has pitched very well this season, garnering praise from his teammates and coaching staff. With a 1.04 WHIP, and a 3-2 record, he is worth taking a flier on in most leagues right now. He has pitched well, and won, against the Mets and Dodgers, and also has an 8 K game to his credit. The walk totals are a little high, but not atrocious. He is currently owned by me in two leagues, and I suggest you do the same, at least for the short term.

Jeremy Guthrie, SP, BAL: I know, he pitches for Baltimore, but he has decent ratios and did have a successful ‘07 season. Opponents are only batting .244 against him this year, and .249 against him last season. His WHIP stands at 1.24, which is respectable.

Chad Gaudin, SP, OAK: He has had control issues in the past, but this season seems a bit different. He has gone 6.0 or more innings in all but his first start, and his walk totals are down. He has 23 K’s and only 8 walks in 30.0 IP. After spending most of his career as a relief pitcher, perhaps Gaudin has found his calling late in his career. With a 3.00 ERA and 1.10 WHIP, as well as a .223 BAA, you could do worse.

Dave Bush, SP, MIL: He has shown in the past that he can be a reliable starter in this league. With a career line of 4.60 ERA, 1.27 WHIP, and .269 BAA, he sounds like more of an NL-only candidate, but deep mixed leagues could also take a chance on him. He plays for a team that scores runs, so the wins could be there if he performs admirably. In one start at AAA Nashville, he pitched 6 innings and allowed only 1 ER.

Luis Ayala, RP, WAS: He is now the setup man for Jon Rauch while Chad Cordero attempts a comeback from his shoulder maladies. Ayala has always been a solid ratio producer in the past, with a low ERA, low WHIP, and he will be good for holds if you count ‘em. He is perhaps one of the safest relief pitchers to own - hence why my buddy, Les owns him seemingly every season.

Ramon Ramirez, RP, KC: If you missed out on Jon Rauch, chances are there are no closers left on your free agent list. This is when you need to either a) speculate on a setup man that could snag the closers role, or b) add the best available setup man regardless. Ramon Ramirez has been stellar for the Royals, racking up 15 K’s in 12.0 innings pitched, while walking only 3. With an ERA of 0.71 and a WHIP of 1.03, he is providing a nice late-inning bridge to Joakim Soria. If Soria were to get injured, Ramirez would likely be next in line. In leagues that count holds, he is a gold mine right now.

Gallardo’s 2008 Season Likely Finished

In what is likely a devastating blow to many fantasy rosters - as well as to the Brewers - Yovani Gallardo has a torn right ACL and may require season-ending surgical reconstruction of the ligament. He is now on the 15-day DL and the Brewers are hoping that once the swelling subsides, they can make a better determination as to whether or not he needs surgery. The ACL prevents hyperextension of the knee (anterior translation of the Tibia on the Femur). If he has surgery, he will be back well ahead of time for the beginning of Spring Training in 2009.

The fact that the knee became quite swollen right away leads me to believe that this tear might be of serious, surgery-warranting nature - but you never know. He was placed on the 15-day DL right away, which is never a good sign either. In addition, the manager’s comments were quite telling:

"The doctor stated that going out there to pitch didn’t do any further damage," Melvin said. "It was torn at the time, and he was able to battle his way through it."

This is basically saying the ligament was already pretty damaged, and that no more damage could have happened. If it was a more of a minor, partial tear, there is no way the Doctor would have said this. Even a slight misstep or having to run and stop suddenly could have made the ligament tear further.

You should know, if surgery is needed, a player can begin jogging usually at 12 to 16 weeks post-op, with return to sports at 6 months being typical. Occasionally, the rehab process can take longer than this.

Let us cross our fingers and hope that this is something that does not warrant surgery. The initial impression, however, is not too good.

Fantasy Implications:

Now that Gallardo is placed on the 15-day DL, feel free to reserve him and cross your fingers that he will not need surgery. For those looking for pitching help, you might be able to land Max Scherzer (doubt it), Micah Owings, Andy Sonnanstine, or Jair Jurrjens. Or you could wait for Clayton Kershaw to be called up later this season.