Under The Knife: Burnett finds bad hop, Mets find more bad luck
Pirates will be conservative in bringing A.J. Burnett back from broken orbital bone
Johan Santana has looked good in workouts and will pitch in games this week
Carl Crawford's return from post-surgery swollen wrist by Opening Day is risky
I hope you've already read the Team Health Reports. All 30 teams are available -- for free! -- here at SI, but in the explanation, I mention that it was the 10th annual version of them. That means this is the 11th season of Under The Knife, my look at the injuries around baseball. It's the second season here at SI and it's added so much to be able to be here at this august brand. My hope is that this column will continue to improve each time out. I do my best to dig up and then analyze how injuries will affect both the team you follow and the team you create.
Injuries are one thing that affects fantasy baseball in the exact same way as real baseball. The difference is that an injury to a fantasy team can be filled quickly. A real team can see a whole season or even years of planning go up in smoke. The difference between success and failure is often a couple of guys, athletic trainers who spend 18-hour days using everything from ice and tape to lasers and underwater treadmills to keep players healthy. Never forget that what you don't see in baseball is as important as what you do see. I just try to bring a little of that to the surface, acting as your fantasy team's medical staff. Thanks for joining me for another season. Powered by Sun King Brewing, on to the injuries:
(Quick note: those players without an Expected Return Date, or ERD for short, are not expected to miss any regular season games.)
Traumatic injuries can't be helped. It's in the definition. Things happen in baseball that can't be predicted, like a bunt popping up into the face of the ace pitcher, breaking the orbital bone. Burnett had that happen and had to have surgery to fixate the bone. It was worse than just a "simple" break, requiring pins and wires. Why all this for a broken bone? The orbital holds the eyeball in place, providing both protection and stability for something we all need desperately yet take for granted. It's the stability that's the worry for Burnett. Once the bone is healed and can hold the eye in place, he'll be able to come back quickly. The estimate is that he'll miss 8-12 weeks, but the Pirates tend to be very conservative. They do have a new medical staff, so it's tougher to read this. Burnett will need to go through a "full progression," according to GM Neal Huntington, so the conservatism is in play there as well. How Burnett is able to keep his arm in condition will be key to his return. I don't expect him to be ready for Opening Day, which means he could be visiting me in Indianapolis by mid-April.
Valley Fever? It sounds like the Mets have gotten another dose of that ancient Mayan curse that has plagued them since 2008. The Mets have had a run of luck -- yes, luck -- that has been ridiculous. I say luck because there's no pattern, a bunch of trauma, and a number of singular and unusual injuries. Still, "luck" is a bit of a cop-out; there are things that can be minimized and the work the team is doing to try to identify those factors seems to have some effect.
But it's this kind of thing, a possible fungal infection that can be debilitating or even deadly, that works against the Mets medical staff. Davis may have been exposed to the fungus while spending the offseason in his Phoenix home. It's not something that should count against the medical staff, but if Davis misses time, it will. Valley Fever is a serious thing, and while Davis' doctors await blood work to come back for confirmation, they'll treat him as if he has the condition. It's seldom deadly, but recently Conor Jackson lost nearly an entire season as he fought the condition. Davis is symptom free for now, so the hope is he either doesn't have the fungus in his system or that he's fighting it off well. He'll be placed on antifungal medication and watched closely. Davis is already a bit risky coming back from his lingering foot injury, so this shouldn't downgrade him on your draft board.
One side effect of the Mets' bad luck is that they have to treat everything like it's a worst-case scenario. That's how their fans react anyway. Wright had a minor pain in his side, the first small sign of an oblique strain, and they were forced to shut him down. I'm not saying this is overreacting. It's smart, but conservative to the nth degree. Wright will miss a couple of days, get back in, and shouldn't have much concern with this. The worry should start if this recurs in the next few weeks, something that would necessitate a longer shutdown. Then again, this time of the year doesn't count, aside from getting work in, something that players can do in a number of ways. Losing spring training days is much cheaper and shows less of an effect than DL days and dollars lost.
The Mets need some good news, so here's some great news. Santana pitched. OK, that's not great, but that he pitched again is great. The key for Santana this spring has been recovery -- coming back from throwing. It was what gave him setback after setback last season as he worked to come back from a serious shoulder injury.* Santana has been up on a mound, throwing at near 100 percent and using all of his pitches, though he has been limited on how much he's using his breaking pitches, not an uncommon limitation at this stage of spring training. He's had no issues doing his side work or making his next workout. Santana is expected to start pitching in games this week, and if he makes it through a couple of outings with no issues, then we'll have to start looking at his stuff. Santana will remain risky, but the patient recovery seems to be working right now. He may only be a fantasy bargain for another week or so.
* I always debate whether I should say "serious shoulder injury" or explain the details, such as "surgery to repair a tear in his anterior capsule." I even think about going technical, with a "comeback from his open anterior capsulorraphy." What works best for the most people is my goal. I think I'll go with the broad "shoulder injury" when we're this far out, explaining the technical details at the time of the surgery. Let me know what you think.
The Achilles is fine. That's the good news. The downside with Howard is that he has an infection in the incision made to replace his torn Achilles. The doctors are watching it closely to make sure that the infection is controlled and removed. Infections are serious business. Face it, locker rooms and the players in there aren't inherently clean. Try as they might, clubbies are fighting a losing battle when it comes to shared facilities. MRSA is a serious, even fatal infection that thrives in that kind of environment. Howard won't be able to do much as they fight the infection, which sets him back slightly. That said, he was ahead of schedule for this unusual-to-baseball injury. Once he's back, he'll be typical Ryan Howard.
Think infections aren't serious? Think something simple like a cortisone injection can't go wrong? Ask Litsch, who had to undergo emergency surgery to clean out his shoulder after an injection led to an infection, which compromised his surgically repaired labrum. It's a bad chain of events that's going to make it tough for Litsch to stay with the Jays. His spring training is over and this could go into April before he's allowed to start throwing again, depending on how much they had to do inside his shoulder and how deep the infection was. Litsch will be fine long term in medical terms -- which means he'll keep his arm and live a normal life. Baseball terms remain to be seen, but his already high risk level is way up.
Crawford has some residual swelling in his surgically repaired wrist, not an uncommon issue at this stage of his recovery. Looking at the recovery of the perfect comp -- Rickie Weeks of the Brewers -- this was to be expected. The key will be minimizing the swelling and figuring out what's causing continued irritation inside the wrist. Crawford will rest for a week, but will keep up with his rehab work. Weeks' recovery came in fits and starts, but he's been healthy and productive since. (Last year's ankle injuries held down Weeks' raw numbers, but that had nothing to do with his wrist history.) Crawford is iffy at best for Opening Day, but he shouldn't miss a lot of time. It does give Bobby Valentine time to take a look at the depth in the OF, especially with J.D. Drew "retired." The worry point for the Sox will be if Crawford isn't swinging a bat mid-month.
The Braves started camp a couple notches to the negative side, but the medical staff is starting to right the ship a bit. Freeman had a mild dislocation of his kneecap early in camp. The problem self-reduced ("popped back in") but there was swelling and pain, plus a worry it could recur. It seems a onetime trauma, but the knee will be watched closely. It's unclear if Freeman is wearing any kind of sleeve or brace, but that would be common at this stage. Freeman's mobility isn't a strong suit, but he does have quick hands and feet. "He looks awkward," a scout told me, "but you never really see him out of position."
The situation with Hanson is even more uncontrollable. While he's coming back from a rotator cuff strain that did not require surgery, Hanson's current issue is recovering from a car accident that caused a concussion. The Braves were already being careful with him, so this has set things back. With their depth, the Braves can afford to go slow with him, to the point where Hanson might not need to open the season in the rotation. I'm told the Braves will "let Hanson come to [them]," which sounds smart.
Grady Sizemore had to have a microdiscectomy on his lower back and will miss at least the first month of the season. You'd be right to think this could go longer than that. If you've heard this term before, it's what Peyton Manning has been dealing with for the last year, albeit at a different location ... Josh Johnson looked solid in his first spring outing. He hit 93 on the gun, which is solid for this point in his spring. His shoulder is still a major concern for me and I'll be watching his next few outings for any sign of a descending recovery ... Stephen Drew is unlikely to be ready for Opening Day after his nasty ankle injury last season. The signs are positive that he will be back and able to play SS sometime early this season ... Speaking of ankle injuries, Buster Posey has been solid early in camp for the Giants, but he's yet to play in a game (as of Monday). They expect him in soon, though they'll be very conservative with him. Look for them to give him some looks in other spots and even at DH during camp ... While everything has been positive so far in '12 for Justin Morneau, it doesn't seem like he's very confident in things staying that way. Last year, the Twins brought in Jim Thome to keep the negative nabobs out of Morneau's head. Not sure who has the job this season, but it's not working ... Mike Napoli is doing things a bit backward. He's catching, but not running or sliding, which tells us the Rangers are more worried about stopping than starting. He's got time to get it ready for the season and the slow tack seems to be working well ... It's never good to have your new closer visit the doctor so soon, but the Reds don't seem too worried about Ryan Madson. His elbow is "irritated" ... Joba Chamberlain is entering the last phase of his Tommy John rehab. He'll be checked out by Dr. James Andrews before letting it fly. He's on track for a May-June return, depending on how conservative the Yankees are with him ... Dellin Betances' control problems are the kind of thing that might make one think about an elbow issue. Problem is, he's two years post-ligament reconstruction, a time that normally is safe from re-injury. The Yankees are going to have to help him find his release point and quick ... Jesus Montero wants to prove he's a catcher, but after taking two hard fouls off his head, the Mariners might want to think how much they want to let him prove it. He's out on Monday and they'll watch him for signs of concussion ... Corey Hart will have his knee scoped to fix a meniscus tear. He'll miss about a month, meaning he could start the season on the DL ... The Brewers are also a bit worried about Shaun Marcum. He's a notorious slow starter, but he's "definitely behind" the others, according to multiple reports. His sore shoulder will need to clear up soon to make the P3 slot he's expected to hold, though the schedule usually makes the first few weeks an ideal time to be down a starter ... Daric Barton will need another cortisone shot in his shoulder. For what it's worth, "cortisone shot" is becoming a generic term, with less and less doctors using the acidic cortisone. Most are shifting to other anti-inflammatories, or even toradol, a painkiller often used in the NFL ... Daisuke Matsuzaka is looking good in his rehab. According to Nick Cafardo, he's throwing at full velocity and using his secondary pitches. The Sox want him to use his full arsenal, something he didn't have under John Farrell or Curt Young. He's due back in late May ... UTK will run weekly through spring training, with special updates as necessary.
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