Posted: Wednesday July 18, 2012 4:57PM ; Updated: Wednesday July 18, 2012 4:57PM
Will Carroll
Will Carroll>FANTASY BASEBALL INJURY REPORT

Under The Knife: Loss of Votto to test Reds depth, medical staff

Story Highlights

Formula finds loss of Joey Votto could cost Reds at least one win in his absenc

Wrist injuries hurt power, which could hurt Jose Bautista' production upon return

Ryan Braun's strained thigh is the latest in a string of leg injuries this season

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The loss of Joey Votto's 14 home runs, 49 RBI and .342 average will test the Reds' offensive depth over the next month.
The loss of Joey Votto's 14 home runs, 49 RBI and .342 average will test the Reds' offensive depth over the next month.

People ask why I cover injuries. The answer was initially because no one else did, but it's also in my genes. I see injuries and see it in terms of runs, wins and dollars, which are the basis for everything in baseball. The draft doesn't bring in as much talent each year as injuries take away. The draft doesn't cost as much, especially with new spending constraints, as injuries cost team in losses. In this era of parity, a win or even a fraction of a win can be the difference between a flag that flies forever and adding to a legacy of frustration. Fantasy players are the same, throwing up their hands as they lose yet another star they bid for or got in a high round. Injuries aren't everything in baseball, but they're a big part of it. Watch over the next few days about how many column inches are devoted to injuries by your favorite beat writers or how many times the announcer for your team talks about sprains, strains, and surgeries. That's why I do this and why I'm working to make everyone recognize that we can do better.

Powered by a need for rain here in Indy, on to the injuries:

Joey Votto, Reds (torn meniscus, 8/20)

If you're one of those people that buys the argument that Peyton Manning was the Most Valuable Player last year, based on the idea that the Colts completely collapsed in his absence, then the Votto injury is going to give you another chance to make your case. According to Tom Verducci, Votto has been responsible for almost a quarter of the Reds run production this season, and in a pitched battle for the division, that lost production could be the difference. I used to utilize a stat called MLVr that helped find a run value per game that could be used to help calculate just how much of a loss it would be. That stat isn't available anymore, but Tom Tango was kind enough to work through the problem for me. His calculations ended up with roughly a 1.2-game loss for the Reds, assuming that Votto can come back on the short end. (It also assumes that Todd Frazier won't have three strikeouts per game.) Votto's injury is a simple one, a meniscus tear that he tried to play through and couldn't. It's identical in function and location to what Giancarlo Stanton is dealing with. All this means that the Reds doctor and rehab staff becomes an MVP candidate the quicker they can get Votto back. Every game lost could be the difference between winning the division and playing golf in October.

Jose Bautista, Blue Jays (strained wrist, 8/7)

An X-ray showing no fractures in Bautista's wrist isn't necessarily good news. Soft tissue injuries can be just as bad, even worse in some cases. Injuries to ligaments, tendons, and especially to the small cartilage bundles inside the anatomical wrist can be as painful and more difficult to deal with than a "simple" fracture. Bautista had an MRI on Tuesday which should provide some more clarity on what is actually wrong rather than what isn't wrong. The acute nature of the injury is troubling; more soft tissue injuries come on insidiously. The Jays appear to think this is a tendon issue. They'll work on removing the inflammation before trying to figure out how to keep this from happening again. Wrist injuries often cost power, so it will affect Bautista more than most. Even once he returns, we'll need to watch to see when the power comes back. That return is unclear, but a reasonable expectation would be about three-to-four weeks.

Ryan Braun, Brewers (strained thigh, TBD)

Ready for one more big name to get injured? (Yes, injuries are up this season, but the number of injuries to star players is up way more. I have no idea whether that is random, but it seems random.) Braun left Tuesday's game in the seventh with a thigh strain, as reported by the announcers. This comes on the heels of a right Achilles problem, a right groin strain and a right hip strain, so the fact that it's his right thigh shouldn't surprise anyone that understands the concept of cascade injuries. Braun was in apparent pain, so I'll be following this one closely. The loss of Braun for any extended period of time would be devastating to the Brewers' 14 percent chance at the playoffs.

David Ortiz, Red Sox (strained Achilles, 7/31)

Dustin Pedroia, Red Sox (strained thumb, 7/19)

Carl Crawford, Red Sox

Are we back to curses? Ortiz said the "C" word after leaving Monday's game with an Achilles injury. Ortiz's injury is somewhat reminiscent of Ryan Howard's, though it clearly wasn't as devastating. Achilles strains are normally caused by putting too much pressure on the Achilles through dorsiflexion, where the toes go up. Many don't see where that kind of motion happens in baseball, but it's pretty easy to see. A power hitter who's got significant weight loading up one leg in dorsiflexion is pretty much a prescription for an Achilles injury, though the tendon is well-suited for this kind of pressure. While reports say there was "no rupture or tear," the injury is a strain, which is, by definition, a tearing of the tendon fibers. Every tear is not complete (a rupture), but every strain is a tear. Ortiz's mild strain shouldn't keep him out long, perhaps a week. The Sox will make a decision on the DL in a couple days after seeing how the leg responds to treatment and rest, but with him in a walking boot and saying he's "in a lot of pain," the DL seems likely.

The Sox did get Crawford back. His elbow is still problematic and could need Tommy John surgery eventually -- perhaps as soon as the offseason -- but in the meantime he should be able to play. There's going to be a difficult time separating his true level of play from the injury's effects. The problem is mostly going to bother him in the field, so the Sox will have to focus on minimizing those effects and making sure that he stays productive for as long as possible. The early results are positive.

Wrapping up with the Red Sox, Bobby Valentine said he thinks Pedroia will be activated on Thursday. Pedroia's been pushing and his results in batting practice have been pretty solid. The rest seems to have done his thumb good. With Ortiz out and Crawford and Ellsbury back, Pedroia might find himself further down in the lineup as the Sox try to make a playoff push. Keeping Pedroia and the rest of the Bloody Sox healthy is going to be the deciding factor in whether it even has a chance.

Andy Pettitte, Yankees (fractured leg, 8/20)

Mariano Rivera, Yankees (sprained knee, DFS)

Know what you call a fracture that's healed about 50 percent? A fracture. The bone -- in this case, Pettitte's fibula -- is not yet healed. It's making progress and that's good, but this only helps with the timeline. Pettitte's leg is making the normal progress, which is, well, normal. He'll begin putting more weight on it, ramping up his activity, but it's going to be the function which will determine his return. It's that same function that will determine whether Rivera will pitch this year. It's possible that he could return. Let's face it, Rivera has never been normal, so why treat him like he is? The question is whether the knee will be sufficiently healed to pitch without a bulky brace. Even a small brace is going to alter his mechanics in subtle ways, which could put more pressure on that golden arm. I don't think the normal rules apply here, so there's no reason to think that if Rivera can't pitch in regular season games that he wouldn't be considered for a deeper playoff series. Once Rivera starts running, we'll have a much better signal on the timeline for his return. We're going to have to see that in the next 30 days for there to be any hope. I'm keeping his ERD as done for the season ... for now.

Chad Billingsley, Dodgers (elbow inflammation, TBD)

The Dodgers put Billingsley on the DL with the vague "elbow inflammation." The Dodgers starter had not one but two MRIs that showed inflammation but no structural damage. The problem is that inflammation doesn't just happen. It's a symptom, not a cause. What that underlying cause might be isn't known here, but we'll assume that the Dodgers have a better idea. That Billingsley was immediately cleared to throw is definitely a positive sign and an indication that his stay could be close to the minimum. The downside is that this could recur, and depending on what that underlying cause is, it could recur quickly. Many had speculated that any significant time lost would force Ned Colletti to make a deal for pitching, but they can probably get by if they want to.

Quick Cuts

Roy Halladay went five innings and 80 pitches, coming out of the game at about the top of where people expected. He wasn't bad, but he did get hit a bit. His arm slot looked a bit lower than normal, though I couldn't get PitchF/X confirmation by deadline. With six strikeouts and no walks, even a slot change would seem a minor issue for those kinds of results ... Matt Holliday left Tuesday's game after taking a pitch to his thigh. He'll likely miss a couple games ... Thankfully, I don't have to say "shock treatment" too many times in this column. Chris Nelson needed that to get his heart on the right rhythm. He'll miss an indeterminant amount of time as he recovers, but the amazing thing is he'll be back at all ... Brandon Morrow was shifted to the 60-day DL in order to get Anthony Gose up to replace Jose Bautista. He was expected to be back well before the 60-day mark ... Neftali Feliz went a solid two innings in his first rehab work. It's still unclear how the Rangers will use him once he's back, but they could use much of the 30 day rehab period to make that decision ... Brett Gardner had yet another scan on his elbow after yet another setback at the same point in his rehab where he's had issues before. I expect the Yankees will have to have a surgeon look inside his elbow at this stage ... Jonathan Lucroy is very close to going on a rehab assignment. It could be a short one if his swing comes back quickly ... Jaime Garcia was shifted to the 60-day DL, but he wasn't expected back before he passes that mark anyway ... Hector Sanchez sprained his knee. If he hits the DL, the Giants are going to really have to shuffle things. It could get so desperate that Bruce Bochy might have to play Brandon Belt ... Matt Capps is headed back to the DL with shoulder inflammation ... Juan Nicasio came back from a broken neck. Minor knee surgery won't be much of a challenge. The Rockies could have him back before the season ends, but they're choosing to shut him down ... I guess Pete Rose has given up on the idea of ever getting into Cooperstown ... Jed Lowrie will miss at least a month with his leg issues. The biggest issue is with a nerve ... Jason Castro will have his knee drained Wednesday. How he responds to that will determine the course of his season ... Vernon Wells will start his rehab assignment on Friday. That starts the clock on his return. Sources tell me the Angels aren't sure how they'll juggle their roster yet, but that they will not cut Wells at this time ... Joe Wieland will have Tommy John after a setback in rehab. Still, can we stop saying 12-16 month recovery for a surgery that should be quoted at 10-12? ... Anything's possible with Zack Greinke, but this "recharging batteries" thing is not the Brewers covering up an injury.

 
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