Late-spring injury update: Hitters
Editor's note: In February, Stephania checked in with updates and explanation of the key injuries in her position-by-position preseason roundup; now she's back with late-preseason updates on a handful of those players -- original text in italics -- as well as updates on players who got hurt this spring. Here are the hitter updates; pitchers to follow later this week. You can see the original Feb. injury roundup of each position by clicking on the position headers.
Buster Posey, San Francisco Giants. From Feb. 16: The image of Posey getting drilled at the plate with his leg twisted underneath him last year is etched into the minds of those who saw the injury happen (or one of the seemingly infinite replays that followed). In fact, Posey's injury was so dramatic it sparked philosophical discussion throughout the sport about whether catchers should invite or avoid collision as part of their job duties (most fantasy owners would universally scream "Avoid!"). Now imagine having to come back to the scene of the accident, as Posey will have to do, to return to your job. Posey must not think about how his leg and ankle were rearranged last time he was behind the plate, just one component of his lengthy rehabilitation, albeit perhaps one of the most difficult. As far as the physical rehab following his injury, Posey has steadily remained ahead of schedule, impressing the Giants' medical staff along the way. In May, Posey underwent surgery to insert screws and repair ligament damage, then underwent a follow-up procedure in July to remove the hardware. After regaining range of motion and strength in his ankle, along with restoring a normal gait, Posey progressed to light throwing and hitting off a tee by the fall. In January, he added sprints to his conditioning work and is gradually expected to add more baseball-specific components to his regimen.
Still, the ankle has not yet been tested by the demands of the position, something that won't happen until deeper into spring training. While the team is encouraged that Posey will start the season on time, the Giants will also adjust, as necessary, based on how his ankle responds as his workload increases. Extended time crouching behind the plate places a significant load on the ankle, so endurance will be a factor. There will also be more torsion through the ankle when Posey begins swinging a bat against live pitching. Finally, there is that issue of Posey getting comfortable with being in that vulnerable position in the event of a play at the plate. His youth and fitness certainly work in his favor, and so far there is every reason to believe he will make a successful return. He is on track for April, but it is not a lock, and the Giants may opt to use him at first base on a routine basis to offset the rigors of catching.
March 28 update: Posey has continued to make steady gains. He has had no issues behind the plate and has shown he can hit the ball, and although running the bases is not smooth yet, he is indeed able to do it. Also, he has not experienced any major soreness or stiffness the day after playing in games. Posey's teammates held their collective breath when he attempted his first tag-out at the plate this spring, exhaling when it became apparent that it was just a routine play in the game for the unfazed catcher. On March 27, Posey caught in back-to-back games for the first time. He acknowledges that the ankle will continue to be tested as his workload increases during the season, especially when he plays deeper into games and regularly on consecutive days. Posey has not experienced any setbacks thus far, and he remains hopeful that pattern will continue.
Kendrys Morales, Los Angeles Angels. Feb. 16 update: Morales is coming off a second ankle surgery last May, a surgery that became necessary when Morales failed to progress to the point of returning to run this past season. Morales' original injury was in May 2010, the now-infamous celebratory walk-off grand slam that resulted in a severe left ankle fracture when Morales landed awkwardly at home plate.
Angels team physician and noted orthopedist Dr. Lewis Yocum offered this quote in the Los Angeles Times last May when it was announced Morales would have a second surgery: "The doctor will address any of the pathological changes he sees," Yocum said. "This will help him get range of motion as well as diminish the amount of arthritic change in the joint."
The recovery time for the procedure was estimated to be a minimum of six months.
Morales has been progressing with his rehab efforts in Arizona, and in January, he was cleared to begin light baseball activities and running "on his own power," according to MLB.com. Morales has been taking batting practice and certainly appears to be ahead of where he was at the same time last year. That said, there are still hurdles to cross, including running sprints and turning corners, to prove the ankle will endure the load. And there's this other guy the Angels brought in to cover first base, Albert Pujols. But Morales could serve as a DH, presuming he can hit with power (which requires transferring load and torsion through that left ankle, especially when hitting from the right) and navigate the bases without hesitation. How Morales is able to increase his workload through spring training will give a better idea of how the Angels might be able to use him. It looks encouraging at first glance, but the bigger test for the recovering ankle joint will come in the form of repeated work over a period of time.
March 28 update: Morales has now shown that he can do something he could not last year: run. In his first game appearance of the spring on March 22, Morales went 2-for-3. More importantly, he ran from first to third base on a hit, showing he could turn the corners. He has been able to hit from both sides of the plate, another good sign for the ankle, and appears on track to serve as the Angels' DH when the season begins. It's worth noting that there remains some question as to how his ankle will tolerate an increased workload. The Angels likely will ensure that he continues to get intermittent days off to help protect him.
Justin Morneau, Minnesota Twins. Feb. 16 update: Maybe it's something in the air in Minnesota. Like his teammate Joe Mauer, Morneau was plagued by injury issues in 2011. He entered the season somewhat tentatively, returning from a concussion injury that cost him the bulk of 2010. Morneau was on the field on Opening Day and seemed to be on an upward trajectory. By May, however, he was experiencing pain and numbness related to a pinched nerve in his neck. A wrist sprain landed him on the DL in mid-June, and shortly thereafter, Morneau underwent neck surgery. He would follow that up in September with a procedure to remove a bone spur from his right foot and a cyst from his left knee, along with a surgery on his ailing left wrist. Perhaps more importantly, in late August, Morneau dove for a ball while playing first base and his concussion symptoms returned. In December, the St. Paul Pioneer Press reported that Morneau was still experiencing symptoms such as headaches after exertion. While Morneau acknowledged being way ahead of where he was last year at the same time, he knows from experience that this is a day-to-day measure. As of late January, Morneau noted continued improvement, telling MLB.com that he is not sure whether any residual headaches are concussion-related. He continues to progress as far as his wrist and is gradually increasing his baseball-related activities. Morneau seems to be more confident about his health heading into 2011, but given his reduced playing time the past two seasons and the nature of the injuries that have most limited him, his prognosis remains uncertain.
March 28 update: Morneau has indeed progressed throughout the spring as far as his health is concerned, and has not experienced a recurrence of his post-concussion symptoms. His primary challenge thus far has been his hitting, but Morneau has remained calm, reiterating that the positive is that he has been thinking about hitting and timing, not headaches and pain. Perhaps he is starting to turn a corner in that area, too; he hit two homers Saturday. It's too soon to say Morneau is out of the woods, and his overall prognosis remains uncertain, but the positive steps of late are encouraging.
Ryan Howard, Philadelphia Phillies. Feb. 16 update: Howard's season -- and that of his Philly teammates -- ended in dramatic fashion during the National League Division Series when he collapsed to the ground on his way to first base after his leg gave out. The culprit was a ruptured left Achilles tendon, an injury more commonly seen in basketball and football. Howard underwent surgery to repair the tendon in October and has been working his way through the rehab process since. Howard has been jogging in the pool and doing light strengthening.
In January, during an interview on Comcast SportsNet, Phillies assistant general manager Scott Proefrock suggested Howard could be ready sometime in May, but he also noted the team would err on the side of caution. Working in Howard's favor is the fact that he plays a position that does not require the agility of a shortstop or the full-speed running of an outfielder. Perhaps most challenging for Howard will be powering out of the batter's box, pushing off from his left foot (which, as a left-handed batter, he does routinely) and running full speed to first base.
March 28 update: Howard developed a superficial infection in the wound over his surgery site near the start of training camp, which led to a procedure to clean it out and Howard's subsequent return to a walking boot. However, the Phillies indicated Howard's surgeon found no issues with the repaired tendon itself. His activity was scaled back to allow the wound to heal, but he has since been able to shed the boot, and is starting to resume light workouts. It's not clear how much this process impacts his overall timetable for return, and there are many more markers to reach before Howard can return. The Phillies had originally hoped he could be ready by the end of May, but it wouldn't surprise me if his return gets pushed back to June or even July.
Ike Davis, New York Mets: Feb. 16 update: Davis injured his left ankle on May 10 last year, when he collided with teammate David Wright. Initially thought to be a fairly minor incident, the injury ultimately ended Davis' season. The final diagnosis was a bone bruise and an ankle sprain. Davis opted to forego surgery, and, as of early January, he had resumed full baseball workouts, according to Newsday. Davis says he is ready to play and emphasizes the injury is in his past. Naturally, it will be important to see Davis going all out at spring training to see how his ankle is responding, but so far his outlook appears promising.
March 28 update: It wasn't the ankle that caused a stir regarding Davis early in spring training, it was the discovery that the Mets feared Davis had contracted Valley Fever. An observation during a physical indicated the presence of a lung infection, and more tests followed. Alarm bells sounded as many thought of Conor Jackson, who endured a protracted battle with Valley Fever while with the Arizona Diamondbacks, causing him to miss extensive playing time. Davis insisted he was asymptomatic, and while no definitive diagnosis was made, the team said it would err on the side of caution and monitor him as if he had the disease. As a result, Davis, who was told to avoid excessive fatigue, has played on a somewhat limited basis this spring. The good news is that his ankle has been a non-factor. The unknown is whether this lung infection and any associated symptoms are truly behind Davis or whether this will present a problem going forward.
Chase Utley, Phillies. Feb. 16 update: Utley's 2011 season didn't begin until June. Even then, it was uncertain whether he would last the season. Impressively, Utley held up for the remainder of the year, leading many to think he was "over" the knee injury which delayed his start.
Utley has degenerative changes in his patellofemoral joint and those changes are not reversible. During the time Utley was not able to play last spring, he dedicated himself to a rehabilitation program designed to offload that area under the kneecap as much as possible. He was eventually able to return to running the bases and playing defense (swinging the bat was never an issue), but at times he appeared slightly uncomfortable and he certainly wasn't snagging any extra bases.
One key to Utley staying healthy will be ensuring that he gets enough rest during the season. The trick with this condition is avoiding an inflammatory episode that could trigger debilitating pain and again bring Utley's play to a halt. Utley has such a strong work ethic that there is no doubt he will remain vigilant about his exercises, but will he pull back to avoid a flare-up? The other issue will be what to expect from Utley offensively. His power was noticeably down last year, a not unexpected side effect of his knee condition. As Phillies general manager Ruben Amaro Jr. told the Philadelphia Daily News, Utley was not able to train his legs the traditional way, which affected his power. But those strengthening restrictions likely still remain in place, which leads to the question of whether Utley can reasonably be expected to regain that power, a concern that Amaro openly acknowledges. We know Utley will work exceptionally hard. We don't know if his body will fully cooperate.
March 28 update: It already has been announced that Utley won't be ready for Opening Day. Beyond that, nothing is certain. Utley left camp to seek consultation from an outside physical therapist after his rehabilitation efforts hit a "plateau," according to general manager Ruben Amaro Jr. Utley did speak with reporters recently to update his status and indicated that he believes he will play, but cannot say when that will be. He also said that the pain is not as severe as last year and that it's his right knee that is causing him trouble, not the left knee that bothered him last year. He believes the exercise regimen he is undertaking will help him to the point where he can return, and he is not considering surgery. The only real news here is that it's his right knee currently causing him the most difficulty, not his left. Utley's condition remains one of management versus cure, and only time will tell how much he can contribute.
Miguel Cabrera, Detroit Tigers: Cabrera suffered a facial laceration and small fracture under his right eye when a ground ball he was attempting to field in a spring game bounced up and hit the edge of his sunglasses. It looked frightening, and could have resulted in an injury that would have cost Cabrera weeks, if not months. Fortunately, that was not the case; after just more than a week away from baseball activity, Cabrera was cleared to return. He expects to be ready for Opening Day.
David Wright, Mets: Wright sustained a partial tear of his rectus abdominis muscle (the six-pack abs), which has sidelined him for the bulk of spring training. The location of the injury was relatively high in the muscle and slightly to the left, not in the lower part of the muscular attachment often associated with sports hernias. In fact, the location of Wright's discomfort initially hinted at an oblique injury, and ultimately, the recovery could turn out to be very similar. The Mets took the cautious approach with Wright, primarily to guard against any setback that could threaten his status for the regular season. Given Wright's history of a stress fracture in his back, abdominal function and strength is particularly critical. After ramping up his baseball drill work, Wright made his spring debut Monday. Presuming no lingering soreness, he will continue to get game play under his belt with an Opening Day start on the horizon.
Carl Crawford, Boston Red Sox. Feb. 16 update: It came as a bit of a surprise in January when the Red Sox announced Crawford had undergone surgery on his left wrist. The procedure was described as an arthroscopic debridement (a "cleanup" type procedure done via a scope), and while no specific timetable for his recovery was given, general manager Ben Cherington said he expected Crawford to play the "bulk" of the season.
But wrist injuries in power hitters certainly generate concern given how much torque is generated as the bat is twisted at speeds exceeding 70 miles per hour. It is that torque which likely played a role in Crawford's injury in the first place. As ESPNBoston.com's Gordon Edes noted, Crawford's surgery was on his TFCC or triangular fibrocartilage complex, a cartilage structure (and its supporting ligaments) within the wrist. It is sometimes referred to as the meniscus of the wrist since it has a similar role in both load transmission and providing stability within the joint. A tear can lead to a catching of the tissue within the joint that causes pain and prevents normal motion. It was that pain when trying to swing the bat that led Crawford to the surgery. Surgical debridement procedures of TFCC tears smooth out the damaged tissue and generally lead to a good outcome. Crawford certainly seems to be moving in the right direction.
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When spring training started, manager Bobby Valentine indicated he did not expect Crawford to be ready by Opening Day. Crawford, however, has made Opening Day a goal and has been taking part in virtually all baseball activities, including fielding, throwing and running the bases. Recently he was cleared to start swinging the bat and, as of this writing, he has had several days of taking aggressive swings in the cage. According to ESPNBoston.com's Joe McDonald, Crawford says his wrist feels good. His status remains day-to-day as the medical staff monitors his wrist to see how it responds to the increasing workload. While it is too soon to say whether he will meet his target of Opening Day, Crawford does appear to be progressing at a solid pace. In the absence of any setbacks, his availability in early April is looking like a possibility.
March 28 update: Crawford's aggressive swings early this spring didn't go as well as Crawford had hoped, and inflammation in his surgically repaired wrist forced him to scale back his activity. After a couple of weeks of no swings, Crawford was allowed to resume a monitored program, and so far he has been progressing well. He will not be ready by Opening Day, however. He instead will stay in Florida for extended work with the medical staff, likely accompanied by a progression into minor league game action. There has been no timetable issued for his return, and naturally it will depend on how he responds to each level of increased activity.
Giancarlo Stanton, Miami Marlins: Stanton took a pitch off his left wrist on March 11 -- fortunately the injury was a bruise, not a break -- but that's not why he has not played since. Stanton also has been dealing with pain and inflammation in his knee, which prevented him from being able to run. After evaluation did not turn up anything significant, Stanton was given a week of rest. He has since been cleared to resume baseball activity and has played in minor league games. As long as there are no further setbacks, Stanton appears to be on track for Opening Day.
Corey Hart, Milwaukee Brewers: Hart underwent meniscus surgery on his right knee in early March and was projected to miss about a month. He has been doing well in his recovery, but might not quite be ready for Opening Day. According to the Milwaukee Journal-Sentinel, Hart should get minor league game action during the last week of spring training. The decision as to whether he will be ready for Opening Day may come down to the wire, but there is no reason to rush Hart, given the length of the season. Even a delayed start would not likely mean extensive missed time. Better to ensure there are no complications down the road.
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