Commentary

Late-spring injury update: Pitchers

Updated: March 30, 2012, 3:17 PM ET
By Stephania Bell | ESPN.com

Editor's note: In February, Stephania checked in with updates and explanations 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 pitcher updates; hitter updates were posted earlier this week.

Stephen Strasburg, Washington Nationals. Feb. 28 update: The 23-year-old pitching phenomenon is entering this season strong as he continues his progression post-Tommy John surgery. Strasburg tore his ulnar collateral ligament in August 2010, and his rehab following surgery has largely proceeded without a hitch. Strasburg even returned late last season to deliver some innings in the majors, a move questioned by some who thought it was risky. From the rehab perspective, however, it made perfect sense; it was simply the next level of progression in the return to pitching following this procedure. In fact, one could argue the big league appearances proved he could throw competitively at the top level. The only element remaining is building his game endurance, something that will develop over the year.

As the Nationals did with young Jordan Zimmermann in his recovery from the same surgery, they will limit Strasburg to approximately 160 innings. As to whether the Nationals might adjust how those innings are spread out to help lengthen Strasburg's overall season (think: playoffs), Adam Kilgore of The Washington Post reported that general manager Mike Rizzo said that is not an option. Count on the Nationals to protect their investment by controlling Strasburg's time on the mound, but all signs point toward expecting good things right out of the gate.

March 30 update: Strasburg has had a strong spring and is scheduled to pitch on Opening Day for the Nationals. The location issues that challenge any pitcher coming back from this surgery have surfaced intermittently, but the ease with which Strasburg seems to be throwing has been impressive. So far he really hasn't had any significant setbacks throughout the course of his rehab. Barring any surprise developments, Strasburg seems to be in line for a solid return.

[+] EnlargeJohan Santana
Sarah Glenn/Getty ImagesJohan Santana has progressed -- albeit slowly -- this spring.

Johan Santana, New York Mets. Feb. 28 update: Santana underwent surgery in 2010 to repair a torn anterior capsule (fibrous tissue that helps provide stability to the joint) in his left shoulder, and while his progress was strong last year, a couple of stalls due to soreness and fatigue, not uncommon in this recovery process, kept him from returning to the big leagues. Now there is much anticipation about what he will do and when he can do it this year after the additional recovery time of the offseason. As of this writing, Santana is scheduled to make a start in a spring training game within the week, and the team is optimistic he could be ready by Opening Day. But as Santana told ESPN New York's Adam Rubin, "I'm not trying to hurry anything. I'm just going to go one step at a time. If it's there, great. If it's not, I'll work my way up. That's what we're looking for." Sounds like the intelligent approach of a guy who's been forced to take things slowly for the past year. The hope is that his return to the big league mound will be uneventful, as in free from setbacks. It would not be surprising if Santana is not pushed deep into games initially while he regains his competitive form.

March 30 update: Santana has stayed true to his word of taking it one game at a time this spring. Each outing he has built upon the previous one in terms of workload, and so far, he has had no negative repercussions with regard to his shoulder. His velocity has been up and down, and his command has been inconsistent, but the fact that his shoulder has continued to feel good the day after pitching is perhaps the most important element. Whether that remains the case for a whole season is the big unknown. As Santana told ESPNNewYork.com: "It is fine. But again, to do it in the course of the season -- for 30 starts, or whatever it is -- that's something we have to see."

Josh Johnson, Miami Marlins. Feb. 28 update: The concerns about Johnson's shoulder heading into last season played out in a more dramatic way than anyone expected. Johnson went on the DL with shoulder inflammation in May and never made it back. While there were never any reports of any significant findings, Johnson could never progress past a certain point. Every time he returned to throwing from the mound, it seemed to trigger a setback, until eventually there was no time remaining on the calendar. But it's what Johnson did differently this offseason that might factor the most into how 2012 plays out. Last year Johnson indicated he focused on building strength -- as in total body strength -- and on his 6-foot-7 frame, he easily could become an even more imposing physical presence on the mound. Still, that might not be the ideal goal for his particular job demands.

This offseason, however, Johnson worked with a physical therapist on very specific strengthening of the musculature that supports his throwing arm. This type of exercise will not make it outwardly appear as if one has spent serious time in the weight room. It will, however, focus on the neuromuscular coordination of the muscles most important to a pitcher, the ones that often go untrained or at least under-trained, when one veers more into heavy lifting. Add to Johnson's new regimen the effect a new park in south Florida could have: less playing in extreme heat and no more rain delays, thanks to a roof, all of which can influence a pitcher's preparation and performance. While concern carries over from last year, given that Johnson was never able to return in 2011, the additional time of the offseason along with an altered training program is at least encouraging. Apparently the Marlins believe that as well, since Johnson is already expected to be their opening day starter.

March 30 update: In addition to continuing to feel good this spring, Johnson seems to be getting his velocity back; he even touched 96 mph in his most recent outing. Johnson is slated to be the Opening Day starter for the Marlins, and the team hopes he will continue to deliver throughout the season. Johnson hasn't pitched a full season since 2009 because of problems with his throwing shoulder -- and there are no guarantees this year either -- but his offseason routine and subsequent spring have everyone around him encouraged.

Tommy Hanson, Atlanta Braves. Feb. 28 update: As with Josh Johnson, Hanson's season ended as a result of shoulder problems. It was reported last season that Hanson had a small rotator cuff tear, one that was characterized as typical for a pitcher as a result of wear and tear. Hanson returned to pitch after spending some time on the DL in June but was forced out again in August and was unable to return afterward. As if that wasn't enough, Hanson was involved in a car accident en route to spring training, which resulted in a concussion. Fortunately, it appears Hanson is recovering swiftly and, as of this writing, is expected to begin throwing from a mound soon.

There definitely is cause for concern with Hanson, just as there was with Johnson last year, in that his season ended with an injury to his throwing arm and no clear resolution. According to the Atlanta Journal-Constitution, one of the steps Hanson took in the offseason to eliminate potential contributing factors to his shoulder woes was to modify his delivery. Working with pitching coach Roger McDowell, Hanson apparently is using his legs to better assist in driving his delivery. This should offload not only his shoulder, but also his elbow, which often can suffer the most catastrophic blow when the shoulder is impaired and mechanics are compromised. It remains to be seen just how effective his adjustments are and how healthy he truly is, something that can be learned only as the season progresses.

March 30 update: Hanson got a late start to his spring because of the aforementioned car accident but has made positive strides since, notching several Grapefruit League starts. Despite the delay, Hanson insists he will be ready when the season opens and is expected to get the Opening Day nod. Will he hold up until the season closes? The underlying damage to his rotator cuff is no secret; then again, many pitchers have similar damage and continue to pitch effectively. There is uncertainty here, but Hanson is at least starting the season on time and feeling good right now.

[+] EnlargeAdam Wainwright
AP Photo/Jeff RobersonAdam Wainwright has posted a 1.45 ERA and 0.91 WHIP this spring.

Adam Wainwright, St. Louis Cardinals. Feb. 28 update: It's safe to say Wainwright's spring likely will be much improved over last year's. Last year, his season ended before it got started when he suffered a torn ulnar collateral ligament and underwent Tommy John surgery. If there was to be any silver lining on that dark day, it was the fact the injury happened so early, leaving Wainwright enough time to recover for the 2012 season. He has been progressing on track and hopes to be ready by Opening Day. By now we know, however, that these schedules remain fluid based on how the athlete performs and feels after each successive outing.

March 30 update: The only thing to add here is that Wainwright continues to progress. In fact, Wainwright has yet to allow a run this spring. He will get the start in the Cardinals' home opener, according to the St. Louis Post-Dispatch. With teammate Chris Carpenter (discussed below) out for the start of the season, Wainwright's solid health takes on even more significance.

Clay Buchholz, Boston Red Sox. Feb. 28 update: Buchholz suffered a back injury in June 2011, later determined to be a stress fracture, which prevented him from returning last season. Buchholz had been making significant progress with his rehab late last year, however, and had the Red Sox reached the playoffs, it's possible Buchholz could have returned out of the bullpen. Since that never materialized, Buchholz was not seen by the baseball audience late last year, but his rehab efforts did allow him to begin his offseason program sooner. This spring he already has thrown more than a dozen bullpen sessions and, according to ESPN Boston's Joe McDonald, Buchholz says this is the best he's felt in a while. The type of injury Buchholz had is certainly something he can be expected to fully recover from and return to competitive form. It sounds as if he is doing exactly that.

March 30 update: Although his results have been all over the place, the most important thing for Buchholz this spring is that his back has been a non-issue. Buchholz has reportedly been working on his pitches and his endurance on the mound this spring. Hopefully, the results will follow.

Juan Nicasio, Colorado Rockies. Feb. 28 update: Nicasio's injury might have been one of the scariest sights in baseball ever. A comeback line drive drilled Nicasio in the head, causing him to fall to the ground, resulting in a fracture of his C1 vertebra, the vertebra that sits just below the skull. The fracture was surgically repaired and, thankfully, there was no neurological damage. In fact, Nicasio was up and walking in the hospital just days after the surgery. As early as October, he was throwing from a mound, along with weightlifting and other cardiovascular conditioning. Perhaps most amazing is the reality that Nicasio is completely healthy and ready to compete, prepared to face hitters and take on what for most of us would be an unsurmountable fear. As of this writing, Nicasio is scheduled to pitch soon in an intrasquad game in which he will face live hitters. Troy Renck of the Denver Post tells the amazing story of Nicasio's recovery, and it certainly has everyone believing not that he can return to pitch again, but that he will.

March 30 update: Nicasio has faced live hitters in multiple Cactus League outings this spring, clearing yet another hurdle in his amazing recovery. There are no restrictions on his throwing, and he has certainly proved that he can function at the major league level. One word describes his return: remarkable.

Chris Carpenter, Cardinals: Two weeks into camp, Carpenter was sent back to St. Louis to have his neck examined. His stiffness and soreness was reportedly related to a bulging disk in his neck, not a new issue for him but a flare-up worthy of concern. Initially, the news was good: The symptoms were limited to his neck, and no nerve irritation was present. Carpenter had returned to throwing and progressed to bullpens and live batting practice, only to see his symptoms take a turn for the worse. According to the St. Louis Post-Dispatch, the diagnosis is nerve irritation leading to weakness in his right (throwing) shoulder. The Cardinals have indicated there is no timetable for Carpenter's return. This news is discouraging; nerve issues can linger for weeks or even months. The Cardinals have adjusted their starting rotation accordingly, and fantasy owners should too.

[+] EnlargeNeftali Feliz
Jake Roth/US PresswireNeftali Feliz seems to have worked past his shoulder problems, at least for now.

Neftali Feliz, Texas Rangers: Feliz has complained of soreness and stiffness in his shoulder, though the Rangers don't appear overly concerned. After a few days of rest, Feliz was able to throw a bullpen without incident. There was some discussion about possibly opening the season with him on the DL. But after throwing in a minor league game and a subsequent bullpen produced no issues, Feliz appears to be a go when the season begins. Whether this was just some spring training soreness possibly associated with his shift back to starting or whether it was a sign of a bigger potential problem is unknown at this point.

Tim Hudson, Braves: Hudson underwent offseason back surgery (fusion of the L5-S1 vertebrae), and it was expected that he would start the season on the DL. Hudson has been progressing in his rehab, and according to the Atlanta Journal-Constitution, he thinks he'll be able to return by May 1 at the latest. So far, his progress seems to be in line with that date; Hudson is now expected to make an appearance, albeit a brief one, in a spring training game. The key for Hudson is developing adequate abdominal strength to protect his spine, not only the fused segment but the vertebral levels above it, which will be subject to some increased motion stress as a result. Hip flexibility is another key component of protecting the spine, especially for a pitcher in which trunk rotation is a part of the job requirement. There is no reason to think he can't be effective once he returns, especially if he takes his time in doing so.