Relevant fantasy baseball injury news

With all of the attention being shifted to the ALCS and NLCS (and rightfully so), there have been some recent developments in the area of baseball injuries that need to be addressed. Fantasy drafts will hinge on some of these players, so it is quite important to better understand the scope of the injuries.

Albert Pujols, 1B, St. Louis Cardinals

On Monday, Oct. 13, Pujols underwent successful surgery on his right elbow for what was originally thought to be Tommy John surgery. Dr. George Paletta performed the surgery, and it was deemed that he did not require reconstruction of the ulnar collateral ligament (the ligament that is repaired in Tommy John surgery) because the damage had apparently not worsened. Instead, Paletta performed an ulnar nerve transposition and decompression because his symptoms were primarily neurological this season (numbness and tingling in the ring and pinkie fingers, as well as decreased grip strength).

This is a best-case scenario for Pujols because the recovery time for this procedure is significantly less than what would be needed for Tommy John surgery. It is important to note that he still has a high-grade tear of the UCL, but it is likely covered in scar tissue and may not tear to the point where surgery is needed. I was skeptical of Pujols’ ability to make it through the 2008 season without some time on the shelf due to the elbow ligament damage, but he surprised me with his resiliency.

Playing first base certainly helps matters. If he were an outfielder, we are likely looking at Tommy John surgery. While playing through some degree of elbow pain throughout the 2008 season, he was able to put up some ridiculous numbers, and there is no reason we can’t expect the same in 2009.

Mike Lowell, 3B, Boston Red Sox

The nagging right hip pain actually ended up being a structural problem within the hip: the acetabular labrum. The labrum of the hip is actually a rim of cartilage that adds depth to the already-stable hip joint. It is usually torn when the hip joint is loaded and “scoured” (forcefully rotated upon while under pressure). This is an injury more often seen in hockey goalies, ballet dancers, figure skaters and gymnasts, but it is being diagnosed more and more often as diagnostic imaging improves and as orthopedists begin to look for it more often.

The recovery time for Lowell largely depends on the extent of the injury. It sounds like the labrum will need to be repaired (sutured together), the synovial (joint) lining may need debridement, and some extensive osseous (bone) shaving will need to be directed at the rim of the acetabulum. The cause of the labral tear is probably from the large bone spur on the rim of the hip joint. In addition, he likely has some damage to part of his groin that may need to be addressed surgically. The exact nature of this injury has yet to surface.

Lowell may miss the early part of spring training and he has already said he will not play in the World Baseball Classic in March. If all goes well, he could be cleared to resume “baseball activities” in about three to four months, but it is still far too early to speculate on an exact timetable of his return to the Red Sox starting lineup. I would expect him to participate in spring training games.

From a fantasy standpoint, there is a good chance that he will be able to put together a solid season; he certainly will be more comfortable than he was this season. Keep an eye on the news during March to see how he is responding to his baseball activities, then draft accordingly. I see Lowell as a utility/bench/roster filler for mixed leaguers in ’09 rather than a starting third baseman.

Travis Hafner, DH/1B, Cleveland Indians

Good news if you are an Indians fan: The damage in Hafner’s right shoulder was not structural. The surgery to his right shoulder was performed by Dr. James Andrews, and lasted only 45 minutes. The procedure was directed toward addressing “chronic changes” in the shoulder. This likely means it was a more basic “clean-up”: a removal of scar tissue, debridement of fraying of the rotator cuff, and perhaps some form of decompression of minor bone spur formation.

Now, Hafner can focus on rehabilitation in the offseason, and I would not be surprised if his power ultimately improves (in part) in ’09. Don’t expect 35-40 home runs next season, but I could see him return to the 20-25 home run range, making him an average starting 1B/UTIL player for mixed leaguers.

Ben Sheets, SP, free agent

The “sore elbow” of Sheets became a huge issue for the Brewers down the stretch, and clearly the injury affected Sheets to a large degree. An MRI taken late in September showed that he had a tear in a muscle near his right elbow joint. The imaging did not indicate ligament involvement, but in any event, this is a concern going forward. Any time you are dealing with soreness, pain, tightness, etc. around the medial (inner) elbow, you’re dealing with smoke. And where there’s smoke…

All indications at this time seem to point toward this injury responding well to plenty of rest, followed by conservative treatment. The Brewers are not going to bring him back, so he will land in a new home in ’09. Plenty of teams are starving for quality starting pitching and may be willing to enter the negotiations for Sheets. From a fantasy perspective, I would draft Sheets only as a No. 3 or No. 4 starting pitcher. If you want to reach and make him your No. 2, I would suggest backing up that pick with another SP selection within the next one or two rounds. Elbow problems have a way of reoccurring, so don’t be shocked to see him hit the DL next year with some form of elbow malady.

Chris is a licensed physical therapist and fantasy baseball enthusiast, and also operates The DL Informer—a fantasy baseball injury site. He can be reached via email at fantasymerch at

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