Kuzul

The NFL draft is this week, as you might have heard. The NBA playoffs have started, a two-month second season that will soak up a lot of attention if we get the expected LeBron James vs. Kevin Durant matchup. The NHL is getting ready for its postseason as well.

Late April is the part of the baseball season where people look away, and that’s a mistake. The games here count just as much, and injuries happen just as quickly. Three or four starts is enough to show us which pitchers are making their normal recoveries. We’re starting to see rehabs that took a bit longer to come together.

We’re also getting a solid look at depth. Traumatic injuries will happen. Players will strain an oblique or a hamstring, and at that point, we get to see how a manager can handle the situation. Late April might be the best time for that, and it gives some real insight if you know where to look.

Let’s take a look around the league at all the injuries, the comings and the goings, and I’ll see if I can guide your eyes to the right spots and your fantasy team to the right moves.

So, on to the injuries.

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Jose Reyes slid awkwardly into second base, and the result has the Toronto Blue Jays questioning if their season is sliding away. Reyes was carted from the field after what appeared to be a grim injury and is headed for scans on the ankle.

Jose Reyes injures his ankle on an awkward slide into 2nd. #bluejays nation hods its breath.

— Dan Shulman (@DShulman_ESPN) April 13, 2013

This is definitely a serious injury for Reyes, a speed player who was making the transition to both playing on turf and playing in the American League. Reyes has dealt with leg injuries, including a history of chronic hamstring problems and a knee injury, both while with the Mets. He has come back from both without losing significant speed, though many question if he’s had to play it safe. His range and non-steal base-running numbers do not back that theory up.

Early word is that Reyes has a severe sprain. He will have additional scans to determine the extent of the damage:

John Gibbons called Reyes injury “nightmare” while Alex A says estimate is out 1 to 3 months depending on MRI results. Reyes going on DL

— Tony Ambrogio (@SNTonyAmbrogio) April 13, 2013

The worst-case scenario is that the ankle is fractured or there is a severe sprain, so the fact that he does not have a break is not necessarily good news. Either possibility would cost Reyes a significant portion of the season and could require surgery. A fracture of either of the lower leg bones (tibia and fibula) has quite a range of possibilities, depending on the location and severity.

An example of this type of injury would be Derek Jeter‘s playoff injury from last season. Jeter needed surgery to fix the tibia and is still working to make it back to the Yankees lineup. 

With damage to the ligaments, this is not a “less than” scenario. Fractures tend to heal cleanly and can be checked easily. With ligaments and tendons, it is more difficult to fix and to monitor. Examples of this kind of injury include Buster Posey, who missed four months after having his ankle damaged in a collision at home plate but returned the following year showing no issues.

A shortstop with a more similar issue is Stephen Drew. Drew injured his ankle (warning: graphic image in link) on a slide, awkwardly impacting the catcher and breaking the ankle as well as doing soft tissue damage. Drew was able to return, but scouts regularly say that he still appears to favor the leg and may have lost some range.

The best-case scenario for Reyes would have been that this is a mild sprain or strain. While he would miss time with it, a relatively straightforward sprain of Grade II or less would usually require little more than a minimum stay on the DL at the top end. 

The Blue Jays medical staff will perform manual tests and X-rays. Most stadiums, including the newly renovated Kauffman Stadium in Kansas City, have X-ray facilities on-site, often steps from the clubhouse. As you can see in the picture on the right, the Indiana Pacers have a common setup. The doors on the left are to their locker room and the door on the right is the X-ray machine.

The Jays medical staff will be assisted by the Royals team physicians as well. It is customary for vistiors to use the home team’s physicians, as team doctors seldom travel. This is common, and if needed, Reyes would be sent back to Toronto for further diagnosis and treatment. It is also possible that Reyes could see a physician like Dr. James Andrews or more likely, Dr. David Altchek, the Mets team physician who is one of the top consulting surgeons in sports.

This is another example of why the seemingly eternal debate about whether it is safer to slide headfirst or feet-first is truly moot. We have already seen a headfirst slide go wrong, costing Ryan Ludwick at least the first half of the 2013 season and perhaps longer after needing surgery to fix his shoulder.

Now, Reyes’ injury reminds us that one bad slide, no matter which part goes first, can be dangerous.

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We’re a week into the baseball season and I have 25 names to write about in today’s UTK. Big names like Derek Jeter, Mark Teixeira, Ryan Braun and Jered Weaver have missed at least a portion of the first week, losses that they and their teams can’t get back.

Someday we’ll take a look at their season stats on Baseball-Reference.com and wonder why their numbers were just a bit low. It takes a bit of a deeper look to understand that missed playing time, missed innings pitched, missed plate appearances are the usual reasons. 

It may be just the first week of the season, but a win is a win. Losing a game in early April means that there’s a game that needs to be won later in order to make the playoffs, when the pressure is higher for everyone.

The same holds true for injury stats. Missed time early in the season tends to snowball or even go into a “death spiral,” a time when the medical staff gets so overwhelmed reacting to a rash of injuries that preventative work falls behind, leading to more injuries.

The idea that a medical staff could get overwhelmed should be laughable, but most staffs operate with two, maybe three athletic trainers at the core. There’s only so much time, despite the fact that it would be easy and cost-effective to simply add another athletic trainer to the mix. 

I had the chance to see several of these staffs at work this week, and unfortunately they’re already working hard. Injuries never take days off. Then again, neither do I.

Powered by the Under Armour E39, on to the injuries.

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Jered Weaver‘s injury was an odd one.

The Los Angeles Angels ace was quick enough to get out of the way of a shot right back at him, but fell on his non-pitching arm in doing so. It was an awkward fall, as you’d expect with a quick twisting move on a sloping surface, which resulted in what looked like a hyperextended elbow.

The team removed Weaver from the game, but he was near his pitch limit anyway, so we really weren’t sure whether he could have continued. The Angels initially only worried about whether he’d make his next start, but images on Tuesday morning showed a fracture near the elbow (via Fox Sports’ Ken Rosenthal), putting him out of action for an extended period of time. 

Though an injury to his pitching arm would obviously have been worse, the non-throwing arm (or glove-side arm) is important for balance and consistency, so changes there could cause some problems, especially for a pitcher with such a long delivery.

The Angels’ time frame for his recovery is at least four weeks, although CBSSports’ Scott Miller is reporting it will be closer to four to six weeks.

Awful news for #Angels: Jered Weaver out 4-6 weeks with broken left (non-pitching) elbow. Big blow.

— Scott Miller (@ScottMCBS) April 9, 2013

That is a reasonable timetable given the actual injury, though there are no similar injuries in my database to compare this with. A fracture should heal normally, and while we do not know the exact location, there’s no reason to think that there should be any complications. 

Since it is the non-pitching arm, the more aggressive timeline is possible without risking damage. While this doesn’t look to be a long-term issue, the Angels will have to handle Weaver carefully until the elbow is back to normal. My guess is they will be as conservative as their record allows them to be.

While Weaver will be able to do some work to keep his pitching arm in condition, he won’t be able to do normal deliveries or exercises such as long toss. He’ll need at least some time in the minors once he’s able to make sure his stamina and his mechanics are in line.

Swingman Garrett Richards is the likely fill-in, though the Angels have used him as a key reliever through the first week of the season with success. Starter-turned-reliever Jerome Williams is another possibility.

Adding any uncertainty to Weaver’s delivery isn’t something that a pitching coach on the hot seat like Mike Butcher wants on his watch. Weaver is an ace on a big-money, long-term contract, and is key to the Angels getting back to the playoffs.

Balancing a full recovery with their need for him at the front end of their rotation will be a very tough task for the team’s medical staff.

Read more MLB news on BleacherReport.com

I made it to Opening Day.

This year, Opening Day meant more than most years, since I was the one that almost went on the DL. Instead, I stood on the field Monday in Milwaukee, looking at the steel roof above the green grass and loving that it was once again baseball season. It was an amazing feeling, talking with so many media friends and having everyone from Doug Melvin to Ryan Braun pausing to ask how I was feeling. 

Of course, there’s a lot of injuries already around the league, which should be no surprise. Almost 20 percent of injuries occur in the spring. Even once Opening Day has come and gone, injuries tend to be a bit front-loaded. The reasons are obvious and inscrutable all at once, but the pattern has held for the decade we have data on and anecdotally for much longer.

It’s a long season, but for too many, the season is already over. Opening Day isn’t a new beginning, but the starting line that is sometimes not reached. Teams will begin to make do, to patch holes and to find ways to deal with the injuries that occur. At some point, they’ll do something about it, but until then, the doctors and athletic trainers will just put in the long hours they have trying to make a difference.

Powered by the spirit of Opening Day, on to the injuries: 

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We all like to look into the future. The problem is that the future doesn’t like to be looked at. Things change, often quickly, and factors we never consider end up making a hash of our best predictions.

Clay Davenport doesn’t pretend to look at the future, instead using his advanced math skills to create a simulation (run one million times) that helps us assess the most likely scenarios. Davenport’s statistics once made up the heart of the Baseball Prospectus statistical engine, back when Nate Silver’s PECOTA was among the most accurate simulations around. Without the Davenport Translations, none of it worked.

Davenport continues to do the hard math work that allows us to look forward to the season. One of his coolest tools is what he calls the Playoff Odds Predictor. Since the POP uses actual results, it gains accuracy as more games are played. Watching the swings of playoff odds is absolutely fascinating in September, and none more so than the last few seasons. 

Using his hand-crafted simulator, Davenport recently published his 2013 projections, some of which will surprise you. Let’s take a look through some of the findings:

WHO WINS?

The six division champions as predicted aren’t going to surprise anyone. Davenport has Toronto (87 wins), Detroit (92) and Los Angeles (91) winning in the AL. In the NL, the projected winners are Washington (86), Cincinnati (87) and San Francisco (92.) 

HOW ABOUT THE WILD CARD?

OK, this gets complicated. In the AL, Davenport has four teams all winning 85 games. A four-way tie would create havoc for baseball’s schedulers with Oakland, Texas, New York and Tampa requiring a playoff before the playoffs.

Suffice it to say, a bit of luck—good or bad—is enough to push this from reality. It’s going to be very close, however, and small things like a trade or an injury could swing two divisions. In fact, the Astros could end up being a big factor. If they’re as bad as many think, those wins shifted into the AL West could push the A’s and Rangers into the postseason.

It’s easier in the NL, where the Dodgers and Braves take the wild-card slots and face each other in the projected play-in game.  

HOW BAD ARE THE ASTROS?

Davenport’s system projects the Astros to win 75 games. That’s still last in the AL West, but it is significantly higher than other projections. While many have the Astros losing 100 games or more (including myself), Davenport doesn’t even have them as the worst team in the league!

That honor and the first pick that goes with it is expected to go to Miami. The latest fire sale in South Florida has brought a team expected to win just 67 games. That’s definitely not going to help sell seats in that new park.

WHO IS HIGHER THAN EXPECTED?

Some may be surprised to see the Rays as an 85-win wild card, or the Red Sox improve to 83 wins this season. Neither is truly surprising given the talent and the tendency of records to even out over the course of seasons absent of any major change. 

More will be surprised that the Pirates are projected to finish in second place in the NL Central, breaking a 21-year run of losing seasons. While 81 wins isn’t a winning record, for the downtrodden fans of Pittsburgh, not having a losing season could be a difference-maker. 

WHO IS LOWER THAN EXPECTED?

The Phillies aren’t going to be happy to see themselves projected not only in third place in the NL East, but a game under 500 (80-82). Davenport is also calling for Baltimore to take a step back from last year, going 78-84. Part of that is that no projection system is going to think that the Orioles’ record in one-run games last season is sustainable.

The Cardinals’ drop to 500 might be surprising, but that’s a tough division and the injury risks on the team seem to be weighing them down. The Brewers also project lower in Davenport’s system than many others, though it admittedly does not take the recent Kyle Lohse signing into account.

NO 100 WIN OR LOSS TEAMS?

Not according to Davenport. In fact, the compression that we’ve seen increasing over the past couple seasons appears to be even more exaggerated. The spread between the best teams and the worst is just 25 games. 

If you throw a blanket over the teams stuck in the middle, just plus/minus five from a 500 record, you’ll end up capturing 19 of the 30 teams. That means that a lot of things that look like luck could end up swinging almost all the races, and that competition will be tight all summer.

CAN I USE THESE FOR VEGAS OVER/UNDER WIN TOTALS?

“Entertainment purposes only,” people. 

Read more MLB news on BleacherReport.com

By this time next week, MLB will have thrown their first pitch. Before that, they’ll pitch several players on to the DL. Injuries often become the deciding factor in many of those last-minute roster decisions. A player may be healthy now, but might have missed opportunities to impress the coaching staff earlier in the spring due to even minor injuries.

We’ll begin the season with a number of big-name players on the DL, but remember that at the start of the season, there’s a bit of a loophole. Teams can put players on the DL with a “retroactive move,” in essence post-dating the start of the DL stint. This year, it means that a player that has not played in a major league exhibition game from March 22 can come off early, as soon as April 6. 

To do this, the players have to be held out of games, and you can see several teams doing this around the league. A player can play in minor league games and preserve the retro move, so as with Derek Jeter and others, they’ve essentially already started the process. Look for a number of these moves to happen this week, giving a short-term roster relief that will allow a team to bring a 26th or 27th player north, delaying that hard final roster decision a bit more.

There’s a lot of injuries to check out around the league, as there will be every week of the season, so powered by Yasiel Puig, let’s get to it:

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The World Baseball Classic has come and mostly gone, leaving us a sparsely attended but passionately watched Caribbean final that should be a boon for Puerto Rico or the Dominican Republic.

I’ll leave it for others to debate why the power teams of the USA and Venezuela went out so quickly, instead focusing on the lack of injuries. In fact, there’s only one of any note, though there have been some minor injuries here and there, but nothing that doesn’t happen at normal spring training. 

The pitch limits have been especially controversial, almost becoming a part of the tactics. Some teams appeared willing to take more pitches, knowing that there were only so many any particular pitcher had in him. But where did these pitch-count restrictions come from and are they effective?

The fact is, no one seems to have any basis for the numbers, though they appear to have served their purpose. As the game moves towards the regular season, we have to wonder why these same sorts of tactics don’t work in reducing injuries.

Will Leitch does a great job looking at how much we don’t know about pitching in this article at New York, but misses the broader point. No one, aside from “some guy with a website” is looking into this. Did the Nationals commission a study that would show the exact forces of the so-called Inverted W? No, they looked at film and correlated to injury. 

If I told you that the new car you bought had half the horsepower and got half the mileage you were told at the dealer, what would you do? I’d get it to a mechanic who would likely put it on a dynamometer. Sure, you could just drive the car and say “wow, this doesn’t feel right” but I’d be very worried about driving a car in that condition. That’s basically what teams are doing all the time.

Brett Marshall, the pitcher Leitch uses as his example in the article, had Tommy John surgery, but the Yankees have never thought enough of the process to find out exactly what forces Marshall’s easy motion is generating. Were the changes he says he made post-surgery positive ones or is he headed back for another elbow ligament inevitably?

Brandon Sisk, Casey Kelly and others have added their names to the list of prospects that will miss a year of their careers rehabbing rather than competing. We’ll have more, I’m sure, and even bigger names.

At what point does a team throw everything aside and say “We’ve got to figure this out?” If there are any owners out there that want to save a couple million dollars this year, you know how to find me.

Powered by the Promus exuding stent, on to the injuries:

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The Cardinals announced on Tuesday afternoon that Chris Carpenter would miss the 2013 season after a recurrence of shoulder problems. Carpenter missed the bulk of 2012 with a shoulder issue that was said to be corrected by surgery. The evidence and Carpenter’s injury history suggests that he will miss all of 2013 and could be done, period.

Carpenter had surgery to repair thoracic outlet syndrome in July, resulting in the removal of a rib to open up space in the area. This surgery is not uncommon for pitchers or other people with overhead, repetitive motions. (The occupation that most often has this issue? Carpenters, ironically, due to the hammering they do.) 

No other pitchers that have had this type of surgery have had significant setbacks of this type. That said, no other pitcher who has had this surgery has the long list of ailments that Carpenter has dealt with throughout his career. The best known comparables are David Cone and Kenny Rogers. 

Carpenter has always had injury issues, especially with his pitching shoulder, going back to his Blue Jay tenure. He came to the Cardinals after the Jays did not believe he would return to effectiveness after a rotator cuff and labrum problem.

The Cardinals rehabbed Carpenter through the 2003 season and were rewarded when he helped them get to the 2004 World Series with an excellent campaign. Carpenter did miss the World Series, losing the last month of the season and the playoffs due to a nerve injury in his shoulder.

Carpenter came back with a strong 2005 campaign, winning the Cy Young award. More problems arose in 2007 when he needed two elbow surgeries, including Tommy John reconstruction. Carpenter missed almost all of the 2008 season while rehabbing. 

Carpenter returned well in 2009, nearly winning the Cy Young Award. It should be noted that I was one of two voters that left Carpenter off his Cy Young ballot that season, though I had his fellow Cardinal Adam Wainwright as my No. 1 ahead of winner Tim Lincecum. My reasoning for picking Wainwright, Lincecum and Dan Haren over Carpenter was in large part based on Carpenter having missed a month with an oblique strain and the lost value of that time. 

Carpenter’s contract with the Cardinals expires after the 2013 season. GM John Mozeliak said at the press conference that he doesn’t believe that Carpenter will pitch for the Cardinals again. The extension, signed in 2011, was for two years and $21 million, but Carpenter was only able to pitch 17 innings at the end of last season. 

Mozeliak stated that the door was open for Carpenter to return this season if he is physically able, putting the team in a similar position to last year. In the meantime, the Cardinals will go young with their pitching. They will need Lance Lynn to give a full season of work after an excellent rookie campaign that saw him hit the wall in the second half.

They will also need top prospect Shelby Miller to step up, giving the team the SP2 that they now lack, while also not extending his young arm too far past the 150-inning mark he got to last season at two levels.

All quotes in this piece were obtained first-hand unless otherwise noted.

Will Carroll has been writing about sports injuries for 12 years. His work has appeared at SI.com, ESPN.com and MLB.com.

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