Mound Musings: Dissecting Pitcher Injuries

Weighing in on Injuries

This week, I'd like to toss out there some food for thought regarding injuries and their impact on the fantasy world. Let me start by saying I am glad to be back after a couple of surgeries. I'm officially on a rehab assignment now, which the doctors say could last 10 to 12 weeks. They can slow me down a bit, but I'm not ready to call it a season just yet! As for injuries to your fantasy pitching staff — and the past few days have seen more than their share — I'm going to collect the injury types into three categories: elbows, shoulders and "other" injuries. Let's start by seeing how the key injury types might impact some arms, including current value, future value and establishing realistic expectations:

Tommy John may be the best known pitcher in baseball:

When you ask baseball fans to name the most recognizable pitchers in the history of the game, you will likely get classic names like Cy Young, Walter Johnson, Nolan Ryan, Pedro Martinez and others who have left their mark, but one name might sneak onto the list for a very different reason – Tommy John. He was a quality pitcher to be sure, but the mark associated with his name is a post-surgery scar on the elbow. Every pitcher knows his name, and so do all fantasy owners.

So, the big question is, how does Tommy John surgery impact the value of a pitcher? The worst of it is that the surgery ends that pitcher's season and takes him off the mound for at least a year. In a redraft, he's done. In a keeper or dynasty, he's going to lose a full year, and, in practical terms, probably won't be 100% for closer to two years. Keeping him on your roster may not be realistic depending on your league roster parameters.

All that taken into consideration, there is a little potentially good news. This surgery is so common now, that teams typically anticipate a full recovery. On draft day, pitchers who have recently undergone ligament replacement surgery are drafted as if they were in peak physical condition. Some pitchers don't make it back all the way, but that is more the exception than the rule. And it's often more related to changes in mechanics designed to reduce stress on the elbow not producing the optimal results.

I'll even take that one step further. Some people, me included to a certain extent, feel that Tommy John surgery is almost like resetting the odometer on your car. The ligament structure in the elbow has just so many miles available (and that varies from pitcher to pitcher and from delivery to delivery). When it's surgically repaired. The clock is reset, and if he can alter the delivery enough to reduce some wear and tear, I think the pitcher with the newly rebuilt elbow might be a slightly safer bet than a pitcher with a high mileage joint. Just remember, it could be close to two years before he's fully back. It will be interesting to see if the nonsurgical path back chosen by Masahiro Tanaka and Garrett Richards (see below) will change the outlook going forward.

Shoulder woes are simply too unpredictable:

Perhaps the worst word you can hear when discussing injuries and how they relate to pitchers, is "shoulder" and any injury involving that joint. The main problem is the unpredictable nature of shoulder woes. In fact, they are so unpredictable that there's no good example of how the rehabilitation might progress. Given the difficulty in predicting a return date, and then establishing realistic expectations following that return, I tend to avoid pitchers suffering from shoulder problems. The potential return has to be significant to justify an investment.

Let's take a look at the Dodgers' Hyun-Jin Ryu. While the path he's on in trying to come back from shoulder surgery isn't exactly a blueprint, it does illustrate the frustrations a fantasy owner could face. It all began when he experienced some shoulder discomfort in March 2015. Evaluation showed no structural damage, and rest and rehab was the initial plan for getting Ryu back on the mound. They admitted Opening Day was questionable, but the overall prognosis wasn't too bad. Then things unraveled.

As the season began, it became clear rest wasn't the answer. Ryu underwent a surgery in May that could end his season or at least shorten it significantly. Surely he would be ready for spring training 2016 and would take the mound as part of the rotation when the season began. Not so. Delays, setbacks, soreness and assorted problems arose as the rehab sputtered. We're now approaching mid-season, as the calendar flips to July, and Ryu still has no firm timetable for a return. He has made a few rehab appearances, but he's been on a restricted workload. The Dodgers hope to see him on the mound again soon, but they and his fantasy owners know the frustration of waiting.

A smorgasbord of other injuries to watch out for:

Elbow and shoulder injuries are the most visible injuries for pitchers, but pitchers also suffer from the full range of ailments from sprains, to strains, to blisters and contusions. Most of these are easier to assess than the bigger injuries, and it isn't as challenging to predict return dates. There are exceptions of course, but you can usually get a good feel for how much time your pitcher will miss and be fairly certain he'll return ready to pitch.

That's the key. You want him ready to produce at or near full capacity. Teams tend to be cautious with injury rehab. Perhaps even more so with pitchers, compensating for an injury can lead to more serious injuries as a worst case scenario, and even in the best cases, unintentional adjustments in their motion and delivery can often result in command issues and/or an overall decline in performance.

Back, neck, trunk and maybe more than any others, leg injuries impact a pitcher to a great extent. Remember, pitchers depend on their lower bodies to generate drive and pitch velocity. If the various body parts aren't healthy and in synch, the end product suffers. Thankfully, management won't want its investment back on the mound until fully healthy and ready to give his best.

Some Notable Rotation Ramblings:

• The much anticipated debut of Washington's Lucas Giolito took place earlier this week. The outing was cut short by rain, but he looked sharp, allowing just one hit and two walks over four shutout innings. Just keep in mind, this is still not the finished product, so he may not be up to stay just yet.

• The Angels' Garrett Richards is still weeks away from returning to the mound even if he can avoid Tommy John surgery, but the notable thing here is the possibility he could avoid the knife. If platelet-rich injections become a viable alternative to surgery, the game could change dramatically. Stay tuned.

• The Dodgers verified that Clayton Kershaw is experiencing ongoing back problems. He hasn't responded as well as they had hoped to treatment so he's undergoing further evaluation. Hopefully it's nothing serious, but back problems can linger and, worse, can impact a pitcher's delivery.

• Some pitchers seem to get better when a winning "feeling" surrounds the team, and that might be a good description of Cole Hamels. The Rangers are on a roll, Yu Darvish should be contributing again soon, and there's every reason to expect a big second half from Hamels and the entire team.

• Speaking of that two-year full recovery period for Tommy John surgery, Miami's Jose Fernandez is right there, and the rest of baseball is trying to catch up. He seems to be making the strikeout a whole new art form. So, if you really enjoy strikeouts, make sure you catch one of his starts. Wow!

• I have been looking for reasons James Shields can't get anybody out, but I'm having trouble isolating one cause. I thought the move to the White Sox might perk him up, but he's still in the middle of the plate and up with everything. I'm just not seeing any light at the end of the tunnel right now.

Brad Boxberger is still out, and now Alex Colome is on the DL, leaving a void in the food chain for saves in Tampa Bay. It appears they might play matchups, with Xavier Cedeno perhaps the best option, but even that would only be in the deepest leagues. The Cardinals have postponed waiting for Trevor Rosenthal's performance to catch up with his electric arm. Seung Hwan Oh appears to be a top shelf option to finish games, but the Cards have a lot of alternatives, so he may end up sharing endgame duties. The Nationals' Jonathan Papelbon could return later this week and will likely step back into the closer's role, but keep Shawn Kelley in mind should Papelbon experience any more health problems, or if Washington can hook up with a trading partner. The Twins' closer Glen Perkins is officially done for the season. Brandon Kintzler was the winner of the most recent musical relievers game, but his hold on the job is shaky at best. The Jays would like to make sure Roberto Osuna's workload doesn't become problematic. Don't be surprised if Drew Storen picks up a few stray saves as things progress.