Fantasy baseball injury report analysis: Carrasco, Darvish, Hamels

Michael Brantley, Devon Travis

Note: Brantley returned 4/25/16. He pinch hit for Rajai Davis.

Both Brantley and Travis are nearing returns from offseason shoulder surgery, though each operation was aimed at a different joint. As a whole, the shoulder joint is comprised of four individual articulations. The complex starts with the sternoclavicular (SC) joint, located where the clavicle (collarbone) joins the manubrium of the sternum (breastbone). The SC joint serves as only the connection between the arm and the trunk of the body. The collarbone extends laterally until it meets a bony process of the scapula (shoulder blade), forming the acromioclavicular (AC) joint. Here, the AC joint serves as a strut for the shoulder, producing a pivot point that permits a high degree of motion.

The scapulothoracic articulation is the often forgotten joint of the shoulder and is situated where the shoulder blade glides on the rib cage. While this union doesn't follow the typical characteristics of a normal joint, it plays a vital role in pitching a baseball and smoothly swinging a bat. The scapulothoracic articulation increases the motion at the fourth joint, the glenohumeral joint, allowing for a larger range of motion.

The glenohumeral (GH) joint is the joint that most people associate with the shoulder and is the ball-and-socket joint of the shoulder. The GH joint is built for mobility and is capable of moving in a variety of ways. However, the extensive range of motion comes at a cost, as stability is sacrificed for extra movement. Fortunately, a fibrocartilaginous ring known as the labrum, numerous ligaments and the neighboring musculature all work together to stabilize the shoulder as best as possible.

Travis' injury involves the AC joint. In November it was discovered that the Blue Jays second baseman had an anatomical variance on the acromion of his AC joint known as an os acromiale. In the condition, the bone process fails to completely unite during development, leaving the individual prone to rotator cuff injuries, as the tendons of the muscle group have limited room to operate. Travis opted to have the issue surgically addressed, and surgical screws were implanted to help fuse the pieces of his acromion together. Following surgery it was believed Travis would be sidelined for four to five months. With the recovery now stretching into the fifth month, at long last there appears to be a light at the end of the tunnel. Travis has begun taking batting practice and reported no issues following each session. The next step would be a minor league assignment, though Toronto has yet to pinpoint when that might occur.

Travis will have some lingering risk when he does return, but the decision to go under the knife was predicated on the idea that it would serve as a long-term solution for his chronic shoulder woes. Now would be the time to stash Travis if he remains available, as his upside at a shallow position is enticing.

Brantley's offseason trip to the operating room was to address damage to the labrum of his GH joint. A labrum tear can result in significant instability of the shoulder and cause the individual pain and discomfort. Following surgery, an individualized rehab protocol is initiated that often includes strengthening the surrounding muscles to reinforce the area.

After a promising spring, Brantley developed soreness in the area, and the Indians wisely opted to scale back his workload. He started the season on the disabled list but will travel with the team to Minneapolis and could be activated as early as Monday. I've mentioned in previous columns that I like Brantley's value this season based on his likely reduced price tag. However, that doesn't mean he's a sure thing right out of the gate. I would expect a dip in his power numbers at the plate for the first few weeks back, and routine rest days seem inevitable. However, if he can continue to progress and maintain stability in the shoulder, he could prove to be a valuable contributor in the waning days of summer.

Carlos Carrasco

The 29-year-old right-hander has already been placed on the DL after suffering a hamstring strain while covering first base. The injury occurred to his left leg, meaning his lead leg is the involved leg. The hamstring on the lead leg is active during the cocking phase of pitching because the muscle group is primarily responsible for knee flexion while aiding in hip extension. As Carrasco begins to drive his arm and body forward to deliver a pitch, his momentum transfers from his back leg to his now injured lead leg, which serves as a lever arm for the high amounts of force being generated. This motion is referred to as a closed-chain activity, because the leg is locked on the ground. When this occurs, the hamstrings become involved in extension of the knee and are vital in ensuring the pitcher remains supported and balanced. A strained hamstring could limit that ability and open up the door for other injuries elsewhere on the body. A MRI will help determine the severity of the strain and provide better insight into just how long he will be sidelined. Given the swiftness of the move, look for him to miss more than just the allotted 15 days.

Check Swings

Yoenis Cespedes: The Mets slugger reported improvement in his right leg injury but hinted he may need to sit for a few more games. Cespedes hasn't played since aggravating a leg contusion during a slide Friday. He initially injured the leg when he dove into the crowd earlier in the week. Cespedes is a somewhat risky play in weekly formats this week, though fantasy owners should monitor this situation.

Cole Hamels: Hamels did not pitch his scheduled start Monday due to soreness in his left groin. The lefty dealt with a comparable injury last season and was back in action after sitting one start. The team is optimistic that the situation will play out similarly and Hamels will be able to extend his current three game-winning streak. Unfortunately, the scratch bumps Hamels from this week's two-start list, limiting his value in weekly formats. Left-hander Cesar Ramos started in his place.

Yu Darvish: In more exciting news, Rangers GM Jon Daniels told reporters the team is planning for Darvish to return to the rotation by mid to late May. The news is encouraging given the team's recent decision to cancel his rehab assignment with Double-A Frisco. Darvish will continue his rehab protocol following last year's Tommy John surgery and remains an intriguing early season stash.

Yovani Gallardo: The Orioles placed Gallardo on the 15-day DL with a bout of tendinitis in his throwing shoulder. Concerns about Gallardo's shoulder have lingered since the offseason and were the reason Baltimore opted to renegotiate its initial contract offer with the veteran right-hander. A MRI did not reveal any significant structural damage and the team has since administered a cortisone injection to treat the inflammation. The Orioles hope he can return to the rotation after four weeks of rest and rehab.

Stotts works as a Certified Athletic Trainer (MAT, ATC, PES, CES) and is a former winner of the Best Fantasy Football Article from the Fantasy Sports Trade Association.

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