Fantasy Baseball: Injury Roundup

September 26, 2008 @ 09:01:41

By Alan Knopf, M.D. and Bryce McRae
Edited by Tim Heaney and Herija C. Green

The Fantasy Sports Doc - Expert Analysis - Dr. Alan Knopf's Take

Dr. Alan Knopf has been a clinical Professor of Orthopedic Surgery and Joint Implant Service at the University of Southern California School of Medicine in Los Angeles. He is an attending staff member of the school's County General Hospital - Keck School of Medicine. He specializes in knee, shoulder, ankle, hip and trauma surgery. Dr. Knopf is board certified by the American Academy of Orthopedic Surgeons and the American Board of Arthroscopic Surgery.

For more information regarding Dr. Knopf's work, please click here.

Chris Carpenter | Starting Pitcher | St. Louis Cardinals | Compressed nerve in right shoulder | Status: Out for the '08 season

Carpenter's latest injury is a sign of a chronic problem with the nerve structures in his neck, shoulder and back. His first experience with this problem came in 2004, when a nerve that runs to right biceps shut down. He complained of numbness in the pinkie and ring fingers of his right hand this year. The righty felt a tugging behind his throwing shoulder during his last outing and was shut down as a result.

The problem can stem from an entrapment nerve injury to the neck (cervical spine), brachial plexus and shoulder.

Cervical Spine - This protects the spinal cord and its branches (tree trunk with roots). These branches are subject to injury from trauma or traction. Arthritic spurs or discs can also put pressure or traction on these roots at every level of the spinal column. There are eight levels of nerve roots on each side of the cervical spine (neck).

Brachial Plexus - The above roots combine with the eight branches to intertwine and form the plexus, which supplies sensation and power to the upper extremity. This plexus is at the level above the chest cage and below the collarbone.

Branches from the brachial plexus then separate at the shoulder blade level to go in front of the shoulder and behind the shoulder joint to supply individual muscles in the arm. The plexus forms basically four major nerves that supply motor power to the arm and hand as well as sensation: median, ulnar, radial and musculocutaneous. Therefore, somewhere along this "neurological highway," in Carpenter's case there exists an obstruction causing an electrical (neurological) "traffic jam."

Results of an EMG (electromyelogram) and an MRI (magnetic resonance imaging) will identify the level of impingement or injury. There are two possible conclusions to these tests.

The first possibility is that the obstruction is at the root level in the neck in the form of arthritis or a herniated (ruptured) intervertebral disc. The likely cause would be multiple levels of nerve root compromises. The surgery for a one-level decompression is about 80 percent successful in relieving the symptom; higher levels of compression produce lower long-term success rates.

The second explanation is neurological entrapment syndrome. This depends on the location of the compromise, namely either the brachial plexus or the individual nerves. This can be relieved by surgical release of the entrapment or a resection of the scar tissue, muscle or any mass that may be pressing on these structures. The outcome of the surgery in the shoulder and arm is normally excellent, but if the brachial plexus is involved the outcome of the surgical release is less certain.

I would put my money on the neck as the site of the problem and hopefully at only a one-level compression. He may return to throwing the baseball in three months post-operative. Keep the picture of a freeway with off-ramps in your mind for this rather complex explanation. Somewhere, a bottleneck has to be opened!

Catchers

Player	Team	Injury	Status/Projected Return	Fantasy Replacement	Fantasy Tip
Kurt Suzuki	OAK	hip	Day-to-day	Rob Bowen	Retain in all
John Baker	FLA	knee	Friday, Sept. 26	Matt Treanor	Late-season boost in all mixed
Yadier Molina	STL	thigh	Sept. 26-28	Jason LaRue	Keep in NL-only

 

First Basemen

Player	Team	Injury	Status/Projected Return	Fantasy Replacement	Fantasy Tip
Todd Helton	COL	back	Done for the year	Ian Stewart	Drop in all
Adam LaRoche	PIT	hamstring	Returned Wednesday, Sept. 24	N/A	Retain in all mixed

 

Second Basemen

Player	Team	Injury	Status/Projected Return	Fantasy Replacement	Fantasy Tip
Howie Kendrick	LAA	hamstring	Returned Monday, Sept. 22	N/A	Add in deep mixed
Ray Durham	MIL	hamstring	Returned Tuesday, Sept. 23	Rickie Weeks	Acquire in deep mixed
Mark DeRosa	CHC	calf	Day-to-day	Ronny Cedeno	Deep mixed option
Mark Ellis	OAK	shoulder	Out for the season	Cliff Pennington	Drop in all formats
Jeff Kent	LAD	knee	Activated; pinch-hitting	N/A	Discard in all

 

Third Basemen

Player	Team	Injury	Status/Projected Return	Fantasy Replacement	Fantasy Tip
Chipper Jones	ATL	shoulder	Pinch-hitter rest of the way	Martin Prado	Discard in all
Chone Figgins	LAA	elbow	Returned Sunday, Sept. 21	N/A	Acquire if available
Mike Lowell	BOS	hip	Sept. 27-28	Sean Casey	Deep mixed option
Ryan Zimmerman	WAS	flu	Day-to-day	Pete Orr	Hold in deep mixed
Melvin Mora	BAL	hamstring	Not expected to return this year	Kevin Millar	Drop in all
Carlos Guillen	DET	back	Likely out for the season	Ryan Raburn/Mike Hessman	Discard in all
Edwin Encarnacion	CIN	wrist	Returned Monday, Sept. 22	N/A	Add in deep mixed
Joe Crede	CHW	back	Likely done for the year	Juan Uribe	Dump in all

 

Shortstops

Player	Team	Injury	Status/Projected Return	Fantasy Replacement	Fantasy Tip
Hanley Ramirez	FLA	shoulder	Returned Monday, Sept. 22	N/A	Start in all
Michael Young	TEX	finger	Returned Monday, Sept. 22	N/A	Return to lineups
Yunel Escobar	ATL	hamstring	Likely limited to pinch-hitting	Omar Infante	Discard in all mixed
Derek Jeter	NYY	hand	Sept. 26-28	Cody Ransom	Hold in all
Rafael Furcal	LAD	back	Activated Sept. 24; backup	N/A	Discard in all mixed
Cristian Guzman	WAS	flu	Day-to-day	Alberto Gonzalez	Hold in deep mixed
Julio Lugo	BOS	quadriceps	Likely done for the year	Jed Lowrie	Dump in all

 

Outfielders

Player	Team	Injury	Status/Projected Return	Fantasy Replacement	Fantasy Tip
Carlos Lee	HOU	finger	Out for the season	Darin Erstad	Discard in all
Vladimir Guerrero	LAA	knee	Showing improvement	N/A	Hold in all mixed
Carl Crawford	TB	finger	Won't start in regular season	Rocco Baldelli	Discard in all
Carlos Quentin	CHW	wrist	Unlikely to return	Dewayne Wise	Dump in all mixed
J.D. Drew	BOS	back	Returned Wednesday, Sept. 24	N/A	Deep mixed flier
Willy Taveras	COL	leg	Done for the season	Dexter Fowler	Discard in all
David DeJesus	KC	hip	Day-to-day	Mitch Maier	Retain in deep mixed
Cameron Maybin	FLA	hip	Day-to-day	Cody Ross	Pick up in all mixed
Michael Cuddyer	MIN	foot	Could return to right field	N/A	AL-only option
David Murphy	TEX	knee	Likely out for the season	Nelson Cruz	Discard in all single-year
Jody Gerut	SD	finger	No timetable	Will Venable	Don't retain in any leagues
Fernando Tatis	NYM	shoulder	Out for the season	N/A	Drop if still holding
Chris Dickerson	CIN	ankle	Done for the year	Corey Patterson	Dump in all

 

Designated Hitters

Player	Team	Injury	Status/Projected Return	Fantasy Replacement	Fantasy Tip
Hideki Matsui	NYY	knee	Done for the season	Brett Gardner	No longer an option

 

Starting Pitchers

Player	Team	Injury	Status/Projected Return	Fantasy Replacement	Fantasy Tip
Edinson Volquez	CIN	knee	Will miss final start	Adam Pettyjohn	Discard in all
Ben Sheets	MIL	elbow	Could be done for the season	N/A	Retain solely in NL-only
Justin Duchscherer	OAK	hip	Done for the year	Sean Gallagher	Dump in all
Mike Mussina	NYY	elbow	Hopes to pitch Sunday, Sept. 28	N/A	Retain in all
Joe Saunders	LAA	kidney stone	Possibly Sunday, Sept. 28	Dustin Moseley	Start if he returns
Erik Bedard	SEA	shoulder	2009 All-Star break	N/A	Drop in non-keeper
Kevin Slowey	MIN	wrist	Unlikely to pitch again this year	N/A	Discard in all
Wandy Rodriguez	HOU	oblique	Returned Tuesday, Sept. 23	N/A	Acquire in deep mixed
Daniel Cabrera	BAL	elbow	Done for the year	Chris Waters	Discard in all
Andy Pettitte	NYY	shoulder	Shut down	Alfredo Aceves	Drop in all
Jeremy Guthrie	BAL	shoulder	Sunday, Sept. 28	N/A	Add in all
Yovani Gallardo	MIL	knee	Started Thursday, Sept. 25	N/A	Ignore in all
Chris Carpenter	STL	shoulder	Spring Training 2009	N/A	Release in all
John Maine	NYM	shoulder	Activated Sept. 24; pitching in relief	N/A	Avoid in all
Brad Penny	LAD	shoulder	Will not return	N/A	Discard in all

 

Relief Pitchers

Player	Team	Injury	Status/Projected Return	Fantasy Replacement	Fantasy Tip
Troy Percival	TB	back	Back is limiting him	Dan Wheeler	Keep in deep mixed
Takashi Saito	LAD	elbow	Day-to-day	N/A	Acquire if available
Huston Street	OAK	forearm	Day-to-day	N/A	Retain in AL-only
Hong-Chih Kuo	LAD	elbow	Finished for the season	N/A	Discard in all

KFFLians are saying....

Comment

 

---

What do you think? We want to hear from you!

Name: E-mail: Please, enter the number that you see

Comment Guidelines

Alan Knopf, M.D.
Dr. Alan Knopf has been a clinical professor of orthopedic reconstructive surgery and joint implant service at the University of Southern California School of Medicine in Los Angeles. He worked for 30 years at the Kaiser Permanente Medical Group in Los Angeles, where he specialized in knee, shoulder, ankle, hip and trauma surgery. Dr. Knopf is certified in arthroscopic surgery.

Bryce McRae
Bryce McRae is a Managing Editor with KFFL and has been involved in fantasy sports since 1999. He joined KFFL as a volunteer writer in March 2005 before becoming a Hot off the Wire Analyst in March 2006. He began working in his current capacity in September 2008. His work has appeared on fantasy sports sites such as Yahoo! and CBS Sportsline as well as in print. He graduated from the University of British Columbia in 2008 with a B.A. in History and U.S. Studies.

Talk Sports 24/7!
KFFL Sports Forums: Over 24,000 strong and growing!

Fantasy Baseball Diamond Market: Ramon Hernandez hits DL (05/25)
Fantasy Baseball Player Prospecting: Travis d'Arnaud, Kevin Mattison, more (05/25)
Fantasy Baseball Diamond Market: DL for Marco Estrada (05/25)