Sheets hurt again, Pedro's prognosis

First-timers and familiar faces head to the disabled list this week as the injuries continue to rack up in baseball, especially in the pitching department. Not that everything is gloom and doom, though; there are a few folks who are recovering from their injury stint who have return dates on the horizon. What's new in the world of injuries? Let's take a look.

Ben Sheets, SP, Milwaukee Brewers: The all too familiar combination of the name "Sheets" and the word "injury" is back in print. Sheets, who is off to a fabulous start for the Brewers this season with three victories, left Friday night's game in the sixth inning with what is being called "tightness" in his pitching arm. ESPN reports that Sheets felt tightness in his right triceps and even after the game, while all wrapped up in ice, Sheets acknowledged that he was "really sore." He referred to his discomfort as a "kind of crampiness in there." In fact, Sheets began feeling soreness in the triceps Monday, the day after his victory over the Mets. The soreness never really dissipated over the week and the Brewers, comfortably ahead in the sixth inning on Friday, decided to pull Sheets and avoid risking further injury. Sheets' concern over this latest setback may be explained by the fact that his current symptoms are located near where his pain was when he tore his latissimus dorsi muscle in 2005, according to a report in the Milwaukee Journal-Sentinel. That problem lingered into the following season, so naturally Sheets is gun-shy about anything that feels remotely similar. In addition to the latissimus injury, over the past two years Sheets has dealt with a groin strain and a significant finger injury, all of which have amounted to a good stretch of missed time. It is unclear at this point how much time, if any, Sheets will miss with this latest ailment, but the team will continue to evaluate him over the next few days. Fantasy owners who drafted Sheets had to know there was an associated injury risk, and although it is not yet panic time, be sure to secure a backup.

Peter Moylan, RP, Atlanta Braves: The Braves have to be wondering where the black rain cloud came from that seems to be hovering over their pitching staff. After Rafael Soriano went on the disabled list with tendinitis in his throwing arm, the team turned to Moylan for relief. That turned out to be short-lived, because pain in Moylan's elbow after pitching April 11 led to testing which revealed damage to his ulnar collateral ligament (the Tommy John elbow ligament) associated with a bone spur. Moylan paid a visit to Dr. James Andrews, who confirmed the team's findings and suggested Moylan attempt a two-week rehabilitation period to see if he could calm the symptoms and pitch again this season. Although Moylan has said the arm has felt a bit better over the past week, the team is not overly optimistic, and it's likely Moylan is ultimately facing reconstructive surgery on his throwing elbow. For his part, Soriano has thrown from flat ground without any ill effects this past week, and should begin throwing from a mound this week as part of his rehab progression. He is eligible to come off the DL on April 22, and he is confident he will be ready to go, but keep in mind, every step in the progression is more stress on the throwing arm. Until we see the evidence that Soriano can handle the increased workload, it appears Manny Acosta will most likely serve as the primary closer.

Carlos Pena, 1B, Tampa Bay Rays: Pena complained of right hamstring tightness Thursday when the Rays faced the Twins, and was removed after the fourth inning as a result. The good news is that Pena did not feel any pain at the end of the game, according to a report in the Tampa Tribune. There was no audible "pop," or anything else that would suggest a serious injury here. As Pena said, he may just have exceeded his "speed limit" and his leg gave him a warning. The Rays have to be somewhat relieved since Pena has jumped out to such a strong home run start. He was held out of Friday's game, largely as a precautionary measure, but he may return to DH this weekend, according to an Associated Press report. The team is wise to give him a few extra days of avoiding hard running so this does not evolve from a minor episode of tightness to a major muscle injury. In the big scheme of things, fantasy owners should not be too concerned about this, because it appears to be just a minor setback.

In brief

Tom Glavine, SP, Atlanta Braves: All good things must come to an end. And so it is with Glavine's amazing 22-year run of avoiding the disabled list. The Braves placed Glavine on the DL Friday, retroactive to Monday, with a strained right hamstring. Although Glavine, who injured his leg Sunday, was expected to be able to pitch against the Dodgers Saturday, ESPN reports that the Braves' team physician apparently felt Glavine's body was not quite ready for competition. In the interest of keeping this from becoming a more serious injury, Glavine will rest and continue to rehabilitate the leg until at least May 1, when he is eligible to be activated. The Braves have certainly had their share of pitching woes early in the season, but as Glavine says, maybe "we're getting it all out of our system."

Jose Reyes, SS, New York Mets: Reyes was back in the lineup Tuesday after missing several games with a strained hamstring but showed no ill effects, going 4-for-5 against the Nationals. Unfortunately he may have something new to contend with as he hit his head against Phillies' second baseman Chase Utley's knee during a headfirst slide Friday night. Although Reyes was tended to for several minutes after the slide, he remained in the game and finished it out. While that would suggest that the injury was not serious, it is worth watching to see if the Mets hold Reyes out at all through the remainder of the series.

Mike Lowell, 3B, Boston Red Sox: The Boston Globe is reporting that the swelling in Lowell's sprained thumb has decreased significantly to the point where he may be able to start swinging a bat soon. There are still a number of rehab steps for Lowell to take, of course. He will begin by hitting from a tee, then progress in batting, then begin fielding exercises, with the ultimate progression to situational exercises, such as diving for balls. Manager Terry Francona told the Globe he did not expect Lowell to be ready to return when he is eligible to come off the DL (Friday), but that is not a big surprise given Lowell's initial timetable was a range from two to four weeks. Nonetheless, the improvement in the swelling is significant because that can be the biggest barrier to progressing activity after this type of injury.

Your questions

Since I have had so many outstanding questions in my Friday chats, and we never have enough time to answer them all, I decided to incorporate some of your questions into my blog each week. Many people are wondering about the long-term ramifications of Pedro Martinez's hamstring injury, including this writer:

JimBob (Wash DC): Hi Stephania, My question relates to Pedro Martinez. ... How serious is his injury, is it a universal injury or is it related to his age, is it going to be a reoccurring injury and/or indicative of other injuries to come, and how do you value him (upon his return) with reference to other pitchers (e.g., is he at the level of Peavy, Billingsly, or Randy Johnson)? Thanks!

Stephania: You are asking a great question, because it reflects all of the different variables you have to consider when evaluating Pedro's situation. Yes, hamstring injuries are universal in the sense that they affect everyone. We have seen pitchers, who rely on the hamstring for trunk and body control during ball delivery and follow through, suffer a strain here. We also have seen hitters suffer hamstring strains, generally during baserunning, because they use the muscle for speed and power. The degree of injury can vary widely, ranging from tightness (which suggests a minor strain or microtearing) to an audible pop, which suggests a more significant injury. The location of the injury can vary as well, from the tendinous region (where the muscle anchors to the bone) which can be near the top, near the pelvis, or near the bottom portion, near the knee to the muscular portion, which is usually felt in the middle of the thigh. Age is relevant in the sense that it can take longer for these injuries to heal in an older athlete, although that is not exclusively the case. The degree of injury and the athlete's level of fitness and flexibility all play a role. In Pedro's situation, perhaps the most concerning thing is the fact that he is dealing with a shoulder that has come off of an extensive rotator cuff repair. He simply cannot throw as hard as he used to, and he relies on his core strength and his legs to help him deliver the ball effectively and offload the arm. If his leg is not at full strength, it potentially compromises his arm. In my estimation, this is why he will not return until the team is convinced his leg is at full strength, and why we heard earlier this week that his return could be delayed until June. I think his value drops as a result of these factors, and even prior to this injury, we did not really expect him to go deep into games, which may mean less "wins" for your fantasy team. I think he is highly motivated to return, which is a positive for him, and he already came back from a shoulder surgery from which few recover. But the physical limitations are what they are, and as a result you need to temper your expectations for his performance, whenever he makes it back.

Thanks for all the great questions and I will keep posting them here on a weekly basis. Best of luck this week and may all your fantasy players stay healthy!!!