2012 preseason injury watch: Outfield

As you prepare for your 2012 fantasy baseball season, injury stories from last season are undoubtedly a factor. A number of players either had their seasons end prematurely due to injury or limped into the offseason with health concerns. Now spring is around the corner, and you need to know how concerned you should be. Since the top predictor of injury in one year is injury the year before, it's hard to feel confident about anyone who lost significant time in 2011. That said, some athletes appear to be on the verge of bursting back on the scene this spring while others cast shadows of uncertainty all around them. Here's what we're hearing about some of the players with major injury concerns surrounding their names.

We'll be splitting up the injury reports by position to make it a little easier to find information about the players drawing the most attention.


Carl Crawford, Boston Red Sox: It came as a bit of a surprise in January when the Red Sox announced Crawford had undergone surgery on his left wrist. The procedure was described as an arthroscopic debridement (a "cleanup" type procedure done via a scope), and while no specific timetable for his recovery was given, general manager Ben Cherington said he expected Crawford to play the "bulk" of the season.

But wrist injuries in power hitters certainly generate concern given how much torque is generated as the bat is twisted at speeds exceeding 70 miles per hour. It is that torque which likely played a role in Crawford's injury in the first place. As ESPNBoston.com's Gordon Edes noted, Crawford's surgery was on his TFCC or triangular fibrocartilage complex, a cartilage structure (and its supporting ligaments) within the wrist. It is sometimes referred to as the meniscus of the wrist since it has a similar role in both load transmission and providing stability within the joint. A tear can lead to a catching of the tissue within the joint that causes pain and prevents normal motion. It was that pain when trying to swing the bat that led Crawford to the surgery. Surgical debridement procedures of TFCC tears smooth out the damaged tissue and generally lead to a good outcome. Crawford certainly seems to be moving in the right direction.

When spring training started, manager Bobby Valentine indicated he did not expect Crawford to be ready by Opening Day. Crawford, however, has made Opening Day a goal and has been taking part in virtually all baseball activities, including fielding, throwing and running the bases. Recently he was cleared to start swinging the bat and, as of this writing, he has had several days of taking aggressive swings in the cage. According to ESPNBoston.com's Joe McDonald, Crawford says his wrist feels good. His status remains day-to-day as the medical staff monitors his wrist to see how it responds to the increasing workload. While it is too soon to say whether he will meet his target of Opening Day, Crawford does appear to be progressing at a solid pace. In the absence of any setbacks, his availability in early April is looking like a possibility.

Jason Heyward, Atlanta Braves: Heyward struggled through a right shoulder injury last year, which had him in and out of the lineup early in the season for the better part of a month. The vague nature of the injury led to frustration on Heyward's part as he struggled to regain his form. It also led to what appeared to be frustration from the organization as his absence lingered. Heyward underwent a battery of tests during the season that confirmed inflammation in his lead batting (non-throwing) shoulder but no specific structural damage. He subsequently underwent an MRI on his neck at the end of the season, which also came back negative. But clean MRIs do not necessarily rule out the presence of a problem, just as positive findings on an MRI do not necessarily translate to pain or dysfunction. It can, however, make identifying the precise source of a problem trickier. In Heyward's case, it never appeared as if he truly "healed" last season, as he was inconsistent at the plate and he ultimately found himself in a time-share situation. As the Braves' season fizzled out, Heyward's shoulder challenges seemed a relative afterthought.

The question heading into 2012 becomes: Has whatever was ailing Jason Heyward truly resolved or is he just feeling better after the extended downtime of the offseason? The answer: We don't truly know. It's likely that Heyward doesn't know for certain either but he has certainly taken steps to try and improve over last year. According to the Atlanta Journal-Constitution, Heyward wasted little time after the season ended before embarking on an intense training regimen. That regimen included physical therapy with an emphasis on strengthening his shoulder, increased cardiovascular work and a modified diet. It also included a renewed focus on his mechanics at the plate. At just 22, Heyward has plenty of opportunity left in him. If the issues with his shoulder are indeed behind him, it bodes well for his season. It's worth noting that as an outfielder, there are plenty of opportunities for Heyward to dive and land on that shoulder (his glove side) or hit an outfield wall. How his shoulder responds to direct contact or to the strain of a big swing and miss, or perhaps even to the cumulative effect of such stresses, will eventually hint at how far his recovery has come. Until then, it will be a matter of wait and see.

Nick Markakis, Baltimore Orioles: Markakis is coming off January surgery to repair a torn abdominal muscle but still has hopes of being ready by Opening Day. According to The Baltimore Sun, Markakis originally injured himself in September while diving for a ball down the right-field line. He continued to play but aggravated the injury later that month. Markakis told the Sun that his surgeon found evidence of chronic injury in the area in the form of scar tissue. The good news is that players typically come back much stronger following this procedure. Perhaps the chronic nature of the injury also explains the decrease in power Markakis experienced in recent years. Coming back strong and fresh might bode well for his productivity this season. Markakis, who says he no longer has any pain, appears to be making good progress with his rehab work and will progress through spring training as his body allows.

Josh Hamilton, Texas Rangers: Hamilton underwent surgery to repair a sports hernia in November, but that might not be his biggest challenge heading into this season. In fact, Hamilton was swinging a bat in January and had plenty of time to regain his conditioning prior to spring training. In early February, however, Hamilton acknowledged a relapse with alcohol, a troublesome development given his history of addiction. Hamilton has always been a force when playing but is known to miss time regularly with various musculoskeletal issues. Whether those injuries are affected by the physical toll his body has absorbed over the years is unknown, but the outlook is certainly more promising when he is on track. Hamilton projects for great productivity when playing but is almost predestined to miss chunks of time during the season.

Matt Holliday, St. Louis Cardinals: Holliday experienced injuries ranging from the uncommon to the bizarre last season. An appendectomy in the first week of the regular season took him out of the game, amazingly, for only seven games. In August, a moth flew in his ear and had to be carefully extracted by the athletic training staff (the moth did not fare well, but Holliday was fine). Late in the season, Holliday injured his right hand, reportedly while swinging a bat in the on-deck circle. It was a painful problem that nearly forced him to the disabled list, but he managed to press through it, for the most part, right into a World Series victory. Throw into the mix a left quadriceps strain that sent him to the DL in June, and Holliday certainly endured his share of ailments. None of them are expected to present a problem for him heading into this season, however, and he should be on track in spring training.

Ryan Kalish, Boston Red Sox: Kalish underwent surgery to repair a torn labrum in November after spending most of last season in pain. Kalish, who had been in line to move into right field for the Red Sox, originally injured his shoulder in April while diving for a ball, playing for Triple-A Pawtucket. According to The Boston Globe, Kalish tried to go the rehab route, but shortly after returning to play, he developed neck pain that ultimately ended his season early. In September, Kalish underwent neck surgery, followed by labral surgery two months later. The Globe notes that if all goes well, Kalish could return in May or June. Since Kalish's injury was to his throwing shoulder, the demands of his position will require a lengthier recovery. Given that he has undergone both neck and shoulder surgeries this past year, the Sox will not rush him back.

Allen Craig, St. Louis Cardinals: Craig underwent surgery on his right knee in November, having screws inserted into his kneecap as the result of a knee-meets-wall injury during the middle of last season. As noted by the St. Louis Post-Dispatch, Craig's recovery was projected at four to six months, meaning he would still be limited in spring training. There is a good chance Craig will not be ready by Opening Day, as he likely will be working on regaining leg strength. His progress during spring training will speak volumes, but expect the Cardinals to be without him for the first month of the season.

Stephania Bell is a physical therapist who is a board-certified orthopedic clinical specialist and a certified strength and conditioning specialist. She is a clinician, author and teacher with extensive experience in the area of orthopedic manual therapy and sports medicine.