Stephen Strasburg
Strasburg's return from the disabled list lasted two and two-thirds innings before he was lifted from the game with another elbow injury. The initial evaluation resulted in a strained flexor mass in his throwing elbow though he is actively seeking a second opinion.
In the meantime, Strasburg has been proactive in his recovery, undergoing a platelet-rich plasma (PRP) injection in the area. Several weeks ago, I broke down the various injection utilized in professional sports. The PRP treatment has become one of the more popular options and is designed to simulate the body's natural healing mechanism. Unfortunately, even a PRP injection will only be a Band-Aid if Strasburg continues to place undue stress on and through his elbow.
Strasburg's pitching mechanics have remained largely unaltered since entering the big leagues. The high amounts of force he generates when delivering a pitch have wreaked havoc on his body, most notably his back and elbow. Reports indicate that his latest issue, the flexor bundle strain, is an acute injury, and the MRI showed no signs of an overuse injury. However, the same thing was noted in 2010 about Strasburg's ulnar collateral ligament (UCL) tear that resulted in Tommy John surgery. It appears the manner in which the right-hander delivers his pitches places an abnormally high amount of force on and through the elbow stabilizers. Both the UCL and common flexor tendon attach to the medial epicondyle of the humerus and act together to aid in elbow stability. If one is weakened, the other stabilizer assumes the additional load and becomes susceptible to injury of its own.
Until Strasburg addresses the root of the problem, look for this to continue to be a repetitive problem. The team hasn't officially ruled him out for the season yet, though a more definitive announcement will likely come following his secondary evaluation. In the meantime, Strasburg becomes waiver wire fodder in yearly leagues and remains a high-risk fantasy player in keeper formats.
Lorenzo Cain
The Kansas City outfielder remains limited by a nagging wrist injury. He reportedly suffered a Grade 2 sprain in the wrist sometime in mid-August but initially played through the pain. However, the pain became such a limiting factor that the Royals have held him out of seven of the their last eight games. He recently underwent a stem-cell injection in hopes of accelerating the healing process, though whispers of the club shutting him down for the year have begun to trickle out. Keep in mind a Grade 2 strain is a partial tear of the ligament and the injury site will likely remain unstable without ample time to heal.
The plan is to let Cain rest for the next week before reevaluating the situation. Unfortunately, this decision leaves fantasy owners in a tough spot, as it doesn't appear a trip to the DL is being considered. As a result, it may be time to move on from Cain and invest in a more reliable outfielder for the remainder of the season.
Check Swings
Dallas Keuchel: The Astros ace is dealing with shoulder inflammation and will miss at least his next two starts in the rotation. A MRI did not reveal any structural damage, meaning his inflammation is likely muscular related though the diagnosis remains vague. Like Strasburg, Keuchel could be a top talent that fantasy owners are forced to drop as expanded rosters may keep him off the DL.
Josh Harrison: Harrison suffered a right groin strain over the weekend and is expected to be out four to six weeks, likely ending his season. The Pirates have faded in the playoff race, but if they go deep in the postseason, Harrison could make a playoff appearance in October. Sean Rodriguez will man second base in his place.
Danny Salazar: Like Strasburg, Salazar is battling recurring elbow problems. He was diagnosed with a mild forearm strain Monday and will be sidelined three to four weeks. He has now missed time on four separate occasions this season, three times with elbow-related issues and one time for shoulder fatigue. The injuries are clearly limiting Salazar who has a 7.75 ERA in his last nine starts.
Aaron Sanchez: The Blue Jays have taken a numbers of precautionary steps to protect their young pitcher from being overworked. While the distance between starts has been a point of frustration for fantasy owners, the 24-year-old has managed to pitch without any serious elbow or shoulder problems. However, the protocol didn't account for a troublesome blister than limited him in his start over the weekend. Sanchez surrendered six earned runs in just 3.1 innings pitched before being lifted. He will have his next start skipped and is unlikely to rejoin the rotation until late next week.
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.
Follow @RotowireATC on Twitter.
Get a FREE RotoWire 10-day trial (no credit card required) at RotoWire.com
