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Cleveland Indians catcher Victor Martinez (elbow) underwent surgery Friday, June 13, to remove loose bodies in his right elbow. He is expected to miss six to eight weeks.
Pittsburgh Pirates catcher Ryan Doumit (concussion) has not played in the team's last two games and is expected to miss the next couple of games as well due to a slight concussion suffered Tuesday, June 17. The team does not believe he'll need to be placed on the disabled list.
Others of Note
St. Louis Cardinals catcher Yadier Molina (concussion) suffered a mild concussion Sunday, June 15, and is expected to join the team in Boston this weekend. He did not play during the team's three-game set with the Kansas City Royals, and there has been no timetable given for his return.
St. Louis Cardinals first baseman Albert Pujols (calf) participated in batting practice and took grounders Wednesday, June 18. He is eligible to return next week, although it remains uncertain as to when he will return.
Chicago White Sox first baseman Paul Konerko (oblique) landed on the disabled list Tuesday, June 17, with a Grade 1 strain of his oblique. Konerko is not expected to do any physical activity for a week and build from there. There is no timetable for his return.
Tampa Bay Rays first baseman Carlos Pena (finger) played catch and took infield and one-handed swings Thursday, June 19. He is set to be evaluated Sunday, June 22.
Boston Red Sox first baseman Kevin Youkilis (back) is expected to return Friday, June 20. He hasn't played since June 15 due to back stiffness.
Others of Note
Texas Rangers first baseman Hank Blalock (wrist) is expected to begin a three-game rehab assignment with Triple-A Oklahoma over the upcoming weekend.Â
Milwaukee Brewers second baseman Rickie Weeks (knee) took ground balls Tuesday, June 17, for the first time since landing on the DL. He may not be ready to return when he is eligible (June 22), but manager Ned Yost has indicated it shouldn't be long after that.
Others of Note
Toronto Blue Jays second baseman Aaron Hill (concussion) was symptom-free Wednesday, June 18, and was scheduled to meet with a specialist Thursday, June 19. If all went well, Hill could return in 10 days following a minor league rehab assignment.
Atlanta Braves third baseman Chipper Jones (eye) suffered a left-eye contusion after a ball hit him in batting practice Friday, June 13. He has been able to continue playing after X-rays came back negative.
Los Angeles Angels third baseman Chone Figgins (hamstring) returned from the disabled list Friday, June 13. He is hitting .304 with one three runs and one stolen base since returning.
Others of Note
San Diego Padres third baseman Kevin Kouzmanoff (back) is scheduled to meet with doctors to have his lower back strain checked out Friday, June 20. He did not appear in the club's three-game series with the New York Yankees and is expected to miss another three to five days. There is still a remote chance he could land on the DL.
Los Angeles Dodgers shortstop Rafael Furcal (back) will likely not return before the All-Star break. He has not played since May 5 because of a bulging disc in his back.
Colorado Rockies shortstop Troy Tulowitzki (quadriceps), who has not played since tearing his left quadriceps April 29, has completed his rehab assignment and is expected to come off the disabled list Friday, June 20.
New York Mets shortstop Jose Reyes (hamstring) was removed from the game Tuesday, June 17, because of tightness in his hamstring but was back in the starting lineup Wednesday, June 18.
Others of Note
Cincinnati Reds shortstop Jeff Keppinger (knee) took batting practice Wednesday, June 18, but it appears unlikely he'll be activated before the end of June .... Dodgers infielder Nomar Garciaparra (calf) has left his rehab assignment in Triple-A Las Vegas to visit with a doctor in Boston. There is no timetable for his return.
Chicago Cubs outfielder Alfonso Soriano (hand) is scheduled to have his hand X-rayed, and he is aiming to take batting practice Monday, June 23. Soriano is looking to return before the All-Star break. However, a better timetable should be known after doctors examine his X-rays.
Boston Red Sox outfielder Manny Ramirez (hamstring) is expected to return Friday, June 20, after sitting out the team's last game with tightness in his right hamstring.
Arizona Diamondbacks outfielder Eric Byrnes (hamstrings) ran at full speed and simulated running out of the batter's box Tuesday, June 17. He was expected to be sent on a rehab assignment Thursday, June 19, and could return Monday, June 23.
Cincinnati Reds outfielder Ken Griffey, Jr. (illness) has not started the last three games due to an illness. He remains questionable for the team's game Friday, June 20.
Detroit Tigers outfielder Magglio Ordonez (side) left early Wednesday, June 18, due to spasms in his side. Manager Jim Leyland does not feel the injury is serious, but he didn't say when Ordonez would return.
New York Mets outfielder Ryan Church (concussion) was cleared to begin exercising Monday, June 16, and was hoping to return from the DL by this weekend.
Pittsburgh Pirates outfielder Xavier Nady (shoulder) is expected to swing off a tee for the second time Friday, June 20, but it's a sign that he could land on the DL with the team recalling outfielder Nyjer Morgan. There is no timetable for Nady's return.
Pirates outfielder Jason Bay (stomach) did not start Tuesday, June 17, due to a stomach bug, but he was able to return the following day.
Texas Rangers outfielder Milton Bradley (quadriceps) missed his second straight game Thursday, June 19, due to a strained left quadriceps. Manager Ron Washington doesn't think the injury is serious, but he wants to play it safe. He is hopeful Bradley will return this weekend.
Others of Note
Red Sox outfielder Coco Crisp (hand) suffered a strain in the top or middle of his hand, but manager Terry Francona expects him to play Friday, June 20.... Florida Marlins outfielder Josh Willingham (back) is on a Double-A rehab assignment and could return early next week. Florida could even rush him back this weekend, if they need him.... Mets outfielder Moises Alou (calf) landed on the 15-day disabled list Friday, June 13, for the third time this season. It's uncertain when he'll be able to return.... San Diego Padres outfielder Brian Giles (shoulder) will undergo an MRI on his left shoulder Friday, June 20, as he has been feeling discomfort while throwing the ball or taking a bad swing. He has not missed any time, and the team hasn't indicated that he will sit.
Boston Red Sox designated hitter David Ortiz (wrist) has had his cast replaced by a splint, but there is still no timetable for his return.
New York Yankees designated hitter Hideki Matsui (knee) is expected to return Friday, June 20. The knee problems that have forced him to sit the past two games stem from 10 years ago, when he damaged cartilage in his knee, and it flares up from time to time.
Chicago White Sox designated hitter Jim Thome (back) suffered some recurring back pain last week that prevented him from playing first base. However, the pain is gone and he could play first if called upon in upcoming interleague play.
Cleveland Indians designated hitter Travis Hafner (shoulder) will continue with his strengthening exercises after learning he will not need surgery. There is no timetable for his return.
Oakland Athletics designated hitter Frank Thomas (quadriceps) will not begin baseball activities until July 1 at the earliest. There is no timetable for his return.
Boston Red Sox starting pitcher Daisuke Matsuzaka (shoulder) was solid during a Triple-A rehab start Monday, June 16, and he is expected to return Saturday, June 21.
Chicago Cubs starting pitcher Carlos Zambrano (shoulder) experienced discomfort in his right shoulder Wednesday, June 18, and will fly to Chicago to have his shoulder examined. He is expected to miss his next start.
Cleveland Indians starting pitcher Fausto Carmona (hip) has been shut down for three days due to a recurrence of the inflammation in his left hip Tuesday, June 17. He will be re-evaluated after the three-day period, which could give the team a better timetable for his return.
New York Yankees starting pitcher Chien-Ming Wang (foot) is expected to miss 10 to 12 weeks due to a sprain of the Lisfranc ligament in his right foot. He is expected to be on crutches and wear a protective boot for at least six weeks. He probably won't return until September at the earliest, and he could miss the remainder of the regular season.
Others of Note
Atlanta Braves starting pitcher Mike Hampton (pectoral) threw 50 pitches over two innings Tuesday, June 17, and felt no pain in his pectoral muscle. He is expected to throw one more time and if everything goes well he could begin a minor league rehab assignment.... Red Sox starting pitcher Curt Schilling (shoulder) is expected to undergo shoulder surgery Monday, June 23, and his season, and possibly career, could be over.... Red Sox starting pitcher Bartolo Colon (back) landed on the 15-day disabled list Tuesday, June 17, due to stiffness in his lower back. There is no timetable for his return.... Detroit Tigers starting pitcher Jeremy Bonderman (shoulder) is scheduled for surgery June 30 to address the thoracic outlet syndrome that forced him to the DL. The team will determine a timetable after the surgery.... Los Angeles Angels starting pitcher Kelvim Escobar (shoulder) reported to the Angels' facility Thursday, June 19, to begin a week-long rehab that could include a two-inning simulated game Saturday, June 21, and an Arizona Summer League game Wednesday, June 25. It has been speculated he could return by sometime around the All-Star break.... Los Angeles Dodgers starting pitcher Brad Penny (shoulder) landed on the 15-day disabled list Tuesday, June 17, with inflammation of the bursa sac and mild tendonitis in his right shoulder. There is no timetable for his return.... Dodgers starting pitcher Hiroki Kuroda (shoulder) landed on the 15-day disabled list Thursday, June 19, due to an impingement and tendonitis in his right shoulder. There is no timetable for his return.... Dodgers starting pitcher Jason Schmidt (shoulder) threw a bullpen session Tuesday, June 17, and is working toward a rehab assignment. He suffered a setback last week. There is no timetable for his return.... St. Louis Cardinals starting pitcher Chris Carpenter (elbow) threw a bullpen session Wednesday, June 18, and is expected to do so again Friday, June 20. He is still hoping to pitch in the majors in 2008.... Cardinals starting pitcher Todd Wellemeyer (elbow) missed his start Thursday, June 19, due to inflammation in his right elbow. He was only expected to miss the one start.... Cardinals starting pitcher Mark Mulder (shoulder) was scheduled for his second Triple-A rehab start, and he could be considered for a start next week if Wellemeyer is not ready.
Tampa Bay Rays closer Troy Percival (hamstring) returned from the disabled list Friday, June 13. He has recorded three saves since returning.
Seattle Mariners closer J.J. Putz (elbow) played catch Wednesday, June 18, and will continue increasing the distance until he is able to throw a full bullpen session. There is no timetable for his return.
Atlanta Braves relief pitcher Mike Gonzalez (elbow) returned from the disabled list and picked up his first save Wednesday, June 18.
Braves relief pitcher Rafael Soriano (elbow) has yet to test his elbow with a bullpen session and the Braves are unsure when he will do so. They are also unsure when he will return.
Braves pitcher John Smoltz (shoulder) said doctors found significant damage in his shoulder during surgery, and he hopes to know more in four or five months when he is able to throw. Similar operations to Smoltz's have limited pitchers to the point where they can't pitch again.
Milwaukee Brewers closer Eric Gagne (shoulder) threw a successful bullpen session Thursday, June 19, and is on a program to join the bullpen Friday, June 27. Manager Ned Yost said he plans to stick with reliever Salomon Torres as closer when Gagne returns, though.
St. Louis Cardinals relief pitcher Jason Isringhausen (hand) returned from the disabled list Saturday, June 14. He is expected to work in middle relief for the time being and threw 2 1/3 scoreless innings Thursday, June 19.
Others of Note
Detroit Tigers relief pitcher Joel Zumaya (shoulder) is expected to come of the DL Friday, June 20.
Detroit Tigers relief pitcher Fernando Rodney (shoulder) was activated from the disabled list Monday, June 16. He has made one appearance - a blown save after allowing three earned runs in one-third of an inning - since returning.
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. He's board certified by the American Academy of Orthopedic Surgeons and the American Board of Arthroscopic Surgery.
The elbow has three basic motions: 1) flexion 2) extension 3) rotation. Pitchers place the highest demand on these function and anatomic structures when throwing a ball. The fast ball is one of the toughest on the arm, and the curve ball is especially stressful on the joint.
The inside portion of the elbow is made up of the ulnar collateral ligament, along with the muscle tendon group. They are responsible for flexion and rotation (pronation) of the wrist during the grip as well as the throwing motion of a pitched ball. The ulnar nerve (funny bone injury) is protected inside these anatomic structures.
The repeat stress on these structures can cause an inflammation, leading to eventual degeneration, tearing and damage to the ulna nerve. The nerve supplies sensation to the ring and little finger as well as providing motor control.
Initial evaluation with a magnetic resonance imaging (MRI) is valuable to determine the extent of damage. Treatment should include rest, immobilization and rehabilitation. A minimum time of one month is justified.
Early return could lead to a "dead arm" (ulnar collateral ligament tear) and Tommy John surgery, which approximately one out of nine major league pitchers have undergone.
Inflammation of the triceps muscle, the extensor muscle behind the elbow, can affect the elbow with the pain of swelling. A micro-tear of the tendon can also affect the ulnar nerve but is also suggestive of an overuse syndrome affecting the inside anatomy that was just outlined. Again, rest and immobilization one month before returning to the throwing motion is the conventional means of treatment.
Impingement syndrome shoulder is also classified as an overuse syndrome. It can involve the rotator cuff tendons, biceps tendon, shoulder bursa or shoulder bones. The shoulder mechanism works just like a crane. The steel cable that lifts the weight and swings it to another position is an analogy to the function of the rotator cuff.
The rotator cuff is composed of four muscle tendon connections that cover the entire head of the shoulder bone (humerus). This complex stabilizes the humerus against the shoulder blade (scapula) and is covered on top by a bony projection of the scapula called the acromion. It is this narrow area that needs to be lubricated in order to prevent fraying of the cable (like oil lubricating a gear).
Bursitis is an inflammation of the sac preventing the breakdown of the rotator cuff (cable analogy). The sliding motion of cable on the pulley of the crane needs constant lubrication. A repetitive motion like throwing with velocity or lifting heavy weight can cause an irritation and cause swelling of the bursa, which can lead to chronic change in the bursa as well as a change in the rotator cuff itself.
If left untreated eventually a rotator cuff rupture will occur with repetitive use. Treatment includes rest, ice, anti-inflammatory pills or steroid injections into the bursa sac (not more than three per year). The inflammation usually resolves in four to six weeks.
If recurrence of bursitis reoccurs, shoulder arthroscopic surgery may be necessary; healing and rehab may take two to three months.
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