Did Josh Johnson owners order up a Marlins ace or a fish filet? Photo credit: regisc
The world didn’t end on 5/21/11, but try telling that to anybody with Josh Johnson on his or her fantasy baseball team. Johnson’s surprise placement on the DL is obviously a very alarming situation for both his real life and fantasy owners, and I’m here to help read the tea leaves and explain what we’re dealing with here. In case you were wondering, I treat all forms of orthopedics injuries, but my specialty is shoulder post-operative rehab, I’m the shoulder guy and Johnson has a shoulder injury, you may want to pay attention.
I hate to say I told you so, but I did tell you so. For anyone familiar with my injury takes from MillionDollarSleeper.com, I advised folks to avoid JJ this year unless he came at a steep discount. I said you’d be playing with fire drafted him as your staff ace. Of course I was one of many people across the web who warned of JJ’s health going into drafts this year, but that’s not important, what is important is that I was right. He’s shelved with “shoulder inflammation”, the same issue that forced him to be shut down late last season, flared up again in the preseason, and according to Johnson himself, has been bothering him all season long. Imagine what his numbers would look like if he wasn’t dealing with an injury, damn.
You might be thinking to yourself, “Don, didn’t Neftali Feliz have shoulder inflammation when he went out, and you said he’d be fine and return from the DL on schedule? Why would Johnson be any different, isn’t it the same injury?” Well my friend, it’s absolutely NOT the same injury, and that’s why I do the thinking around here. This is not an isolated incident as a result of goofy role changing like Feliz. This is a guy with a history of throwing arm trouble, including TJ surgery. This is a guy who’s had lingering shoulder soreness since the end of last season. Sure things felt better during the off-season as he was able to rest and rehab the shoulder, spirits were high and all was well in the world. What happened when he started pitching again? The soreness returned. Not a good sign. He’s had soreness all season, meaning he’s tried to pitch through it (great way to make it worse) to see if it’s just some of the general soreness all pitchers experience or if it’s something more. Seems obvious to me that it’s something more, and always the pessimist I’m concerned about his viability this season.
I’ve discussed at length in previous pieces why shoulder inflammation is bad, I’ll spare the lengthy explanation again. The general course of treatment is rest and anti-inflammatory course, followed by rehab and a gradual throwing program. If all goes well the athlete returns to duty, timeline anywhere from 2-6 weeks. As of this writing I have yet to see any reports of an MRI being planned or taken, but it wouldn’t surprise me if they did one. You can’t be too careful with your young ace. I also wouldn’t be surprised if there’s a cortisone injection in his future both to wipe out the swelling and expedite his recovery. His return to the mound will depend on his symptoms, imaging and overall quality of his mechanics (both of the shoulder joint and his throwing motion).
Is it possible that JJ is simply dealing with a little swelling and he’ll return when eligible and pitch great the rest of the season? Yes. I hope this is the case, I don’t wish injury upon anyone. Do I personally think that’s what will happen? No. Rest and rehab has already been tried, it didn’t work, the soreness is back. Guess what happens when I’m sent a patient with shoulder pain who doesn’t respond to rest, PT exercises and activity modification? They go back to the MD and probably get an MRI. That MRI will likely show some sort of structural damage or abnormality, and shortly thereafter they usually end up needing surgery.
Prediction: Johnson receives an injection in the next few days which helps his symptoms and he misses the next 2 weeks resting and rehabbing as expected, returning to the Marlins in mid-June. He pitches well leading up to the All-Star break, is selected to the team, but declines participation to rest his arm. Shortly after the All-Star break, the soreness returns, and Johnson is forced to the DL yet again. An MRI is taken and reveals inflammation, some rotator cuff fraying and a bone spur. He’ll need arthroscopic surgery to clean out the spur, and is fortunate that the rotator cuff damage is not a full thickness tear, thus he avoids reconstruction. If I owned him (which I don’t) I’d wait until he returns and has a couple productive outings, then I’d sell sell sell. I just don’t think this is the last we’ll hear about his shoulder this year. I hope I’m wrong, but that just doesn’t happen very often!
Victorino was placed on the DL with a "grade 1-2" hamstring strain, meaning it's a little worse than a typical grade 1 but not quite as bad a typical grade 2. Grade 1 muscle strains are your basic run of the mill muscle strains, with microtearing and swelling of the muscle but no significant structural damage. Recovery time typically 1-2 weeks. A grade 2 strain means there is partial tearing of the muscle, the range of which is vast (the grade jumps to 3 when the muscle is completely torn). Since they are calling it a "grade 1-2", there is likely a small tear in the hammy, which is why they DL'd him. Recovery time for a smaller tear is probably 2-4 weeks if he doesn't aggravate it, 4-6 weeks if he rushes it and reaggravates.
The concern with Shane is that his game is based on speed, and you put a ton of stress on the hamstring when you run, especially if the muscle isn't stretched or warmed up enough. Baseball players commonly injure hamstrings (Nelson Cruz ring a bell?) because they go from standing or sitting around to full fledged sprints/activity at any given moment, there's no gradual buildup to action in baseball, it's very "stop and start", which can be tough on muscles. As long as he stays the course and doesn't rush his rehab, Victorino should be fine in the long run, just don't expect him to run like hell the first couple weeks back as they ease him in.
What a jab at my MDC team MDS, ha. Anyway, glad he brought it up and didn't decide to push through it. At least he said he had been feeling it all year and was still pitching good. I'm ganna bite the bullet on this one and sink or swim with my favorite fish in the deep blue sea Josh Johnson. Sorry Flipper.
Onto other matters whats the look out on Victorino’s sore hammy? I’ve considered moving him, but he is just to talented and I have some decent backups to fill in for him while he is out.
There were a number of injuries that popped up over the weekend, if anyone has a specific question feel free to ask!
When it comes to Jason Heyward, I'm concerned but not in panic mode yet. He has "rotator cuff inflammation" in his non-throwing shoulder and has been dealing with it since Spring Training. Generally speaking this would be more problematic if he was a pitcher or it was his throwing arm, the fact that he doesn't throw with the injured shoulder is a big plus as throwing is about the worst thing you can do to your shoulder, and it'll probably allow him to return a bit sooner. It's also why I'm only in concerned but not full fledged panic mode, but there's still some issues here.
The puzzling aspect of this and the long term concern I have is that if the non-throwing shoulder, the arm that doesn't get abused nearly as much as his throwing arm, is flaring up and hasn't stopped since Spring Training, is there a structural issue at play here? I've commented in other articles about genetic "defects" that many individuals have in terms of the bone structure of the acromion bone in the shoulder joint, could Heyward have a hooked acromion that's impinging the rotator cuff muscles underneath it? If that's the case it'll need to be shaved off, an arthroscopic procedure that'll put him out of commission anywhere from 4-8 weeks. Could he have labral damage, ala Justin Upton and Adrian Gonzalez? It's possible, I haven't read about an MRI being taken yet, but it's a possibility.
He's been given a cortisone injection, which is standard procedure, and he'll rest and rehab the muscles and I'd expect him to return when symptom free in 2-4 weeks. It'll be important to monitor his recovery. If his symptoms return or persist despite rest, rehab and injection, chances are it's a structural issue and he'll be headed for the operating table. If he responds favorably, he'll be back and playing.
It's unfortunate to see a young and promising talent like Heyward have so many nagging injuries so early in his career. I know I personally don't have any shares of Heyward, I think he's overrated and was far too expensive for my tastes, but the injury issues further devalue him in my mind. Even if he does return, the symptoms could easily come back when the injection wears off, and while he may be able to play with it don't be surprised if it saps his power numbers. Adrian Gonzalez had a non-throwing shoulder injury last year too, it was the labrum in his case, but it drained his power stroke toward the end of the season. I'm not saying Heyward's season is over, we're a ways off from that happening, but I would tread cautiously. If I could get good value for him (which you probably can't), I'd deal him, but you'll likely have to stand pat and hope for the best.