Risk Ratings: Risky Rehabs and Returns for MLB 2014

Will Carroll@injuryexpertSports Injuries Lead WriterFebruary 27, 2014

Risk Ratings: Risky Rehabs and Returns for MLB 2014

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    One of the best ways to get a quick advantage in any fantasy draft is to understand the comebacks. Whether it's Tommy John or knee surgery, the idea that any player can be predicted is false. It's only some injuries and some players that can be accurately predicted. Anything outside of that adds to the risk portfolio of any team and/or fantasy team.

    In this slideshow, I've selected 10 players that have a rehab that could alter the fortunes of themselves and their teams. Albert Pujols might be a value if he slides in your fantasy draft, but he could also alter the values of the pitchers on the team and the players hitting around him in the lineup. If Derek Holland can come back, some of the pressure on the Rangers bullpen will be relieved.

    There's always context, so it's important to understand where these players are, what a reasonable expectation is and how to value them. I checked with team officials, medical staff and scouts before writing these up to give you the best view. Of course, throughout the season I'll be following these and the rest of the injuries in my Under The Knife column. For now, let's take a look at 10 of the most impactful injury rehabs as we head into the 2014 season.

Manny Machado, Baltimore Orioles

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    Manny Machado is smiling again, but will he be ready for Opening Day?

    The Orioles honestly don't care. Talking to team sources, the O's want their young star to be healthy and are happy that last season, he elected to have the knee surgery to fix his minor knee problem that led to such a dramatic end to his season.

    Machado had experienced a similar situation in the minors, but it hadn't recurred. When it did in such dramatic fashion, the O's wanted closure. Machado initially resisted, but talks with surgeons led him to have the surgery that locked in his patella and fixed the surrounding issues. 

    He shouldn't have the issue again and once past the initial rehab, we should be able to put this situation in the rear-view and think of Machado as any other young, stud player, rather than worrying about the next time his patella dislocates. The surgery should correct the underlying issue.

    So far, the rehab has gone to plan, with Machado wavering between on and ahead of schedule. Most of that is likely the Orioles pulling the reins. Machado wants to be ready for Opening Day and the O's want Machado fully healed. Right now, it looks like he'll be ready by mid-April, but it's fluid. 

    Given the state of knee surgeries and how far along Machado is, there's very low risk with Machado. Treating this like an ACL injury is reasonable in terms of recovery, which means once he's back, he's back, with only a slight initial loss of speed and range, which should return in the medium term.

Albert Pujols, L.A. Angels

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    The future of the Los Angeles Angels isn't Albert Pujols. That would surprise anyone that was there the day two years ago when Pujols shifted west from St. Louis. Mike Trout is that guy, but if Pujols isn't going to be the next Vernon Wells, he's going to have to be healthy.

    Pujols was always going to be in decline while an Angel. The team paid him with the idea the inevitable decline would be slow. Instead, his plantar fasciitis and chronic knee issues went from minor maintenance to derailing his season entirely. 

    Remember, Pujols has never been healthy. The elbow issues, the foot issues, the knee and back issues have always held him back, but he's produced and occasionally gritted his teeth to get out there. That didn't happen in 2013, partially because there was no reason to do so. The team, Trout and all, was out of it.

    The thought is that Pujols sacrificed a month of the season to get right and be ready for the next year (and eight years), but he also didn't have the surgeries the team expected. His foot was handled as it always was and the knee wasn't scoped again. Pujols comes into the season rested and healthy, but chronic conditions should respond to rest and be taxed by play.

    We won't know whether Pujols can play through it this year like he did most of his career or whether 2013 was just the start of a rapid decline until it's too late. The risk is clearly there, but I have a hard time saying something someone did year after year suddenly can't be done. I don't think Pujols will compete with Trout when it comes to MVP votes or playing time again, but I think the big, angry guy will be back. 

Matt Harvey, New York Mets

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    If things go to plan, Matt Harvey won't pitch this year. That's very conservative, but is also very realistic. Harvey could pitch at the end of the season and is pushing to do so, but there's no significant upside for the Mets. If he makes it through the rehab, as he should without issue, and pitches through a handful of games in the minor leagues, Harvey and the Mets will know he'll be ready for the 2015 season.

    It will take some restraint. Like Stephen Strasburg a couple years back, it will be tempting to let Harvey throw a couple games at the big league level, both to give him a boost of confidence and to showcase him for season ticket holders. 

    However, throwing at that level won't add much to the rehab. If he can throw, he can throw and he'll get in those minor league games, likely in July or August. The plan is to let Harvey rest through the end of the season and have a normal offseason before returning in 2015. It's a patient outlook.

    Where it gets complicated has little to do with Harvey. Instead, it's the new kid, Noah Syndergaard who could complicate things. If Syndergaard follows the same path as Harvey and makes it to the majors, the Mets will need to watch him closely at the end of the season. The easy fill in would be Harvey. 

    Expect the Mets to stay patient. Sandy Alderson and his team have always been about the long play and with a healthy Harvey, they'll have what a lot of teams don't: a true ace. 

    One other interesting note: go back and look at the reviews of Harvey's mechanics. By and large, they were very positive. Visually, there were no outstanding problems, but he blew out his UCL anyway. That's a major worry and a reason having biomechanical data on players is important. The Mets never did that with Harvey. 

Derek Holland, Texas Rangers

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    Derek Holland tripped over his dog, or in the shower, or something. How he injured his knee doesn't matter to us, but the results do. Initial reports were a torn meniscus and an extended recovery after repair. This is pretty standard across sports, but the recovery time didn't match.

    That's when the other shoe dropped. Holland not only had his meniscus repaired, but the surgeon did some microfracture on an area of the knee. I'll leave out the technical details here, but that means the recovery is not only much more involved, but is much less assured of success. For whatever reason, microfracture hasn't been very successful in baseball.

    Holland's return is key for the Rangers. Along with Matt Harrison—whom I covered early this week in my article about the riskiest players—he could be an ideal No. 1 or 2 for a playoff contender. Yet both of them can't seem to stay healthy enough to do that, putting pressure on the younger pitchers like Martin Perez and Nick Tepesch.

    Holland should be throwing by April and in the minors by late May, which should put him on track for a return around the All Star break. The rehab should be reasonably standard and just needs to make sure his mechanics are stable and he builds up his arm normally. The Rangers have their minor league club across town in Frisco (AA), where their rehab ace Carlos Olivas and special assistant Greg Maddux can handle some of the process. 

Tim Hudson, San Francisco Giants

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    Tim Hudson's ankle injury was one of the most gruesome in baseball last year. Many worried, including myself, that our last image of Hudson's career would be him writhing in pain on the infield dirt. Instead, he's another reminder that for injuries, image isn't everything.

    Hudson's ankle fracture was luckily just that, a fracture. The ligaments and other soft tissue weren't overly damaged by the freak accident and Hudson has made a nice, normal recovery. He's been in a throwing program that was not significantly delayed and now with a new team and new role, things look solid coming into the spring.

    We have to remember with Hudson and other fractures that my flip-sounding remark of "bones heal" is really just that simple. It's painful and takes time, but bones heal swiftly, cleanly and are easy to monitor. That's why the San Francisco Giants had little hesitation signing Hudson.

    The only issue Hudson has had is with running and fielding. Teams may try to bunt on Hudson occasionally to test him, but he has respect around the league, so that won't be overdone. 

    Hudson is 38 and he's on the outside of the Tommy John "honeymoon" period, but he's not being expected to be the ace of the Giants. He's expected to be good and to absorb some quality innings, which shouldn't be an issue. With a two-year deal, the ankle's recovery should allow him to leave the game his own way.

Jason Motte, St. Louis Cardinals

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    Jason Motte has had a standard recovery from his Tommy John surgery early last season. For pitchers, that's the normal nine- to 12-month rehab period with a few setbacks, if any. Even if Motte isn't ready until a few weeks into the season, it's because the Cardinals have been conservative with his rehab, not because of problems with the process.

    It also signals the other issue for Motte: he was easily replaced. The Cardinals are loaded with arms. While they struggled a bit at the end of the season as Edward Mujica melted down, they were able to shift through Mitchell Boggs, Seth Maness and finally Trevor Rosenthal. 

    Getting Motte back is a positive, since he's good, but he's hardly irreplaceable. Instead, his return should allow the team to let Rosenthal shift back to being a starter (though he's been on a reliever's workload early this spring) and build its pitching depth behind its homegrown rotation. 

    Expect Motte to be eased back into the closer's role, but to take and hold the job. For hard-throwing relievers coming off Tommy John, there have been more issues getting back their control. Joe Nathan is a good example of this, taking nearly 18 months to be back to his normal form. The thought is that hard throwers have a more difficult time finding that perfect release point and locking it in because they have less room for error.

    The idea that Motte might have less control won't make NL batters very comfortable at the end of games. Mike Matheny might not enjoy the process either and will need to have Plan B at times, but he has the arms and the patience to handle it. Make sure if you take Motte, you have it as well.

Wandy Rodriguez, Pittsburgh Pirates

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    David Todd of ESPN Radio in Pittsburgh convinced me Wandy Rodriguez belonged in this discussion. The Pirates broke their winning season and playoff drought a year ahead of schedule, built largely by bridge players like Rodriguez. While A.J. Burnett and Rodriguez fit the plan, they weren't supposed to be here this fast, much like the Rays of nearly a decade ago. Will the Pirates have that kind of run?

    Much of that depends on whether they take the "plexiglass principle" step back. Teams often take a big step up and then a smaller consolidation step back, as Bill James posited many years ago. The Pirates would seem to be primed to be in that position, especially with Burnett heading to the Philadelphia Phillies in a surprise deal. 

    Part of whether they step back or not will depend on whether Rodriguez can continue to be a bridge player. If all goes well, prospect Jameson Taillon will be in Pittsburgh by June, but Rodriguez is going to need to take on innings to keep Taillon and Gerrit Cole from doing too much too soon. Charlie Morton and the cast of pitchers that will fill the back end of the rotation have to absorb some as this rotation goes from external to internal.

    By 2015, the Pirates will have the top three or four pitchers general manager Neal Huntington envisioned a few years back. The window will be wide open for the Pirates. The 2014 season is a much bigger question, which means they'll need Rodriguez to go 180 innings if they want to contend.

    Coming off forearm issues that pushed him out of the playoff push, Rodriguez has had a quiet rehab and a good start to spring. There's a lot of time left and part of his issue is fatigue, which isn't going to surface this early in camp. If Rodriguez can continue through camp without issue, the Pirates get a leg up on the NL Central. If they can keep him healthy through July, they'll be neck and neck with the Cardinals. 

Dylan Bundy, Baltimore Orioles

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    Dylan Bundy was held up as an example early on. His long toss program was pitched as a great training program but whether it is or isn't—and I'm agnostic to a point—the truth is Bundy's elbow didn't hold up.

    This is despite having biomechanical data, never being overworked and having a progressive pitching program. As with Stephen Strasburg and Matt Harvey before him, handling a young, stud pitcher the "right way" didn't work. In any other business, losses of this type would lead to real change. In baseball, they shrug, wait a year and hope Dr. James Andrews puts him back together well.

    Bundy has had a normal Tommy John rehab so far and should be throwing in games by May. That puts him on track for the Orioles by the end of the season, though there's some push to have Bundy relieve this year, which could get him to the majors quicker and limit how many inning he throws. Of course, we don't know how Bundy would adjust to the role and the recovery since he's never done it.

    Bundy is going to be an interesting data point for a theory of mine. Obviously no team wants to lose one of their young pitchers for a year of what could be key development. However, looking through the data for the last decade, it doesn't look like it's a real problem. In fact, it looks like the rehab itself, along with rest and conditioning, acts to improve development.

    By and large, young pitchers, especially at the low minor level, develop as if they didn't lose a year at all. (They do lose game knowledge and experience, but I believe that's a bit overrated. If you can throw, you can throw.) With Bundy, Lucas Giolito, Taylor Guerrieri, Manny Banuelos and several others, it's a pattern worth noting. 

Casey Kelly, San Diego Padres

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    Casey Kelly is a bit of a mystery for the Padres. They still don't know if he'll be a starter, let alone the ace they thought they were trading for a few years ago when they got him from the Red Sox in the Adrian Gonzalez deal. Many development types point to Kelly's struggles as the result of his two-way play, but I'm still unconvinced that had anything to do with it. There's just no evidence for it, especially when you look at every other level of baseball.

    Kelly is coming off a normal Tommy John surgery, though the Padres have been conservative with him at every step. He's not going to be ready for the start of the season, but at about a month behind pace, the Padres will be able to step him through extended spring and the minors to get him back, once they figure out what they want him to do when he gets there.

    Kelly still has elite-level stuff, but as with most TJ returnees, the command and control that was the hallmark of his good starts will be the last to reappear. Watch to see if he's not giving up homers, which will indicate he's still got that late movement on the ball that makes him so hard to barrel up. 

    If Kelly comes back and can slot into the Padres rotation by mid-season or earlier, they'll have to watch his innings since he's still young and has never gone more than 142 innings in a year. He remains a potential ace in the future and a real fantasy sleeper this season. If the Padres are going to be 2014's surprise team, Kelly could be the biggest surprise of all. 

Chad Billingsley and Josh Beckett, L.A. Dodgers

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    The crazy part about these two well-known, big-dollar pitchers is their return isn't needed. They'll be additive, if they're able to get back and get back to level, but the Dodgers have some solid starters at the read. Dan Haren and Paul Maholm are ahead of them for now and some younger pitchers like Zach Lee are just behind.

    Beckett is expected to be pitching at some point this spring, though having him ready for Opening Day after shoulder surgery will be tough. Beckett had his Thoracic Outlet Syndrome corrected and pitchers tend to come back from this very well. If he can show his old stuff is coming back, Maholm's not going to be long for the rotation (though he'll still be a nice lefty swingman for Don Mattingly).

    Billingsley is a bit further behind after April Tommy John surgery. His rehab has gone according to plan and he could be back pitching for the Dodgers by May. While the arm looks good, he's just not going to be able to beat the clock. Getting a couple starts in the minors hurts his fantasy value slightly, but also makes him a possible sleeper in a lot of drafts.

    The toughest part for the Dodgers might be figuring out how all these pieces fit together. Depth is never really a problem, but unless Haren has injury problems of his own, there's only one real rotation slot for two established pitchers. Beyond that, it could hold back Lee's push, where we've seen some pitchers get frustrated spending a long summer in Albuquerque.

    Don Mattingly will have to deal with all that and more, as will Stan Conte, who's back on the bench for the team this year as Head Athletic Trainer. Injuries will be a major issue for the Dodgers, so they'd be glad to deal with "too much" starting pitching.