Injury Risk: Players to Avoid

Injuries in fantasy baseball are inevitable as evidenced by the high number of players that spent time on the disabled list last year. Top-tier players were not spared, as 14 of the top-25 ranked players in the RotoWire preseason Top 200 spent at least one stint on the DL, including six in the top-10. However, prudent fantasy owners will protect themselves on draft day by targeting players with lower inherent injury risk. Here's a look at a few players with injury concerns for the upcoming season.

Miguel Cabrera
1B – Detroit Tigers

The inclusion of Cabrera on this list may come as a bit of a surprise given his recent run of dominance, but the two-time American League MVP has recently started to show signs of wear and tear. For the last several seasons, Cabrera has been bothered by multiple nagging issues. In 2012, it was a lingering ankle injury followed by a chronic groin problem in 2013. He addressed the sports hernia with offseason core surgery that limited his functional movement through the All-Star break in 2014. He reinjured his ankle in August and ultimately needed offseason surgery. In the procedure, bone spurs were removed from the area, but a more serious issue was also discovered.

Physicians determined that Cabrera needed an additional surgery to address a stress fracture in one of the tarsal bones in the foot. The particular bone involved was the navicular. Located in the mid-foot, the navicular is essential in proper weight transfer and force absorption generated during ground impact with running and jumping. The navicular also serves as an attachment site for a muscle and a stabilizing ligament of the foot.

To repair the fracture, surgeons inserted two screws. Fortunately, non-unions and hardware failure in navicular repairs are both relatively rare and the effects on Cabrera's long-term future should be minimal. However, the recovery process can take up to six months, meaning Cabrera could miss the start of the season if things progress slowly. Even if he's able to return by Opening Day, a dip in productivity seems probable and the involved risk may be too high for a likely first-round selection.

Prince Fielder
1B – Texas Rangers

For the majority of his career, Fielder has been a model of consistency, missing just 13 games in his first eight full seasons in the majors. However, a streak of 547 consecutive games played came to an end last season when he began experiencing neck spasms and weakness in his left arm. The injury was ultimately diagnosed as a herniated disc in the cervical region of his spine. He underwent a discectomy and cervical fusion of the C5 and C6 discs in his neck, a multi-faceted surgical procedure designed to remove the damaged disc and fortify the surrounding bony tissue.

Fielder began swinging a bat in September and hopes to be ready for spring training. However, an injury of this magnitude is worth a pause on draft day. Any injury that involves a nerve needs substantial recovery time as this type of tissue heals at a particularly slow rate. As a result, pain and muscle weakness can linger. Broncos quarterback Peyton Manning required a similar procedure and experienced weakness in his arm for over a year after surgery. If Fielder experiences any lingering symptoms it would likely affect his productivity, especially his power numbers. Subsequently, this would be a major problem for a slugger whose fantasy value is directly tied to his ability to crush the ball.

Typically, a history of good health helps minimize a player's risk, but the severity of Fielder's first major injury is too impactful to ignore.

Troy Tulowitzki
SS – Colorado Rockies

If a MLB version of the board game Operation were ever developed, Tulowitzki would make the perfect patient. Since 2007, the Colorado shortstop has torn the tendon in his left quadriceps, significantly lacerated his right hand, fractured his left wrist, strained his rotator cuff, broke his ribs, endured numerous contusions to his hands and forearms, and undergone surgery to remove scar tissue irritating a nerve in his groin. Even worse, this list doesn't include his most recent operation to repair a torn labrum in his left hip.

The labrum is a fibrocartilage ring designed to deepen the primary joint of the hip. Along with neighboring muscles and ligaments, the labrum stabilizes the joint while allowing for a high degree of motion. Unfortunately, the labrum can be torn following a violent collision or excessive, repetitive motion leading to pain and instability in the joint. The recovery for this type of procedure is lengthy and Tulowitzki's availability for spring training is cloudy at best. Save yourself the headache and invest your time and energy elsewhere.

Carlos Gonzalez
OF – Colorado Rockies

Gonzalez's list of injuries isn't quite as impressive as his Colorado teammate, but he too has earned the injury-prone label after suffering through multiple ailments in recent years. His 2013 season was a statistical success despite a sprained middle finger that bothered him intermittently.

However, he never found his groove last season after an offseason appendectomy and an in-season surgery to remove a fatty mass in his index finger. Of greater concern, he battled quadriceps tendinitis for most of the year before undergoing season-ending surgery to repair a tear in the tendon. The damage was more extensive than the surgeons had hoped and an inflamed bursa sac was also removed. Early reports estimated that his recovery would take between five and six months, though the Rockies are optimistic he will be available for spring training. Gonzalez has more draft value than Tulowitzki, but he's no longer a first-round option.

Hanley Ramirez
SS – Boston Red Sox

The Red Sox brought back their former prospect in the offseason with a four-year deal. It's a risky investment considering that Ramirez has missed more than 65 games in two of his last four seasons. Ramirez's extensive list of injuries includes a fractured rib, reconstructive surgeries on his left shoulder and right thumb, as well as multiple strains to the muscles in his lower leg. Last year alone he missed time with an oblique strain, calf tightness, a hand contusion, and inflammation in the acromioclavicular (AC) joint his throwing shoulder.

The reoccurring lower leg strains stand out as the most glaring red flag. Ramirez's game is predicated on speed and mobility, but it's hard to be effective when the muscles of the leg are chronically injured. An isolated strain could be overlooked, but Ramirez has strained his groin, hip flexor, calf, and hamstring muscles at various points throughout his career. These muscle groups all work synergistically to properly move the leg during activity and a limitation in one has a trickle-down effect on the others. This leaves the entire kinetic chain vulnerable to another and potentially more significant injury.

Age can't be ignored either. It has been nearly a decade since Boston originally dealt Ramirez to the Marlins, and he returns at the not-so-ripe age of 31. Time is one of a professional athlete's worst enemies with the risk of injury gradually escalating as the calendar turns. At age-30, the increase becomes noticeable as players past this point have a tendency to make more trips to the DL.

Physiologically this can be attributed to the muscles of the body beginning to decrease in mass and fatiguing quicker. For a player with a history of injury, the effects of age can be amplified.
Even with a change to a less physically demanding position, Ramirez simply has too many potential warning signs to overlook. Let someone else assume this risk on draft day.

Dustin Pedroia
2B – Boston Red Sox

Pedroia is bound to garner attention especially among the ravenous Boston fan base. A careful evaluation reveals a player who has statistically declined in four straight seasons, and one that has spent a lot of time in the athletic training room nursing an assortment of injuries. Pedroia's two most recent surgeries involved his left hand and wrist. The first operation was to repair a torn ulnar collateral ligament (UCL) in his thumb. The UCL stabilizes the metacarpophalangeal (MCP) joint located on the inside of the thumb, near the webbing of the thumb and pointer finger. The ligament is a primary component of grip strength and any limitation in the area can alter a player's swing.

A second surgery was required this offseason to treat another problem in the same vicinity. Last spring, Pedroia began experiencing pain and inflammation in his left wrist and thumb that was eventually diagnosed as tenosynovitis, an inflammation of the tissue surrounding the tendons of the wrist and thumb. Tenosynovitis is marked by persistent swelling and pain that limits the strength and range of motion of the thumb. Pedrioia attempted to play through the injury, receiving multiple cortisone injections, but ultimately opted for surgery in September.

The injury clearly took its toll as Pedroia finished the season with career-low marks in batting average, home runs, OBP, and OPS. He could potentially improve his ability to hit for contact, but it's hard to imagine his power numbers recovering after two trips to the operating room. A group of younger second basemen with more upside have begun to emerge and may serve as more suitable options that the 31-year-old former MVP.

Josh Hamilton
OF – Los Angeles Angels

Hamilton was limited to just 89 games last season, tying his career-low total since returning to baseball in 2007. He spent time on the DL with a torn UCL in his thumb and missed a large chunk of games down the stretch nursing a rib injury. These two examples are just the latest ailments to sideline Hamilton, who has made numerous trips to the DL and undergone surgery on his shoulder, knee, thumb, and groin at various points throughout his career.

Hamilton sustained the thumb injury while attempting a head-first slide, the same manner in which he suffered a broken arm in 2011. His injuries serve as a reminder that an aggressive style of play may be fun to watch, but does increase a player's inherent injury risk. Other players that play with reckless abandon include Washington's Bryce Harper, Cincinnati's Billy Hamilton, and St. Louis' Yadier Molina. However, Hamilton's risk remains noticeably higher and fantasy owners should consider shoring up their offense with more reliable options before taking a flier on the former All-Star.

Masahiro Tanaka
SP – New York Yankees

The Yankees rookie was putting together a phenomenal debut season before a partially torn UCL in his throwing elbow derailed his 2014 campaign. New York opted not to send Tanaka in for Tommy John surgery, but instead treated him conservatively with rehab and a platelet-rich-plasma (PRP) injection. He was able to return to the mound late in the season, though the results were mixed. A non-surgical approach for a significant UCL injury isn't unprecedented, but history suggests that Tanaka is simply delaying the inevitable. Former Dodgers pitcher Chad Billingsley approached his partial UCL tear in a similar fashion, but was unable to avoid reconstructive surgery. The Yankees will continue to handle his workload with the utmost care, but his price tag in most drafts won't be worth the risk.

Mat Latos
SP – Miami Marlins

With the Tommy John epidemic in full swing, it's hard to put much stock in any starting pitcher. However, some pitchers are riskier than others with the Marlins right-hander standing out. Latos struggled through a down year in 2014 while making just 16 starts for Cincinnati. His problems began in October of 2013 when he underwent a debridement procedure to remove bone chips in his throwing elbow. Latos was reportedly progressing nicely until he tore the meniscus in his left knee and required another surgery. His elbow problems resurfaced during rehab, delaying his season debut until June.

The pain lingered throughout the year and prematurely ended his season in late September. Latos returned to the operating room in order to have stem cells injected into the injury site at his elbow. The belief is the injection will stimulate tissue growth and allow him to return at an accelerated rate. However, despite Latos' best efforts, it's hard to have much confidence in a pitcher with issues in both his lower and upper extremities.

This article appears in the 2015 edition of the RotoWire Fantasy Baseball Guide.