This article is part of our Fantasy Baseball Injury Report series.
After initially being placed on the 10-day disabled list with a finger blister, Ohtani's health status took a drastic change for the worse. During treatment, the rookie phenom mentioned to the Los Angeles medical staff that his elbow had been bothering him. Further testing revealed a Grade 2 sprain of the ulnar collateral ligament (UCL). Now Ohtani is staring at a significant recovery that could ultimately end in Tommy John surgery.
The situation is complex, so let's look at each facet of the problem. To start, the involved structure is the stabilizing ligament located on the inside aspect of the elbow. The surgery necessary to repair the ligament is the infamous Tommy John surgery.
Ohtani's injury is not a total ligament tear or rupture. Injuries to ligaments are known as sprains and are graded based on the severity of the associated damage. Mild or Grade 1 sprains often occur with excessive stretching of the ligament. Damage is limited to microfibers within the ligament, though the overall integrity of the structure remains intact. A sprain receives a Grade 2 classification when actual fibers of the ligament tear, usually in an incomplete manner. Grade 2 injuries are often referred to as partial tears. Injuries graded 3 or higher are marked by a complete or near complete tearing of the ligaments. A total tear is better known as a rupture. Compete tears are commonly accompanied by a loss of function and stability and often require surgical intervention.
This is where things
After initially being placed on the 10-day disabled list with a finger blister, Ohtani's health status took a drastic change for the worse. During treatment, the rookie phenom mentioned to the Los Angeles medical staff that his elbow had been bothering him. Further testing revealed a Grade 2 sprain of the ulnar collateral ligament (UCL). Now Ohtani is staring at a significant recovery that could ultimately end in Tommy John surgery.
The situation is complex, so let's look at each facet of the problem. To start, the involved structure is the stabilizing ligament located on the inside aspect of the elbow. The surgery necessary to repair the ligament is the infamous Tommy John surgery.
Ohtani's injury is not a total ligament tear or rupture. Injuries to ligaments are known as sprains and are graded based on the severity of the associated damage. Mild or Grade 1 sprains often occur with excessive stretching of the ligament. Damage is limited to microfibers within the ligament, though the overall integrity of the structure remains intact. A sprain receives a Grade 2 classification when actual fibers of the ligament tear, usually in an incomplete manner. Grade 2 injuries are often referred to as partial tears. Injuries graded 3 or higher are marked by a complete or near complete tearing of the ligaments. A total tear is better known as a rupture. Compete tears are commonly accompanied by a loss of function and stability and often require surgical intervention.
This is where things get tricky for Ohtani. Based on the designation, it's clear he has a partial tearing of his UCL. Despite the damage, Ohtani is choosing to pursue conservative (nonsurgical) treatment on the area. The right-hander has opted for platelet-rich plasma (PRP) and stem cell injections as part of the recovery process. PRP treatment involves extracting a bit of Ohtani's blood and isolating a protein-concentrated mixture from the sample. The PRP mixture is highly concentrated with platelets, the primary component of blood responsible for clotting. The sample is injected at the injury site, increasing the platelet count with the hope of making the body's natural healing response work faster and more efficiently. However, PRP injections are far from a guarantee. While some players including Masahiro Tanaka have had success treating UCL injuries with PRP, the success rate is roughly 50 percent.
Additionally, Ohtani's history suggests this is more than an isolated event. He previously suffered a low-grade UCL sprain that was detected shortly after he signed with the Angels. He utilized PRP injections then too, but the current degree of damage is more significant. Still this occurrence suggests his pitching style is applying undue stress on his elbow and contributing to the ligament's breakdown. As a result, his level of risk will remain elevated even if the PRP gets him back on the mound. For now, he's slated to be reevaluated in three weeks, meaning Ohtani shouldn't be expected back for at least a month. If Tommy John surgery is eventually needed, look for Ohtani's recovery to carry over into the 2019 MLB season.
Check Swings
Ronald Acuna Jr.: The Braves rookie is making progress in his recovery from a mild ACL sprain and could be back in action by the weekend. Acuna has resumed controlled hitting and light jogging, and will be reevaluated Monday on Atlanta's scheduled off day. If he has cleared all medical benchmarks, the team will send him on a brief Minor League rehab stint. If Acuna is available for the series against San Diego, he'll return after a three-week absence. This quick turnaround will be a much appreciated outcome, after it was feared Acuna would miss the remainder of the season.
Zach Britton: Baltimore is expected to welcome back its former closer to the bullpen. Britton hasn't pitched at the big league level since tearing his Achilles last season. However, his recovery appeared to go smoothly, and he has looked solid during his five rehab appearances. The two-time All-Star surrendered just one run over that stretch, allowing four hits, no walks and striking out six. He isn't expected to automatically takeover the closer role and will be eased back into ninth inning work. Britton is worth a pickup if he remains available, and those invested in Brad Brach should expect a dip in his value.
Carlos Correa: The Astros expect their starting shortstop to return to the lineup on Tuesday when the team starts a series against the Athletics. Correa has missed four consecutive outings with soreness in his right side. An MRI failed to reveal any structural damage. While those results are encouraging, it's important to keep in mind that something is causing him discomfort. This is likely why Houston has exhibited restraint with his return and will continue to monitor him moving forward. Fantasy owners should anticipate potential days off in the week ahead and should factor in an elevated level of risk for the immediate future.
Josh Donaldson: The Blue Jays third baseman has resumed batting practice and some field work, but has yet to test his injured calf with running. The calf is a key component in explosive movement, especially during acceleration. Donaldson will remain out until he can complete this motion, meaning a return to action is far from imminent.
Vladimir Guerrero Jr.: Fantasy owners have been anxiously awaiting Guerrero's call to the show. Sadly, any chances of him joining the Blue Jays this year may have been altered by injury. Guerrero was recently diagnosed with a strained left patellar tendon. The patellar tendon is the conjoined tendon of the quadriceps muscle group that connects to the tibia just below the kneecap. The kneecap (patella) actually floats within this tendon, making it a sesamoid bone. The injury isn't overly concerning at this point but will be treated conservatively to insure his long-term health. As a result, we may not see Guerrero until next season. His value will hold in keeper or dynasty formats, but it plummets in one-year leagues.
Masahiro Tanaka: The Yankees starter is expected to miss multiple weeks after straining both hamstrings on the base path. While the strains are reportedly minor, recovery will be difficult due to the involvement of both legs. The team is optimistic he can return prior to the All-Star break, but a late July return wouldn't be surprising.
