THE BIG HURT: Possible 2020 effects of 2019 (and more recent) injuries

[Ed.—We are excited to have the Big Hurt back for the 2020 season. There will be a couple columns during the pre-season, and then we'll transfer to our regular Big Hurt schedule of three days a week come Opening Day. In addition in 2020, we will debut our Injury Mailbag column, and we want YOU to be invovled! James Ferretti, DO, will take your injury questions. The first Mailbag will run in two weeks, and use THIS LINK to submit your questions. The column is intended to discuss more broader or detailed injury issues, such as standard recovery times, cascading affects, specific medical procedures, and more. Please refrain from asking specific return times on invididual players; that still will be covered in the Big Hurt. But otherwise, get those general injury questions in!] 

Spring training is just underway, and we already have a bunch of injuries to mull over. Many of these are carry-overs from 2019, but there are a couple of new ones on the list that occurred recently. We’ll delve into these, using our regular Big Hurt format.

Tommy John victims

No, Tommy John hasn’t made a comeback; we just want to note that we’re not going to cover all the Tommy John recoverees in this column. The risks and timetables for TJS are pretty well known: 12-18 months for pitchers and 6-18 months for hitters, with about 85% of players making it back to their previous level.

Everyone else

James Paxton (LHP, NYY) – Back, microdiscectomy/peridiscal cyst (February 2020)
Good news: he’s getting his 2020 IL trip out of the way early! This one isn’t a 2019 injury per se, but his back has been bothering him since the fall. Doctors discovered a small cyst on a lumbar disc, likely the result of trauma, and removed it. It’s not major surgery, and while it will take some time for him to recover, the success rate for baseball players is nearly 100%. He carries an FAB reliability and has hit the IL every season of his MLB career, so he’s still an extreme health risk.
2020 Impact: Likely minimal, other than time missed. Still extreme risk overall.
Est. Return: Late May or June

Luis Urias (SS, MIL)–L wrist fracture (1/28/20)
The typical recovery time is about eight weeks, which puts him back on the field in mid-to-late March. That doesn’t give him much time to get his timing back, so extended spring training might be in the cards. He broke his hamate, which is perhaps the worst-case scenario, but it was non-displaced and on his bottom (non-power) hand, which should help minimize the effects. Still, expect a slow start to his season.
2020 Impact: Potential for reduced power, perhaps lasting into May or June
Est. Return: Sometime in April

Adalberto Mondesi (SS, KC)–L shoulder, labrum surgery (October 2019)
He suffered a shoulder subluxation in July, returned too soon, and injured the shoulder again in September. He then had surgery in October to repair a torn labrum. He is expected to be ready to go to start the season, but labrum injuries take a long time to fully heal. As we saw with Gregory Polanco (see below), even if the shoulder feels good, there may still be issues. Mondesi may struggle a bit to start the season, and is a higher risk for injury for the first 2-3 months.
2020 Impact: High risk; Possible reduced production at start of season
Est. Return: Opening Day

Gregory Polanco (OF, PIT)–L shoulder surgery (September 2018)
He suffered an horrific injury at the end of 2018, came back way too soon in 2019, and ended up on the IL again after only 150 AB. His prognosis is much better this time around, but there remains a high risk that his shoulder still isn’t right, as labral tears are very difficult to heal properly. He could well return to form, but he’s a very high risk.
2020 Impact: Very high risk; Possibility of reduced production
Est. Return: Opening Day

Chris Sale (LHP BOS)–L elbow inflammation and pneumonia (August 2019/February 2020)
We’ll start with the easy one: he’s recovered from the pneumonia, and at worst, it delays his season start by a week or two. His unexplained elbow problems from 2019 are a bigger concern. From May-August, he put up a 14.3 Dom and 10.9 Cmd, so his ability wasn’t the question. However, the likely explanations for his elbow issues (UCL damage, tendon damage, et al.) tend to have high rates of recurrence and often require surgery. He’s not exactly a ticking time bomb, but his risk is very, very high.
2020 Impact: Very high risk
Est. Return: Opening day/mid-April

Christian Yelich (OF, MIL)–R kneecap fracture (September 2019), plus stuff
He hit a ball off his knee, but it was a non-displaced fracture and he’s fully healed at this point, so the knee injury shouldn’t be an issue. He does have a history of back problems, and those things tend to recur, so he’s not without risk, however.
2020 Impact: Elevated risk
Est. Return: Opening Day

Tyler Glasnow (RHP, TAM)–R wrist, nerve decompression (November 2019)
Nerves become compressed when the surrounding tissues thicken and put pressure on the nerve. This is likely the cause of his forearm issues in 2019. The surgery is low-risk, with high odds of success. The biggest possible issue is recurrence, which can take 6 months or more to present. He’s likely at 100% right now, but there is some risk as the season progresses.
2020 Impact: Moderate risk
Est. Return: Opening Day

Eugenio Suarez (3B, CIN)–R shoulder surgery (1/28/20)
He had surgery to remove some loose cartilage in his shoulder, the result of a swimming injury. The minimal recovery time is 6-8 weeks, but it’s quite variable and full recovery can take 3-6 months depending on the nature of the surgery. There’s still a chance that he’s ready for Opening Day, but he may not be 100%. Expect a slow start, whether he’s on the field or not. There’s also a risk of instability in the joint down the road.
2020 Impact: Variable return time; High risk; Potential for reduced production
Est. Return: March/April

Yoenis Cespedes (OF, NYM)–Both heels, surgery/R ankle, multiple fractures (August and October 2018, May 2019)
Recall back in the middle of 2018, when we discovered that he had calcification in both his left and right heel. He had two surgeries that fall and was expected to miss a big chunk of 2019. Early in his rehab, he had an encounter with a wild animal at his home. We won’t boar you with the details, but he ended up breaking his ankle in several places, ending his chances of playing in 2019. The reality now is that Cespedes is 34 and coming off three very significant surgeries. There is a very good chance that there has been irreversible damage that will affect him the rest of his career. The issue isn’t recurrence as much as it is questions about the ankle's effect on his athletic ability. He’s started working out and is a limited participant in spring training, so we’re telling you there’s a chance. But also a ton of risk.
2020 Impact: He's so risky, even his risks have risk
Est. Return: Got a magic 8-ball? Possible April/May return; Opening Day is possible but a long shot

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  For more information about the terms used in this article, see our Glossary Primer.