MLB injury mailbag: Wander Franco’s eyes return, as Ozzie Albies considers long hiatus


In this mailbag: the latest on Wander Franco’s quad injury, the nature of Ozzie Albies’ broken foot and more!

Wounds inside was founded by an orthopedic radiologist, Dr. Anand Lalaji (aka Dr. A), who contributes to all injury descriptions. Dr. A assembled a team of doctors and data scientists to create an algorithm to assess the impact of injuries on a player. This algorithm powers all Inside Injuries analytics and determines each player’s performance. Risk of injury, Health performance factor (the level at which a player is expected to perform if they return too soon, for example) and Optimal recovery time. This information is based on years of medical experience and historical injury research and has proven to be incredibly accurate in determining the impact of injury on a player’s performance and risk of future injury.

A quick description of our injury algorithm terms:

  • SHOUT = Injury Risk Category (Low, High, High) – the overall likelihood of a player getting injured
  • HPF = Health Performance Factor (Peak, Above Average, Below Average, Poor) – our metric for predicting player performance
  • TRO = Optimal recovery time – the time a player needs to fully recover from an injury (different from the time they will actually miss)

Is Freddy Peralta a take or a drop? I have three spots in IL and four spots on the bench in a 12-team league. -Dan B.

Peralta left his start on May 22 with “shoulder tightness”. An MRI then revealed a much more serious injury, a right lateral sprain. It is a large flat muscle that extends from the hip to the shoulder. Peralta’s damage is to the upper portion of the muscle near the humerus (upper arm bone). It is heavily involved in the pitching motion as it is important for shoulder rotation and extension. The lat connects the upper and lower body, so it’s crucial for transferring power from the legs into the arm to generate speed and ball spin on every pitch.

Our algorithm considers this a Grade 2 (Moderate) strain, an injury that typically results in a 2-3 month absence for pitchers. Peralta was recently transferred to the 60-day IL, so he won’t return until the end of July. He has done some light work but is nowhere near throwing from the mound. With three spots in IL, I think it’s worth keeping Peralta as he could bring some fantasy playoff value. We see many pitchers struggle initially when returning from a side stump, and setbacks are common. This means we have to be patient with Peralta. He will remain at high injury risk for the rest of the year, but his HPF (Health Performance Factor – Projected Performance) will slowly improve as we get closer to August.

What’s new on Wander Franco? -Chuck D.

Franco’s quad issues began in April when he felt muscle strain. He didn’t take enough time off and the injury persisted. The Rays eventually placed him on the IL when he escalated the injury on May 30. Now more than two weeks after the injury, Franco is making progress but is not yet cleared for a rehab assignment.

According to our algorithm, Franco’s injury, a grade 1 quadratic strain, has an optimal recovery time of three weeks. He progressed to agility drills earlier this week and will slowly increase his workouts as long as the quad responds well to the increased activity. It’s an easily aggravated injury, and it’s already been a problem for two months. A cautious approach now will lead to a lower risk of injury in the future, and therefore to improved performance throughout the season. Franco could be activated as early as next week.

What do you expect from Alex Cobb’s health ROS? -Steven Y.

Cobb landed on the IL nearly two weeks ago but is already close to a comeback. He first felt tightness in his back between starts, then reported tightness in his hamstrings followed by a sprained neck. These can all be related. The tightness of the hamstrings, which he had been battling for some time, affects the back, which could have resulted in a compensatory neck injury if he adjusted his mechanics and put more pressure on the upper back/belly. neck.

On Tuesday, Cobb pitched a three-inning mock game. If his body reacts well, he may not even need rehab because he hasn’t missed much time. A return to the rotation on Sunday seems too quick medically. Cobb has underlying issues he needs to address, and several weeks of strengthening his hamstrings and core are crucial if he is to avoid another injury. The internal injury algorithm has Cobb’s injury risk as high right now. Another week off would be very good for his health the rest of the season, but he is pushing to be back on the pitch as soon as possible. Even though his injuries seem relatively mild at the moment, his quick return makes his prospects for the rest of the season less promising.

How did Ozzie Albies break his foot on a swing? He must have had a pre-existing injury (strain fracture?). – Chris H.

It looks like an accidental injury, but if there’s enough pressure and torque on that back leg, it can lead to foot damage on an awkward swing like this. Albies had surgery on Wednesday. His recovery time depends on the exact nature of the injury, which we don’t know yet. He has already been placed on the 60 day IL. There are two likely possibilities for Ozzie’s exact injury.

The first is a Jones fracture. This is a type of fracture at the base of the fifth metatarsal, running along the outside of the foot. His foot appeared to move, so multiple metatarsal fractures are a possibility. It’s an injury that can start as a stress reaction and then turn into something more serious on a game like this. The recovery time is around two months, which means Albies could be back in the Braves roster by the end of August. There is a high risk of re-injury and waiting 10 weeks before returning greatly reduces this risk. There is poor blood circulation in this area of ​​the foot, so surgery is often needed to ensure the bone heals properly.

The second possibility is a Lisfranc fracture, which is more concerning. The Lisfranc joint is located in the middle of the foot, where the metatarsal and tarsal bones meet. It is a complex joint made up of small bones and a hard ligament. Although this injury should not affect Albies after this season, it comes with a longer recovery. Realistically, Albies would be sidelined 3-4 months if it was a Lisfranc fracture, which would make it difficult to come back before the playoffs. It is also possible that there are associated ligament injuries that have not yet been reported.

I feel bad for Royce Lewis. He has a partial tear of the same ACL that was surgically repaired. Once repaired again, what is the prognosis for him? Will this be a permanent problem that will impact him for the rest of his career? – Chris H.

Lewis tore the ACL in his right knee for the second time in just over a year. This time it’s called a partial tear, but the severity doesn’t really matter when it comes to this ligament. A partial ACL tear (unless it is very small) requires full reconstruction in the same way as a ruptured ACL. The procedure and rehabilitation are identical.

Now Lewis will undergo a second surgery and face another 12-month recovery. Not only does the knee need time to heal after surgery, but the surrounding muscles atrophy. It takes a long time to regain strength and this is important for a safe return to sport. His medical team will also need to study his mechanics to determine if there is a defect in his movements or a weakness somewhere that is leading to these knee injuries. This assessment should reduce the risk of future knee injury or compensatory injury. Lewis can still have a long and successful career in MLB, but realistically we won’t see him at his best until the end of 2023 or even the 2024 season.

Fernando Tatis is expected to undergo a CT scan this week. Could you give an overview of these results? -Steven M.

The Padres didn’t get the news they were hoping for this week, but that shouldn’t come as a surprise and I don’t think that means there’s been a setback. Tatis underwent surgery on his left wrist three months ago due to a scaphoid fracture that occurred during the offseason. This bone is located at the base of the thumb and does not receive good blood circulation, so it can be slow to heal. He also did not heal properly between the fracture in December and the operation in March, which complicated the procedure. The surgery often involves a screw to stabilize the fracture as well as a bone graft.

So we are three months after the operation and Tatis is still not cleared to pick up a bat. It is considered weekly and will continue to focus on certain field and throwing drills. I expect he will be cleared to swing in the next 2-4 weeks and then he would need more time to prep and go to rehab. Realistically, we won’t see him in the Padres’ roster before the All-Star break. A comeback in three months was always going to be aggressive; 4-6 months is much more realistic, and that’s how the Tatis timeline is going right now.

(Top photo: Kim Klement – USA TODAY Sports)


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