Collateral Damage: Fillet o’ Philly

Chase Utley, Philadelphia Phillies (Bilateral Knee Soreness)
Both of Utley’s knees are in pain. They likely degenerated further from his 2011 condition despite modifications to his strength and conditioning program. Last year, the second baseman dealt with chronic patellar tendinitis and trouble with the cartilage on the back of the kneecap. The patellar cartilage has very little ability to heal itself; if it generates pain, surgery is required. The surgery would most likely involve a microfracture technique, something that would put Utley out for at least several months.

The cartilage isn’t the only issue, though. The tendon undergoes changes to the point it’s not really tendon tissue any longer; it changes at the cellular level. In tendinosis, those changes lead to tendon weakening and make the tendon more prone to rupture. It’s one of the reasons why there is an increased chance of Achilles tendon ruptures with cases of chronic Achilles tendinitis.

Utley has not been able to do many baseball activities because of his chronic knee pain. He is seeing a specialist for a second opinion and to guide future treatments, but there have been public discussions about surgery. The best-case scenario is likely several weeks on the disabled list to start the season. A more realistic expectation is that Utley will likely be out for several months. What’s more concerning is GM Ruben Amaro Jr.’s comment: “I worry about Chase because it’s a chronic knee problem… about his career, I don’t know.”

Miguel Cabrera, Detroit Tigers (Facial Fracture)
Cabrera’s bloody run-in with a ground ball on Monday led to eight stitches to close the laceration under his right eye. In these cases, there will usually be additional tests just to make sure nothing else was injured. Cabrera had a CT scan, which showed an orbital bone fracture in his right eye, and initial estimates are that he will be out a few weeks.

Cabrera will take a week off from all activity to allow the swelling surrounding the eye to heal and not jeopardize the eye itself. Severe fractures of the orbital floor can trap some of the eye muscles and prevent eye movement. After the swelling goes down, Cabrera will begin baseball activities again. The Tigers and Cabrera are hopeful that he can be ready for Opening Day, but it will be a tight timeline. As long as there are no injuries to the eye or the eye muscles, Cabrera should not have any long-term issues.

Michael Martinez, Philadelphia Phillies (Right Foot Fracture)
Things just have not been going well for Phillies lately. In the seventh inning on Tuesday, Martinez was hit in the foot by a pitch and fractured his fourth metatarsal bone. He was able to stay in the game and even scored on a Freddy Galvis triple, but he was clearly favoring it and limping by the time he crossed home plate. Martinez was in a boot after the game, and although a timetable has not been pinned down, he almost certainly will start the season on the disabled list. These fractures usually heal within four to six weeks.

Zach Britton, Baltimore Orioles (Left Shoulder Soreness)
Britton has been dealing with a balky shoulder since he strained his shoulder last September. He felt soreness while throwing in December and has not been able to shake it yet this spring. He is going to see Dr. James Andrews to see why his shoulder has not responded to therapy. While Britton’s shoulder has improved through therapy, the soreness springs up when he pitches. Going to see Dr. Andrews isn’t always a death sentence, but this appears to be more than just inflammation; it could be a rotator cuff or labrum issue. Britton had an MRI on February 8 and will take those images to Birmingham.

Neftali Feliz, Texas Rangers (Right Shoulder Stiffness)
Feliz left yesterday’s start with right shoulder stiffness and is considered day-to-day. It’s not great news for a few reasons. First, his history of shoulder problems dates to a 2009 stint on the minor-league disabled list with shoulder soreness. Last year, Feliz was on the disabled list in April with shoulder inflammation. A spring recurrence is concerning. In addition, Feliz is transitioning to a starting role. He will be re-evaluated over the next few days to see if this is a minor blip or something more serious.

Flesh Wounds
Seems like the only good news to come out of Phillies camp is that Ryan Howard should be able to come out of his walking boot within the next two weeks. … Nick Swisher returned from left groin tightness on Tuesday… and then had to leave Tuesday’s game with right groin tightness. … Franklin Morales should make his spring debut today. He has been dealing with shoulder weakness. … Vicente Padilla strained his right hamstring while lifting weights on Monday. No word yet on how long he will be out. … Andres Torres strained his left calf but does not have plans for an MRI. He will be re-evaluated in a few days. … Kyle Blanks is dealing with a sore left shoulder and will also be re-evaluated in a few days. … Wilton Lopez has been dealing with forearm soreness. He’ll be out for a few more days. … Carlos Marmol left yesterday’s game with a cramp in his left hand. He will undergo a precautionary MRI. … Brandon McCarthy tore his fingernail yesterday but should be fine within a few days… Reid Brignac received a cortisone injection for inflammation in his foot and will likely be out for several more days. … Drew Storen was diagnosed with strep throat. … Greg Dobbs (hamstring), Logan Morrison (knee), and Giancarlo Stanton (knee soreness) have been cleared to resume baseball activities. … Derek Jeter will not play until Friday to allow his calf strain to heal. … Ryan Braun has dealt with a tight groin for several weeks. He will sit for several days to heal before the regular season begins. … Corey Hart has started to take batting practice. … Arodys Vizcaino had Tommy John surgery and will miss all of 2012. … Zach Braddock hasn’t pitched recently because of a quad strain. He is day-to-day. … Brandon Kintzler may have turned a corner in his rehab for a sore elbow. … Andrew Miller strained his left hamstring after throwing only two pitches, and although it seems minor, hamstring strains can be difficult for pitchers to return from… At least Ryan Sweeney (quad) was able to return to Boston’s lineup on Tuesday. … Dodgers infielder Ivan DeJesus Jr. has a torn left oblique. There is no timetable for his return.