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Under The Knife: Baseball is back, and injuries are already piling up

Love or hate "Opening Week" -- and I'm much more on the hate side -- baseball has started, which means the training room is filling up. The fans I saw in Anaheim were cheering for their team, hoping that a brand new first baseman will lead to a championship. That early season optimism is everywhere, from the gallows version of the 4-0 Mets to the "it's early" version of the Red Sox and Yankees. The lesson is "don't panic," even when it comes to injuries. There were injuries in spring training and there will be injuries all year. The difference is the planning that your team -- fantasy or the one you root for -- has in place to deal with them. There's no real pattern to the injuries we see in baseball, since most are traumatic. Even the chronic, insidious injuries seldom have much in the way of signal (which is a big part of the issue). We'll quickly see which teams know how to handle problems and which medical staffs can minimize concerns. Powered by The Might Have Been, on to the injuries:

Two tweets sum up the injury to Doug Fister. Greg Tracy asked how long Fister would be out, saying "he hurt a body part I've never heard of." My pal B.J. Maack, an athletic trainer, got me into one of those semantic discussions about the correct nomenclature for an injury like this, the kind of thing only a true medhead can appreciate. (Most doctors I spoke with just say "tear" for a costochondral injury.) Fister's tear of the cartilage between his ribs is a painful injury, but not a serious one. Cartilage doesn't heal well, so the key is to minimize the damage. If you think about this injury like an oblique strain, you'll probably have the timeline right. Fister will miss about a month. Look for when he starts throwing again to give the best hint as to his return date. Once he's pain free, he can begin the process.

Dodgers ace Clayton Kershaw wanted to pitch on Opening Day. He came to the ballpark sick and fought his way through a couple innings before Don Mattingly found him lying on the ground in the tunnel. He was dehydrated from vomiting and exhausted from the effort. Some are praising his performance and, yes, there's something to be praised here. But any regular reader of this column will recognize the issue. A pitcher that is that drained from illness is going to have to do things differently. Kershaw was effective and not far off on velocity, so how was he doing it? In essence, Kershaw was pitching the first inning more fatigued than he would normally would the ninth. Kershaw was probably pulled before any real damage was done, but small issues can sometimes turn into big ones. Just ask Aaron Harang, who is still trying to bounce back from what seemed like an innocuous relief outing a few years back.

I don't mean to laugh at A.J. Burnett, but the categorization of his injury in my database is just funny. It doesn't get granular enough to say "orbital", so we end up with "fractured face". Burnett's not disfigured or even that injured now, thanks to quality medical care. He's throwing and is well ahead of the too-conservative schedule the Pirates were pushing in the first days after his surgery. Burnett will make one or two rehab starts and should be back quickly. I don't anticipate any problems, save for stamina, in those starts. There's still a question about whether Burnett will need some sort of protection, but that would be something like a pair of Bangerz.

The Nationals shut down their closer for much of the spring, but the rest hasn't helped. He's still dealing with pain and inflammation, even with light work. He'll head down to see Dr. James Andrews ... and quit hyperventiliating. The Nats don't think Storen is headed for Tommy John surgery. Instead, the belief now is that there's some bone chips in his elbow. Elbows are elbows and that there are chips is problematic, but players have come back from even repeated instances of chips pretty quickly. The visit to Andrews will be the tell, but at this point, keeping Storen out six to eight weeks makes the ERD seem about right. Most pitchers come back from this very well. Also, don't confuse this with removing bone spurs, which can be contraindicated in some pitchers.

Chipper Jones had knee surgery on March 27. He'll return on April 10. If that seems quick to you -- and yes, Chipper does like to come back on his own schedule -- it's really not. Many remember Mary Lou Retton, America's sweetheart of the '84 Olympics. What they don't remember is that just weeks before, she had undergone knee surgery. Arthroscopic surgery was very uncommon then, even being called "experimental" at that stage. So years later and without the need to perform backflips, Jones coming back isn't really that big of a deal. He should play normally, though the Braves do intend to force Jones to rest more this season. One final note on Retton: There is a consequence to athletics that we don't see. At age 38, Retton needed a hip replacement. Given Chipper's issues with his knees, seeing him require knee replacements before he's 50 wouldn't be surprising at all.

The Red Sox are off to a bad start and help isn't on the horizon. The first likely returnee is Carl Crawford, but, as of yet, Crawford hasn't played a game. He's doing more baseball-related activities, including batting practice, but there's no word as to why there's a hold-up on his playing. Sources tell me that each step is just taking longer than expected, not that there's been a setback. Once Crawford gets into games he shouldn't need a long rehab assignment, but the length of each step worries me in terms of putting a solid date on it. The ERD is very conservative and if Crawford can get into a spring game by the end of the week, he'll be back sometime in April, assuming there are no complications.

The Rays have a hellish first month, with power team after power team on the schedule. Fortunately, they should get B.J. Upton back quickly. He's been out with a sore back as the result of an outfield collision, but the DL move was both precautionary and the kind of smart roster management move that the Rays utilize as well as anyone in baseball. Upton will stay at Port Charlotte, joining the Single-A club there. The expectation is that he'll need about ten days, but many think that could be long. The Rays tend to be very methodical with rehabs, so Upton will have to show the medical staff that he's ready and having no further spasms while also demonstrating that his swing is tuned up for major-league play. Upton shouldn't have any issue with either and this back injury shouldn't be something that recurs. Watch his power during the rehab assignment, however, since there's always some concern that a tight back will slow rotational velocity, especially in someone as powerful as Upton.

It wasn't the debut that Yu Darvish wanted. If the Rangers had been an organization with a 30-pitch rule, he wouldn't have lasted past the first out. Instead, Darvish made it into the sixth, which was a victory for him and the bullpen. He ended up going 110 pitches, and showed decent if not overpowering stuff: He had five pitches, 96 mph on his fastball and solid movement. What he didn't get were SAMS -- swing and misses. That worrying figure could be chalked up to nerves, but it certainly bears watching. Darvish has ace-type stuff, but will need to turn that into results. His next several starts will be key to deteriming whether that first inning was nerves, familiarity (he was facing two Japanese players) or whether he's one of those pitchers who struggles in the first. It was a solid effort by Mike Maddux to keep him on task despite the language barrier.

I was gearing up to write about the increasing use of Toradol in baseball, but Craig Calcaterra nailed it. My only other issue is that Toradol can cause short term memory loss and a "feeling of euphoria." I'm not sure I would want to be a batter when the guy throwing the ball 90 mph is stoned ... Giancarlo Stanton missed Monday's game with a sore knee. At least through the first month of the season, that chronic knee issue is going to cost Stanton a game here and there ... Ryan Howard is doing some new fielding drills. He's not quite ready for a rehab assignment, but he's close ... I like the two-inning usage of Aroldis Chapman. If Dusty Baker can be a bit more creative with the usage, Chapman won't be a closer. He'll be a weapon ... Brian Roberts is taking batting practice and performing some other baseball activities. He has no timetable for a return, but this is the first positive sign in a while ... Skip Schumaker is expected to start a rehab assignment early next week. His strained oblique has kept him out for a while and he'll need 5-7 days, or about 25 at bats ... Dustin Mosely hits the DL again and the Padres will replace him with Anthony Bass for the time being ... Joey Devine will have surgery on his elbow. The expectation is that it will end up being Tommy John surgery ... I'm doing a baseball tour this summer, so if you'd like to come along for six games, check out the deal. Space is very limited.

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