Under The Knife: Draft filled with more injury risks than usual

Draft day will come and go, bringing new talent to the 30 teams. It will leave some richer, some disappointed, and hang tags on all of them as "first round picks." That comes with expectations, a weight that will drag some down. Unfortunately, too many in the high rounds come with medical risks as well. This is more than just the typical risk that a young player without much track record brings or even the normal workload concerns of the high school ace, that once in a lifetime pitcher that a coach sees carrying his team to the state title. Several people inside baseball charged with reviewing files of potential draft picks have told me that there are more medical red flags than ever before. It's largely among pitchers, with complex injuries to the elbows and shoulders of talented young players. Things like growth plate injuries, epiphysial fractures, multi-structure shoulder injuries and more, all in players considered among the best prospects in baseball. If we know that even the healthy ones will break down at a better than 50 percent rate before they reach the majors, not to mention the performance concerns, the draft would seem riskier.

All that said, the new draft pool might make some teams more willing to take on risks. As late as Saturday, the Astros had not ruled out Lucas Giolito, a top HS pitcher who missed most of the season with a sprained UCL. Giolito is throwing in rehab and could be picked in the Top 10 rather than heading to UCLA. Only MLB's Jonathan Mayo is saying he believes Giolito is too much of a risk and will head to college. Up and down the draft, there are similar concerns -- more injuries and more willingness to accept risk. Remember, there is no combine, no chance for teams to review medical records beyond what is voluntarily given and no physical prior to signing. At least one team is using a system to get functional data on pitchers, but they're being very secretive about this. I know of one situation where a player's agent -- er, advisor -- knew of the system and blocked the use of it and another where the school was "uncomfortable" with the placement of cameras. The draft remains an art and not a science.

Powered by thoughts and prayers for Lindsey and Jim Duquette, on to the injuries:

Kemp's angry reaction on a scoring play last week told us as much as any MRI could. Kemp limped around the bases and then was visibly angry and frustrated. That was as much a confirmation that he knew he'd re-injured his hamstring, stressing it in the same location previously. Since muscle heals itself with scar tissue, which is, by definition, weaker, it's not surprising, but that's hardly the same thing as expected. The Dodgers tested Kemp, made sure his leg passed their tests, both functional and otherwise, and then looked him in the eye. I have no doubt that Kemp said he was ready and believed it. It just takes one wrong step, one force just a bit outside the norm, to put him back on the shelf and the Dodgers back on high alert. Kemp will be out longer, likely about a month,

Pedroia is using a plastic brace underneath his batting glove in order to protect his strained thumb, according to a report from Peter Abraham. It appears to be working as Pedroia put on a laser show during batting practice. There's also a question of what's he doing in the field? Pedroia can't have too restrictive a brace in the field since he needs to grip the ball. I was worried that diving in the field and sliding had been the problem, but I'm told that it's batting that's the real issue. Expect to see Pedroia in the lineup on Tuesday. It's safe to put him back in your lineup in most leagues.

The Mariners have always been a little bit cautious with Hernandez. Once known as an arm-shredding factory, the new M's have done well managing Hernandez and others through a course of healthy seasons. Given that and their place in the success cycle, there's very little reason for the team to put Hernandez on the mound after he left his last start with a sore back. It's not considered serious, but if Hernandez can't get his side work in on Monday, they'll be smart and skip (or at least delay) his next start. There's just too much downside for Hernandez to make his next start unless he's perfect.

The Astros will make the first pick and are probably one of the first teams to start selling once that process is done. Brett Myers, J.A. Happ, Wandy Rodriguez and Carlos Lee are all names that will come up as teams try to fill gaps and the Astros try to rebuild a system. Lee left Friday's game with a strained hamstring. The Astros treated him through the weekend, but it was clear by Sunday that he was going to miss at least a week and the team pushed him to the DL. Lee should be back at or near the minimum, giving him plenty of time to show that he can help a contender like the Marlins, who had been scouting him prior to the injury.

Early reports were confusing on Casilla, with reports that there was bruising "below the tibia." Since we know it was a knee injury, let's assume that the area in question is the tibial plateau, which is just below the kneecap and could be considered part of the knee. (Team sources would not confirm this, which leads me to believe they were happy to be unclear about Casilla's injury earlier.) Casilla was out through the weekend, leaving the save opps to Sergio Romo, but no one seems to think the bruising will keep him out more than a few days. Bone bruises are tough to read, so we'll have to wait for the Giants to give us indications that Casilla is ready to pitch again. In the meantime, keep him on your bench.

For those who haven't noticed, I tend to put players in order in UTK. I try to put the ones with the most fantasy impact at the top. Occasionally, I'll put the more interesting or educational one, and even more occasionally, my editors will disagree with my order. I say that because it's a bit odd to have a Yankee down this low. (Johan Santana is lower because he's not injured, not because he's less impactful.) Gardner is beginning the process of coming back after his elbow injury has extended much longer, due to setbacks and being at the long end of every estimate. If he can come back strong, all that will be forgotten. If Gardner's going to be back by next weekend, as Joe Girardi hopes, then he'll have to either start a rehab assignment quickly or skip it altogether.

Terry Collins let Santana go 137 pitches on his way to the first no-hitter in Mets team history. I say "let" but I think Collins would have needed a crowbar, a tractor and a precinct or two to hold back the crowd if he'd tried to get Santana off the mound. Santana was effectively wild throughout, something we've seen from other no-hitters. A no-hitter clearly is as much luck as skill, but we also know that there's a cost. Santana, coming back from shoulder surgery, hasn't gone this long ... well, ever. There's also an apparent extra cost to no-hitters or near no-hitters, an adrenaline factor, a reaching back that seems to tax pitchers more than even an elevated pitch count shows. Turns out the Mets are ahead of me, adjusting their roster to give Santana an extra day off as well as shadowing Chris Young, who is likely to have a low pitch limit when he returns this week. Remember, Johnny Vander Meer might be remembered for those two no-hitters he threw as a rookie, but do you remember anything else he did? (And yes, Ramon Ramirez will go on the DL after injuring a hamstring while celebrating Santana's no-hitter.)

Both SI's Tom Verducci and ESPN's Jayson Stark used their columns last week to detail the kind of numbers we regularly do here. More voices and well-respected ones like Verducci and Stark can only help move this mission forward ... Adam Jones will have an MRI on Monday to determine what's going on with a lingering wrist problem. Added to Nick Markakis' amazingly optimistic timeline for his hamate fracture, the O's hope wrist injuries don't come in threes ... Joe Maddon updated the press about Evan Longoria. He's making progress and is on track for a rehab assignment mid-month ... I'll admit I have no idea why Roy Halladay had a recent CAT scan. That's not a normal test for pitchers ... Did anyone know that Ryan Howard had his own podcast? In it, he says his rehab is going well, but still no solid timeline ... Joe Mauer left Sunday's game with a "minor" thumb sprain. Watch this closely... Stephen Drew will have to shift to a rehab assignment, but mostly because the XST season is over. The D'backs still aren't clear when he'll return, so don't take a rehab assignment as a true indication. Rehab clocks can be reset ... Brian McCann was out on Sunday after getting hit by a pitch. His knee swelled up after the contact ... Drew Storen was shifted to the 60-day DL. It's a procedural move, but underlying it, Storen is well behind the expected schedule. He's playing catch now, which would make the All Star break a realistic timeline, assuming no setbacks ... The Cards think Jaime Garcia's elbow problem was minor and that they have it sorted. He's expected to start on Tuesday ... Expensive injury for Roy Halladay ... Alex Avila missed the weekend with a sore hamstring. It's not expected to keep him out long ... Sergio Santos is throwing from a mound, but it's looking more and more like he'll be out until the All-Star break ...Tests on Edwin Encarnacion's hand weren't conclusive. They'll do more over the next couple days ... Draft day always makes me feel old. Seeing names like Lance McCullers Jr., Jose Mesa Jr. and Hutton Moyer makes me wonder where the time has gone ... Yoenis Cespedes returned to the A's lineup after rehabbing his hand injury. We'll see if the human trafficking investigation that has put his agent and several other touts under watch will affect him ... Jonathan Sanchez got torched in a rehab start. He'll get activated next week anyway ... Vladimir Guerrero went 9-20 with 4 homers, which is what you'd expect him to do against A ball competition. He shifts to Las Vegas (AAA) now and we'll learn more about whether he can help the Jays. If you're killing for power in a deep league, he's a speculative stash now ... Ryan Kalish shifts up to Portland (AA) as his rehab clock ticks. He'll need to be back mid-month based on the current clock and Sox expectations ... Yes, really ... I work on the internet.