Will Carroll
Friday February 10th, 2012

Take the salary lost to injuries over the last five seasons and you could put in a winning bid for the Dodgers. That's how many big name players have been hurt in recent years and 2011 was no exception. Among those with nine-figure contracts to miss significant time were the Phillies' Ryan Howard, the Yankees' Alex Rodriguez and the Twins' Joe Mauer while other well-compensated stars like Hanley Ramirez also sat out significant chunks of the campaign.

Injuries, and the cures for them, come in many varieties but there's really only two types: chronic and traumatic. Chronic injuries are ones that wear down and finally sap enough performance that they have to be addressed. Traumatic injuries come from one event, such as the home plate collision that ended Buster Posey's season last May.

It's important to note a key difference about them: how they affect the chance of something bad happening again. For instance, Posey might never get hurt in a collision at the plate again, but he's not more likely to get hurt either. The risk can be reduced by several different things, but lightning does strike twice. Teams and fans of the players below can only hope their best players aren't on this list a year from now.

Ryan Howard, Phillies, 1B

Injury: Ruptured Achilles tendon

Return: June 1

Effect: Slight loss of power, reduced lateral mobility in field

Howard collapsed to the ground at Citizen's Ban Park while he tried running out what would be the final out of the Phillies' stunning loss to the Cardinals in last year's NLDS. The good news for Philadelphia is that Achilles tendon ruptures are an "easy fix" for surgeons, and Howard claims that he's doing very well since his surgery last October, already running and hitting.

The Phillies are going to be conservative with Howard, bringing in some other options to play first base (even bringing back Jim Thome) that will allow him the proper time to fully heal and not tax the new tendon that has been grafted into place.

It's hardly breaking news that Howard isn't the most mobile player to begin with, so the real effect will be on his power. It was his left Achilles that popped, the back foot necessary for generating power. It wouldn't be unusual for Howard to be a bit tentative early on, at least until he gets confidence that his legs truly are back under him. That tentativeness could show itself as a loss of power, but the rehab staff in Philly will be working on this mental aspect at the same time they handle the physical rehab.

Another possibility is that Howard could add some loft to his swing, knowing he doesn't want to have to leg out a double. That latter move is common among aging sluggers, leading to a tradeoff of power for average. If you're looking for the real effect of the injury after he returns, look at his contact numbers. They could rise, even for someone like Howard who has struck out 182 times on average the past six years. If you'd rather stay away from stats, just look for big swing-and-misses once he's back making rehab starts.

Alex Rodriguez, Yankees, 3B

Injury: Chondromalacia in knee

Return: Opening Day

Effect: Reduced range and power

Chondro-what? It's a big word that means Rodriguez is aging and his knees lack the normal, smooth cartilage that protects the joint. He famously had a "blood spinning" procedure in November not unlike the PRP (platelet rich plasma) injections that have gained traction in sports medicine over the past few seasons. There's nothing illegal or even shady about this procedure; Dr. Andrews even called it "standard procedure" during a presentation in January.

Rodriguez missed 40+ games last year to a knee cleanout and a thumb sprain that seemed to linger and sap his prodigious power. It's clearly the former that has Rodriguez more concerned and that will continue to be a maintenance issue for the Yankees' medical staff. As with Howard, it wouldn't be unusual for Rodriguez to try and put more balls in the seats at this stage in his career as he tried to run down Griffey, Mays, Ruth, Aaron, and Bonds on the all-time home run list.

Buster Posey, Giants, C

Injury: Compound fracture/sprain/dislocation of ankle

Return: Opening Day

Effect: Move from catcher, drop in batting average

It's impossible to watch Posey being steamrolled at the plate by the Marlins' Scott Cousins last May 25 without cringing, but if you can look, you'll see that Posey's foot was positioned incorrectly. He rolled over it and something had to give. In this case it was both the ligaments that hold the ankle in place and the bone that holds him upright.

Broken bones heal, but think of this as the worst possible high ankle sprain. If Posey's lost any mobility, he'll have a tougher time dealing with the squatting, which could lead to arthritic changes in the joint. Posey's hitting well, running without a limp, and has even done some catching, so he should be able to be back behind the plate, if the Giants choose to do that.

Speed was never part of his offensive game, but the loss of lateral mobility may hurt him on defense. There are few good comparables for this type of injury, especially for a catcher who is also an elite young and athletic hitter. The Giants would be smart to start shifting Posey out from behind the plate. He was a college shortstop at Florida State, so he has the athleticism to play elsewhere and his bat can support a number of different positions. Posey should be ready to go when spring training opens, which will give us plenty of looks at his mobility.

Hanley Ramirez, Marlins, 3B

Injury: Unstable right shoulder

Return: Opening Day

Effect: Reduced power

Dr. James Andrews did an open repair on Ramirez's shoulder in September. Open repairs (where the surgeon cuts open the shoulder and exposes it for work, rather than using arthroscopes) are uncommon in all but the most serious injuries. Ramirez has had problems in both sides now, so he's been through the process with positive results.

He should be ready for spring training and has already been hitting before camps open. One source says that while Ramirez is swinging, it's impossible to gauge his power at this stage. It's one thing to hit the ball hard during soft toss and entirely another to hitting a big league fastball. That was the problem for the Rays' B.J. Upton, who had a similar procedure after the 2009 season and came back on much the same schedule. Upton's surgery was a bit later -- November versus September -- and the lingering effects went into June for him. Oddly, Upton had a power surge prior to the surgery and it never really came back, but his power did return to his normal levels. Expect Ramirez to struggle early, especially with power.

Grady Sizemore, Indians, OF

Injury: Torn meniscus in knee

Return: Opening Day

Effect: Reduced speed, range, and power

Let's get this straight: Sizemore had microfracture surgery on his left knee in 2010. He injured his right knee on a slide in mid-July of 2011, tearing the meniscus and necessitating arthroscopic surgery. He rested the knee and then had surgery to fix an unrelated sports hernia before returning in September. It didn't last long and Sizemore was forced to shut things down and have surgery in early October. He had the right knee cleaned out and smoothed down, plus had some lubricant injected into the knee to help it heal up. It wasn't microfracture.

It's still serious, though, especially given the fact that the body is bilateral. An injury on one side forces the body to compensate in unconscious ways to protect that injury from pain or re-injury. Given the previous, serious problems on the other side, it's more important to get the "good" side healthy as possible.

Sizemore has lost speed and much of his confidence as well, but there's flashes of it. After the microfracture surgery, he had his doubles power back quickly and some think that, just as with prospects, a healthy Sizemore could see some of those turn back into homers. I'm not so hopeful, though I think Lonnie Soloff, the Indians' athletic trainer, gives Sizemore his best shot, which is a big reason Sizemore re-signed with the Tribe. Soloff first came to attention as an assistant trainer with the Reds, responsible for helping Ken Griffey Jr. come back from his own series of leg injuries. Some might not think of Griffey's time with the Reds as a rehab success, but look again. The Indians would take similar results for Sizemore.

Joe Mauer, Twins, C

Injury: Inflamed sacroiliac joint

Return: Opening Day

Effect: Defensive position shift

The catchphrase "Well played, Mauer" went viral for Sony PlayStation in 2010. Last year, Twins fans were saying "Just play, Mauer!" Mauer was always a worry among the medheads. At 6-foot-5, he's a tall catcher, with long limbs that put more pressure on his hips and knees. He's also a catcher, which forces him to take unnecessary physical abuse. Mauer, a three-time Gold Glove winner, is thought of as a fine defensive player, but neither his caught stealing percentage nor any of his other defensive numbers are particularly outstanding.

That leads us to the simple question of why Mauer is catching at all after a run of injuries and the Twins' long-term commitment (an eight-year, $184 million contract through 2018) to him. Mauer's problem was an inflamed sacroiliac joint, the place where the spine and pelvis come together and flex. That's more important for a catcher than any other position aside from pitchers, so standing him up -- at DH or any other position on the field - would help immediately.

Putting Mauer behind the plate a few times a week, in the field a few times (perhaps in rightfield to keep his plus-arm in play), and at DH a few times seems simple to everyone but Twins manager Ron Gardenhire and Mauer himself, who insists on staying at catcher. The power should come back if his legs (and that troublesome SI joint) stay healthy.

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