Fantasy baseball 2024 injury report: Updates on Justin Verlander, Kodai Senga and more

Greg Scholz has updates on seven of the most impactful players dealing with injuries ahead of the 2024 fantasy baseball campaign — including when we can expect them back in action. 

Before we dive in, here’s a quick glossary of terms commonly used by Inside Injuries:

  • IRC = Injury Risk Category (three designations: “Low,” “Elevated,” “High”) — the overall likelihood a player will get injured
  • HPF = Health Performance Factor (Peak, Above Average, Below Average, Poor) — our metric to predict player performance
  • ORT = Optimal Recovery Time — the amount of time a player needs to fully recover from an injury (not the same as how much time they will actually miss).

Justin Verlander, HOU, SP

While a member of the Mets, Verlander entered the 2023 season with a shoulder strain that kept him out until early May. Now, as a member of the Astros, he’s facing a similar issue.

In 2023, Verlander was dealing with a teres major strain. There has been no official confirmation as to what his injury is this time around, but Verlander said he felt that his preparation for this season was behind schedule due to his shoulder. At 41 years old, age has to be brought into consideration in conjunction with injury history for the three-time Cy Young award winner.

Operating under the assumption that this is related to the original teres major strain, Verlander is in danger of missing the early weeks of the upcoming season. The teres major muscle is located near the shoulder and upper back. It plays a crucial role in the movement and rotation of the arm. The good news is that recovery from a teres major strain is pretty straightforward in most cases. Usually it involves rest, ice, compression, and elevation early on in an attempt to reduce inflammation. The next steps would be physical therapy aimed at restoring range of motion, strength, and flexibility.

Long term, Verlander shouldn’t face too many complications so long as he does not make significant changes to his mechanics.

Walker Buehler, LAD / Shane Baz, TB, SPs

I lumped these two together because they’re both high-ceiling pitchers who are recovering from Tommy John surgery. For Buehler, this is his second TJ surgery, with his first coming back in 2015. Baz is in a similar boat, as he underwent arthroscopic elbow surgery (different from TJ) in March 2022. The surgery kept him out until June of that year. Ultimately, he required TJ surgery in September 2022 and missed the entire 2023 season.

Both pitchers are reportedly progressing well, with Baz throwing his first bullpen session of 2024 last week. For Buehler, things are a bit more complicated. With no reported setbacks, his return date has been pushed back at least once already. Originally, the Dodgers wanted him back for the 2023 playoffs, but that didn’t pan out. Heading into 2024, it was reported that Buehler would be back before opening day, but recent reports indicate the team would be more comfortable with him returning in April or May.

Buehler’s case highlights why predicting a return from TJ surgery is never easy. A pitcher can be recovering just fine with no setbacks and still be behind a traditional recovery schedule. Both pitchers will return at some point this year, but the ramp up period needs to be slow and steady. Otherwise, they’re at risk of suffering another injury later in the year.

Kodai Senga, NYM, SP

Now that Verlander and Max Scherzer are gone, Senga enters 2024 as the presumptive ace of the Mets rotation. With that comes the expectation that he’ll be the opening day starter — a designation that is in jeopardy thanks to a posterior capsule strain. Senga underwent a PRP injection to address the injury and won’t throw for three weeks, meaning he should return around March 17 — just 11 days before opening day.

A posterior capsule strain refers to a strain in the ligaments and/or connective tissue at the back (posterior) of the shoulder joint. The muscles and structures in this area stabilize the shoulder and play a major role in maintaining proper mechanics during repetitive, high-velocity, overhead throwing motions. The PRP injection Senga underwent is meant to accelerate healing and recovery by injecting platelet-rich plasma into the area. These injections are common, but the efficacy varies, so it’s not a “one size fits all” treatment.

Provided Senga’s strain is a Grade 1 or lower, he should be able to return before opening day. However, these sorts of injuries can be played through before the healing process is completed, meaning the player could face injury issues later in the season.

Manny Machado, SD, 3B

The Padres’ third baseman underwent offseason surgery in October 2023 to address his tennis elbow (lateral epicondylitis). Despite the name, it’s not just related to tennis players. The injury itself is characterized by soreness on the outer side of the elbow. It is an overuse injury, which is why it’s more associated with tennis. In Machado’s case, it’s likely that he was dealing with symptoms for a while before finally addressing it. Most of the time, mild cases can be treated fairly conservatively. Specifically, Machado had his extensor tendon repaired.

Generally, surgery involves removing degenerated tendon tissue. Then, the remaining healthy tissue is repaired. Recovery from surgery is fairly straightforward, but timelines vary. Considering Machado’s surgery took place in early October 2023, he should be approaching the end of his recovery window.

He’s ramped up his recovery over the past two months, which has included both throwing and hitting. With no reported setbacks, the last steps for Machado will be the most important. This is when he’ll need to ramp up his recovery to match game speed and intensity. If his body responds well to the ramp up period, his health should be fine for the rest of the season.

Vinnie Pasquantino, KC, 1B

The Royals made a handful of surprising moves in the offseason, signing a handful of free agents. One of the less surprising transactions was signing Bobby Witt Jr. to a long term extension. He’ll be the centerpiece of their young core for years to come. Across the diamond from him is another solid young player in first baseman Vinnie Pasquantino.

Pasquantino put up solid numbers in 61 games last season before a torn labrum ended his campaign. The labrum is a small ring of cartilage that surrounds the socket of the shoulder joint. It primarily works to stabilize the joint itself and act as cushion against internal and external forces.

Now entering his third season, Pasquantino has been available in all three of the Royals’ spring training games. In the small sample size, he hasn’t produced much, but this is what spring training is for. His availability alone is a great sign for the upcoming season and there isn’t much concern for the shoulder moving forward.

Aaron Judge, NYY, OF

The biggest name on this list, Judge made headlines when he said that the toe injury he suffered last season would require maintenance for the rest of his career. I’m here to ease some concerns on that front.

Judge tore the ligament at his MTP joint on his right big toe. For anyone who watches football, where this sort of injury is more common, we call this turf toe. The reason it needed surgery and will require future attention is due to the significance that the big toe plays in a variety of lower body movements.

One of the major things the big toe does is provide balance and stability to the foot, especially while in motion. When we run, or even walk for that matter, the big toe takes on a significant load. If the MTP joint is injured, the load the big toe can bear is significantly lessened. Another major note for the big toe and MTP joint is that, once it’s injured, it doesn’t take much to aggravate it, even after surgery.

As for mitigating that risk in the future, there isn’t a ton that can be done in-game other than potentially putting supports in the toe box of his cleats. More than anything, Judge will just have to listen to his body more. If the toe is hurting or he feels tenderness in the area, it will need to be addressed immediately. Otherwise we could see decreased performance as he is forced to compensate for the pain by adjusting mechanics.

The good news is, even though it may be easier to injure the toe in the future, that doesn’t mean these sorts of injuries happen every day. It would take another unique circumstance for a similar injury to occur.

(Top photo of Justin Verlander: Sam Navarro-USA TODAY Sports)

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