Fantasy baseball 2024 injury report: A Matt McLain mystery, Kevin Gausman concern and more



Greg Scholz is back with updates on six 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).

Matt McLain, 2B/SS, CIN

I wanted to talk a bit about this one because there is a lot of confusion surrounding it. With basically no injury information confirmed, we’re in a spot of making our best prediction based on what is currently available. So, while there won’t be a final answer as to what we think the injury is, this is a “fun” one  — quotes because no injury is fun — because it allows us to look at all the facts and work from there. At the time of writing, some of the key information we know is that the team said there is no bone chip or fracture. Beyond that, the Reds have simply left it to “soreness in his non-throwing shoulder,” while hinting that surgery is a possibility.

So, if it isn’t a bone chip or fracture, what could it be? Well, it could be a lot of things. We do know that McClain and the team are contemplating surgery, but also seeking a second opinion to explore non-surgical options, so the injury is likely severe enough to impact his ability to perform at all facets of the game. Let’s look at some potential injuries that are not fractures, but serious enough that surgery is a possibility:

  • Rotator cuff tear — A lot of smaller tears can be managed with physical therapy and injections, but larger or full-thickness tears of the rotator cuff tendons often require surgical repair. Surgery in these cases is generally preferred because it can reduce risk of re-injury down the road.
  • Labrum tear — Similar to a rotator cuff tear, labral tears don’t always require surgery, however one of the most common ones that often does require surgery is called a SLAP (Superior Labrum from Anterior to Posterior) tear. These occur at the point where the biceps tendon attaches to the labrum.
  • Injury to the AC joint — If you are a football fan and follow the NFL, Colts quarterback Anthony Richardson had his rookie season shut down thanks to an AC joint injury. He and his team went back and forth on if he needed surgery or not before deciding it was for the best. If ligaments are torn at the AC joint, surgery is almost always required so that the joint can remain stable and heal correctly.

Like I said earlier, these are all just possibilities based on all available information. The injury reportedly happened during practice, so it’s likely that there is an identifiable traumatic event that is the cause. All three of these injuries could be caused by diving for a ball, colliding with another player, or being hit by a pitch.

Josh Lowe, OF, TB

The Rays scratched another player from their opening day roster last week when it was announced that Josh Lowe was battling a Grade 1 oblique injury.

Oblique injuries are common in baseball (and golf) because the obliques are part of the abs. Located on either side of the mid-to-lower torso, these muscles do a handful of different things. Primarily, though, they stabilize the core and assist in core rotation. It’s unclear exactly how Lowe suffered the injury, but it more than likely occurred during a batting practice session. Additionally, it’s worth noting that Lowe was battling a hip injury in February that kept him away from baseball activities. The obliques extend down to the pelvis, with the external oblique inserting at the iliac crest of the ilium (hip bone), so it’s highly likely the two injuries are related.

Lowe is coming off the best season of his young career, but his injury history does raise some flags — maybe not red ones, but yellow at least. The good news is that none of his injuries carry long-term implications — at least not yet. This oblique injury, for now, is the same. It’s only a Grade 1 and it should heal well with conservative treatment.

Kevin Gausman, SP, TOR

It’s never a good sign when a pitcher complains about arm and shoulder fatigue. Often, it can be a precursor to something much more serious. That’s the concern for Blue Jays starting pitcher Kevin Gausman.

Before the doom and gloom sets in, Gausman did undergo an MRI that reportedly showed no structural damage. The key structures they’d be looking at here would be the rotator cuff in the shoulder and the UCL ligament in the elbow. Given the time of the injury and factoring in Gausman’s age (33), early signs point to this injury being the result of an insufficient ramp-up and conditioning program. However, he isn’t out of the woods yet.

If Gausman continues to struggle with arm and shoulder fatigue as he participates in bullpen sessions and simulated games, it could result in things like tendonitis or damage to those structures I mentioned before.

Right now, we’re predicting he’ll be back around mid-April, but his Injury Risk will remain High for the first few months of the season.

Gerrit Cole, SP, NYY

Arguably the most interesting injury on the list — and the one with the potential largest impact — is Gerrit Cole’s elbow. When it was announced that he was dealing with an elbow injury, there were a lot of quick takes suggesting he needed surgery. The good news is that he should avoid going under the knife.

Cole is reportedly dealing with nerve inflammation and edema in his elbow. Most people have a general idea of what inflammation is, but edema is where some confusion sets in. Basically, edema is when there is too much fluid trapped in tissue. Symptoms include pain and swelling, and infection is a possibility. Together, these two injuries can significantly impair grip strength and the elbow may feel weak.

Treatment is fairly simple if caught in the early stages, as it appears in Cole’s case: rest and physical therapy. Unfortunately, this doesn’t heal quickly, though. Cole likely won’t return until mid-June. The worst case scenario would be if he does not respond well to treatment. If that were to happen, Cole may need surgery to relieve pressure in his elbow.

The bad news is that, when he does return, there is some risk that the issue continues or pops back up again at a later date, meaning his Injury Risk will be High until around September.

Max Scherzer, SP, TEX

Scherzer missed 36 games towards the end of the 2023 season due to a teres major strain in his shoulder. He managed to return to the Rangers rotation during the ALCS, where he made two starts. After that, he was the starter for Game 3 of the World Series. He pitched just three innings before being pulled due to lower back tightness. Scherzer was then removed from Texas’ postseason roster.

After the Rangers won the World Series, Scherzer said the pain in his back continued despite attempts to treat the pain. Ultimately, he was diagnosed with a herniated disc in his back and he underwent surgery.

In the back, between each vertebrae, is a disc. These work as cushions that help with flexibility and shock absorption. Each disc is made up of a gel-like center and a strong outer layer. Over time, that strong outer layer can degenerate, allowing that gel-like layer, also called the nucleus pulposus, to protrude. This is a herniated disc.

Symptoms of a herniated disc include pain, limited mobility, and weakness are common. If conservative treatments don’t work, surgery is required. This was the case with Scherzer.

Recovery from surgery varies from person to person, with some recovery periods lasting up to a year. As for Scherzer, a midsummer return is certainly possible. That said, we will need to see how his body responds to the ramp-up period now that he’s been cleared for baseball activities. Additionally, there will need to be maintenance to ensure that re-injury doesn’t occur and that he is pain free. He will have a High Injury Risk for 2024.

Eduardo Rodriguez, SP, ARI

The 30-year-old lefty was in the headlines last season for less-than-ideal reasons. That said, between his finger injury and the drama surrounding his no-trade clause, E-Rod managed to put up a respectable 13-9 record with a 3.30 ERA in 2023. In the offseason, he signed a four-year, $80 million contract with the Arizona Diamondbacks.

Heading into the 2024 season, he was expected to be their No. 3 starter behind Zac Gallen and Merrill Kelly, but that will have to wait. Rodriguez was diagnosed with a strained lat and will be on the injured list to start the season.

A strained lat, or latissimus dorsi strain, involves damage to the large muscle in the back that helps control the movement of the shoulder, arm, and back. For pitchers, it often is the result of overuse, but it can also come from a single pitch that was thrown too hard or with improper mechanics. There isn’t an identifiable pitch where this can be seen with Rodriguez, who left his start against the Cubs on Tuesday before the second inning, but he was seen wincing in pain as he warmed up.

The good news is that the team believes it is a Grade 1 strain, however they do not want him to return until he is completely pain-free. For Rodriguez, this means he’ll likely be out until late April to early May. If he is completely pain-free by then, his Injury Risk will only be Elevated.

(Top photo of Matt McLain: Kareem Elgazzar/The Enquirer-USA TODAY Sports)





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