Injuries are the great equalizer in fantasy baseball, and there’s no greater frustration to those of us analyzing the game than the unpredictable nature of injuries. How do you process the severity of a shoulder injury or an unexpected triceps issue? Today, injury analyst Stephania Bell offers up insight which can enable you to make more informed decisions in your leagues, even when detailed information itself may be lacking. Whether you’re a fantasy baseball manager or just a fan of a player or team, here is how to think about injuries like an expert.
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Mike Trout of the Los Angeles Angels was placed on the 10-day IL this past Friday (retroactive to May 1) with a left knee contusion. However, the term “contusion” — fancy language for a deep bruise — is not be taken lightly. Bone bruising as a result of a hard or awkward landing while running is an unsurprising mechanism of injury. Trout said he felt this latest injury when he lunged for the first base bag, but felt optimistic that he might be able to return shortly after the required 10-day period.
The nerve endings in bone are why we experience pain with bone injury, as anyone who has broken a bone can attest. Bruising is bleeding and therefore can be very painful and, if not managed properly, can lead to further bone injury. Trout’s comment that there is nothing “structurally” wrong with his knee, while understandable coming from him given that there is no major visible tissue failure, is debatable. After all, this is the same knee in which Trout suffered two separate meniscus injuries just last year.
The menisci (of which there are two in each knee, one medial and one lateral) are critical for joint cushion and stability. In the absence of even a portion of the meniscus, joint forces increase dramatically and can accelerate degenerative changes within that joint, wearing down the cartilage surfaces that cover and protect the ends of the bones where they interface. Once the cartilage has degenerated or worn thin (arthritis), the bony ends will make direct contact at certain points during weight bearing, resulting in pain.
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As a result, there has been more effort in recent years to preserve as much of the meniscus as possible after an injury. While the meniscus is a fibrocartilage structure that does not heal independently, depending on the type/location/size of a tear, the approach to treatment takes into consideration whether it is amenable to surgical repair. If it is necessary to resect a portion of the meniscus, the goal is to preserve as much of the healthy portion as possible in an effort to protect the joint cartilage surfaces.
Knowing Trout had two injuries to the same knee in 2024 raises the suspicion of a knee that is now more predisposed to early degenerative changes. Placing Trout on the IL so he is not initially loading the knee as it heals is important for resolution. Trout’s optimism aside, it may take longer than just 10 days for both the symptoms to resolve and for him to resume fully unrestricted baseball activity.
The concern however is not just for this episode but for what it might signal with regards to his future. How susceptible will he be to other similar exacerbations? The Angels already moved Trout to right field this year in an effort to preserve his health — yet just one month into the season, he finds himself on the IL. He recently joked with reporters that he’ll “try not to lunge at the bags” but playing freely also means not consciously thinking about how certain movements inherent to the game might present an injury risk.
No one has ever questioned Trout’s work ethic or his loyalty, but neither of those qualities can reverse the cumulative toll that all of his injuries have taken on his body. Of the ailments Trout has endured, his lower extremity (knee, calf) and back injuries pose more of a reinjury risk than the upper extremity injuries (hamate fracture, thumb ligament/UCL tear) he has sustained. Even if he increases his percentage of DH appearances, his gameplay will still involve swinging the bat and running so there is no escaping risk altogether.
Trout’s early power display this season proves he still has so much to offer. Let’s just hope his body cooperates.
