MLB injury mailbag: Jonathan India’s nagging hammy, Kris Bryant’s back and more

In this mailbag: The extent of Jonathan India’s hamstring, expectations going forward for Kris Bryant (back) and more!

Inside Injuries was founded by an orthopedic radiologist, Dr. Anand Lalaji (aka Dr. A), who contributes to all of the injury write-ups. Dr. A put together a team of doctors and data scientists to create an algorithm to evaluate the impact that injuries have on a player. This algorithm powers all of Inside Injuries’ analysis and determines each player’s Injury Risk, Health Performance Factor (the level a player is expected to perform at if they return too soon, for example) and Optimal Recovery Time. This information is based on years of medical experience and historical injury research and has proven to be incredibly accurate in determining how injuries will impact a player’s performance and risk of future injuries.

A quick description of terms from our injury algorithm:

  • IRC = Injury Risk Category (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)

Will Jonathan India struggle with his hamstring all season or is there a situation where it fully heals? – Michael B.

Jonathan India is on the IL for the second time this season due to his hamstring. India was first injured on April 14 as he was running to first base. He returned just 12 days later, which was about a week before reaching his three-week Optimal Recovery Time. After just four games India then found himself back on the IL due to an aggravation. Our algorithm now has his injury as a grade 2 hamstring strain – repeat injuries are typically more serious, especially when they happen this close together. India can get healthy, but a much more cautious approach needs to be taken. He shouldn’t return until June.

Before the regular season started I was concerned about an uptick in muscular strains due to the abnormal offseason and shortened spring training. India is one of many players to quickly suffer one of these lower body injuries. He then made matters worse by rushing his return, and now he is forced to start his recovery over. If India takes enough time to allow the hamstring to fully heal this time, and he works on his leg strength and mobility, then he should be healthy enough to return and make an impact. His Injury Risk will remain increased throughout the season, though, as hamstring strains are highly recurrent.

Is Joc Pederson really going to avoid an IL trip, or are they being optimistic? How are these types of injuries normally handled? – Jonathan W.

An MRI showed that Joc Pederson is dealing with a grade 1 right adductor strain, so, yes, the Giants are being too optimistic here. Pederson was injured while trying to beat out a throw to second base last Wednesday and hasn’t played since. The adductors are a group of muscles that run along the inner thigh. They are important for stabilizing the hip and rotating the upper leg inward. This type of movement is involved both when fielding and hitting, so it is not something he should play through.

The Inside Injuries algorithm has Pederson’s Optimal Recovery Time at three weeks. His Overall Injury Risk will remain High at least through the end of May, and his HPF is currently Below Average. Pederson has been great at the plate to start the year, but this injury will certainly affect him if he tries to play before it is healed. This season he is slashing .353 / .382 / .745 with 11 runs, six home runs and 10 RBIs. The Giants may be tempted to play him as the DH in an attempt to avoid the IL, but there is a significant risk of making the injury more severe.

Any word on Kris Bryant? Expectations on his performance moving forward? – Erik P.

The Rockies placed Bryant on the IL over the weekend due to a back injury that has sidelined him since April 25. The injury has been referred to as both “tightness” and a “strain.” If this is just some tightness / soreness, then it’s realistic for him to return in two weeks without a significant impact on his performance. A strain is more concerning, although the MRI showed no major issues. All this really means is that there was something serious like a herniated disc, but it could still have shown a mild strain.

I’m expecting Bryant to miss around two weeks with the injury. He has been cleared to play catch. It’s a positive sign that he wasn’t completely shut down from all baseball activities, but swinging the bat is what will really stress his back. Bryant has a lengthy injury history but no previous back problems. That’s encouraging because back injuries, especially the more serious ones, have a high tendency to recur. If Bryant waits to return until his back is truly fully healed, then I’m optimistic that this won’t have an impact for the remainder of the season. Our algorithm has this as a grade 1 back strain, and it comes with a three-week Optimal Recovery Time.

Any indication of the nature / duration of the Ryan Pressly injury? “Sore knee” seems pretty vague. – Peter E.

Ryan Pressly landed on the IL nearly three weeks ago due to inflammation in his right knee. It was expected to be a short absence, but he still is not ready. Pressly was throwing bullpen sessions last week yet there still is not a timeline to return. When Astros manager Dusty Baker was asked about a potential setback, he responded with, “No, not really. “He just hasn’t had a step forward.”

This is clearly something more serious than just some soreness. The inflammation was significant enough that Pressly had his knee drained. While this is a fairly simple form of treatment, it does indicate that there was a lot of fluid in the joint. Now it’s time to figure out why that is happening so it can be treated properly and prevented in the future. If it’s something like arthritis or cartilage damage that is causing the fluid build-up, that is concerning.

Pressly underwent surgery on this knee back in 2019 and then had issues with it soon after his return as scar tissue was breaking up. The surgery was described as an arthroscopic procedure, but an exact diagnosis was not revealed. He also dealt with pain in the knee late last season. Based on his recovery time back in 2019 and the ongoing problems, one likely possibility is that he had a meniscus torn. When this happens the little piece that tears is cut out. The recovery is quick, but it can lead to lingering problems as there is not as much cushion remaining in the knee. If this is the case, then Pressly will continue to deal with knee problems. He may be able to return soon, but it will need to be managed carefully throughout the season. That may include more off days and a rehab program to strengthen the surrounding muscles.

Is there any specific concern over Byron Buxton’s most recent injuries or is it a general injury? – Michael B.

We’re not even a month into the season and Buxton has already had two injury scares. The hand contusion from a HBP last week really isn’t a big deal, but he also injured his knee the previous week. It did not require an IL stint and the MRI did not show any significant structural damage, but I still believe it was a mild sprain. The Inside Injuries algorithm listed this as a grade 1 sprain with a two-week Optimal Recovery Time. My concern going forward is more about his overall Injury Risk, although that knee is still more vulnerable to another injury now.

Buxton’s recent injury history includes a hand fracture, hamstring strain, hip strain, left foot sprain, multiple concussions and shoulder surgery. He has appeared in 493 games through seven MLB seasons. The only season that Buxton exceeded 100 games played was in 2017. He has so much talent, he just can not stay healthy. Our projections have Buxton in the High Injury Risk for the remainder of the season, so expect another (likely more serious) injury at some point.

(Top photo: Andy Lyons / Getty Images)


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