One of the most persistent myths in sports medicine, and especially in pitching injuries, is that sprains and strains are somehow different from tears. They’re not. A sprain is a tear of a ligament. A strain is a tear of a muscle or tendon. That’s it. The tissue stretches too far and some fibers rip. Sometimes it’s a few strands; sometimes it’s the whole thing. Whether you call it a strain, a sprain, or a tear, you’re talking about the same basic injury: structural damage to soft tissue. And yet, because of the way injuries were talked about for decades — before MRIs, before ultrasounds, back when diagnosis was done with a manual test and a guess — we’re still stuck using these outdated words that make everything sound either worse or better than it actually is.
Grading systems don’t help either. A Grade I strain or sprain is a small tear, maybe 5% of the fibers, a tweak. Grade II is a bigger tear but not a full rupture. Grade III means the thing is torn completely. These grades were invented long before we had any way to actually see inside the body to confirm them. It was based on clinical signs — swelling, weakness, pain with movement. They were best guesses by people who didn’t have the tools we have now.
Yet even with all the imaging tech available today, we’re still using the same system, mostly because it’s simple and familiar, not because it’s actually accurate. A player can have a tiny Grade II tear that lingers for months, or a “high Grade I” that feels fine in a week. The reality doesn’t always match the number.
Part of the reason this confusion sticks around is language. Teams, agents, even doctors sometimes prefer the softer terms. "Strain" sounds like something you can play through. "Tear" sounds like surgery. So you get a pitcher with a partially torn lat and it's announced as a "low-grade lat strain," because it buys time, keeps panic levels down, and fits into the expectations set by a fanbase and media who have been trained for decades to think a "tear" is the worst-case scenario, even when it’s not. (The word you want is “rupture.” Or really, don’t want.)
If we want to move forward, we have to start telling the truth in plain English. A strain is a tear. A sprain is a tear. They happen on a spectrum, from tiny to catastrophic. MRI reports should come with clear percentage estimates. Instead of "Grade II strain," say "about 20% of the muscle fibers torn." Instead of "shoulder inflammation," say "early-stage tendon damage, no rupture yet." If that sounds scarier, good. It’s supposed to. Soft-pedaling injuries helps no one. It delays treatment, skews rehab timelines, and sets unrealistic expectations for returns.
We have the technology to see injuries. We should have the language to match. Every minute we spend arguing over what to call a tear is a minute we’re not spending figuring out how to fix it.
I should honestly bring the shirts back. For now, on to the injuries:
BRAYAN BELLO, SP BOS (inflamed shoulder)
LUCAS GIOLITO, SP BOS (sprained elbow/strained hamstring)
The thing about rehab assignments is that it’s so tough to tell whether the pitcher was good. They got lit up by Single-A kids? Usually bad, but sometimes the pitcher just doesn’t care, is getting his work in, and is giving those kids a story to tell people back home. “Sure, I got cut, but I took Curt Schilling deep!” The one key tell is when a team basically tells you it’s not enough by extending the assignment, forcing one more start or homestead on a player. That’s what the Sox are doing with both Brayan Bello and Lucas Giolito.
Bello will make his next rehab start on Friday, but it’s likely not his last. The results will tell, but he’s going for 75 pitches as a goal in this outing. He hasn’t been efficient in his outings previous, but a source tells me that that’s less about stuff and more about consistency, so I’m sure the Sox will be looking at that when he goes tonight. For Giolito, efficiency is also an issue. He threw 61 pitches in his outing Wednesday, but 30 of them were in the first inning. There was discussion about pulling him at that point, but the decision was made to let him keep going and he righted the ship a bit.
Part of it is that not only do Bello and Giolito need to be better before they’re pitching in Boston, the rotation isn’t bad now and decisions have to be made. Richard Fitts put up 13 K’s in his last outing, but took the loss. He’s pitching well and would seem to be ahead of Sean Newcomb, but if both Bello and Giolito are ready soon, what to do with both get interesting. One could fit in long relief, no pun intended, but two? Matt Moore, injured all season, was cut loose which doesn’t directly correlate, but the fact is that the Sox have to get their roster right soon.
PABLO LOPEZ, SP MIN (strained hamstring)
Hamstring strains are interesting for pitchers in that they seldom happen during pitching. Pablo Lopez managed to do it in the act, rather than fielding or on the bases, and while it’s not a significant strain, it’s enough to put him on the IL for now. He’d been very efficient in his first three starts and looking like the same durable and steady rotation anchor the Twins need again in ‘25. A couple weeks off shouldn’t change much, and Lopez should be able to do enough work to avoid a rehab start.
One thing I heard recently is that many teams are looking at their biomechanical data coming from HawkEye to determine whether or not a pitcher will be affected more by certain injuries. I don’t know that’s the case here, but the Twins have a great medical staff and are more analytics driven than many realize. Also, Rocco Baldelli understands injuries better than most and is able to deal with them differently, which often makes him willing to play a man down, or to adjust to make sure an injury is healed properly rather than pushing through it.
With Lopez on the shelf, the Twins called David Festa over from St Paul to take the start on Friday and he’ll likely get a couple more, though the fun name of Zebby Mathews was said to also be in consideration. Lopez shouldn’t miss much more than the minimum if things go to plan and he should be able to keep his arm going while his leg is healing.
FREDDIE FREEMAN, 1B LAD (sprained ankle)
More than a few - like, a lot - of people around baseball called, texted, sent me Twitter DMs (don’t do that) and asked what the “real” story on Freddie Freeman’s ankle is. This is one of those classic stories, right? The luggage fell on my arm. I saw spiders in my dreams. From what I can tell - and I feel like I have a good BS meter - the “he slipped in the shower” story is real.
But that makes it a bit more worrisome. Follow me here. Freeman had surgery to clean out his ankle. Not to tighten it up, but merely to get the debris, arthritic changes, the junk that floats around inside a joint space, and get it out of there as much as possible. That’s good, and simple. I did have some questions about why just a clean up would require an extended recovery but again, I don’t have any evidence to say it’s anything but that.
Which means there’s a chance - a chance, Dodgers fans! - that there’s damage in there that’s regenerating the debris. Add in the additional trauma of a slip and fall, or slip and twist in this case, and at age-35, it’s not unheard of to have significant arthritic changes. All of us regenerate and replace cells of all types, but bone remodeling remains one that is complex and uncontrolled. There’s even still some debate on how it happens. For those more technical of you, no, this is likely not an osteochondritis dissecans process.
To simplify somewhat, the fact that Freeman re-injured himself is not in and of itself problematic. If it happens again, or repeatedly, then there’s a bigger problem and one that could accelerate.
RYAN BLISS, 2B SEA (ruptured biceps)
Injuries are reminders - memento fragilitatis, if you will - that this can all vanish. Every pitch, every swing, every play could be the last and even as good as sports medicine is, there’s still a chance it’s the last. For Ryan Bliss, a normal swing in April is his last of 2025, as his biceps tendon gave and the muscle simply rolled up. It’s an unusual, dramatic injury and he’s probably going to sit with the athletic trainers soon as they think about all the signs they had that something might be up that they missed. It’s inevitable.
Bliss will have surgery to re-attach the muscle and should have every chance to return. He’s small and a scout that saw him when he was at Auburn mentioned that he had to be max effort to get anything resembling the power he’s had in the minors. It’s his non-throwing arm, so it shouldn’t affect him as much in the field, but the question will be whether he loses all power. His legs should make up for it, but he’ll need even more steals if he’s a 5 homer guy instead of 12.
Man, I knew when I was doing that intro that “rupture” was going to come up and here it is. I know jinxes aren’t real. It doesn’t make me have a twinge, an idea that there’s a pattern to all this randomness, even if Bliss’ arm injury was as inevitable or as random as anything else. The plus is that medical science is at a point where Bliss isn’t just going to have a normal life, but a baseball career.
WYATT LANGFORD, OF TEX (strained oblique)
EVAN CARTER, OF TEX (bruised hand)
What is going on with the Rangers and oblique strains? It feels like we’re seeing more of these this season and more issues returning. Just look over at Adolis Garcia, who’s showing less contact and power, even almost a month back from his own. That’s part of the worry with Wyatt Langford, who’s own strain was significant enough on the MRI to push him to the IL.
Langford’s been very steady since locking in the starting job last year, barely touching the minors. He did have a hamstring strain last year, but he came back well and put up solid numbers across the board. That shouldn’t change much here, but the drop in numbers around the league post-strain is an intriguing trend.
The Rangers have plenty of options, including Josh Smith and Kevin Pillar, to fill in, but Evan Carter may not be one. He injured his hand on a bunt attempt and was sent for imaging. It would be bad timing if there’s a fracture, though going just 2 for 22 at Triple-A doesn’t scream that he’s ready for a call-up. Worth watching to see if Carter is forced out for weeks in the midst of his comeback.
Quick Cuts:
Spencer Strider has nothing left to show in Triple-A after dominating again. He went 90 pitches and lines up to take the start for Atlanta next Wednesday. That would be AJ Smith-Shawver’s slot, so we’ll have to see how the Braves shift their rotation … Tony Gonsolin (back/elbow) has a bit more to show. 3 1/3 innings and even with Justin Wroblseski down in a bit of a rotation, the Dodgers just don’t think Gonsolin is ready yet. He’ll have at least one more outing in Oklahoma … Clarke Schmidt (shoulder) went 61 pitches, which should be enough to get him activated, even if he’s a bit limited in his first start next week … Liam Hendriks (elbow) looked great in his first rehab outing. He struck out three. He’ll pitch again over the weekend … It’s tendonitis in his pitching elbow for Justin Steele, but he thinks he’ll just need the minimum before getting back in the rotation. We’ll see … Jesus Sanchez (oblique) started his rehab assignment on Thursday. If all goes well, he could be back after the weekend … Mark Canha strained his abductor after bouncing off the outfield wall. Yeah, that’s a weird sentence. Drew Waters comes up to take his roster spot, but Jonathan India is likely to get more outfield starts in his absence. Help is coming soon … Spencer Horwitz is taking batting practice and could be about a week away from a rehab assignment. He’s on track after his spring wrist surgery … The Angels finally pushed Yoan Moncada to the IL after his thumb sprain just didn’t get better. He first injured it almost a month ago and playing through it was causing setbacks … I’m not a big pop fan, but the new Selena Gomez album is brilliant.