Six pitchers you're better off avoiding in fantasy drafts due to injury concerns

New York Yankees starting pitcher Luis Severino walks off the field during the fourth inning of Game 3 of baseball's American League Division Series against the Boston Red Sox, Monday, Oct. 8, 2018, in New York. (AP Photo/Frank Franklin II)
Luis Severino's rotator cuff has put his season start in peril. (AP Photo/Frank Franklin II)

By Virginia Zakas, Inside Injuries

Special to Yahoo Sports

Over the last few weeks we have covered infielders and outfielders to avoid. Now we are back with six pitchers to stay away from based on their current ADP. These guys have battled injuries over the last few seasons and come with too much risk.

Before we dive in, here are two classifications to keep in mind throughout the story.

IRC = Injury Risk Category (Low, Elevated, High – this is the likelihood of a player suffering an injury in 2019).

HPF = Health Performance Factor (Peak, Above Average, Below Average, Poor – how we expect a player to perform based on any current or past injuries).

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Luis Severino, New York Yankees

IRC: Elevated - 19%

HPF: Below Average - 44%

Significant Injuries: rotator cuff inflammation

Severino experienced pain in the back of his throwing shoulder and was scratched from his schedule start on Tuesday. The immediate concern with pain in this location is either damage to the rotator cuff or a lat muscle strain. An MRI showed rotator cuff inflammation, which is relatively good news, but he isn't out of the woods just yet. This is something that can lead to long-term problems with the rotator cuff.

The plan is to shut him down for two weeks to allow the inflammation to calm down. He received a cortisone injection, which will help to reduce inflammation and manage the pain. Severino will be re-evaluated and hopes to be cleared to throw once he hits that two-week mark, but that might not be enough time for his shoulder to heal. Inside Injuries is showing a three-week Optimal Recovery Time if this is inflammation and nothing more. He will focus on rehab and strengthening his shoulder over the next few weeks, but he shouldn't throw at full strength until the end of the month.

Severino won't be ready on Opening Day, but if all goes well he could return to the Yankees rotation by late April. This is one of those injuries where he needs to be very patient and not rush back. When cleared to throw, he needs to start slow and throw from 90 feet for a few days, making sure there's no pain or excessive soreness before progressing to longer throws and eventually to the mound. This process should take around two weeks, and then he will need time to stretch out his arm so he is ready to rejoin the rotation.

Following a 19-8 season where he posted a 3.39 ERA, Severino received a $40 million contract extension. If there isn't an underlying cause to the inflammation such as a rotator cuff tear, he should still be able to perform as an ace starting in May. But if there is a more serious problem going on that wasn't identified on the MRI, it's going to be a rough season. Also keep in mind that this serves as an early red flag that he could suffer more serious rotator cuff damage down the road. It could be this season or it could be years from now. Consider Severino a high-risk pick, but he has enough upside that he should be considered if he somehow drops outside of the first 100 picks.

Clayton Kershaw, Los Angles Dodgers

IRC: High - 48%

HPF: Poor - 19%

Significant Injuries: shoulder injury, biceps tendinitis, multiple back injuries

I don't care how good Kershaw is when he is healthy. You just can't draft him at his current ADP (45th overall). Not only has he had back problems in each of the last three seasons, but he battled biceps tendinitis last season and is now having issues with his shoulder. Kershaw's days of being one of the most reliable aces in the game are long gone.

The Dodgers have yet to rule out Kershaw as their Opening Day starter, but he's quickly running out of time. Kershaw has been throwing but not pitching, and there's a big difference. He is slowly increasing the distance of his throws, so far progressing to 75 feet, but has yet to resume throwing off of the mound.

Inside Injuries currently has Kershaw's Injury Risk at 48%, which is incredibly high. It wouldn't be a surprise if Kershaw ended up missing half of the season due to his injuries. His body is breaking down. If it's not his back, it's a problem with his throwing arm. I don't care how far he falls in drafts, he just isn't worth the risk unless it's a late round pick, and someone else is probably going to take a chance on him as one of their top pitchers.

[Positional Rankings: Top 300 Overall | C | 1B | 2B | SS | 3B | OF | P]

Stephen Strasburg, Washington Nationals

IRC: High - 51%

HPF: Above Average - 67%

Significant Injuries: cervical nerve impingement, shoulder inflammation, Tommy John surgery, back strains

Strasburg threw just 130 innings in 22 starts last season and has averaged 145 innings over the last four seasons. In 2018 he posted the worst ERA of his career (3.75) and his lowest strikeout percentage (28.68%) since 2014. Strasburg struggled to recover from a few different injuries, including cervical nerve impingement and right shoulder inflammation, and they certainly hurt his performance even when he was healthy enough to pitch.

Strasburg's injuries date all the way back to his rookie season. He underwent Tommy John surgery in 2010 and since then has had issues with his shoulder, upper and lower back, oblique, lat and elbow. That alone should be enough of a reason to avoid him in fantasy drafts, but if that isn't convincing enough, our future projections should scare you away. Right now his Injury Risk sits at 51%, a warning sign that he is once again going to miss a large chunk of the season. What we don't know is which injury will flare up, but it's going to be something. His HPF is ok at 67%, but it isn't going to get back into the Peak category at any point this season. Strasburg has too many injuries to his name and is never going to be the pitcher he once was when he was the ace of the Nationals staff.

Jimmy Nelson, Milwaukee Brewers

IRC: Elevated - 14%

HPF: Peak - 85%

Significant Injuries: right shoulder surgery for partial anterior labrum tear

Nelson ended up missing the entire 2018 season after surgery to repair a torn labrum in his throwing shoulder. He was initially expected to return mid-season, but the recovery took much longer than expected. He reported to spring training without any restrictions, although he was briefly shut down last week due to a slight setback. Nelson's shoulder is already feeling better, and he was cleared to throw his first bullpen session on Monday. While Nelson does remain an Elevated Injury Risk, and could for much of the year, he has made steady progress and could be ready to join the Brewers rotation at the start of the season.

Nelson was very impressive before his injury in 2017, posting a 3.49 ERA and a 27.34 K%, by far the best in his career. He's a guy that we will need to watch closely throughout spring training. During his BP session his fastball hit 92, two mph below his 2017 average. Nelson is scheduled to throw two innings in his Cactus League debut this week.

We don't really know what to expect from Nelson after missing an entire season, so don't stretch and take him until the last few rounds of your draft. His current ADP is 249, so at that price he could payoff as a late-round pick.

Alex Reyes, St. Louis Cardinals

IRC: High - 48%

HPF: Above Average - 67%

Significant Injuries: torn lat, Tommy John surgery

Reyes remains one of the top prospects in the game with sky-high upside, but there is plenty of risk as he works his way back from two season-ending injuries. First, it was Tommy John surgery in 2017, then early in 2018 he suffered a torn lat tendon, requiring surgery and another lengthy recovery. Reyes has already made his spring debut and is expected to be ready to go at the start of the season, but it remains unclear how the Cardinals will use him. He isn't a guy that is going to see 150+ innings this season, and he could end up in the bullpen for much of the year. It might make sense to start him in the bullpen and then use him as a starter in the second half of the season if his body is responding well. Consider Reyes a high risk/high reward guy to target late in drafts but not inside the top 200 picks.

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Mike Foltynewicz, Atlanta Braves

IRC: Elevated - 18%

HPF: Below Average - 46%

Significant Injuries: elbow soreness, Thoracic Outlet Syndrome, triceps tightness

Foltynewicz was a pleasant surprise last season, posting career bests in ERA (2.85), K% (27.15), innings pitched (183), wins (13) and WHIP (1.08). Unfortunately his elbow flared up last week, setting him back and making him unavailable as the Braves Opening Day starter. Folty has already been cleared to resume throwing, and the medical staff wasn't concerned enough to send him for an MRI. But when you look at this injury combined with his career numbers, it's clear Folty isn't worth a pick at his current ADP inside the top 100.

This injury alone isn't enough to drop his ADP significantly, but it is another warning sign that he might not live up to the lofty expectations this season. In his five year MLB career, he has also had surgery for Thoracic Outlet syndrome, battled bone spurs and landed on the DL with triceps tightness. His Injury Risk is Elevated at 18% — not as concerning as some of the other guys on this list, but it's still something to watch. On top of that his BABIP in 2018 was .251, much lower than his .303 career average. Don't go after Foltynewicz unless it’s with one of your last picks.

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