The Houston Astros are 23-31, sitting fourth in the AL West, and have now used more than 15 IL stints this season.
But for the first time in months, there is genuine positive momentum on the injury front. Several key players are deep into rehab assignments, and returns are coming into focus.
Here is the latest clinical update on every significant injury situation in the organization.
Josh Hader: Left Biceps Tendinitis: Nearly Back
Hader is the closest of all injured Astros to a major league return, and his rehab numbers have been outstanding.
He began his rehab on May 5 and has since appeared in six games across two levels, throwing six innings, allowing one run, walking one batter, and striking out nine. That is elite closer-level production in a rehab context. He threw one scoreless inning with two strikeouts in his seventh minor league rehab outing on May 24 at Double-A Corpus Christi and is getting close to rejoining the big league club.
From a sports medicine standpoint, the most critical indicator for biceps tendinitis recovery is not pain level at rest, but pain-free explosive effort under repeated load.
Hader’s ability to maintain velocity and miss bats across seven consecutive outings at multiple levels confirms the tendon has fully settled. Espada confirmed Hader needs five more rehab outings before activation, though that reporting is now nearly two weeks old and his outing count suggests a return is imminent, likely in the first week of June.
Hunter Brown : Grade 2 Right Shoulder Strain: Ramping Up
Brown’s rehab is progressing on schedule, though the timeline has been appropriately conservative given the severity of his initial diagnosis. Brown touched 96 mph in a 22-pitch live BP session and made his first rehab start Sunday at Double-A Corpus Christi, a significant milestone after being shut down from all throwing since early April.
His next rehab start is scheduled for Triple-A Sugar Land this weekend, with the Astros returning home Friday to host Milwaukee.
The progression from Double-A to Triple-A is a deliberate escalation of competitive stress on the shoulder, testing the repaired musculature against higher-level hitters before returning to major league intensity.
GM Dana Brown confirmed the All-Star’s return is set for the middle of June, with the goal of getting him stretched out to 75 pitches before rejoining the team.
Clinically, four rehab starts spanning roughly three weeks is appropriate for a starter returning from a Grade 2 strain. A mid-June return with no setbacks is realistic and well-supported by the current trajectory.
Tatsuya Imai : Right Arm Fatigue: Breakthrough Moment
The most surprising and encouraging update this week belongs to Imai, and it came in the most dramatic fashion possible.
Imai threw the first no-hitter of the 2026 season Monday in a 9-0 win over the Rangers, with Steven Okert and Alimber Santa handling the final three frames to complete it.
The performance was as clinically meaningful as it was spectacular.
For a pitcher who had been battling arm fatigue, command issues, and a difficult mental adjustment to the major leagues, executing at that level is proof that his arm has genuinely recovered.
Despite Monday’s gem, Imai still carries a 6.17 ERA and 1.50 WHIP across 23.1 innings in six starts this season, with his next tentative outing scheduled for Sunday against Milwaukee.
The command inconsistency remains the primary clinical concern going forward, though Monday’s outing provides an important confidence baseline for his continued development.
Jose Altuve : Grade 2 Left Oblique Strain: Trending Positive
Altuve is the newest significant name on the IL, and the early news has been cautiously encouraging.
The 36-year-old suffered a Grade 2 left oblique strain on an awkward swing last Saturday in a game against the Texas Rangers.
He noted the injury is not as severe as the oblique strain that sidelined him for part of 2023 and has headed to the team’s facility in West Palm Beach to continue rehabilitation.
A Grade 2 oblique strain involves partial muscle fiber disruption and typically requires 3 to 5 weeks of recovery for position players, with the return-to-play gate being pain-free rotational loading at full effort.
The 2023 comparison Altuve made is clinically relevant: prior oblique injuries create scar tissue that can alter the muscle’s elastic properties, increasing re-injury risk if the rehab progression is rushed. A late-June return, assuming no setbacks, is a reasonable projection.
Joey Loperfido : Right Quad Strain: Minor Setback
Loperfido started his rehab assignment at Double-A Corpus Christi on Sunday but will pause until Wednesday after fouling a ball off his foot during that game.
The foot issue appears separate from the quad strain and should not significantly delay his return, which remains projected for late May to early June.
The Astros are finally seeing light at the end of a very long tunnel.
The clinical picture across the board is trending toward health. Whether it comes in time to salvage a playoff run is a question the standings will answer.
Follow my blog for ongoing injury and return-to-play coverage throughout the 2026 Houston Astros season.
