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May 14, 2010

Under The Knife

Beltran Gets Moving

by Will Carroll

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Juan Pierre can replace Manny Ramirez. That statement is true. For baseball analysts and medheads alike, the problems with that statement goes beyond true or false. It's the difficulty in measuring that makes it really frustrating. A replacement player can hit well above their true talent level for a couple weeks or they can fall on their face, exposed by extended playing time. Tom Gorman made a great effort in trying to quantify the effect of injuries in a research piece in Baseball Prospectus 2005. His injury accounting method works, but is something that can only be done in retrospect and requires a lot of subjective and time-consuming labor. My Injury Cost measure is a simplified version of Gorman's work, an attempt to use MORP to show the true value lost rather than the raw measure of days and dollars lost. I've toyed with further estimators, mostly based off one of my favorite statistics, the ruefully underutilized MLVr, but I'm no statistician. In some work I did as part of a consulting arrangement for a team in 2009, we took this a bit further and tried to simulate what would happen if a team simply stayed healthy all season long. Was there a balance point between durability and production? The answer proved elusive, in large part because no team will ever be completely healthy. Traumatic injuries or illnesses happen. A team made of nine Cal Ripken's or Lou Gehrig's would have nine times the random chance of injury. Due to all the randomness, it's difficult to come up with any one number, but the effect is actually smaller than most would guess in all but extreme cases of irreplaceable players like Albert Pujols. Small injuries, of course, can be the difference between making the playoffs and not. While the effect isn't huge, the reduction and management of injuries remains one of the most cost-effective things a team could do. Few make a real effort, and even those spend significantly more on a supplemental pick than they do on their medical staff and research. If Bud Selig can give a couple million dollars to combat drugs in sports without any discernible return, couldn't he find a similar amount that might help the owners reduce the billion dollars they lost due to the DL in the last five years? 

Brad Lidge (elbow stiffness, ERD TBD)
The MRI that the Phillies ordered on Lidge's elbow showed no significant damage or loose bodies. That tells us (and them) what it isn't, but not what it is. The current thought is that there's some scar tissue or impingement, but that's not exactly a good thing. Lidge will work to get the immediate pain and any inflammation out of the elbow and start trying to throw again, though there's no reason to believe it won't have the same problem. The Phillies are in the trial and error period here, and without a solid diagnosis, that process is tougher. There's still no solid timeline on Lidge's return. The next milestone will be him throwing at all, but this one could range anywhere from a couple days-he's still not on the DL-to much, much longer. Late word out of Philly is that Lidge could be available this weekend, but color me dubious.

Carlos Beltran (arthritic knee, ERD 6/1)
He's running! Beltran made the next step, literally, in his rehab as he ran laps around the field. It's not much, but it's definitely something. Observers say that Beltran was very ginger with it intitially, but opened it up a bit in subsequent laps. One said he was "loping around pretty well," while another said that he believed the overall session was very positive: "I think he was a bit wary at first and getting used to how that brace will feel. Watching him from across the field, I don't think he knew what he could do and couldn't do, but got more confidence pretty soon."

The most important thing is that Beltran was running without pain. We'll have to see how his knee responded afterwards. It's likely there was some swelling, but seeing him out there again sometime this weekend would be a very positive sign. He's scheduled to progress to sprints and the bases within ten days, which would put him on track for a June return. I continue to think a rehab process needs to be focused on getting him in the lineup quickly, though he'll surely need some time to tune up his swing after nearly a year off.

Jeff Mathis (fractured wrist, ERD 6/10)
The Angels are struggling in a way we haven't seen during the Mike Scioscia era. Part of that is an erosion of talent, but injuries are also playing a part. One key piece is Mathis, who's been out since late April with a broken wrist. Mathis got the cast off on Wednesday and will start the process of getting game-ready. It looks like he's on track for an early June return, right in the middle of the six-to-eight week timeframe for the injury. Mathis' power and bat control will be affected as expected for this type of injury, but neither are strengths for his game anyway. It's the confidence that Scioscia and the pitching staff have in him that's missed, and they'll be very glad to have back in the lineup.

Justin Duchscherer (strained hip flexor, ERD 5/15)
Things looked pretty bleak as Duchscherer hobbled off the mound, his so-called good hip acting up much in the same way that his surgically-repaired opposite hip had a couple seasons ago. A lot of treatment later, Duchscherer is ready to take the mound on Saturday for the A's after a very positive session. One doctor I spoke with had an interesting take on Duchscherer, who missed time last year with depression: "I'm not saying this negatively, but we have a guy who's been diagnosed with clinical depression strong enough to disable him. Should we be surprised when his initial reaction to an injury is decidedly negative and introspective? I'm not diminishing any of his physical symptoms, but every story I saw, including yours, focused on his own self-diagnosis." It's an interesting point. While Duchscherer's history is notable here, every athlete has a mind-body issue when it comes to injuries. I tend to discount most players' evaluations of themselves for precisely this reason, but it's quite possible that there's more information encased in them than I'd expected.

Franklin Gutierrez (back spasms, ERD 5/15)
When a team only has a couple regulars hitting above .250 TAv, losing one of them is especially bad. Gutierrez missed his second game with back spasms, spasms that a source described as the "bring-you-to-tears" kind. While Gutierrez certainly sees this as painful and problematic, the problem is muscular and can break quickly. The medical staff in Seattle is working hard and has indicated that Gutierrez is expected back quickly. They held him out of yesterday's game just to be sure, but there were signs that Don Wakamatsu wanted him in the lineup. It's hard to tell from here if that's a garden variety field vs. medical issue, where the manager wants his player back as soon as possible while the trainers want the player healthy to their standard before sending him out, or if there's even more pressure on Wakamatsu to win now. My guess would be the former, since Jack Zduriencik and his staff don't seem the quick-trigger type. Expect Gutierrez back this weekend.

Jason Kendall (bruised forearm, ERD 5/14)
Before Trey Hillman exited stage left, he said that the bruise suffered by Kendall was the worst in-game contusion he'd seen. Kendall, a durable catcher, was hit by a pitch on the forearm, so it's surprising that there was such a response. He stayed in the game after being hit by 91 mph sinker from Fausto Carmona, even getting a hit later in the game. Kendall, like any catcher, takes fouls off his body as a matter of course, so what caused this kind of response? That's unclear, but really, it's just a mystery rather than a problem. Kendall is expected to come back after a day off yesterday. He'll be reunited with his former manager, Ned Yost, which should work well for Kendall and give him more influence on the pitching staff.

 Quick Cuts: Jimmy Rollins was scheduled to play the field in extended spring training yesterday, but there are no reports on whether that happened. If it did and things went well, look for him to be in games this weekend and back in Philly next week. ... Eric Young Jr. has a stress fracture in his tibia and will head to the DL. He could be out as much as two months. ... Ryota Igarashi should be back for the Mets soon. He made it through an extended bullpen session without major issues. He's expected to head out on a rehab assignment this week. ... Sounds like Jarrod Saltalamacchia has gone the full Mackey Sasser with his throws. ... Ben Sheets intelligently worked on both a cutter and a changeup this spring. It looks like those are starting to pay off, a great adjustment to his elbow issues. ... Both Carlos Ruiz (knee) and Brian Schneider (Achilles) are hurting, so the Phillies brought up Paul Hoover, who could see some playing time. Schneider's headed to the DL. ... J.P. Howell will throw some batting practice today. It's a step. ... I'll be in Columbus, Ohio on Monday. Anyone want to go see the Clippers?  

Related Content:  The Who,  The Process,  Elbow Stiffness

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