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May 20, 2010

Under The Knife

Thursday Update

by Will Carroll

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Grady Sizemore (bruised knee, ERD 6/10)
Paul Hoynes knows more about the Cleveland Indians than I'll ever know about anything. His tweet that Sizemore might need surgery after being diagnosed with a deep bone bruise was more than a bit confusing, however. A bone bruise can't be fixed by surgery, so what might "Hoynsie" have been saying? I called one of my favorite orthos and asked. "The bruise is a symptom," he said. "Maybe the meniscus is torn or even had been taken out. The [Carlos] Beltran situation would be the worst-case scenario, but that doesn't match up. Sizemore's only symptom is a bruise and a knee that's had a couple minor issues. He's run, he's played the field, and he has a pretty minor trauma. You're right, it doesn't add up." So we're missing information here. After several discussions with doctors and trainers, the opinion was that Sizemore may have an underlying cartilage issue that was aggravated by an earlier slide, but watch this video. Sizemore says that he "couldn't put weight on" the knee, but he walks off without much of a limp from what I can see. He had the leg tucked under him, so it's not that he stuffed it into the bag. This one's just a flat-out mystery with what we know not adding up.

Jorge Posada (fractured foot, ERD 6/20)
The news that Posada has a fractured foot clears up any questions about the knot he had. The bad news is that clarity equals a month on the shelf and some question about whether he'll be able to catch full-time when he does return. It's his right foot, which matters more when he's batting right-handed than it will at any other time. This type of fracture, described as a hairline one along the instep, tends to heal pretty cleanly, but there is some recurrence risk, especially given how it happened and what Posada is required to do behind the plate. Squatting alone is going to put some pressure on the bone, which is why I think he could come back to the DH slot. The medical science focused on fractures is getting players back more quickly and with less recurrence. Maybe Posada and Sally Field can have a chat while he's on the DL.

Nick Swisher (strained biceps, ERD 5/21)
Marcus Thames (sprained ankle, TBD)
It's not just Posada hurting in New York. Swisher remains on the bench as he continues to get treatment on his strained biceps. The injury isn't going to put him on the DL by itself, but with all the injuries that the Yankees are dealing with, their flexibility is a bit tight right now which could force a move if Swisher doesn't make progress over the next couple days. Word out of New York is that Swisher can only hit righty, so last night's matchup with Wade Davis didn't help things. The Yankees have James Shields scheduled against them tonight, then get some help on Friday as the Mets have Hisanori Takahashi scheduled to go. If Swisher isn't able to go by then, the DL is going to get discussed anew though it looks like he'll be back. Meanwhile, Thames managed to sprain his ankle; reports have him stepping on a bat in last night's loss, an unusual play that even Joe Girardi said he hadn't seen before. The video is unclear in how this happened. Now the Yankees might push Thames to the DL in order to make a roster move, though he's said to be day to day. They'll sort that out today as the front office reconfigures the roster.

Josh Beckett (back spasms, ERD 6/6)
Let's be clear: the Red Sox did not place Beckett on the DL in order to make sure the protest was not upheld. Beckett's controversial removal from the game against the Yankees on Tuesday night aside, this is as simple as things get. Beckett has a minor but significant back problem that's not allowing him to have his normal follow-through, taking some motion off his pitches. The Sox's medical staff will try to get to the root cause of this, using the next two weeks to try and make sure that this doesn't become a long-term problem. Given Beckett's struggles this season and his shift to a stoic presence on the mound, I'm not convinced yet that this is the sole problem, so don't expect a miracle cure, even if the back is no longer a problem. All sources tell me that Beckett is expected to miss at or near the minimum, though they might send him to the minors for one start, as much for confidence as rehab work.

Brett Anderson (flexor strain, ERD 5/29)
After a side session with hitters-as opposed to a simulated game,by semantics-Anderson is on track for a May 29 return. He threw 40 pitches at "near full-throttle" according to an observer and had no problems. Anderson's remaining concern is his ability to recover from the session, but all signs seem positive. It sounds as if he'll have a rehab outing early next week, probably at Triple-A. There are some concerns beyond that about stamina, but the Athletics are already monitoring Anderson's workload pretty closely. Having lost Justin Duchscherer, the team is going to have to rely more on depth than an innings-eater unless they make a surprise move into the trade market. Anderson remains their best chance of having a real ace, though it's not likely to happen this season. Helping this team contend could be a major milestone for him in that development, but he'll have to add durability to his well-stocked tool shed before we can hang that on him.

Tom Gorzelanny (bruised finger, ERD 5/30)
While I continually talk about protecting pitchers from comebackers, there's no way to completely protect a pitcher. Gorzelanny was an object lesson in that on Wednesday: he took a sizzling comebacker off his pitching hand and there's no way to protect that. Gorzelanny was hit on the ring finger and was lucky to come away with just a nasty bruise rather than a fracture. We'll have to wait to see if he'll be able to make his next start, though given early pain and swelling that's unlikely. With Carlos Zambrano coming back to the rotation, the Cubs have some flexibility if Gorzelanny isn't ready next time his turn is up. We'll get a sign when his throw day comes up this weekend. Expect Gorzelanny to miss one turn.

Matt Diaz (infected thumb, ERD 6/30)
Diaz's injury is one of the strange ones. He had to have surgery to remove a splinter and to clear up the infection that has set in. Obviously, it's the infection that's most worrisome. In today's sports world, one of the biggest concerns is infection, specifically MRSA. Living in close quarters and sharing space often leads to transmission of things like cold and flu, but it can often be worse. Teams have gotten much more strict about safety measures and education, but the bacteria don't really care. Diaz should be fine in the long term, but he'll be out for longer than the minimum while on a regimen of antibiotics. Some reports have him out until nearly the All-Star break, so we'll have to wait for some sign of baseball activity to get a better gauge on when he'll return. At that point, we'll have to address whether or not he has a spot to return to or not.

Kyle Blanks (strained elbow, ERD 5/22)
There's really something to the sophomore slump, isn't there? I've never seen a study, but there are plenty of anecdotes to go around. Blanks is adding to that, but at least he has a bit of an explanation now. Blanks is dealing with another injury, this time in his arm. He has a strained tendon in his throwing elbow, which I guess doesn't explain why he's hitting under .200. Early word is that the DL isn't necessary, but with things like this paired up with slow starts, there's always a chance that a team might use the coincidence to give the player a breather and some work on the side. The big outfielder doesn't seem to have health as one of his tools, pairing the elbow injury with ongoing maintenance for his plantar fasciitis.

Trevor Hoffman
With a lot of teams and a lot of pitchers, taking time off to "work on mechanics" after a rough start to the season might be just lip service. In this case, Hoffman is working with Rick Peterson, someone who takes pitching mechanics very seriously. This is likely more than a simple tweak, as Hoffman has been roundly crushed this year, with not much difference between his so-called fastball and that formerly devastating change. In this article, Peterson indicates that Hoffman is going to change his arm angle to a lower slot to try to get more downward plane. (Yes, I'm a bit confused,too.) If that's the case, that's more about trying to find something that's more effective rather than something that's going to free up a bit of velocity. There's still some hope that Hoffman can turn it around, but if he's going to have to rely on guile, then the Brewers might not be able to rely on him. There's no injury here, so there's no ERD.

Quick Cuts: Dallas Braden left his start because of illness and dehydration, not because of an injury. In this case, Braden was tough-guying it through the flu. ... Marco Scutaro had a cortisone shot in his non-throwing elbow, necessitating a roster shuffle. Scutaro should be back in a couple days and it's considered annoying more than serious. ... Reports out of Florida have Carlos Beltran running, but that he's at least a month away from a return. ... Things have been quiet on the Kelly Shoppach front, perhaps because John Jaso is proving an adequate backup. Shoppach should be getting close to baseball activities, but the Rays don't seem to be in a rush. ... Jack Wilson had a setback in his rehab from a hamstring strain. He's returning to Seattle for tests. ... Freddy Sanchez was activated by the Giants, but it sounds like he won't be getting anything near a full workload just yet. ... Here's what I know about Travis Snider's wrist injury beyond the public information:        ... Michael Gonzalez is throwing again, but the Orioles don't seem to expect him back any time soon. ... Former Diamondbacks top pick Jarrod Parker is throwing again after last year's Tommy John surgery. He's young and talented enough to get back on track quickly. He's on schedule in his rehab and could pitch in games by August. ... Rafael Furcal is finally making some progress from his hamstring strain and could go out on rehab assignment very soon. ... Manny Ramirez was scratched from last night's game with a foot injury. No details at deadline, but keep your eyes on this one.

Related Content:  Back,  Tom Gorzelanny,  Fractured Ankle

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