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May 26, 2010

Under The Knife

Wednesday Update

by Will Carroll

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Grady Sizemore (bruised knee, ERD TBD)
For the past couple days, things didn't make much sense. We heard that Sizemore had a bone bruise, but that surgery remained an option. That only makes sense in one context—that the bruise is inside the knee and is symptom rather than the cause. Now that Sizemore has headed out to see Dr. Richard Steadman, the surgeon that invented microfracture, things seem a bit clearer. I'll caution that Steadman does more than just microfracture surgery, and even in the case of Carlos Beltran, microfracture remains a last-chance kind of procedure. At 27, this kind of chronic knee problem is one that could alter how Sizemore plays the game and could take the Indians' center fielder out of the game altogether. Baseball's history with microfracture procedures is neither long nor storied, so expect a lot of interim steps if this is the road he's limping down. There's still no clear timeline for his return.

Carlos Beltran (arthritic knee, ERD TBD)
Speaking of Beltran, I'd thought that we'd see things moving very fast once he got to running. I was wrong. If anything, they're moving even more slowly, a real source of frustration for Mets fans. Even the New York media hasn't found much to report on. He's still jogging, but hasn't really added much to his workload. There's nothing resembling a sprint yet and there's nothing resembling a game on the horizon for Beltran. Sure, he was shifted to the 60-day disabled list, but that was a pure procedural move; the 60 days will be up very soon anyway. Until we see Beltran running hard, making cuts or 90-degree turns, there's no way to do more than guess at a return date. If you're a conspiracy-minded sort, you might wonder if the Mets aren't counting out the games before he's missed 90 days, a common elimination period for disability policies. I don't know whether or not Beltran and his knee have a policy and don't think that's what is going on here. I think it's more likely that the Mets will get to mid-June and decide whether they'll have to make a move, perhaps eating the $20 million in non-deferred money remaining on Beltran's contract.

Luis Castillo (heel bruise)
Word late Monday had Castillo heading to the DL, but yesterday the second baseman was in the Mets' lineup. Going 1-for-4 isn't going to convince anyone that he's the player he once was, but that the Mets would blow up the chance of a retro move says something about his readiness. One of the consequences of last season's injury meltdown and the media attention that has lingered is that the team is a bit gun shy. What would be an easy move has to go through a convoluted Goldberg-esque decision process because of that shadow. Castillo's heel bruise is a bit like the one's we've seen around baseball this season, with Joe Mauer being the most notable case. It's painful, but it heals up. Expect to see Castillo avoid the DL, but get rested more over the next 10 days.

Dallas Braden (sprained ankle)
Since pitching the game of his life, Braden hasn't had much luck. He lasted just four innings into his latest start, this time due to a sprained ankle. Braden tried to argue with Bob Geren when he came out, but the Athletics' manager won that argument, as he should every time. Braden was a bit frustrated, but seemed to understand the decision, closing his remarks with "see you in five days." There's no reason to think that won't happen, though I'd write it in pencil until he makes his side session this weekend. I've talked in the past about the fatigue and stress of pitching a no-hitter, so it's fair to say that Braden's seeing that now after throwing a perfect game. That it's minor nagging things rather than a massive breakdown as we've seen in the past is actually a bit of a positive. The further out he gets from that day, the more normal things will get, but remember, normal for Braden isn't terribly durable.

Homer Bailey (strained shoulder, ERD 6/12)
As I said on Monday, the images would give us a lot more clarity on Bailey's shoulder. That said, the image I keep coming back to is that move he made, flexing, then twisting his arm. Try it at home and you'll see that it "opens" the shoulder a bit, which meshes very well with the diagnosis of inflammation. The underlying cause might be some sort of impingement, and that's something that will need some work to correct. It's usually a result of a mechanical flaw, so it's up to pitching coach Bryan Price now. You can't say they don't have the facilities to do what the Reds need. Bailey isn't expected to miss much beyond the minimum, but shoulders on power pitchers are funny things. We'll have to key on when he gets back to throwing and what sequence they rehab him in before getting a better handle on a real timeline. Assuming things go as expected, a mid-June return is reasonable. (One note here: That article is pretty amazing in a couple ways: First, Dave Haller is now working for the Tampa Bay Rays. Second, one of the quotes—"In five years, I think 20 teams will have a similar system"—turned out to be dead wrong, though I agreed wholeheartedly at the time. Now, five years later, only one other team does.)

Victor Martinez (bruised toe, ERD 5/28)
Jacoby Ellsbury (fractured ribs)
Mike Cameron (strained abdominals, ERD 5/25)
The Boston Globe's Amalie Benjamin says that Terry Francona said there was only certain information he could give out on injuries, due to HIPAA and FEMA. I double-checked with her and yes, Francona said FEMA. You know, the Federal Emergency Management Agency. Given what's going on with that other BP, I hope FEMA's got bigger disasters to work on than the relatively minor issues in Fenway Park. I have no idea what the Red Sox manager meant by that, but he does have some injury issues. Victor Martinez fouled a ball off his toe and limped away, but the Sox are ready for this kind of issue and will use Jason Varitek behind the plate until Martinez is ready. Martinez is likely to be back in a couple days at DH, but there's no clarity as to when he'll be ready to catch again. It's a pain tolerance thing. As for Ellsbury, who's back from his fractured ribs, and Cameron, who came back Tuesday from his strained abdominals, the Sox seem to be looking to the future. Cameron was brought in to ostensibly be a better defensive center fielder and shift Ellsbury to make left field a plus defensive position. We don't know if that would have happened, but now they'll flip-flop when both are in the lineup, with Cameron playing left and Ellsbury in center. There's no injury-related reason for this, and it seems a bit twitchy for the steady-handed Sox. It does appear that Cameron will get time in center field, especially over the next couple weeks. Ellsbury's ribs still aren't 100 percent.

Curtis Granderson (strained groin, ERD 5/28)
Granderson and Jimmy Rollins don't have much in common besides the obvious comparisons. They're both African-American ballplayers with speed, but the medical issues they have will have some connection. You see, the Yankees don't want to see Granderson do what Rollins did. (Of course, the Phillies didn't want to see that more.) Granderson is expected back on Friday, according to manager Joe Girardi, and the center fielder has shown no issues in his rehab games, but caution is always a good plan when dealing with this type of injury to this type of player. A coach or athletic trainer can say "don't go all out," and while a player hears them, the instincts can take over and over-stress a still-healing muscle. Granderson will play a full game in the outfield on Thursday on his minor-league rehab assignment, the final test before he's activated.

Andre Ethier (broken finger, ERD 6/2)
The Dodgers are very encouraged by the early results of using a soft splint on Ethier's broken finger. During batting practice Tuesday, the kids catching home-run balls on Waveland Ave. were encouragedtoo. Ethier was hitting without pain and with some real power. With the splint, the chance that Ethier could re-injure the fracture is reduced, now barely more than any other player who's out there without adequate hand protection (i.e, almost everyone. Quick, has anyone seen a player currently using the bright yellow Xprotex gloves?). He could be on a rehab assignment by the weekend and off the DL early next week. Assuming there's no pain, there's no reason to think the right fielder can't hit some home runs in games, too.

Quick Cuts: Angels third baseman Brandon Wood went on the DL with a hip flexor strain. I'm sure his weak hitting had nothing to do with it. ... Angels catcher Jeff Mathis is throwing and could begin a rehab assignment next week if his wrist holds up. ... Phillies closer Brad Lidge had a nice side session and will have another tomorrow. He's still hoping to get activated without a rehab assignment next week. ... Dodgers left-handed reliever George Sherrill hits the DL with a sore lower back. No details, but sources say it's "not major, but not good either." ... Reds outfielder Chris Dickerson is starting baseball activities a bit earlier than expected after wrist surgery. ...  Kelly Shoppach is headed out on a rehab assignment in the next week. The Rays will have a big decision to make when the catcher is ready (or the 20-day rehab clock runs out). ... I watched Pirates left-handed pitching prospect Donnie Veal pitch on Sunday for Triple-A Indianapolis and saw no evidence of any injury, but he's on the DL now with a forearm strain. ... Pirates first baseman Steven Pearce is headed to the DL with a Grade 2 ankle sprain. He'll miss the minimum, but could be out longer based on the way the roster works. ... The O's lose another reliever to the DL with Alfredo Simon heading on with a strained hamstring. ... I've been doing these weekly videos with my guy Noah Coslov of Cinesport, if you're interested in seeing a couple minutes of injury talk.

19 comments have been left for this article.

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