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June 3, 2010

Under The Knife

Thursday Update

by Will Carroll

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Mark Teixeira (bruised foot)
Jorge Posada (fractured foot)
"Didn't Jorge Posada have negative x-rays?" That's the type of irrational behavior that just flummoxes me. A Yankee fanatic—not fan, but fanatic—asked this question after it was announced that Teixeira had good news. Teixeira's foot is bruised and sore, but according to images, not broken. Yes, it's possible that a fracture can be missed, such as when a fracture is so small that it only takes two weeks to heal, as it did with Posada. Teixeira was back in the lineup at first base on Wednesday and it appears that the breathless Yankees fans can go back to complaining about something else as they dust off their championships. As for Posada, he returned from the DL and immediately went to DH. The question now is when he can move from DH to catching. Joe Girardi said that Posada had not been cleared by doctors to catch, so we have to think there's some reason. According to one of my favorite orthos, he thinks the answer is in the fracture. "If he's back there squatting, he's putting pressure on that bone in a way that he wouldn't walking, standing, or even running," he explained. "Squatting puts a lot of pressure on the forefoot and toes, so if this fracture is up there, as we'd guess it would be, putting 200 pounds of pressure on it is going to test just how healed it is." Caution's the play here and Francisco Cervelli is helping them be patient. Posada didn't appear to be wearing anything at bat, so I'm guessing that he has some sort of padding or hard plastic in the shoe or even in an ankle wrap.

Carlos Beltran (arthritic knee, ERD 7/15)
Over the past couple days, I've read some articles focused on anonymous sources. Morgan Ensberg, always an intriguing read, even when I disagree with him, rails against "cowards" who hide behind anonymous quotes and the writers that use them. In another, a writer railed about anonymous quotes being used to assail Bryce Harper's makeup, then closes with an anonymous quote from a GM regarding Harper's potential. I use anonymous sources every day, so I pay very close attention to things like this. In this article, the anonymous quote from a Mets front office-type is very intriguing. Sure, I can see why someone wouldn't want to go on record about Oliver Perez's status, but why would this person not want to give the very limited details about Beltran amping up his running program? The answer is likely that it's the same person and by protecting both quotes, no one gets to play guessing games. What really struck me is that Jerry Manuel (on record this time) said that he was willing to give Beltran frequent rest and occasionally use him at the corner outfield spots. Occasionally? Beltran at center field is a disaster waiting to happen and it seems that Manuel is headed down that path. Beltran is only running at 80 percent, whatever that means... well, it means that he's jogging briskly, but not running or turning sharply, which sounds a lot less than 80 percent of the way back to baseball. I just worry that whatever progress Beltran makes isn't going to last, but there are positive examples, such as Lance Berkman, if you want to hang your hat on that one. The ERD is shifted back again, this time to the far side of the All-Star break.

Mark Reynolds (strained quad)
There's no question that Reynolds swings hard. So hard that sometime last week, he strained his quad. The medical staff has kept him going, but the quad is at a stage where it's not getting any better, held in a limbo by hard work and pain tolerance. The Diamondbacks, struggling and facing some sort of shakeup according to media reports, might push Reynolds to the DL in order to let it heal up, though he pinch-hit in Tuesday's game, blowing a retro move. More interestingly, Nick Piecoro of the Arizona Republic points out that this injury actually has roots going all the way back to spring training. There's really no indication of how the D'Backs will handle this going forward, so these imminent changes might give the team a reason to tell Reynolds to heal up rather than just buying the third baseman a couple days of rest.

Chipper Jones (inflamed finger, ERD 6/7)
Jones left Tuesday's game with what the Braves described as an "inflamed right ring finger." This comes shortly after missing a couple games with a sore groin, so it's a typical Jones week at this stage in his career. There's no known causation for this injury, but it's evidently been lingering for a couple weeks. Sources tell me that the finger hasn't responded and that the likely next step is a cortisone injection, though Jones is hesitant. When batting lefty, the finger is more of a problem due to Jones' grip. Jones drops his pinky over the knob of the bat, leaving that ring finger against the knob and taking much of the force of the swing, much the way that Andre Ethier's pinky did. We'll have to see how this progresses, though Ethier isn't a good comp. Jones' finger isn't fractured. The DL doesn't seem likely, but missed time is.

Mike Cameron (strained abdominals)
The injury to Cameron is going to linger. The type of abdominal strain he has is one I'm all too familiar with, having undergone surgery last year to correct a similar problem. It's not something that gets better instantly and even after surgery, I can feel it "grab" during certain activities. Cameron didn't have surgery, but even healed enough to play baseball, it's the residual soreness afterward that's the issue. The Red Sox had tests that showed Cameron doesn't have new tearing, so this is going to be an issue of maintenance, warm up, and pain tolerance. That's nearly impossible to predict, leaving the Sox medical staff working on all phases of injury management in hopes of keeping Cameron productive and relatively comfortable. Sources tell me the team is very reluctant to put Cameron back on the DL with Jacoby Ellsbury still out. That means we'll be dealing with this story for a while.

Daniel Murphy (sprained knee, ERD TBD)
Positional change risk is something we talk about here sometimes, especially in the Team Health Reports, but Murphy got an object lesson in it at Triple-A Buffalo. In only his second game at second base, Murphy got rolled up big on a double play. It was one of those rough-but-clean plays you'll see when a guy's trying to break up a double play, I was told by an observer, but Murphy was caught on the wrong side of the bag. He couldn't put any weight on the leg as he was being carried off the field and was in obvious pain after the game. While there are no details on the extent of the injury, Murphy did start the season on the DL with an MCL sprain on that leg, so he's not going to be the guy called up by the Mets to replace Luis Castillo now. It's also a reminder that minor-league athletic trainers have a pretty heady job, trying to keep guys one step (or many) from the big leagues healthy, all without staff to assist them or the fancy equipment big leaguers take for granted.

Placido Polanco (sore elbow, ERD 6/5)
J.A. Happ (forearm strain, ERD 6/27)
Jimmy Rollins (strained calf, ERD 6/9)
The Phillies seem to be trying to prove that even the most talented team can be felled by injuries. If you look at their success during their proto-dynastic run of the last few years, much of it is colored by what some would say is a lack of injury, but what I'd say is more accurately described as minimization of injuries. Chase Utley had major hip surgery, but they were able to keep him out there on the way to a World Series. Over the last few weeks, the Phillies have dealt with a lot of little injuries that have amounted to a stack, but they're starting to trickle back into the lineup. Polanco is expected back at the end of the week after getting a cortisone shot in his elbow. The cortisone was necessary to relieve some inflammation, though there are rumblings that Polanco has some bone chips. Coming after a hit by pitch from Tim Hudson, "chips" implies something was wrong and that hit moved them or that there was more to that injury than we thought. Polanco is expected back on Friday. Happ is making progress after a slow, progressive rehab. He'll throw three innings at extended spring training today and if things go well, he'll start a rehab assignment next week. The rehab is expected to go three, maybe four starts, which puts him back towards the end of June. Finally, the Phillies are going to be patient and conservative with Rollins, as expected. Rollins is eligible to come off the DL on Sunday, but the medical staff is going to hold him out a couple of extra days to make sure that there's as little chance of a recurrence as possible. There's going to be a hold on his running, even more than last time, so fantasy teams are going to feel more of an effect than the Phillies will.

Simon
Thanks to all who kept my dog, Simon, in their thoughts. Simon injured his CCL, the canine equivalent of the ACL. Turns out he had a congenital laxity in his patellar tendon, allowing the kneecap to subluxate and put more pressure on the CCL. Veterinary surgeon Dr. Tom Lee performed a fibular transposition, moving the smaller bone of the lower leg (just like in a human) to allow the equivalent of his MCL to take on the role of the CCL. It's not an operation that would work in a human due to the way that the canine stifle (knee) loads, but it's impressive technology. More impressive, his ERD is six to eight weeks. Dr. Lee expects him to be walking within a week and back to 70 percent by three weeks. 

Quick Cuts: Mark Teahen will miss a month with a fractured finger. The White Sox third baseman will have a pin inserted to help it heal. ... Derrek Lee was scratched from the Cubs' lineup amid rumors that the Angels were trying to deal for him. The Cubs say Lee has a mild hamstring strain. ... Kendry Morales has still not had surgery on his leg as far as I can tell. If there's still significant swelling there after 72 hours, there could be more damage than just the fracture. I'm working to get more details. ... Vicente Padilla is scheduled for the first of three rehab outings on Thursday. ... Jon Rauch admits he's having some hamstring issues, but says it isn't affecting his pitching. His results say differently. ... Alexi Casilla will have his elbow scoped, removing a bone spur and generally cleaning things up. He'll miss six weeks or so. ... Boof Bonser's rehab clock has almost expired as he recovers from a groin strain. It's very unclear what the Red Sox intend to do with him, but they'll have to decide this weekend. He's unlikely to make another minor-league appearance. ... Castillo will head to the DL with heel problems. His left heel is bruised, but his right heel is having issues because of the gait change. ... The Indians think Anthony Reyes will go on a rehab assignment by the start of July as he returns from Tommy John surgery. His recovery could allow the Indians to make a deal. ... My Ken Griffey Jr. memory? I was in Tim Kremchek's office doing an interview with him on the day that Griffey won Comeback Player of the Year. Griffey burst in, hugged Kremchek, and said "We did it." They said a couple things, then Griffey turned, smiled and said "Sorry." I just smiled back. "No problem, Junior." In five years, I wonder if Griffey will be remember for what he did or what he didn't do. He retires without a ring, without major records, and yet I can't imagine him not being a first-ballot Hall of Famer. I'll leave that analysis to Jay Jaffe, but it's stunning to look at his numbers and see the difference between reality and perception over the last decade. No one clamored for Reggie Jackson to be a unanimous Hall of Famer, though that's whose career Griffey just had.

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