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November 8, 2004

Under The Knife

A Run on ACL Tears

by Will Carroll

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It was a long week for me, so I won't bore you with an intro. I'll just thank you for being readers and letting me have the greatest job in the world.

Powered by Peet's Mocha Sanani, on to the injuries:

  • Sometimes injuries seem viral, coming in bunches. Usually these are new injuries that, once discovered, are more widely noticed.

    Over the last few weeks, baseball has instead had a rash of anterior cruciate ligament injuries. Torn ligaments are certainly not new in baseball, yet the clustering of these injuries is new. Since the start of September, Adam Kennedy, Jason Kubel, Carlos Guillen, Jody Gerut, and now Rocco Baldelli and Lance Berkman have fallen victim. As with most injuries, the surgery to repair a torn ACL has gotten less invasive with a shorter rehab period. However, this is still a procedure that is done "open"--with a scalpel rather than an arthroscope--and that has significant short- and long-term consequences. Depending on the severity of the tear and the complexities of the repair, a player can come back in six to 12 months. Giving hope to some of these players are the recent cases of Corey Patterson, Javy Lopez, and Mike Lieberthal. Patterson's return from a June Grade II tear in just eight months is most encouraging for a "speed player" like Baldelli.

    The recovery of these players depends on many factors--degree of tearing, condition of the knee and surrounding muscles, general physical conditioning, work ethic in rehab, and the type of player and skill set they possessed before the injury. It is also important to note if there is other ligament or cartilage damage, a common collateral injury. Kubel seems to have the most extensive damage, involving at least one other ligament and his patellar tendon. Speed players, as well as those who rely on lateral motion, will be more likely to take longer to recover function. For those of you setting fantasy keepers, expecting a full season from any of these players is pure folly. Expecting normal production from them once they return is reasonable.

  • Curt Schilling may have the most famous ankle in the world. You surely know the details of what he went through during the playoffs. Now, surgeons will go in to repair what they literally held together with a couple of stitches. The repair of Schilling's ankle's ligament structure is expected to be routine, putting him on track to open spring training healthy. Schilling has always been a quick healer, coming back ahead of schedule in 2003 from both an appendectomy and a broken hand. Schilling should have every chance to be just as effective in 2005, perhaps more effective if he can stay healthy.

  • A pitcher seldom wants to be compared to Darren Dreifort. For once, it's not that bad. Jason Isringhausen will undergo arthroscopic surgery to repair his acetabular (hip) labrum. Dreifort had similar surgery prior to the 2004 season and had no further problems. The labrum in the hip is similar to the labrum in the shoulder, but the injury isn't nearly as serious for pitchers. First, pitchers don't throw with their leg. Also, the hip joint, while similar to the ball and socket joint of the shoulder, does not have the range of motion nor take the same types of forces. Expect "Izzy" back on the mound by the time spring training comes. If Dreifort and Paul Shuey can do it, I'm sure Isringhausen can. (For those of you that want to look back, here's something UTK said about the topic back in June.

  • Izzy isn't the only Cardinal heading under the knife. Albert Pujols will have surgery to treat the plantar fasciitis he suffered with all season. This is a slow-healing injury, one that has derailed and even ended careers, so expecting Pujols to come through with little or no consequence may be possible, but certainly will bear knowing and watching. Like most injuries, we won't know how it will affect him until he gets back on the field in February.

  • Steve Kline is also headed under the knife, but he won't be a Cardinal when he returns. Once his finger heals up from a tendon repair, he'll be heading east, if my sources are right. There's very little chance that he won't continue to be what he has been for the last several years. He can be a LOOGY forever, wearing the filthy hat of the highest bidder.

  • The Mets are swapping Jose Reyes and Kazuo Matsui across the keystone for next season. Matsui has to hit while Reyes has to stay healthy. I have a lot more confidence in the former, with Reyes under the tutelage of Mackie Shilstone this off-season. Shilstone is a guy who sells a great program and delivers…well, when his biggest success story is bulking up Jonathan Bender, a seven-foot, 213-pound stick figure, I worry. There were better programs that Reyes could have gone to; that could come back to bite a team that really isn't that far from being good.

  • Joe Mauer, like Reyes, was expected to take home trophies after this season. Instead, his season was almost lost, but with just enough playing time to tantalize Twins fans with his potential. Mauer is working hard this early off-season but there remains a high likelihood, I'm told, that he'll have more knee surgery. The Twins have a while to figure out how they'll line up next season, but they'll need to decide quickly whether Mauer needs a move to third base.

  • Gary Sheffield put up MVP-caliber numbers--we'll know if it got him the trophy later this week--with a bum shoulder. There's still some debate as to whether surgery will be required to fix it, so Sheffield is still hopeful that he'll be able to avoid the knife. Either way, he's not expected to miss much if any of spring training and will spend next year punishing pitchers much like he did this season.

  • Some teams like facts, some teams like faith. It's like that in a lot of places, but putting millions on the line in hopes that someone will do something sounds to me like something I'd want facts on. The Mariners seem to be fixated on Richie Sexson. They'll point to Ken Griffey Jr., who was able to come back from more serious shoulder surgery, or Shawn Green who came back from similar surgery to hit well. It's Green that I would compare most closely to Sexson's situation. Green's still not all the way back, a combination of shoulder degeneration and the passing of time. If that's enough for the Mariners, well, that is their pattern.

  • The way the whispers around baseball sound, the Rockies are this year's version of the Expos. Whether they'll be the team that everyone comes to remains to be seen, yet there are certainly a number of players that teams might be interested in. Reports have everyone from Preston Wilson to Todd Helton on the block "for the right offer." The GM meetings in Florida will get things started, perhaps getting the action rolling for the Winter Meetings in early December. With all the early action on contracts (Pedro Martinez and Carlos Beltran both had offers leaked to the press), this could be more interesting than last year's off-season and the murmurs of collusion. As far as the rumors of a Sammy Sosa for Shawn Green deal? A high-level source tells me "this smells like Ken Griffey for Phil Nevin."

  • Quick Cuts: Anyone up for a Tampa Pizza Feed? I'll be down in Florida for the Thanksgiving holiday and have an open night on my calendar for Monday, November 22. If we have enough interest (10 or more), I'll put it together. Tampa is, of course, home of the Medical Staff of the Year … I did radio in Albuquerque the other day and I was asked what I would offer Pedro Martinez. That's easy; what did Bartolo Colon get? And who gave it to him? … Can Troy Glaus play third base again? That's an open question. Like most things, I can't say that someone can do something until he does it. Sources tell me that Glaus should be able to play a credible third, but that he may have permanently lost some arm strength.

Finally, a quick note to correct something: In my last UTK, I discussed Daisuke Matsuzaka and his pitch count during the Japan Series. I should have given credit for that to Rotowire, which had the story first. While I had their credit in my notes, it didn't make it into my final version, an oversight I regret.

Related Content:  Back,  The Who,  Surgery,  Year Of The Injury

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