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August 1, 2005

Under The Knife

Upping the Workload

by Will Carroll

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My wrist is day-to-day, though injuries never sleep. Let's skip the intro so I can do a little analysis at the end. Someone please just tell me that the texts of Ryne Sandberg's and Peter Gammons' speeches are available on the Web somewhere.

Powered by an amazing weekend of baseball that was overshadowed by the trade deadline, on to the injuries ...

  • I got through my notes and calls wondering if it would just be easier to start today's UTK with "Dear Theo " The Red Sox are a team that's typically banged up a bit at this stage of the season, but the deep roster is keeping most of the duct tape from showing. Given their lack of activity at the trade deadline, most of their improvement will have to come internally.

    The team expects to get Matt Clement back on the mound this Thursday, just nine days after his frightening incident. Clement had no problems with some side work and should have no physical concerns in his return. Wade Miller's shoulder problems don't appear to be related to his rotator cuff, so that's a big plus. His fatigue is obvious, so extra rest or even a job-sharing arrangement with Curt Schilling might help extend his usefulness. Miller is tentatively scheduled to start Wednesday, so watch his mechanics and usage closely.

    The news is worse for Trot Nixon. Nixon's oblique strain is a Grade 2, meaning there is significant but not complete tearing, roughly from 1/3 to 1/2 the thickness of the muscle. An MRI showed the tearing and resultant fluid buildup, pushing his likely return from 4-6 weeks to 6-10 weeks. This puts him in dangerous territory, close to the end of September and unable to get swings in the minors. Nixon will be on the playoff roster to be sure. The question will be what moves might come with it to ensure the Sox aren't a man down. The Sox also are watching Mark Bellhorn, expected to be activated this week after a quick stop in Pawtucket, and John Olerud, who strained his hammy while driving in a million runs this weekend.

  • The Twins' season, very literally, could come down to the MRI Torii Hunter has on Monday. If Hunter is lost for the season, as is likely, the Twins will push Lew Ford to center field, a significant defensive drop as well as an offensive loss. Ford's move cascades down to using Michael Ryan, just called up, in the role vacated by Ford. That's a move from Hunter's 0.047 MLVr to Ford's -0.100 to Ryan's -0.126. The long-term implications for Hunter and the Twins are worse. The record of players coming back from significant ligament injuries almost always shows a significant reduction in speed and range. Hunter could be forced to a corner outfield slot in the last year of his four-year deal.

  • Kerry Wood is now a reliever. As odd as it sounds, we're still unsure what it will look like in the stat line. Wood made his first appearance at low-A Fort Wayne. Wood came in at the start of the half-inning, having warmed up for the previous inning. He threw 15 of 22 pitches for strikes and struck out two, about what you would expect for Wood in the Midwest League. The real test is how his shoulder responds to the outing. He's expected to pitch in Peoria on Tuesday. His role in the Chicago bullpen has yet to be determined.

    Nomar Garciaparra had a good day at Double-A, moving towards his late-week activation. The most positive sign was Garciaparra making a couple of steal attempts (likely hit-and-runs) without incident. Scott Williamson is also expected back late this week.

  • The key to the NL West lies in one man's wrist. J.D. Drew is a significant enough hitter that even without seeing Tom Gorman's calculations, I'm confident that a month, perhaps a bit more, of Drew in the Dodger lineup will tip the balance of the pro-mediocrity division. Drew believes there's a chance that he'll be back at the end of August, something that meshes well with what we know of similar injuries. He's been just slightly ahead of the normal rehab schedule; soon, we should be looking for reports that Drew is hitting off a tee. The Dodgers will swap out players from the DL. Jose Valentin is back from the DL after a couple months' rehab on his injured knee while Jayson Werth is headed onto the DL with knee problems of his own. Werth has lost range of motion in the knee and will have further tests to determine the extent of the damage.

  • The injuries to the outfielders in Oakland might be the best chance we have to see the entire organization--front office, field management, medical staff and scouting--all at work. Mark Kotsay was able to get back on the field despite some lingering soreness from his chronic back condition, helping cover a distinct lack of outfield depth at the major-league level. Kotsay went 0-for-4 on the day, looking less than 100% at bat and in the field. When Kotsay and Bobby Kielty, also dealing with lower back pain, head to Minnesota, the team will have to get creative. If these injuries linger, the team may have to get creative in the month of August. Marco Scutaro is likely to see himself back in the outfield, backed up by Keith Ginter. That's hardly an ideal lineup for a team chasing the Angels, so a reach into the minors could come. The timing of a visit to Minnesota could hardly be worse, but its creativity we love to see from the A's, isn't it?

  • The Yankees were left with nothing at the break, smartly grabbing what was available (Shawn Chacon and various waiver detritus) before the deadline. The waiver wire figures to produce few trade options in August, so help, if it's coming, will have to come from within. Carl Pavano is close and now Jaret Wright is showing positive progress. Wright made his first rehab start at high-A Tampa, going 65 pitches in 2 1/3 innings. Normally, that's not positive. Wright's control, never good, is still on the DL. He's facing at least three more rehab starts and will have to find that control before he'll be able to think about coming back to the Bronx. We'll know more after his next start, but at this stage, he's not likely to help the club in August.

  • Sometimes I see a series of moves and just know that Transaction Analysis is going to be especially stinging. Adam Eaton was activated from the DL and sent to the bullpen, where his lack of game-ready breaking stuff is supposed to not be an issue. I'd love to see a list of what type of success he had during at-bats where he didn't use a breaking ball or the percentage of his outs that came on a breaking pitch. I'll assume that the Padres know what they're doing here.

    The acquisition of Chan Ho Park combined with Eaton's activation pushes Tim Stauffer back to Portland. This recent batch of starter-to-bullpen moves (Eaton, Wood, Curt Schilling) all seem to be informed to some extent by the success of John Smoltz in both directions and the seeming realization that even a so-so starter with one 70 pitch can succeed in the closer role. I'm not so sure, from a sports medicine standpoint, that things are quite that simple.

  • It looked bad when Jay Powell went down. No one could escape thoughts of Tom Browning and Tony Saunders. It's somewhat relieving to say that Powell's experience wasn't quite that bad, but certainly bad enough for. Powell fractured the distal (elbow) end of his humerus (upper arm) during the pitch. There's no indication that his recent Tommy John surgery had any role in the injury. Dr. Joe Chandler of the Braves indicated that he's never seen anything like it. The surgery does involve drilling holes through the humerus, but given the number of surgeries performed in identical manner, it's unlikely that this would not have occurred previously. Perhaps Powell's bone had some other problem or simply couldn't hold up under the stress of pitching. Powell is facing surgery to correctly align the bone. There's been no discussion yet of a return; at 33, this could be a sad end for Powell's career.

  • Quick Cuts: Travis Hafner will play a game at Double-A Akron to make sure he has everything in his head screwed in straight. Assuming no setbacks, Hafner will be back in the Indians lineup on Tuesday I've never seen the black cloud hovering over Austin Kearns, though we now have proof it's there. Kearns left Saturday's game after straining his hamstring--while walking to first base Anyone noticed that Jason Giambi is hitting like his pre-chemical self? Or is that post-chemical? So confusing The Mariners' various transactions seem to indicate that Felix Hernandez will make his debut soon, perhaps as early as Thursday. Like many of you, I'm anxiously awaiting a good look at his mechanics Roy Halladay will be back this week for the Blue Jays. Clean breaks aren't good, but modern sports medicine makes them not so bad Jose Guillen is expected back in the Nats lineup on Tuesday after missing a couple games with shoulder problems. Call it karma.

Morituri te salutant

Injury analysis is still crude enough that we can make a broad statement and still consider it an advance. There's nothing close to the granularity or accuracy found in statistical analysis. There are a couple "rules of thumb" that appear to hold true, though more research is needed to make them more accurate and, more importantly, to figure out the underlying mechanisms. It's important that we look at these and drill down to the real information.

The first rule is that pitchers struggle with the first time they throw more than 150 innings in the majors. There's no clear reason why major-league innings are more taxing than minor-league innings. My best guess is that pitchers have to bear down more and are under more stress. James Click was kind enough to calculate which pitchers will be facing this hurdle so that we can watch them over the next two months.


NAME              PROJ_IP    PREV_HIGH_IP
Dan Haren          222.0        72.2
Chris Capuano      218.2        88.1
Runelvys Hernandez 202.2        91.2
Noah Lowry         201.0        92.0
Gustavo Chacin     198.2        14.0
Josh Towers        196.2       140.1
Jeff Francis       196.2        36.2
Brandon Backe      196.1        67.0
Bruce Chen         191.2       146.0
Brad Halsey        187.2        32.0
Daniel Cabrera     187.1       147.2
Joe Blanton        187.0         8.0
Chris Young        186.1        36.1
Scott Kazmir       182.2        33.1
Zack Greinke       181.1       145.0
John Patterson     179.0        98.1
Kirk Saarloos      160.0        85.1
Dave Williams      159.1       114.0
Casey Fossum       152.2       142.0
The A's are in the thick of a division chase and have three starters on this list. Haren is a bit of an interesting case, having actually pitched deep into October last season without significant ill effect this season. It's possible that his "coming together" in May could have been related to early-season fatigue.

The second rule is that pitchers who face a major increase in innings are more likely to be injured. James Click again collected a list of pitchers that are projected to throw at least 150 innings with an increase over last year of at least 50 innings:


NAME              PROJ_IP    PREV_IP
John Smoltz        247.2       81.2
Chris Carpenter    238.2      182.0
Roy Halladay       229.2      133.0
Dan Haren          222.0       46.0
Chris Capuano      218.2       88.1
A.J. Burnett       218.1      120.0
Mike Mussina       215.2      164.2
Jarrod Washburn    211.1      149.1
Andy Pettitte      211.1       83.0
Paul Byrd          211.1      114.1
Runelvys Hernandez 202.2        0.0
Noah Lowry         201.0       92.0
Horacio Ramirez    199.0       60.1
Gustavo Chacin     198.2       14.0
Kip Wells          196.2      138.1
Josh Towers        196.2      116.1
Jeff Francis       196.2       36.2
Brandon Backe      196.1       67.0
Brian Moehler      192.1        0.0
Bruce Chen         191.2       47.2
Jamey Wright       190.2       78.2
Brad Halsey        187.2       32.0
Gil Meche          187.1      127.2
Joe Blanton        187.0        8.0
Chris Young        186.1       36.1
Scott Kazmir       182.2       33.1
John Patterson     179.0       98.1
Chan Ho Park       177.2       95.2
Joe Mays           176.2        0.0
Kirk Saarloos      160.0       24.1
Hideo Nomo         160.0       84.0
Dave Williams      159.1       38.2
Smoltz is a special case and a number of these pitchers are coming back from injury, so there's not always a clear concern. Both these lists give us something to watch as the late season fades into saving the iactators for the next chance at a pennant. Someone get me an interview with Livan Hernandez and we'll save the world.

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