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March 20, 2006

Under The Knife

Will's Faustian Bargain

by Will Carroll

People often ask me how I got my job. While the honest answer is that I'm lucky and I don't sleep, I often wonder if I did sign some deal with the devil. I vaguely remember a shadowy figure smelling of sulphur and a pinprick of blood as I signed my name. Would I have done the deal if having the greatest job and best readers was a tradeoff for talking about Pete Rose, steroids, and injuries to my favorite player?

Yes. I wasn't using my soul anyway.

Powered by In-N-Out Burger, on to the injuries:

  • The Cubs may think I'm psychic, but if I could predict injuries, the THRs would be more accurate than they currently are. What I do is listen to the right sources and pass that info along. That said, the Cubs aren't lying when they say that Mark Prior hadn't reported pain and that this is a new injury. Prior hadn't reported pain; he had reported continued soreness and tightness, part of the reason he was being treated gingerly. When the subscapularis muscle finally gave way, it was new. Prior has a grade two tear of the muscle, one of the four muscles of the rotator cuff and the one that's most involved in internal rotation. After seven to ten days of rest, Prior will start in on an aggressive rotator cuff and shoulder-strengthening program, then get back into his throwing program. He'll likely start the season on the DL, though the Cubs don't need a fifth starter until later in April. Prior's mechanics likely kept him together this long, but overuse is both cumulative and insidious. The only real comp for this injury is Jose Contreras, who missed much of the season in 2003 with a similar--but not identical--problem. It wouldn't surprise me if Prior needs surgery in the medium-term to clear some of the scar tissue that has built up in the muscle.

  • The Cubs got much better news on another important shoulder last week. Derrek Lee injured his shoulder after diving for a ball in the WBC, aggravating a condition that held him back last season. Though the recurrence is a bit worrisome the condition is manageable. Not only did he play through the initial injury last season, he was able to hit effectively. Don't expect much to change for Lee due to this injury. It's only worrisome in the much longer-term.

  • Things have looked good for Barry Bonds as camp progresses. His knee has held up remarkably well, he's run free and easy despite not taking off any weight this offseason, and his bat appears potent. He'll be the most watched player for a lot of reasons this year. While I don't endorse gambling, I'm going to give an over/under on Barry Bonds at 120 games played and 400 plate appearances.

  • The Blue Jays had a major scare on Saturday when A.J. Burnett left his spring training start in the second round, holding his elbow. Burnett had complained of pain in the first inning and his only pitch in the second convinced him to come out. Burnett is still in the "honeymoon" period, the five years after Tommy John surgery where the ligament is still new enough and strong enough to withstand whatever damage a pitcher throws at it. An MRI confirmed that the ligament was not torn, and was described as clean, according to sources. What caused the pain? Most likely, Burnett had some sort of adhesion (scar) that was torn, though Burnett's history of bone spurs in the elbow raises the specter that those spurs could have become chips. This is something to watch and one of the many reasons that the Burnett signing was risky.

  • Pedro Martinez is looking much better in camp after the treatment of his toe problem got a bit more aggressive. Martinez will continue to be troubled by the toe--it's not getting better, but it can be managed relatively easily, with a worst case scenario of surgery that would cause him to miss several weeks. The Mets think that can be kept at bay. I wonder if that bone-on-bone toe joint could use some Synvisc.

  • The news is a bit more complex for Carlos Delgado. The elbow tendonitis that held him back last year has resurfaced. The Mets have good reports on Delgado, considering Mets trainer Ray Ramirez had his brother Rich in the Puerto Rico camp. (Rich is a Marlins minor league trainer.) The Mets insist the problem is minor and he should be ready for Opening Day. The worry is that this now appears to be a chronic problem. Watch for how Delgado extends his arms.

  • The WBC may have claimed Luis Ayala, but the loss would have happened anywhere. According to sources familiar with the situation, Ayala's UCL simply snapped. As you probably know by now, while the injury is often triggered by one pitch, a single pitch by itself has never caused it. Ayala will have Tommy John, and while the timing is bad, it wouldn't have been any better had Ayala blown it out in spring training. The Nats are also dealing with Cristian Guzman's shoulder, as his torn labrum will probably require surgery. Guzman admits he's been playing with the injury for a few years but that it's now gotten so bad he can't play through it. Score another one for more complete physicals.

  • Labrum injuries are still bad, though not as bad as they once were. Now, when you hear that a player is trying to play through an injury--like Craig Counsell is doing--you can actually expect success in many cases. Counsell is the type of player who should be able to do it--he's self-aware, smart, and doesn't rely on his physical gifts alone to play the game. It will both cost him and pain him to play, but other than his unique batting stance--something I can't figure out when he's healthy--I don't see any major problems beyond the actual injury. Counsell remains the best available placeholder for Stephen Drew and/or Justin Upton. The trade of Alex Cintron tells you what the D'Backs think.

  • The Brewers are doing a bit better this week than last. The look on Roger Caplinger's face when he went to the mound to check on Ben Sheets was one that sums up every trainer. Sheets has been such a focus that even a minor setback like he had just drains the life out of these guys. Sheets is doing significantly better and some observers say he's throwing as if there had been no problem at all. It's not that simple, of course, though it's certainly a good sign. As with Burnett, a situation that initially looks bad can turn out to be nothing. The Brewers seem a bit more concerned with Rickie Weeks. An oblique injury heals slowly and can linger, so even though Weeks proved he can play with pain and recover well, they'll still be very conservative with their young second baseman.

  • It won't be official--and someone please tell me why the DL isn't automated somewhere in the MLB.com universe--but Kazuo Matsui could be the first guy ticketed for the disabled list. His knee injury, a Grade 2 MCL strain, will put him on the shelf. For a player compared to Cal Ripken in Japan, Matsui's been fragile in his three years in the states. He's out three weeks, starting up the rumor mill in Queens. Expect Alfonso Soriano's name to come up any second.

  • Chris Duffy hurts all over. He's fighting a bad hamstring, bum shoulder, and then Curt Schilling puts one in his skull. Duffy insists that the pitch was intentional. Whether it was or not is beyond the scope of this space, but the results are certainly worth discussing here. He's back in the lineup after almost a week off, a week where he lost ground to fellow young outfielder Nate McLouth. I'll admit McLouth is one of my favorite young players, but Duffy was also fun to watch last summer. Duffy's so banged up that even if he makes the club as their starting CF, the Bucs will need to have someone ready for the time off he'll need to stay healthy.

  • It was a good sign when Rafael Furcal finally took the field for the Dodgers, given the amount of money and placement problems the move cost the team. It was a better sign when Furcal was running, cutting and even stealing a base over the weekend. Furcal's knee surgery was minor, but lingered; this isn't the end of the problem, but it looks better and better. Given no problems leading up to Opening Day, we can probably say that Furcal is beyond the problem and back to normal.

  • Quick Cuts: Jim Thome left a weekend spring training game with a sore hamstring. This is definitely something to watch Finally got a chance to see some tape of Jason Kubel. (Do I still say tape when it's really a computer file?) Kubel looks good with just a trace of a limp, though I have no way of gauging whether he's lost a step. Those who do that for a living say he's slower out of the box Josh Willingham could start the season on the DL with back problems if they continue to flare up. While the problem isn't considered significant, it does raise questions about his ability to stay at catcher Frank Thomas in game action next week? That will be a Big Test for the Big Hurt Rick Ankiel probably won't make the club due to his patellar tendon injury. Worse, the team is increasingly concerned he'll need surgery. The kid is cursed Things are looking good for Jose Guillen. He liked the second opinion he got on his wrist, but watch for any sign of recurrence like a lack of power or shaking his wrists after at-bats Jose Contreras had some symptoms of bone chips in his elbow. The Sox say it's triceps tendonitis and have the x-rays to prove it Bobby Kielty is out with an oblique strain. This is becoming a chronic problem for Kielty, who missed time with the same problem late last season With Aaron Small down with a hamstring strain, Carl Pavano is being watched more closely. He's had a good spring according to several that have watched him pitch on the side

You'll notice in this UTK and those throughout the season that we are using the injury encyclopedia from the Kerlan-Jobe Orthopaedic Clinic, one of the world's top hospitals for sports medicine. I'm happy to both offer BP readers this information and to be working with the fine doctors and medical staff of Kerlan-Jobe. Building an injury encyclopedia is something I've wanted to do for years, but partnering with the best is a far better solution.

This week, BP Radio is another great source of injury info. Among others, we had a great conversation with Dr. Tim Kremchek, who offered insight on Kerry Wood, Brian Roberts, and helped us understand the type of injury Mark Prior is dealing with. Be sure to check it out. We'll also be starting a regular mid-week podcast featuring Brad Wochomurka. We'll start the series with an interview with Don Hooton, President of the Taylor Hooton Foundation, an MLB-funded group crusading against steroids. It's an extended interview you won't want to miss. There's still a lot of work left to do.

Starting next week, UTK goes to its in-season schedule.

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