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April 7, 2006

Under The Knife

No Intro

by Will Carroll

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No time for an intro--there's too much to cover tonight, so on to the injuries:

  • The big news of the day was the Eric Gagne announcement, as the Dodger closer heads back to surgery for nerve excision in his pitching elbow. In about 20% of cases (according to a 1992 Kerlan-Jobe study), elbow reconstruction patients have problems with the ulnar nerve, but in this case, it is a sensory nerve crossing the elbow that is trapped. Some patients have pain when scarring entraps the nerve, while others have parasthesias--pain, numbness or tingling in the affected enervations. The ulnar nerve handles the pinkie finger and outside of the hand, something that would greatly affect Gagne when he grips his changeup. This sensory nerve appears to control feeling in the forearm.

    There's no real track record for this type of surgery (excision) for a baseball pitcher, giving us little to go on for an estimate of recovery. The Dodgers have said he'll miss 4-6 weeks, though I think his season's in jeopardy. Gagne is in the last year of his current contract, though the Dodgers hold an option at $12m. Expect there to be a lot of talk about whether the Dodgers saw this coming when making the Danny Baez deal. Also expect rumblings of a a coverup with the infection/virus and suspension. Jon Weisman does a nice recap of the situation over at Dodger Thoughts, including my comments from the time of Gagne's second elbow surgery last year. My biggest concern is that the Dodgers--a team that looked unlucky last season--appear to be headed down the same road, having lost Gagne, Nomar Garciaparra, and Kenny Lofton to the DL already.

  • The Dodgers weren't the only team getting bad news. Their NL West rivals, the Giants, saw their newly signed pitcher, Noah Lowry, leave the game early with what was suspected to be an oblique strain. Many of you have asked about the seeming epidemic of oblique injuries this year, so I went to Dr. Tim Kremchek and asked. He thinks it's mostly the weather, with inadequate stretching and players cooling down before getting on the field. There are teams that bring along their own masseurs, but no full-time flexibility coaches that I'm aware of. Granted, many strength coaches do function that way, but for million dollar athletes, would adding one more guy to the medical staff not be a good investment? In Lowry's case, it turns out to not be an oblique injury at all, but rather a lower back injury.

  • The Cubs get the best news of the bunch, as they begin to plan for the return of three pitchers. The order should go: Kerry Wood, Mark Prior, and finally Wade Miller, though Miller and Prior seem to be on about the same schedule. Wood is throwing well, rated by many who saw him this spring as "fully back." One player who watched him throw batting practice said that his "BP curve was better than most guys' 'A' curve." Wood is on track for a late April return as the Cubs resist pushing him. Mark Prior is about to move from flat ground to the mound, which is certainly a big step. He's had no recurrence of the pain in his shoulder, though his stamina is down. Assuming that he continues to move forward, he's still looking at a few weeks of work before even thinking about some rehab starts. Wade Miller is at about the same stage as Prior now, as he comes back from his shoulder surgery, but isn't progressing as fast. The addition of these three into any lineup is a major plus; keeping them in the rotation is the challenge.

  • Pedro Martinez wasn't sharp--his velocity was off slightly and his command was spotty in giving up five runs, five walks and most notably, three HBPs. Given all the concern for his big toe, escaping with the win might be enough for most Mets fans on a day where they got a glimpse of their beautiful new Ebbets Field homage. Martinez didn't have any visible signs that the toe was a problem; his delivery was consistent, he didn't have any pained mannerisms, and worked quickly. He just didn't have the results. Homers by Carlos Delgado and Carlos Beltran saved him, a result I'm sure Martinez is just fine with.

  • The Nationals need to check their forearms. John Patterson copied Pedro Astacio, coming down with what the team is calling "forearm tightness." Team sources say that it's just that, tightness and soreness in the forearm, but some point out that forearm tightness is often a cover for elbow problems. Patterson has been working on a new changeup, which could be affecting him. Even with the tightness, Patterson was effective. It's definitely worth keeping an eye on given Patterson's injury history.

  • Dustin Pedroia wasn't in the game last night when Pawtucket opened their season with Friend of BP Scott McCauley in the press box. (Scooter's now the second voice of the Indianapolis Indians radio team. That's a nice promotion from being the co-host of BP Radio.) Pedroia is still coming back from his shoulder problems this spring and with the temperature near freezing, there'd be no reason to risk his playing anyway. Pedroia missed spring training after what was termed a strained shoulder. However, Chris Snow at the Boston Globe states that Pedroia's injury was a subluxation. This is similar--but not as severe--as the injury to J.J. Hardy from a few years ago. Every bit of information helps.

  • Quick Cuts: Correction from yesterday--I stated that Cesar Izturis would have to be back in 30 days after starting a rehab assignment. For position players, the limit is 20 days If you're not checking out Ballbug, you're missing out on a great new resource Freddy Garcia's velocity in his first game might have been the cold, I said, but one source who saw him in Arizona (where it is not cold) said he never clocked over 86 Sources tell me that Ryan Klesko will have shoulder surgery, though no official announcement has been made Waiting on Rocco Baldelli? Tampa Bay is in no rush to bring him back and will wait for him to be 100%.

BP Radio this weekend goes to Fantasyland. That's right, we'll have Eliza Dushku, Kristin Bell, and Kari Byron. No, wait, wrong fantasies--we'll talk with Sam Walker and Sig Mejdal from the best-seller Fantasyland, as well as our fantasy expert Jeff Erickson of Rotowire and XM fame.

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