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June 26, 2006

Under The Knife

In the Cards

by Will Carroll

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After a busy weekend on the injury front, let's get right to them. Powered by a fresh pot of Dazbog coffee, on to the injuries:

  • Things do look bad for Mark Mulder, but they're not dire. Deep into his contract year, Mulder is on the DL with what is reported as either impingement syndrome or a rotator cuff inflammation. Both are effectively the same thing--impingement syndrome describes the rotator cuff being "pinched" due to inflammation causing the rotator cuff tendon to get trapped under the acromion. This normally isn't resolved surgically, though extreme cases could lead to what's known as a "Mumford procedure" to open up the space. Mulder also had a frayed labrum, something that seems to be asymptomatic and that Barry Weinberg accurately said is common among pitchers. This is a story of how the injury was managed and Larry Borowsky does a great job of breaking that down at his site. Mulder is going to miss at least a month; his response to rest and treatment will tell us if it will be longer than that. This reminds me of Chris Carpenter at the end of 2004--it looks bad now, but in the longer term may not be so bad. His wallet may take the most damage from this.

  • Barry Bonds left Sunday's game with irritation in his left knee. This is disappointing given how good he looked running (and hitting) this past week. It's also a good lesson in sticking with the plan. Bonds hadn't been getting the same extra rest that he has most of the season, in large part because of both his self-reported improvement and his upswing in production. This episode should be considered a mild setback, likely meaning he'll go back to getting the extra rest he had been getting for much of the season. It should also mean the end of his base stealing days. The Giants are hoping to get Moises Alou back early this week to help shoulder some of the load, and they seem quite concerned about the "tender elbow" of their closer, Armando Benitez.

  • Getting Derrek Lee back is a good thing, something that should far outbalance the loss of Freddie Bynum and Tony Womack, though you wouldn't know it from the way Dusty Baker was talking. He apparently needs healthy horses, or something like that--his metaphors have grown tiresome and if he's trying to say he wins when he has talent, well, so do most managers. While Lee's Sunday start doesn't tell us much about the health of his wrist, there are no reports that he had problems with soreness then or after his abbreviated rehab stint. Womack injured his back while running, leading many to think this may have as much to do with his hamstrings as it does with his back. Freddie Bynum is more concerning. During Saturday's game, his arm began to swell. Bynum has a history with blood clots in that arm and he remains hospitalized as tests are run. Besides Lee's return, the Cubs got another positive with a better performance from Mark Prior. He tired early--that sounds familiar--but had more command, if no more velocity than his last start.

  • Snap. Crackle. Pop. Those are things you don't mind hearing at breakfast, assuming you like Rice Krispies. It's not something you want to hear during a rehab. J.J. Hardy had a setback during his rehab from a severely sprained ankle. Hardy has some laxity in the ankle, causing a tendon on the lateral aspect to pop in and out when it's bearing some weight. Surgery is being discussed, which would end his season. The Brewers have adequate backup with Bill Hall, but using him at one position reduces the flexibility of the Brewers lineup. At this point, Hardy is going to try and rehab it again once the ankle calms down. With the recovery time from surgery in the three-month range, he could wait until the early off-season and make it back for spring training.

  • Things are looking a little better for the Red Sox rotation, and I'm not talking about the recent starts from Jon Lester and Curt Schilling. Matt Clement is throwing long toss without a problem and should get back on the mound soon. That will be a big test, but so far, the spasms and laxity in his upper arm and shoulder have been contained by treatment from the Sox medical staff. David Wells has rejoined the team after a couple weeks in San Diego. There has been some speculation that Wells had another surgery, but there's no evidence to back that up. There's also no real timetable for Wells' return, though with his appearance bonuses, there's no reason for him not to want to get back. Having him back with the team is a sign that something's happening, though none of my Sox sources had any idea what that something is.

  • Dallas McPherson has come up in some of the million current Angel trade rumors. One of the great myths of the trade market is that an injured player cannot be traded; it's not true, it's just hard to do. McPherson heads to the DL with back spasms, something that could be related to his long-standing hip problems. The TTO All-Star had been playing well upon coming back, though his power numbers are off expectations. Erick Aybar, another of the young Angels that could be shopped for some offense, will replace him on the roster.

  • Roger Clemens gets all the attention, understandably. Brandon Backe might be just as key to the Astros playoff hopes. Fernando Nieve has been passable at the back end with Wandy Rodriguez and Taylor Buchholz being, well, not so passable (though better than Andy Pettitte). One of those younger pitchers is sure to lose his rotation slot when Backe is able again. He's close to a rehab assignment and could be back on target, just after the ASB.

  • I got a load of emails saying that at least the Mets didn't have Duaner Sanchez throw the same "one more pitch" that Victor Zambrano did before heading off to the surgeon. That's an unfair criticism, but indicative of the type of scrutiny that a team is under in the major markets. Sanchez looked like he had a serious problem with his shoulder, but the injury was actually a nerve in his neck that was under pressure. You'll see this called a "pinched nerve" in most outlets and while that's not incorrect, it's like one of those tests I hated in school--it's not the most correct answer. The injury is essentially a stinger, an injury more commonly seen in football and wrestling. I wrote in the "Black and Blue Report" last year about this:
    For those wondering at home, a stinger is a stretch of the brachial plexus, otherwise known as a whole bunch of nerves that run between the shoulder and the neck. Often in football, a player will take a hit that will push his shoulder down and his head away, basically stretching the two away from each other. This can lead to simple things like muscle strains and tears, but often, and worse, it can result in a stinger. A stinger is usually temporary, and the player will run off the field with complaints of dead arm. Ever woken up in the middle of the night after sleeping on your arm and you can't feel it, can't lift it, it basically feels dead? Same thing here. It's pretty scary to a football player, whose biggest fear is usually paralysis. This injury needs to be watched closely, and the player should not be cleared to return to the game until he has full strength in that arm. The trainer will usually test that by having the player squeeze the trainer's fingers with both hands. If the injured side isn't as strong, the player stays out. If a player suffers multiple stingers, full strength can take longer to return, and in extreme cases it might never return. So while a stinger is often thought of like a hangnail in football, it is something that players should be wary of.
    So, what Sanchez faces doesn't look to be serious. It could be related to the type of nerve injuries that Brad Penny and Chris Carpenter had in 2004, though those were certainly more serious than even the worst recurrent stinger. This doesn't look to be long term, though the short term is a mystery due to the lack of comps to work with.

  • Quick Cuts: Those of you in the Dallas area should hurry and see if Jamey Newberg has any more open slots for his Newberg Night, scheduled for next Sunday. Come see Jon Daniels, Jamey Newberg, and others talk Texas baseball. Oh, I'll be there too Mark Ellis could start a short rehab stint later this week, meaning his return to the A's lineup is imminent. Adding him to their lineup will only help fuel the now-expected A's summer run Jason Giambi missed the first game of Sunday's doubleheader with back spasms. He was back for the second game showing no ill effects Late report on Robinson Cano indicates that his hamstring strain isn't serious. Expect him to miss a couple games ... Childs Walker has another great article on amphetamines over at The Baltimore Sun Brian Jordan has a broken collarbone. While he could return before the end of the season, his age and the Braves' slide means they may not need him back. This could be the sad end of a nice career for a guy once mentioned with Bo Jackson on the upside and Deion Sanders on the (baseball) downside Gary Bennett left Sunday's game with an apparent oblique injury. If there's any consolation here, it's that he was the backup and the Cards seem to know a thing or two about oblique treatment Max Kellerman had a very interesting back and forth with former champ Lennox Lewis during the (boring) heavyweight fight on HBO Saturday. Kellerman seemed to indicate that he thought the use of HGH and other substances was widespread in boxing, above and beyond the known use due to several suspensions in the last few years (James Toney and Fernando Vargas come to mind.) Kellerman is someone I've always wanted to get on BP Radio.

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